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Home My WebLink AboutPermit Mechanical 2011-5-31 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. ",t':.' ';,?tAT~$dR'fW()i=:.'cdNsTROCYidN :C' e" . " . ~esidential 0 Government D.Commercial ~j';'?'~JOB~'siTE':]N'F()R~~TiQr'ln(Ni:Ui!Q!;AfiQN~~"("!o:.'; Job site address: ~ q t-ftt . s t- City:$' ;., P.-.lcJ... (Hl.. ZIP:'i'7<f 77 70336 Taxlot.: 0 70 DESCRIPTION OF WORK . Mechanical Permit Application . 1 . ~:~j{CITY:OF:SPRINGEIEED"'ORE'GON;{: .t8....:i'#B.;"";...:!''''--'. _...:,.-"t(::'t-"-,,.'l..t"--~""~ .."- . -''''~,i'-'_~,........- "..;.rlt,.:......~~,'_-. 225 Fifth Street. Springfield. OR 97477. PH(541)726.3753 . FAX(541)726.3689 -.C;~f~~~~~~~~:~&i~~p.RQt?~Rt;Y:~'OW.N:~B;tt~~<<:~~~:~l~~~~~{.~~;; Name: S+/?v"..... Address: ~ <($ City: 5; f't'l O(C ZIP: '11"( 11 Phone:S'((.q7Or Fax: E-mail: This installation is being made on property owned by me or a member of my immediale family, and is exempt from licensing requirements under ORS 701.0 I O. .~ Signature: l1;~Ji.'J\~!J~,;t~;(:'Qf'l;rRAC!f:()~gIN$TA~tAf,ICilt-H);i('~;;'.'.."\,f)' , Business name: :? '," e",,{{''o- .:t, fc.2~ State: 0 Address: City: GAI'...! Po.' Phone~rr -r>> f'ff3 11jfJ S- E-mail: CCB license no.: Print name: fnO'J...O ""/'- ~ Signature: ..... 440-2545-J (11/08/COM) ':'~';~">,,"'i ","''', ';'..,.:,' ':'-....,.,....,,; ".., .: c ;;...~'~ . ! - "'~l~.'-.~..;.. ';" <.c"DEPARrMENTUSE ONLY";;';:, '.. ',~'. - ~.-.. """" ,., , .. '; 'J ,;.- " SP~~., ~'a)' /6 Date: FEE SCHEDULE j;"" ":':.' "" ".'J.. .," .~s. ~',;,.~" ;\C:',!\,.1;,,~ .' , }'.'::;':' ,,c.;,,': ,'. ., ~'J~.' d~~~-~~}~', ,.,;!:~tal, . ;iResldentlal"l&.;;'':'~''''''):.:;lv,,'r;.' ,-:';''.(':\,i''.{?,-c-f,''.'r' Qty~. "'c',:. .-..:.,.~...,.-.,'i; ,:,,'" .",,~.. 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First Appliance I $79.00 $ furnace/burner including ducts and vents Up to 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 $7.00 $ Additional outlets (each) $4.00 $ Air-handling units, including ducts Up to 10,000 CFM $11.00 $ Over 10,000 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/I,750 BTU $57.00 $ Over 50 hp/l,750 BTU '$95.00 $ Incinerators Domestic incinerator I $20.00 I $ :': C Om mere 13 j:~~,~!~:\::rf~N;j\~}~~':,;:(Y-(~:?~~:?~~~~-;;J~,:~> "7';/:~;1-r~"'t~:r'.'t~~::;}\~..w ;~\) :'!,\";:'~~;' Enter total valuation of mechanical system and installation costs $ Enter fee based on v'aluation of mechanical system, etc. $ i::""\';-:, ;.."l-""):~.i!. 1'.':r:~;;.;..~;.!";::~P:;:::':';;";'..";'t,;:~b'.-t'}.:-',:c;-;,: :f~~~ ~!~~~~~~;~ :-<Total':i ::-,:Mls.cella neous\fees:.\:-.'i.~"':~~ ',!.~::!:~:~;;;':,rt,;-) "I';d)'st,;';;:. ,;: ~.'. ~ ,,: ".:: .'~ ....'.-- 'i~, "t,.,. "',,-':"'.;-' :~' "......,. ..' ~, \ ,.; .\'",,,'.' '..', .',,~ Reinspection $58.00 $ Specially requested inspections (per hr.) $58.00 $ Regulated equipment (unclassed) $13.00 $ Each additional inspection: (I) $58.00 $ ~lg""~iiIf$~~~JAPiiffic;6;N:j;'qUS-E-""~~)im"Q~W!1': ,"','.,.,"j;",~.~~'tq';j". . c,:,]l",,,,,,,,I&:,, "'.~; . -_. __.' ~", __ ' i&';f;',;f;: ,'; R~"~,':f"''::.~e'l1t.it>.,,,'.!:Jf~<;f;~ (A) Enter SUbtotaJ..gf~fees (or enter set 71 minimum fee oy.:S!9.00) , $ (B) Investigatlve-ree tequal to [A]) $"" 2:7 ... (C) Enter 12% surcharge (.12 x [A+B]) $() (D) Seismic fee. 1%(.01 x [A]) $ p: (E) Technology Fee (5% of [A]) $"'6 ,v.;:.. TOTAL fees and surcharges (A through E): $ y;: VII .f . SPRI1N~ FIE~ '~l. ''''',- .. , '{~t\ ~fGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01216 IVR Number: 811121670378 WW'N. ci. springfield. or. u s 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennitcenler@ci.springfield,or.us PROJECT STATUS: STATUS DATE: Issued 05/31/2011 ISSUED: APPLIED: 05/31/2011 05/31/2011 EXPIRES: VALUE: 11/26/2011 $0.00 SITE ADDRESS: 245 24TH ST: Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361409900 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New heat pump. split system Phone Number: OWNER: ADDRESS: lENT STEVEN R 245 24TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION I Contractor Type Mechanical Contractor Contractor Name APPLIED REFRIGERATION TECHNOLOGY INC lic Type CCB # of Units: BUilDING INFORMATION ~ # of Stories: Height of Structure: TYpe of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: 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: Lie No 133020 Lie Exp 10/29/2012 Phone 541.830.5513 Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Site Information I Engineered Fill: Fill Volume: Flood Hazard ~lil' land Hazar ,fNTION: Oregon law requires you to Retaining ~~.ow r~les adopted by the Oregon Utility Soils Repo lfiQlllil?n Center. Those rules are set forth n AA"!}S2-D01-0010through 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. . THIS PERMIT SHALL EXPIRE IF THE WORK .. AUTHORIZED UNDER THIS PERMIT IS NO~\ . COMMENCED OR IS ABANDONED FOR i:>;..... ANY 180 DAY PERIOD. . . . Springfield Building Permit 5f31f2011 10:55:27AM Page 1 of 3 . ~ '. SPRI..N GFIE. L~ ~.,..-- \""'~- ,~ "".....; OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01216 IVR Number: 811121670378 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: STATUS DATE: Issued 05/31/2011 ISSUED: APPLIED: 05/31/2011 05/31/2011 EXPIRES: VALUE: 11/26/2011 $0.00 SITE ADDRESS: 245 24TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361409900 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: New heat pump. split system DEVELOPMENT INFORMATION ~ 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 ~ Descriotion Tvee of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID ~ DescriDtion Technology fee (5% of permit total) First Appliance Fee State of Oregon Surcharge (12% of applicable fees) Tot'al Amount Paid Amount Paid $3.95 $79.00 $9.48 $92.43 Date Paid 05/31/2011 05/31/2011 05/31/2011 Reciot# 2011001357 2011001357 2011001357 Springfield Building Permit 5131/2011 10:55:27AM Page 2 of 3 -- SPRI,;,~" fIEL~ ~'A "~ ~ .\",,\' OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01216 IVR Number: 811121670378 www.cLspringfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennilcenter@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 05/31/2011 ISSUED: APPLIED: 05/31/2011 05/31/2011 EXPIRES: VALUE: 11/26/2011 $0.00 SITE ADDRESS: 245 24TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO:' 1703361409900 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New heat pump. split system Plan Review I Department Application Acceptance Received Due Date Comoleted Result 05/31/2011 05/31/2011 05/31/2011 Over the Counter Pe'rmit'lssuance~ -.<,:-- ',,- , '- 05/31/2011 F05/3.11f0l1 "05/3,1/2011':;>lssued' ":, " ..J'. .. '-- "--"" ,-,.-'." ~,' Mechanical Review 05/31/2011 05/31/2011 Comments: Over the counter permit ~mtral Review _ ~ .-- 05/31/2011 _ O~/31/2011 Comments:' Overt~e counter permit ,.' T. . . .- - ~ I 05/31/2011 Not Required 05/31/2011 ". ..,; Over the Counter - !J,. ~ -~ ~ INSPECTIONS REQUIRED Inspections 2300 Rough Mechanical 2999 Final Mechanical Reviewer David Bowlsby -, cD'!vid"Bowlsby . >~..>.. ..fi." David Bowlsby David Bov.:lsby " ~ Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. 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. 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 construction. / 731/(( ( Date . - c Owner or Contractor Signature Springfield Building Permit 5/31/2011 10:55:27AM Page 30f3 .- SP~~.,...N.G._...FIE~ ".~-\.~ .' 01 -,'. OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield, OR 97477 541.726.3753 www.cLspringfield.or.us 811-SPR2011-01216 245 24TH ST permitcenter@ci. springfield. or. us RECEIPT NO: 2011001357 lDES.CRI~TION;' - - First Appliance Fee State of Oregon Surcharge (12% of applicable fees) Techr;;:l~gy fee (5% of permit total) RECORO NO: 811-SPR2011-01216 DATE: 05/31/2011 - '. ACCOUNT-CODE ,. AMOUNT.D.UE 224-00000-425604 79.00 821-00000-215004 9.48 100-00000-425605 3.95 TOTAL DUE: 92.43 . .' AMOUNT PAID ---........v__-'._.,_.,....__~_ I .. - '.. .. " _. ~.,.. -', - '.." -, ,,- , ...., LJ~~YM~~l_ TX,P-!;~.~~Y9B.-:.~!tlJ~~~~~Y.:~_._.~,' .. ."-~:~..9_QMJ:VLI;~IS -, ,. Check APPLIED REFRIGERATION 1927 TECHNOLOGY INC __I 92.43 TOTAL PAID: 92.43