HomeMy WebLinkAboutPermit Mechanical 2010-8-17
, .
Mechanical Permit Application
225 Fifth St'eet . Sp,ingfield. OR 97477 . PH(541)726-3753 . FAX(541)726-3689
{.~"'-''::~''_'''~'''1\ - ~''';/;-'. \' ";i' ,~,':"W- ""'~ ~ '~-~I:-";,ii'< -"':;:>-:H:'~;-)i:~;'-', -;;;"
":\/.;OEPARTMENTc.USEONL Y"\<,cj"
.7~-,.:i, ';'/ 'if;";,', C',< ,,'" _..,'- " ,- ,"_, ",', '~';."f'. ,....., ",.',.;1
SPRINGFIELD
~-
Permit no.: S 1 0 - '7:S
Date: JI' ('7 (0
This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days.
,~~:':tE>\!j't~'CAfrtEG6R):li.Q~ycQNstRU,c;'TioI'i2~7t;,"tf:"-' "l'
mesidential D Government D Commercial
""NPH0-~"; 'C';" ... - - -. ;,' ,;--.....- ._-, J:;---- .... '" . ,n ...,_.. -, - ,.... ..,-,'- - H_. .~w- "," -,_.- ~"1l-W -~ ," ,- .....-',.. . - '-"n::'i;.~Y' 19'';!'';
Mii'",f,'JOEl,~'~lillE,;INI?ORM~;r:ION.'L~NDf,l;qc:~;r:IQN~1,q ';'t"':
Job site address: r,'
City: State:
Address:
City: ZIP:
Phone: [!rf -qfS-
E-mail:
This installation is being made on property owned by me or a
member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
Business name:
Address:
City:
Phone:
Print name:
Signature: _____
~~~
C\~ (V
'0 6\[)'~
\))';~~c~~
~~-
~
440-2545-J (l1/08/COM)
-,~ - ""FEE SCHEDULE .'. '.
. it- .'
i'f '~.'. '-.1,'.- '.;",_r"-.-,' '{~!h;:~,'i!~i"~$'':';'~r,f<;"t~'~:i.i''.: Qt '"I( Cosh:' 1,:,,]'ot81,
~;ReSldentlallA'i~1rtilll},~:f.f,';J;n,_,>jfJ;~"" ";<.. If. y.. '31.'" .,"'- 4~%icost ';fi,j,:
;.<;.:, ....;.L....."'''~~'P,..,',!.".'"\'/;.,t, ;:~ ."_ j ./-_.." ~ t'...."..', ^,Fi';::......~"'"<... i€ IL'" l~ >',;'"ea;\. "~;r;~-f
First Aooliance I $79.00 $7,. =
"'urnace/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 $
Vent 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 I I $7.00 I $
Additional outlets (each) I I $4.00 I $
Air-handling units, including ducts
Upt , FM 1~--1<\T fu""--Ql $1Y.OO $ IIl~o
Over t 0.000 CFM $20.00 $
Compressor/absorption system/heat pump
Up to 3 hp/l OOk BTU $17.00 $
Upto 15 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 I I $20.00 I $
~ .',"'.:': .::: .. /""{";;~
Enter total valuation of mechanical system
and installation costs $
Enter fee based on valuation of mechanical system, etc. $
tr~IJ~~~!l!u'~g~!rf~'~,~f~;~If~~~~l~~~ ii~#;~ ~i:~~1~~~~~ ':"":., Total\":i_
~":'\1 ,/, "-r::cost::\;-
Reinspection $58.00 $
Specially requested inspections (per hr.) $58.00 $
Regulated equipment (unclassed) $13.00 $
Each additional inspection: (I) $58.00 $
'~J~R,i~r'T"OC~'4~€"'--"""'~,~-"-<>~--~"r~', ""';'~--ftt.. -' - ~~'~i!Jl;S:-i!-::;"";"--L"i'l.1,"'3~*"~"
it~~",;;L~~~~.:..~~1f -r.~'A~F?LSI_CAN;r~~tjSE~,<;~;~~~~~1t~~';I~j;;hj1~JL;:iiW:
(A) Enter subtotal of above fees (or enter set /(,,"0
minimum fee of $ 79.00) $
(B) Investigative fee (equal to [A]) $
(C) Enter t 2% surcharge (. t2 x [A+B]) $ 'it ,.....
(0) Seismic fee. t%(.Ot x [A]) $
(E) Technology Fee (5% of [A]) $ '1~
TOTAL rees and surcharges (A through E): $ (/2 32-
----
. '
www.cLspringfield.or.us
CITY OF SPRINGFIELD
Building I,~esidential Permit
!;UJ;,,;. ~);.:. i:~>. !" ,"
PERMIT NO: 811-SPR2010-00073
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541.726.3676
5~~IN.....G... F.. I E.L ~
~;
. ~c it:b
. >1i?~ OREGON
perm itcenler@cLspringfield.or.us
':i'O):C '" :,', 0~ ;..hL .~
IVR Number: 811132081125
PROJECT STATUS: Issued
ISSUED: 8/17/10
APPLIED: 8/17/10
EXPIRES: 2/12/2011
VALUE: $0,00
SITE ADDRESS: 375 CAMBRIDGE Springfield
ASSESOR'S PARCEL NO: 1703233402200
SCOPE: Mechanical Only
WORK INVOLVED: Repair
lYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
OWNER:
ADDRESS:
Heat pump replacement
. ,'!.."
Contractor Type
Contractor Name
J coo INC
J COO INC
'. .;- ~-~:;
'~\r' . , Phone Number:
'.f'~T!ENTION: Oregon la '
. ,aI/oW rules adnnloc< h.. ,::!e9Ulres you 10
iC0N1:RA'C.tORrrNFORMA-'nON~; ~~~~ Ullfiiity
00 -., VV'UlnrJ' . ~ e orlh
90, You mo" nh'_... UicsTypel\R 95;1.i~M<!
cal/inn the .~nt~'-"; ~.'~CB'S or the ruilJ"
Umber for the n'M'~:. ~!;B,~, r e ephC!!W!o
BUILI?-'~G'i'NFbRMA:tION332,?4~~I,'ncation
',~;:,,~(,:. ;.;:.:.~ ~~.,.
# of Stories:,~ '"If''-''''' j lot Size:
I Heig,~j~it~~t~uc!,~i~'='. '. Sq Ft 1st Floor:
Type of Heat: ,_i'.... Sq Ft2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq FI Garage:
N CH!~ti1at, Sq Ft Carport:
THIS P-ER"MIT SHALL ' Sq Ft Other: .
AUTHORIZED UN DE E~P.IRE IF THE WOAAcupancy Load:
COIElectricaJ~~i~~~~~e^I!a;[i'Jil3MIT IS NOT
.""~,,,.. ) ~'nONED
AN\Springfie ' e e dltiOw. FOR
M' CUI UL\I "[)lI:\n.. d 'Ed't' .
eClla",~,a. peeta.IlY~o e I IOn:. " '
~tJ[JicjkaJ J Deveiop~ent Code:
Plumbin.g Specialty. Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
Lie Exp
05/06/2012
Phone
541-746-7065
541-746-7065
DONALD MCLEAN LIVING TRUST
375 CAMBRIDGE
SPRINGFIELD OR 97477
04/12/2010
# of Units:
o
# of Bedrooms:
Sprinkled Building:
Fire Alarms:
Energy Path:
Site Information
~
Engineered Fill:
Fill Volume:
Flood Hazard Area:
land Hazard Area:
Retaining Wall:
Soils' Report Required:
,uTtlic..,,~ -." '.,'
'. ',:.~'>" ~'t,~~ '5~:.. \.' ~
. >t;t'''}ij:~\ ,:'-(i<"~~,>' .
rli\p.)f~S ': ~',jw'f
,(n."""
, :,f'
Springfield Building Permit
8/17/2010 1:55:10PM,.\
L: ! '"
Page 1 013
',I~.. .' " Ij . r
oil,.
; i.:::, ",
'~.,i~:rJ'). ,- ',il:l", ' ,
f '
,,:
.\~ .
S~RIN.GF.IE. ~.
_::-
. .~
/". OREGON
www.ci.springfield.or.us
.' -'~ 1 ~;f;. l.'l \ "
CITY OF.,SPRINGFIELD
~;~ J;"l'{ '\
Building {Residential Permit
PERMIT NO: 811-SPR2010-00073
IVR Number: 811132081125
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitce nter@ci.springfield,or,us
PROJECT STATUS: Issued
ISSUED: 8/17/10
APPU~p': 8/17/10'
EXPIRES: 2/12/2011
. VALUE: $0.00
~t:c...,,'.: ~'C'
SITE ADDRESS: 375 CAMBRIDGE Springfield." .:,:";';'
I\X~ ~'_".,
ASSESOR'S PARCEL NO: 1703233402200 "
SCOPE: Mechanical Only
, ":""f WORK INVOLVED: Repair
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Heat pump replacement
DEVELOPMENT INFORMA TION ~
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage: ,:. ~-.
Highest point o~,str,u<:t~re ~~~ l'}:~'"
north property;lin'e:: ;,',' \ ~ '; f 1/ ' "
..~ !I.\~ht ,~
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLic IMPROVEMENTS ~
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout'Drains:
..:<";, .,
it:D: jl'l "";1;' I>
-~--~ .....:......,.;;:.,!;....
:~i{~1'~: ";- {.. '
':;';i':::~.I~~: 't .1/;;";
~y~' .
Valuation Description ~
Descriotion
Tvee of Construction
Unit Amount Unit Tvee
Unit Cost
Value
[. :;;j~'1.::''" --~---~3L'r,
_~,fj_j"'" .~.
c, '::f""" -;;',,'
Descriotion
Air Handling Unit up to 10,00~_ cfm
First Appliance Fee
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
Total Amount Paid
.,' :~X?;:}1.i:E_ESJ~AIR';~""~~,;~&J.i:.Jiii~i12:~:::fti ..':~~r ~;{L,":1~':5:.~:~::~~.::
)JAmount P.aid .:~ - Date Paid Receiot #
.,~,.:.r;h< . ", $'17:00" 08/17/2010 299247
";;', "., ,: -------S7900 08/17/2010-----299247-
$1152 08/17/2010 299247
$4.80 08/17/2010 299247
$112.32
"~; ".1:\
!t:'i)': ,~':-;; /!',-.,"
."
;l?"!,;,' '..;:,
'.;'i<.',t; ~, . '.!t,.(;;
Springfield Building Permit
r. ~,: .
': 8/17/2010 1:55:10PM
Page 2 of 3
. '
www.ci.springfield.or.us
PROJECT STATUS: Issued
..~~c~.~,
l;'f~~~J".
i~ > '~~;'; '1.
,,-,..-4',.,.
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00073
IVR Number: 811132081125
ISSUED: 8/17/10' .
APPLIED': 8i17i%.~"
. ~"'~' ":i - , ," '1
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541.726-3769
Fax: 541-726-3676
perm itcenter@ci.springfield.or.us
EXPIRES: 2/12/2011
VALUE: $0.00
SITE ADDRESS: 375 CAMBRIDGE Springfield
ASSESOR'S PARCEL NO: 1703233402200
PROJECT DESCRIPTION:
Heat pump replacement
"
.'
SCOPE: Mechanical Only
WORK INVOLVED: Repair
TYPE OF STRUCTURE: Residential
t::~.~t!:~~;J'~- g'-:-,zY~,-~~~~:l~,5 ,;;;:.:, <;',:"~ t.~::;:._,-;, _ '<'T~:'~:;~~2'_: eL~n,IBt:t~~j~~~';l~::};~~~''^ :':::;: ~ "~:', ,';'~, '~r;;~ . ~'~:~: ~;'''~-~'~:'~'~~~';~I, ~;~,=:J
Deoartment
Permit Issuance
Application Acceptance
Initial Review
. Planning Review
Public Works Review
Structural Review
Race ived
08/17/2010
08/17/2010
08/17/2010
08/17/2010
08/17/2010
08/17/2010
Due Date
08/17/2010
08/1712010
08/17/2010
08/17/2010
08/17/2010
08/17/2010
ComDlete. ,-
08117/2010;'.
08/1712010"
,"""
08/17/2010
08/17i29.10._
08/17/2010
08/17/2010
Result
,~
Over the Counter
Ove~ the Counter
Not Required
Not Required
Not Required
Reviewer
Chris Carpenter
Chris Carpenter
Chris Carpenter
Chris Carpenter
Chris Carpenter
Chris Carpenter
Comments
Over the counter permit
Over the counter permit
Over the counter permit
Over the counter permit
Inspections
2300 Rough Mechanical
2999 Final Mechanical
INSPECTIONS REQUIRED ~
..
By signature, I state and agree, that I have carefully examin\ed the comp!etedapplication and do hereby certify that all
information hereon is true and correct, and I further certify t'hatJany arid 'aiL work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the, State"o'r Oregcin~pertaining to the work described herein, and that NO
....,.. T . '1
OCCUPANCY will be made of any structure without permis'sion 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 insp~9tiol=l re requested at the proper time, that each address is readable from the street, that the
permit card is located at the front of the p erty, and the approved set of plans will remain on the site at all times during
oon~ruction. .'
~
Owner or Contractor Signature
Springfield Building Permit
~ \:. "
,_.JiO"} 'i:,~,;'il~..pate,.
68.-/ ?r/O
, ;.
:~:)iO''', G\;(y';',\l! '.",,' '
".("
.1 Ji n , \J~:r ;,
';~'_dtt.. ,I'j ').
.,'
~;;'~L:
.... "11
:'!. .~~:" ,i.:;ro r~ j
!,y;' 1
(',i1ic
..,j,.,
.~ji
8/17/2010 1:55:10PM
Page 3 of 3
. '
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
perm itcenler@ci.springfield.or.us
RECEIPT NO: 2010000072
RECORD NO: 8JI-SPR20JO-00073
DATE: 08/17/2010
I '''1PAYMENT"FiPE , ' ;:j>AY:OR,,:;cAslIigRrCCARP,E~;T;~f3!GOMl'I[gJ\!.l:S;;i;
Credit Card J COO INC _C',' ';"1'
" .",
i!i,(:~!fRI~:ftQr:l~~'! ""%'5+ .s<!i~ ;','103';;;;-"'" ."::.,,m;~~~';!%';;;.;~;,6;Qe.().ON:T:..e.o[)E~~I'II().UNTJ)_lJC~~J.' ::;'.L',:d
Air Handling Unil up to 10,000 cfm 224-00000-425604 $17.00
First Appliance Fee .2.24.~0..?..?0.425604 _._____!!9.00
State of Oregon Surcharge (12% of applicable fees) 821.00000.215004 .111.52
Technology fee (5% of permit total) .__..~9.Cl.:00000~425605 $4.80
TOTAL DUE: $112,32
,.,. . ,(>';: dj.:AMOUNTPAI,l:I'
$112,32
';j
009950
--.~':~',.~::::~: :
";-'-
"
- -. - .."
'~tJ{~:';'Jll:~'{r:;~Ft' :r'i'i: I.
", '~.?'.)'
",.. . ~~ __'h
. ~l
..... 0',-....
'~i{:~:".itf(:li;~' ~,
. ~~'