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HomeMy WebLinkAboutPermit Mechanical 2010-6-3 Mechanical Permit Application ~\c;~,f .,-. ',-'</- ,;',t':W,' .;;""""';~..,'" ~'",,:> .'..~'''''ij''" .i;Ii_" -'(c)l.<:-,.'~~~;~.~' '':.~- '_~,;:DEPARl'MEN:r USEONlY'""'-" ',',. ~-' '. "e_,. "".;- ;,',; "<' _' '. "." " . ,,' ~ ,-.,',',' -,,;:,:;t,,~' ',' -,1'-0/ 225 Fifth Street _ Springfield, OR 97477 _ PH(541)726-3753 _ FAX(541)726-3689 - ::;-J7-- Pennil no.: Date: 3 - This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or irwork is suspended for 180 days. ;'/":;,~4~;,"~cAtEGORY(~-QF;~'CONStROC:Tlblil'!i'~:;:,~_. ":. ." , Vi[ Address: City: Phone,'QI-qrH{ L.f &6'& ZIP:- E-mail: CCB license no.: 1 Print name: Wo-n'"M Signature: ~ &? \V~\;-o 440.2545-) (] 1I08/COM) '. -. , 'FEE SCHEDULE . 9R~'iid~htia'If.1,,!ltb;;X~w!ffu'~~j>~,~,:~k:)"&;~:*" "Qty' -', f>:~_~~~t:'1>, ",~:,T~.taJ.. ,.,- J S';-';~""1"~~"'.'''r.v'l-:". .. ~.,;!;;~~~-; ~t;:j~j~,~'j"'/1\\l1'~';';;f;.i",~,{j. .. ~;._,,)< .::_'!;:~ ea;":;it:';2'," i<f,<~i cost~:1>' First Appliance l $79.00 $'" CI.l V Furnace/burner including ducts and vents 7 Up to lOOk BTU/hr. Over lOOk BTU/hr. Heaters/stoves/vents Unit heater Wood/pellet/gas stovelflue Repair/alter/add to heating appliance/ refrigeration unit or cooling systemJ absorption system Evaporated cooler Vent fan with one duct/appliance vent Hood with exhaust and duct $ $ $17.00 $20.00 $17.00 $38.00 $ $ $58.00 $ $13.00 $ $9.00 $ $13.00 $ $58.00 $ Floor furnace including vent Gas piping One to four outlets Additional outlets (each) Air-handling units, including ducts Up to 10,000 CFM I $11.00 Over ]0,000 CFM I $20.00 Compressor/absorption system/heat pump Up to 3 hp/I OOk BTU $17.00 Up to ] 5 hp/500k BTU $29.00 Up to 30 hp/l,OOO BTU $43.00 Up to 50 hp/l,750 BTU $57.00 Over 50 hp/l, 750 BTU $95.00 Incinerators Domestic incinerator ~ $7.00 $ __ $4.00 $ $ $ $ $ $ $ $ I $ $20.00 ~;:Comit1'erc(ar.~~\'!~?~-ii~~~~,::~.:rq;~~~!~~~;~~::i~i~:fr:~7:!;::t:,:~?f~t'0~:r~;;i i'f~f;~:t.:y Enter total valuation of mechanical system and installation costs $ Enter fee based on valuation of mechanical system. etc. $ fr''''''~'\e~:',;SI''''Y'4t'~'';';I~/~;~~~':;'''::;:'W'~\,;;''<'~N~\r,~1;:';: "~',:>Sl! llr ::Cifst....,' ;y',~ Total", ;'2~~~~~},!~~~"'I;J(!t~!~!~~~,~~W:?il;T.BFA~:~!{i'fs2; H~,,~~ ~~~;: ea';;j$t~~ :;"',\~'()st.,~"<':;. Reinspection $58.00 $ Specially requested inspections (per hr.) $58.00 $ Regulated equipment (unclassed) $13.00 $ Each additional inspection: (1) $58.00 $ f1~~~~1~f~~;srt~fAF,tRi$fcA,NJ?~~iJ_s:E~l~1~Wlf~1:~%1ll1~: (A) Enter subtotal of above fees (or enter set minimum fee of $ 79.00) (B)'Investigative fee (equal to [AD (C) Enter 12% surcharge (.12 x [A+B]) (D) Seismic fee, 1% (.0] x [A]) (E) Technology Fe, (5% of[A]) TOTAL fees and surcharges (A Ihrough E): nqyV $ -- $ C\.~)I $ - $ "'>.~"" $ aq,.""~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~:, !., :' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00712 ISSUED: 06/03/2010 APPLIED: 06/03/2010 EXPIRES: 12/03/2010 VALUE: Springfield TYPE OF WORK: Single Family Residence SITE ADDRESS: 1335 CENTENNIAL BLVD ASSESSOR'S PARCEL NO,: 1703253310500 TYPE OF USE: Addition PROJECT DESCRIPTION: Add gas piPi~ to appliance and cap existi'rig"gas piping, NOTle: SMAt' OW\R51l=THEWORK Owner: LEE DIANA K THIS PtKM11 OER THIS PERMIT IS NO I Address: 1335 CENTENNIAL B~HOR\ZED .uONR, IS ABANDONED FOR SPRINGFIELD OR 9';@ff.!tJlMENCED 00 DAY PERI ' " ' , Owner: LEE SUSAN AM ANY 180 ' Address: 1335 CENTENNIAL BLVD SPRINGFIELD OR 97477 I CONTRACTOR INFORMA T10N . Contractor License AMERICAN GAS APPLIANCE SERVICE IN 77621 BUILDING INFORMATION ~ Contractor Type Mechanical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Residential Expiration Date 10/31/2010 Phone 541-954-4686 .:' # of Stories: R3 Height of Structure Type of Heat: Water Type: Range Type: Energy Path: ':'TT..ENTlO&~~i1ding: n/a NOli ~~!W.~=I " ~ 952-DOf-oOfOthr saresetfortb .......,. You mlli>J~!n~o~9h OAR 952-001_ calling the C1IlB1ellet(IIJ ~Ie~, therufes by nUmber for trw.Qre9D~ ,tel~l?hone Centes A... . ,lltlrr>... ~ NotIfIcation 10'''' ~!lr21111~). Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: ,Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS ~ Sidewalk Type: Downspouts/Drains: ~ " : I ..' , " .~. ,\11>"1 ,; " Paee I 'of 2 " ,_~,',Ol' ,H'. 'i:i 'J' " .' -.~"'~""'- ..,..... ..~,... " .. "...:ur.";"F',l'..l "1:~: ~'~";'~" "'1 ,~j" Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I V aluation Descrip~tion ~ Description $ Per Sq Ft or multiplier Tvpe of Coustruction Square Footage or Bid Amount Total Value of Project Fees Paid ~ Fee Description + 12% State Surcharge + 5% Technology Fee Gas Outlets 1-4 Minimum/Adjustment Mechanical ;, ~'~ il Amount Paid 01, .. :.....1: , , , '- " ,"~:~;i;.", $9.48 . $3.95 () $7.00'.'. $72.00 Total Amouut Paid $92.43 . Daie Paid I Plan Reviews ~ 6/3/10 6/3/10 6/3/10 6/3/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-007I2 ISSUED: 06/0312010 APPLIED: 06/03/2010 EXPIRES: 12/0312010 VALUE: Value Date Calculated Receipt Number 2201000000000000619 2201000000000000619 2201000000000000619 2201000000000000619 .,"!I" ,r.,1 ,.:".,." . To Request an inspection call the 24 hour recording at. 726-3769. All inspections requested before 7:00 ,." " f a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reauired Insnections , Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. , .I i;';. ;.;.. By signature, I state and agree, that I have carefully.examinell the completed application and do hereby certify that all information hereon is true and correct, and I furth:e~.'certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the L;;'s of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readahle from ,the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. fj\l;WA~.~ W(3jIO Owner or Contractors Signature .'i " ~:. ~ I . '. .. ..~' ::S \ " : Page 2 of 2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone .,:Rl"~,!!!'~'ii, ',~'" Wi&: ..' '~, ' ~. , .. """"-'--~" '<"'-', -...; City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000619 Date: 06/03/2010 11 :30:50AM Paid By DIANA K LEE Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 7.00 72.00 9.48 3.95 $92.43 Job/Journal Number COM2010-00712 COM2010-00712 COM20 1 0-00712 COM20 I 0-00712 Description Gas Outlets 1-4 Minimum/Adjustment Mechanical + 12% State Surcharge + 5% Technology Fee Payments: Type of Payment CreditCard Amount Paid KLK KLK 093659 In Person Payment Total: $92.43 $92.43 </',<3 , ;, .:,'~r.<,~ i1'~ ~~" 'i~~~;ti; '. .-'Ihl 'J>~J~j '(-"1:1 , .." ~ t F. , :~1 l~iO ,. 'i:;l'; , ~ 'T " : i ",. . t""- ~ 1.#-:: !~..:,....;,~; ..;;, ,"-. , :ii \\l;1;~\:;.i ..;;. :'-'1.'. ., cReceintl Page I of I 6/3/20 I 0