HomeMy WebLinkAboutPermit Mechanical 2010-6-21
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Residential Mechanical Authorization To Begin Work
69600-BMC-10-00140
Approval Code: 072611 6/21/2010 8:30 am
E-mailedTo:seth@lowesweatherization.com
City Of Springfield
225 Fifth St.
Springfield, OR 97477
Phone: 541-726-3753
Email: permitcenter@ci.springfiefd.or.us
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o New Construction (K) Addition/alleration/[~'place~enl
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IZJ 1 or 2 family dwelling 0 M'ulli-family 0 Commercial 0 Access~~
. _:;..JOB'SITEINFORMATION,ANDLOCATIClN."" C ~:~: :";"'.1
Job Address: 802 54TH Pl !'
City/State/ZIP: SPRINGFIELD, OR 97478 r
Suite/bldg.lapt.no.: 'Ii
Project Name: I
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Cross Street/directions to job site: I
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Description
Mi.nim9m F~es"
First Appliance Fee
Mecha.nica~.PerrTiIU~ee!{':;'"
Subtotal
Stale surcharge (12% of permit
total
Technology fee (5% of permit total)
$79.00
$79.00
$9.48
$3.9S
TOTAL PERMIT FEE
$92.43
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Tax map/parcel no.:
1702331201522
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Insulation of heat pump
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Name:
Phone:
Fax:
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Email:
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.~ ' .:. ", CONTRACTOR' .
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ceB lic. no.: 176741
Business Name: LOWES WEATHERIZATION INC
Contact:
Address: PO BOX 21337
CityfStatefZIP: EUGENE, OR 97402
Metro lie. no.:
City lie. no.:
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Phone: 5414852282
. fax: 5414852292 "
Email:
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Upon review and approval by your local jurisdiction, your permit will be e-malled or faxed
within one business day, with Instructions on how to schedule your inspection. I
The local building department may determine that an Authorization To
void if it does not meet applicable land use laws and local ordinances.
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NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained.
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Inspections Phone: 541-726-3769
This Authori~ation To Begin Work must b~ pos~ed;at the job site until replaced by a Permit
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00792
ISSUED: 06/21/2010
APPLIED: 06/21/2010
EXPIRES: 12/21/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 802 54TH PL
ASSESSOR'S PARCEL NO.: 1702331201522
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Heat pnmp installation
Owner: BJORNBAK LESLIE F
Address: 802 54TH PL '
SPRINGFIELD OR 97478
Contractor Type
Mechanical
Contractor , , , License
LOWES WEATHERIZATIONl>' 176741
Bu-iLD'Il~G'iNFORMA TION ~
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# of Stories:
Height hf Strncture
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Type ot: Heat:
Water Type:
Range Type:
Energ)jIPath:
Sprinkled Building:
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I CONTRACTOR INFORMATION ~
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Expiration Date
06/19/2011
Phone
541-485'2282
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secoudary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
Frontyard Sethack:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION ~
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" ~. Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
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% of Lot Coverage:
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REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMEROVEMENTS
Street Improvements: ., J,,, .NO : JAt'C"@\t?T~e"iF iHE WORK
Storm Sewer Available: ' ;,~~:: '"J,,,:,,THISYERMIT SU,,",,,,,,S'"J.ll&JIWM\l'! IS NOT
., ...,.,,; ~':. 'AUTHORIZto l'lI.n:.n'l'IL! FOR
SpeCIal 1'lt\1i"PEtVl'IbN: Oregon law . ,'i.,.:;"".. ",.;':'.. 'OMMENCED OR IS ABANDONED ,
follow rules ad t d reqUires you to I C 100
Notes: Notification Cen~ eTh by the Oregon Utility I\NY 180 DAY PER ' .
In OAR 95 _ _ r. ose rules are set forth 1
. ou may obtain copies of th'
calling the cente~. (Note: the te,: ~lilltion Descri
number for the. Oregon Utility Notifi~~
Canter I~ t..<lnrL"''''F. :!'1'"ell'l>q Ft Square Footage
Description TVpe nfu18"""",illo44) It' I' Value Date Calculated
, . or mu Ip ler or Bid Amount
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Pa2e 1 of2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phnne
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Total Amount Paid
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00792
ISSUED: 06121/2010
APPLIED: 06/21/2010
EXPIRES: 12/21/2010
VALUE:
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Total'IValue of Project
Fees Paid ~
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Amount Paid
$9.48
$3.9?,
$79:00 "
$92.43
Plan Reviews ~
Date Paid
Receipt Number
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, 6/21110
6/21110
6/21110
3201000000000000316
3201000000000000316
3201000000000000316
To Request an inspection call the 24 hour r;~~_Qrdi~g"at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, in~p~ctiJris',requested after 7:00 a.m. will be made the following
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work day. 1
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Reauired 'Insoections ~
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Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is cotriplete.
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By signatnre, I state and agree, that I have carefnlly examiJed th"'c~n;~leted application and do hereby certily that all
information hereon is true and correct, and 1 fnrther certify that any arid all work performed shall be done in' accordance with
the Ordinances of the City of Springfield and the, ~aws of the St"ie of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any str"dure with6ut permission of the Commnnity Services Division, Building Safety,
I further certify that only contractors and employees who a~e.in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are r~quested at the proper time, that each address is readable 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. '
Owner or Contractors Signature
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Pace 2qf 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department I
RECEIPT #:
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3201000000000000316
,
Date: 06/21/2010
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Job/Journal Number
COM20 I 0-00792
COM20 I 0-00792
COM20 I 0-00792
Payments:
Type of Payment
ONLINE CHGS
cReceintl
Description
1 st Appliance
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
ONLINE PERMIT CHGS
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I Check Number
Received ~y Batch Number
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ONLINE
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Page 1 of I.
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Item Total:
Authorization
Number
Amount Due
79.00
9,48
3,95
$92.43
How Received
Amount Paid
Lowes Online
Payment Total:
$92,43
$92.43
6/21/2010