HomeMy WebLinkAboutPermit Building 2010-8-3
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-01042
ISSUED: 08/03/2010
APPLIED: 08/03/2010
EXPIRES: 02/03/2011
VALUE: $ 2,500.00
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 3680 JASPER RD .,
ASSESSOR'S PARCEL NO.: 1802061202700
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SpHngfield TYPE OF WORK: Commercial Miscellaneous
TYPE OF USE: Alteration
PROJECT DESCRIPTION: Mechanical and plumbing for hoiler replacement
Public
Owner:
Address:
Contractor Type
General
SPRINGFIELD SCHOOL DISTRICT 19 . '101.1 \0
525 MILL ST.. leC\Ultes Ijlili\'!
. ~ \a'i'i MO\"l ...
SPRINGFIELD OR 97477 . ..,.,nl--\". O\.e.,~?;;.G~'.\\!e~~e;'e set '~~;.
1\:\ \C... aOu\'t;':;-'" "56'\U'''''-' B.9t)/~.-
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01'-\'\ 9,,'" '''ootal I . 1\\8 .,' G.a\\o\"l
Contract~ 0., ,/01.1 ll\a'l \"lIe\. ,\,\0 0\i\il'l \,\olr:icense
LEE cONSf~Yi' .,!0N eRA~ '2._'2.~",A163579
\"IUll\Oc INFORMATION
Expiration Date
12/09/2011
Phone
541-683-3607
# of Unils:
Primary Occnpancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
,po.."
# of Stories: ..,.... ....,....'
Height of Struclnr,~
Type of Heal: , '
Waler Typ~:", ,
Range Type::,";' ,'. .'
ii, '~n~rg;PalhP' " \-\r. \!'JOt'-\<.
, . Sprinkled B~.ll;r. W 1 \1 vY~O\
~f.1~~~'~t~~ ~~~~k 'f
f>-\)l5 D Ot'- \~
CO~~c~V(..I1'~a\Si9D.
f>-~'/ ~ '01i\$-/feet Trees Rqd:
Paved Drive Rqd:
, J~:pf,L~t:go:yerage:
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''''::l;;~{:... . ,....':.."J ...
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LOI Size:
Sq Ft 1st Floor:
Sq FI 2nd Floor:
Sq FI Basement:
Sq FI Garage/Carport
Sq Ft Other:
Occupanl Load:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Sethack:
Solar Sethacks:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLlbMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Inslruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
Description
Type of Construction
I Val~~ti,on D~SC~h)tion ,
$ Pei- i'lq:Ft ,.::r Square Foolage
or multiplier or Bid Amount
Value
'Dale Calculaled
Page I of2
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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PERMIT NO: COM2010-01042
ISSUED: 08/03/2010
APPLIED: 08/03/2010
EXPIRES: 02/03/2011
VALUE: $ 2,500.00
Mechanical CII Use Bid Amount
$1.00
2,500.00
$2,500.00
$2,500.00
08/03/2010
Total Value of Project
L Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Fixture
Mechanical-Value
Minimum/Adjustment Mechanical
Minimum/Adjustment Plumbing
Amount Paid
, "I
$16,44':'" ":,"
$6:85,;';
$19.00'"
$67.75
$11.25
$39.00
. Date Paid
8/3/10
8/3/10
8/3/10
8/3/10
8/3110
8/3/10
Receipt Number
2201000000000000912
2201000000000000912
2201000000000000912
2201000000000000912
2201000000000000912
2201000000000000912
Total Amount Paid
$160.29
I in~-"B..eyi~ws ~
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To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
I ' ReQuired InsDec~
Rough Mechanical: Prior to Cover , .
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Final Mechanical; When all mechanical wor.k:is~completerh,,', d'"
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Rough Plumbing: Prior to cover and in'chiding required'testing.
Final Plumbing: When all plumbing work is complete.
By signature, 1 state and agree, tbat I have carefully examined the completed application and do hereby certify' that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structu~e,without permission of the Community Services Division, Building Safety.
1 further certify that only contractors and employe:~!3yh~iirej~;c,ompl,iance with ORS 701.005 will be used on this project.
1 further agree to ensure tbat all required inspectioiis'::fre'r';;qii~sied';i't"jhe proper time, that each address is readable from the
street, that the permit card is located at the front of,th~;prop'erty"and the approved set of plans will remain on the site at all
times durin construction. ., -':Ifio~ ":'"
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Date
Pa~e 2 of 2
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Mechanical Permit Application
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')',,'' DEF.!ARTMEN;J;TOSEON~V:'.'~:t
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Permit no.: {lIO - (O'-l:l-
Date: 1,? 10
225 Fifth Street. Spdngfie]d, OR 97477 . PH(541)726-3753 . FAX(54])726-3689
This permit is issued under OAR 918-440-0050. Permits expire if work is not started within] 80 days of issuance or if work is
suspended for 180 days.
'!~~\~,:~\1~i0~tAtEG'ORXdo.l!i!CONStROC:t10.N1X\,Z"'.C',':,
D Residential D Government D Commercial
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l~yri~1t10I3li~IIPE"INF:QgM~]IQNt:AIIID,j';IfQc:;tl.]IQN;,-0~1, 'i,};f:
Job site address: ., '?CI
City:
ZIP: ''t7<-/??
'. DE'SCRIRTlbl'.(OFWORi<
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E-mail:
This installation is being made on property owned by me or a
member of my immediate family, and is exempt fi-om licensing
requirements un r 0 S 701.010.
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Address:
City:
Phone:
ZIP:
E-mail:
CCB license no.:
Print name:
Signature:
772-'7
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440-2545-J (1 ]/08/COM)
C,". . , --'.\:~- -~- ....FEE SCHEDULE " .'
~~~~l~.!:ht~~Iif~~~t~A~;~~~~tF_~~~~,2~1:5~i ,91?:,' ~"~ .f~stt{i", no.Total,1
/~,,*rea;-:::...;4;;i'! ~?!cost::?i::Y
First Annliance $79.00 $
Furnace/burner including ducts and vents
Upto lOOk BTU/hr. $17.00 $
Over lOOk BTU/hr. $20.00 $
Heaters/stoves/vents
Unit heater $17.00 $
Wood/pellet/gas stove/flue $38.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system! $58.00 $
absorption system
Evaporated cooler $13.00 $
Ven! fan with one duct/appliance vent $9.00 $
Hood with exhaust and duct $13.00 $
Floor furnace including vent $58.00 $
Gas piping
One to four outlets $7.00 $
Additiona] outlets (each) $4.00 $
Air-handling units, including ducts
Up to 10,000 CFM I $11.00 $
Over 10.000 CFM I $20.00 I $
Comnressor/absorption svstem/heat pump
Up to 3 hp/l OOk BTU $17.00 $
Up to ] 5 hp/500k BTU $29.00 $
Up to 30 hp/l,OOO BTU $43.00 $
Up to 50 hplJ,750 BTU $57.00 $
Over 50 hplJ ,750 BTU $95.00 $
Incinerators
Domestic incinerator $20.00 $
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Enter total valuation of mechanical system
and installation costs $ r:L-::, V 0
Enter fee ba.sed on valuation of mechanical system, etc, ~7 ?)
~'M";'~';~;::~J,T:\'~' iif.;;:;;:~'~;;~~'~(Pi'J.-"gt~'i'_,/"';'iT';jf;~~;<,~l,1[ fti~~ ~;W~~~~~i~f~ "~'uTotal"_~1
~ . ISC~ an~ousl.feeSz:::it;t{t:;~j.1Yr!i,t~~.
~1-"i),,' "':'~.' ;e,;';,' ."!" "".' ',}<"..,,..,,,,~"'"~ .' " ""<eo, ""C"',,_ ~Ji.'.r"'rl~ ?~'r" _ '"~ ; .",~,-,Jj :'~":cost,"t'. ~
Reinspection $58.00 $
Specially requested inspections (per hr.) $58.00 $
Regulated equipment (unclassed) $13.00 $
~
(A) Enter subtotal of above fees (or enter set 7 ( . Dc..7
minimum fee of $ 79.00) $ '7 ~
(B) Investigative fee (equal to [AD $
(C) Enter 12% surcharge (.12 x [A+B]) $ q'f:-.-
(D) Seismic 'fee, ]%(.0] x [AD $
(E) Technology Fee (5% of [A]) $ \'!..?
TOT AL fees and surcharges (A through E): $ '1?HJ-
-!-II .1~
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #: . 2201000000000000912
Date: 08/03/2010
1:36:06PM
Job/Journal Number
COM2010-0]042
COM20] O~O 1 042
COM20]0-01042
COM20]0-01042
COM20]0-01042
COM2010-01042
Description
Fixture
Minimum/Adjustment Plumbing
Mechanical-Value
Minimum/Adjustment Mechanical''''
+ ]2% State Surcharge
+ 5% Technology Fee ',.
:'I.~" "".
Item Total:
Amount Due
19.00
39.00
67.75
1 1.25
16.44
6.85
$160.29
Payments:
Type of Payment
Check
Cash
Change
Check Number Authorization
Received By Batch Number Number How Received
Paid By
LANE CO SO 19
JOHN SARACENO
cjc
cjc
91386
]n Person
In Person
In Person
Payment Total:
Amount Paid
$]47,13
$14.00
($0.84)
$160.29
Job/Journal Number
COM20] O~O 1 042
COM20]0-01042
COM2010-01042
COM20]0-01042
COM20 I 0-0 1 042
COM20 10-01042
Payments:
Type of Payment
Check
Cash
Change
Description
Fixture , .
.,,'...
Minimum/Adjustment Plumbing':,:.,
.", .\>'.1111:' -~
Mechanical-Value ,-..:;~1,tl"/;:1 c
Minimum/Adjustment Mechanical.'"
+ ] 2% State Surcharge
+ 5% Technology Fee
"
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Paid By
LANE CO SO ]9
JOHN SARACENO
',_.ifJC
cjc
91386
In Person
In Person
In Person
Payment Total:
Amount Due
19.00
39.00
67.75
11.25
16.44
6.85
$160.29
Amount Paid
$]47.13
$]4.00
($0.84)
$160.29
Job/Journal Number
COM2010~0]042
COM20]0~01042
COM20]0~0]042
COM20 I 0-0 1 042
COM2010-01042
COM20]0-01042
Payments:
Type of Payment
Check
Cash
Change
cRcceintl
.,
Description
Fixture
Minimum/Adjustment Plumbing
Mechanical-Value
Minimum/Adjustment Mechanical
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
LANE CO SO 19
JOHN SARACENO
. .' :,.<;~~eck Number
;:~Heived By 'J;Jatch Number
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Page I of 1
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9]386
Item Total;
Authorization
Number How Received
In Person
In Person
In Person
Payment Total:
Amount Due
19.00
39.00
67.75
11.25
16.44
6.85
$160.29
Amount Paid
$]47,13
$14.00
($0.84)
$160.29
813120 I 0
Plumbing Permit Application
225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-36B9
i,,?iTD'EPARTMENT iJSfbNLyA~~!;t~
This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits
expire if work is not started within 180 days of issuance or if work is suspended for 180 days.
'fi,'';'''j!j:riiJ~OCAL;GQ''ERNI\IlENT'API?ROVAlBiiJli0;''''G''\;;]~;iin
Zoning approval verified? DYes D No
Sanitation approval verified? DYes D No
CATEGORY, OF CONSTRUCTiON'
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E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family, and is
exempt from licensing requirements under OAR 918-695-0020.
Signature:
. CONTRAqOR .INSTALLATION.., .,'
Business name: L e: tZ: fU) \ -' '0.0
Address:
City:
Phone:
E-mail:
CCB license no,:
Plumbing license no,:
Print name:
ZIP:
BCD license no,:
Signature:
440-2500-) (II/OBICOM)
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New residential
1 bathroomll kitchen (includes: first
100feet oj water/sewer lines, hose $238,00 $
bibs, ice maker, under floor /ow.point
drains and rain-drain packages)
2 bathrooms/1 kitchen $374,00 $
J bathrooms/} kitchen $439,00 $
Each additional bathroom (over 3) $95.00 $
Each additional kitchen (over I) $95,00. $
Residential fire sprinklers (includes plan review)
o to 2,000 square feet $58,00 $
2,001 to 3,600 square feet $115,00 $
3,601 to 7,200 square feet $174,00 $
7,201 square feet and greater $232,00 $
Manufactured dwelling or pre-fab (circle one)
Connections to building sewer and $58.00 $
water supply
Commercial, industrial, and dwellings other than one~ or
two~family
Minimum fee $58,00 I $
Each fixture ( $19,00 I $ I "I
Miscellaneous fees
100' storm, sewer, water line $76,00 $
Each fixture, appurtenance, and piping $19,00 $
Storm water retention/detention facility $19,00 $
Irrigation systems $19,00 $
Piping or private storm drainage $19,00 $
svstems exceeding the first 100 feet
Specialty fixtures $19,00 $
Reinspection (no. ofhrs. x fee per hr.) $58,00 $
Special requested inspections (no. of $58,00 $
hr,. x fee per hr.)
Each additional inspection: (I) $58,00 $
~ ~"';"D'!:'\~ Mjnimum fee $
Enter value of installation and equipment $
Enter fee based on installation and equipment value. I $
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(A) Enter subtotal of above fees
$ :;8' -
(Minimum Permit Fee $58,00)
(B) Investigative fee (equal to [A]) $
(e) Enter 12% surcharge ,C.12 x [MB]) $ &".:!-
(D) Technology Fee (5% of [A]) $ 2~.!!--
TOTAL fees and surcharges (A through D): $ (o7'f2-1--