The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2010-10-15 Mechanical Permit Application l>.' ,"-" - '"':- . "~r.. :~r ^ ~""". .",; 1";": ,.... ~, ::"'>#.-;. k.,.'0"~ ':;,"1- ~ -~C;;rQ~ QEr.S<fRING_li',JE~n~-o.RE}.GQN~i1;,- 225 Fifth Street. Springfield, OR 97477 . PH(541 )726-3753 . FAX(54 1)726-3689 SPRINGFIELD ::J ~~_4'~'t r~,*,.. a;, ~ Date: '. 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, " .:""~;"2:;:"i.~CAtEG()RY;~Of;:'C()NStROCTION~1;": ':..' ',. ":' ~hJ,\ "">e' 'r' ""-""'''"..;.:''''..''R'e...p,...E-'RT.''' 'e'w' 'N' .E'R.'~'!J;3l>I.'..'.'''''...,..,,'';;..,.<. ~~tJ~~\k~(>~::wt1W'f:~..\~'~':~_,_:,,~, ,m _"~.''fi\~_'n _, _ ,. "". ~if~ie:'W:.l!;t:2:~:{'~i'i~~{Jl:t,;~,,\;:::~ \T oY'\ ~ 6t \ '-<..\ 1-51(,) 3\5'0 Name: Address: ZIP:Gj1t/"11 Phone. E-mail: This installation is being made on property owned by me or a member of my immediate family, and is exempt ITom licensing requirements n r ORS 7 1.0 O. Signature: l'i1~itl'ill!$.i~~l<::'pt:lJ' ;feftIN~JAIfI?~tloNlri.~"~;.:~; .;~1it!i :~i! Business name: f9t,:.,,/rt.-t::'A, ., Address:, City: Phone: E-mail: CCB license no.: Print name: ZIP: Signature: 440-2545-J (11/08/COM) . . .. -",' -'.~'" . FEE SCHEDUL.E .... , ~', . .. . !)~e.~j~~~n~!~.l~~~.~_~~~1~;~: ~~:;i1i{;t:G~,~;'!i-{ ,Qtr" f:41i-1~~'~~ii. ,,:rotal. t.:o;.:~'C'ost;:i::;I': First Aooliance , $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/pelletlgas.stovelflue $36.00- $ , Repair/alter/add to heating appliance/ refrigeration unit or cooling system! $56.00 $ 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 $56.00 $ Gas piping One to four outlets II $7.00 I $ Additional outlets (each) I I $4.00 I $ Air-handling units, including ducts Upto 10,000 CFM I $11.00 I $ Over 10.000 CFM I I ,$20.00 I $ Comnressor/absorotion system/heat DumD - Up to 3 hp/IOOk BTU $17.00 $ - Upto 15 hp/500k BTU $29.00 $ Up to 30 hpll ,000 BTU $43.00 $ Up to 50 hp/I,750 BTU $57.00 $ Over 50 hpll,750 BTU $95.00 $ Incinerators Domestic incinerator I I $20.00 I $ .~Comff1'erciaJ~~,~~FW)::"~:5~0~~ (' :;t~rJ~~:~~:~:;~; ;!~;'~~~',Tc'~' ~":~i~~~;t:~'~' ,~-:y ,,~.:~ Enter total valuation ofmechanicaJ system and installation costs $ Enter fee based on valuation of mechanical system, etc. I $ r~:i~~c~V:!~~~'~~'~f~~.~,~!;t~~~t~~~~~_J it~'rii~ ~~',:~osth ~':(~Total..-t;; -- ::.~. -- ~,~~-ea:?~: :c'ost/,'; Reinspection $56.00 $ Specially requested inspections (per hr.) $58.00 $ Regulated equipment (unclassed) $13.00 $ Each additional inspection: (1) $58.00 $ '~,;,"\"m"~'f"~J:'~"'!," ."..." ,~. ''''.~,-"- ,- --,.. - ,,-.. -. "',--_.-. "f' .. .......-~"-. &"" H'.",.. ".,.,.", "'lc~" :J:6~,),tttl~~':q~iY~'~~':.~ii~AP,Rt:lCANT~~V.S E,~~~~'W~1~11~~~I!;~',::rf$f,:: (A) Enter subtotal of above fees (or enter set 'r;ru.:.- minimum fee of $ 79.00) $ (B) Investigative fee (equal to [AJ) $ (C) Enter 12% surcharge (.12 x [A+BJ) $ c;r u- (0) Seismic fee, 1%(.01 x [AJ) $ , (E) Technology Fee (5% of [AJ) $ '1 '1.2" TOTAL fees and surcharges (A through E): $ 0713 "-., ~ S~R.I.H GFI.EL~ ~:"""':', ". ,~ " \ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00523 IVR Number: 811134005529 ISSUED: 10/15/2010 APPLIED: 10/15/10 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: Issued STATUS DATE: 10/15/2010 EXPIRES: 4/13/2011 VALUE: $0,00 SITE ADDRESS: 525 F ST, Springfield, OR 97477-4036 ASSES OR'S PARCEL NO: 1703352400900 SCOPE: Mechanical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Install new gas fire pace OWNER: ADDRESS: COTTON JENNIFER 525 F ST SPRINGFIELD OR 97477 Phone Number: Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type Lie No Lie Exp Phone BUILDING INFORMA TION ~ # of Units: o # of Stories: Height of Structure: lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Type of Heat: Water Type: Fire Alarms: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: ATTENTION: Oregon law req0ccupancytl:load: lo/:ow rilles ,r1"otp.d by the 0 . U't'l't' Electrical Specially Code,Edition: reg on II y I "UlIlll,U1IUfl I ,"""mer Those rules a t 1 th Springfield Fire Code Edition: ' re se or d, vAn "O'-U'J' -l)()1 0 through OAR 952001 Mechanical Specially Coile Eilition:. -- UUVU. ruU rnRV Ootam caples 01 the I b Municipal I Development Code: - ru es y l,..a1l11iy 'fiR {'pnTer (Note" the tel h Plumbing Soecially Code Eaiti6ri: . ep one nUIIII),~t ji'l[ tnA I /rp.(]on Utili." I\.lot'f' ,. Residential Specialty,Code Edition: 2008 I lea Ion , "enter ,< 1-/jUO-332-2344) Structural Specialty Code Edition: . Hazmat: Range Type: # of Bedrooms: Sprinkled Building: Energy Path: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 10/15/201 1:29:32PM Page 1 of 3 S~R. ING. FIEL~ .-- -~ -~\ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00523 IVR Number: 811134005529 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: Issued STATUS DATE: 10/15/2010. ISSUED: 10/15/2010 APPLIED: 10/15/10 EXPIRES: 4/13/2011 VALUE: $0.00 SITE ADDRESS: 525 F ST, Springfield, OR 97477-4036 ASSESOR'S PARCEL NO: 1703352400900 SCOPE: Mechanical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Install new gas firepace DEVELOPMENT INFORMA TION ~ REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: # Street Trees ~eqd: Paved Drive Reqd: % of Lot Cover~tge: Highest point on structure to north property line: Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Availab"'e: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value I ..~ .,_.~._--.,.".'" --,- - - 7-T'~~~ES-PAID--' j- Amount Paid $79.00 $9.48 $3.95 $92.43 ...of -1 Descriotion First Appliance Fee ?tate Cl! Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Total Amount Paid Date Pa id 10/15/2010 10/15/2010 10/15/2010 ReceiDt # 374619' 374619 374619 Springfield Building Permit 10/15/201 1:29:32PM Page 2 of 3 . SP~IN.. GFIE~ ~,\~- ','" ~ . .. \. OREGO~ www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00523 IVR Number: 811134005529 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541-726-3676 permitcenler@ci,springfield.or.U5 PROJECT STATUS: Issued STATUS DATE: 10/15/2010 ISSUED: 10/15/2010 APPLIED: 10/15/10 EXPIRES: 4/13/2011 VALUE: $0.00 SITE ADDRESS: 525 F sT, Springfield, OR 97477-4036 AssEsOR's PARCEL NO: 1703352400900 SCOPE: Mechanical Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: 1-' Install new gas firepace ~_' ..~ """n _ .... _.._ _ ~ - " ~ -- Pi~-n R;~i~~-,-::_~t; ~~ Comoleted Result 10/1512010 Over the Counter ";::' ':~,.,.- ----.-...- :-~-;;:~ -. - " Deoartment Application Acceptance Comments: Initial Review Received Due Date 10/15/2010 10/15/2010 Reviewer Chris Carpenter 10/15/2010 10/15/2010 10/15/2010 Over the Counter Chris Carpenter Comments: Over the counter permit Permit Issuance 10/15/2010 10/15/2010 10/15/2010 Comments: Issued Chris Carpenter Public Works Review 10/15/2010 10/15/2010 10/15/2010 Not Required Chris Carpenter Comments: Over the counter permit Structural Review 10/15/2010 10/15/2010 10/15/2010 Comments: Over the counter permit Planning Review 10/15/2010 10/15/2010 10/15/2010 Comments: Over the counter permit Not Required Chris Carpenter Not Required Chris Carpenter INSPECTIONS REQUIRED ~ Inspections 2310 Rough Gas Rough Gas: After line is installed and required t~sting and capped if not attached to an appliance. Final Mechanical: When all mechanical work is complete. 2999 Final Mechanical By signature, 1 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. 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 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 cons 'on. /\J!IJ!LO Owner or C tracto Signature Date Springfield Building Permit 10/15/201 1:29:32PM Page 3 of 3 S~RI~G.._f IE~ ~l... ., #U i;.' \~ .-; \. OREGON www.ci.springfield.or.U5 TRANSACTION RECEIPT 811-SPR2010-00523 525 F ST CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 permitcenter@ci.springfield.or.us RECEIPT NO: 2010000589 I DESCRIPTION'. RECORD NO: 8IJ.SPR2010.00523 DATE: 10/15/2010 LeAYMENT TYPE PAYOR" .CASHIER:CCARPENTER . C.Q-MMElfr:S.' --" AMOUNT DUE. $79.00 $9.46 $3.95 $92.43 AM.Q.UNLP.AlD I ...-;.~, "'~, . . ~ .+,. .Ac::_C9.ll.t:lLc9JJ.E. 224-00000-425604 621-00000.215004 100-00000-425605 TOTAL DUE: First Appliance Fee State of Ore90n Surcharge (12% of applicable fees) Technol09Y fee (5% of permit total) Credit Card 36644P Jonathon Purscelley $92.43 $92.43