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Home My WebLink AboutPermit Mechanical 2010-10-6 Mechanical Permit Application ;...'::;.- " - I . f:' ".~' ..,,,. }-~'. . ~,i <;rr~ pF~,Sl!~~GFtEp~!; Q~E~~JJN::;', 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 SPRINGFIELD ~"f:L:'tr::''"-c, , , "~~t'~ .__~;.' _~".~. ;;.'; ".."",:~ ,;;,0'>: --_,c: "''-" ',';:~:' ._....,,:. "',:";, '.':;i,',', ,.,-:(.~>,.,,':' ':- c_':' ,.: ,:j,!';:DEPARTMENrUSE'ONLY':'::ii~ ,''''':':', ".-.- "r: ;,'. >C'" ',- ,. :~,. ','.- '."; *_,,;-\:,;-_,_, :.':..';,-.,. Permit no.: SIO - CO "'Ib Date: 10 - b -fo This permit is issued tinder OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ",>"0;:'("nc'AJEGORY.?()~WC()NS'rRUCTI()N';'~?:;.;:. ,/ ": D Residential D Government l!l~Cornmercial ~t~'W{i:j.OB;;s.i:tE;;iN "()RI\II'4;fi()Ni~ANb~iE()c;Nj'I()Ntii'" t.it'i I City: State: 01'2. Taxlot. DESCRIPTioN, OF WORK City: Phone: 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. Signature: ~i'Jix%1,I!r,&i\~;9()NTr{A(:;;t()R,iYIN$TAi.::EA"'.I()Nj~'~;l,:"': tv( ~ .;,~.,,:. . Signature: 440-2545-J (11/08/COM) ,77.q~ 'J::". 'FEE SCHEDULE 12~~~;~.~:~~iil?i~.;{:!.ixill1:~'h'i};;:Y;d!);::' ,q~;. First Aooliance urnace/burner including ducts and vents Up to lOOk BTU/hr. Over lOOk BTUIhr. Heaters/stoves/vents Unit heater Wood/pellet/gas stove/flue Repair/alter/add to heating appliance/ refrigeration unit or cooling system! absorption system Evaporated cooler Vent fan with one duct/appliance vent Hood with exhaust and duct Floor furnace including vent Gas piping One to four outlets '. :";:h~~~~t ~;. 17f;~}~~~t'~,;*;., $79.00 $ $17.00 $ $20.00 $ $17.00 $ $38.00 $ $58.00 $ $13.00 $ $9.00 $ $13.00 $ $58.00 $ $7.00 $ $4.00 $ Additional outlets (each) Air-handling units, including ducts Up to 10,000 CFM I $11.00 I $ Over 10,000 CFM I $20.00 $ Comnressor/absorDtion svstem/heat numD Up to 3 hpllOOk BTU $17.00 Up to 15 hp/500k BTU $29.00 Up to 30 hpll,OOO BTU $43.00 Up to 50 hpll,750 BTU $57.00 Over 50 hpll,750 BTU $95.00 Incinerators Domestic incinerator ~::::;\+:i::,: $ $ $ $ $ I $20.00 I $ '.' P"i: Enter total valuation of mechanical system and installation costs $ ~ ~ ,Ot) Enter fee based on valuation of mechanical system, etc. $ :r~.i~g~l~~~~~~;f~~~,:t';i;").f".f!;':li; ii;;risii!i1"t:i~:': ":;}~~~~I" Reinspection $58.00 $ Specially requested inspections (per hr.) $58.00 $ Regulated equipment (unclassed) $13.00 $ Each additional inspection: (I) $58.00 $ ;t~~~t~im:iUWg~Y~.~~S:~~~;~Jji~~P_P.:tJICA~H~;~t(S'E~f:~~}~?;~W;~f%n~j~Jr~~~1~i!ffi;: (A) Enter subtotal of above fees (or enter set minimum fee of $ 79.001 (B) Investigative fee (equal to [A]) (C) Enter 12% surcharge (.12 x [A+B]) (D) Seismic fee, 1%(.01 x [A]) (E) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through E): .~. '.; $ $ $ $ $ $ 777 ", - www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00446 IVR Number: 811132240849 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.uS PROJECT STATUS: Issued STATUS DATE: 10/6/2010 ISSUED: APPLIED: 10/6/10 EXPIRES: 4/4/2011 , VALUE: $0,00 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477-8800 ASSESOR'S PARCEL NO: 1703220004102 SCOPE: Mechanical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Convert single stack to three independent stacks OWNER: ADDRESS: PEACEHEAl TH PO BOX 1479 EUGENE OR 97440 Phone Number: Contractor Type Mechanical Contractor Contractor Name FM SHEET METAL INC CONTRACTOR INFORMATION ~ Lie Type CCB BUilDING INFORMATION ~ Lic No 89710 Lie Exp 03f15/2011 Phone 541-726-3000 # of Units: o # of Stories: I Height of Structure: Type of Heat: Water Type: Range Type: Hazma.t: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: # of Bedrooms: Sprinkled Building: Fire Alarms: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Energy Path: Site Information ~ !'-Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Relai~ligliMlmON: Oregon law requires you to soildcpj~rflMlnilldOpted by the Oregon Utility !'lotlflcatlon Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090., You may obtain copies of the rules by calling the center, (Note: the telephone number for the Oregon. Utility Notification Center is 1-800-332-2344), NOTICE' . ,";':V:"':;'7(~':' .: THIS PERMIT SHALL EXPIRE IF THE WO~~\: AUTHORIZED UNDER THIS PERMIT IS N . ):. COMMENCED OR IS ABANDONED FOR.".~ ANY 180 DAY PERIOD. .. . . Springfield Building Permit 10/6/2010 8:53:30AM Page 1 of 4 SPRINGfiELD. ~ ~EGON CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2010-00446 IVR Number: 811132240849 permitcenler@ci.springfield.or.U5 PROJECT STATUS: Issued STATUS DATE: 10/6/2010 ISSUED: APPLIED: 10/6/10 EXPIRES: 4/4/2011 VALUE: $0.00 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477-8800 ASSESOR'S PARCEL NO: 1703220004102 SCOPE: Mechanical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Convert single stack to three independent stacks DEVELOPMENT INFORMA TION ~ Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped; Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Oescriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value L~~^.,,:~~~.:;;~,:;?~;-,T,~-:~ ~. ":~t:.~~::,(, ,:~:~:~'~:~:+i,::::+::rt~~~$~~A(DZ~l~!?f.~'~~;\f;", ;~'},~~:~~;!!;'i""r'~~-:-::::0~0-:::\:-~~-'-~~~:;:-,"-, . '~t Descriotion Mechanical Permit f:~~(based on value of ~or~L !echnology fee (5% of permit total) State of Oregon Surcha..'.ge (12~ of applicable fees) Total Amount Paid Amount Paid $664.92 $33.25 $79.79 $777.96 Date Paid 10106/2010 10/06/2010 ~--""'~- 10/06/2010 Receiot # 374502 374502 374502 Springfield Building Permit 10f6/2010 8:53:30AM Page 2 of4 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00446 IVR Number: 811132240849 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 5~.~"~G=L~ ~~ij\. A~ -':tf/;.. ~.1 "- ....:;;'-~, OREGON permitcenter@ci,springfield.or.us PROJECT STATUS: Issued STATUS DATE: 10/6/2010 ISSUED: APPLIED: 10/6110 EXPIRES: 4/4/2011 VALUE: $0.00 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477-8800 ASSESOR'S PARCEL NO: 1703220004102 SCOPE: Mechanical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Convert single stack to three independent stacks L~' ;,.!~,~~.t;:=:'81i:',,:~~.;''''~'T~''~.:,~:'~?i'~r:'~-'w<'''='0~;~~I~~:"'~~y.fe~~'~~-:-'~_;YF'!;'~,:~t~i;~'~:~00':-~:f~r2.~?!J':-~ ,;,~:,o~-~~ -;:r >~-'-;:~ 7 '":"~J Springfield Building Permit 10/6/2010 8:53:30AM Page 3 of 4 ST.NG=~ ~1;"~ JU"- < .. ""."" OREGON CITY OF SPRINGFIELD 225 FifthSt Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541:726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2010-00446 IVR Number: 811132240849 permilcenter@ci.springfield.or.us PROJECT STATUS: Issued STATUS DATE: 10/6/2010 ISSUED: APPLIED: 10/6/10. EXPIRES: 4/4/2011 VALUE: $0.00 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477-8800 ASSESOR'S PARCEL NO: 1703220004102 SCOPE: Mechanical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Convert single stack to three independent stacks By signature, I state and .agree, that 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 or 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. 1 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 readable from the street, that the ~'i7? "Z7";;,~ ")"7'~ '" "'.'00 ,"" ".", .,,, re~" '" ~ ,." '" .-. "". - f/vj;:-- ~ / l ~ i~fcJ { , Owner or Contractor Signature Date Springfield Building Permit 10/6/2010 8:53:30AM Page 4 of4 . , , . wvm,cj,springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00446 3333 RIVER BEND DR CITY OF SPRINGFIELD 225 Fifth 81 Springfield,OR 97477 541-726-3753 permitcenler@ci.springfield,or.us RECEIPT NO: 2010000487 RECORD NO: 811-SPR201O-00446 DATE: 10106/2010 tpESCRIPTIONQf~~,:,~;:,:~~::i_ ~;::::::'~:i;~t~"~.'G-~ic:;-:?~:q:,,;, :~!::!::'QU[ijrc:ORE:-J;~ ~'_;u;i_i~J\I!Ql.!~rr::lLl.IE:':!;"-:(< '. ,r- -I Mechanical Permit fee (based on value of work) 224-00000-425604 $664.92 Iechnol091..!ee ,(5% of permit total) ..__~00',~0000-~25605 $3325 ~f Oregon, Surcharge (12% of appli~.!'ble fees) 821-0000?-215004 $79.79 TOTAL DUE: $777.96 [-lR,I>,i.II/I.E:jit.tYPI;r:::::"-PAYQBj'1-~,?cASHiE.R;DB()WLSf~.Y~t,J :c:QMMEr-ltS:;~:\;";2:-.=1- ",--" ':-~: :'lLAoo.Q.UtiT:J:'AI D" .' c_-.1 Credit Card 022138 FM SHEET METAL INC $777.96 $777.96