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Home My WebLink AboutPermit Mechanical 2011-6-30 Mechanical ~ermit Application . ;. <;:;':;'.~ .~,~.."~,;.c,;._.... ,-, -, ":_' .~. ',-.,..; '_".' _:: "J;.,,~,. . "'_ . ': """:";."~.~,i..;:~ -"': ;.c':DEPARTMENT USE ONLY'.<:-/" '.~ ' 'j .', ,',., .".,' -.' '-., 225 Fifth Street. Springfie]d;'OR 97477 . PH(54])726.3753 . FAX(541)726,3689 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. "';'CATEGORyTbFitONSTRucfION:,'."" " .'_,",... _J_.'_"'-' ,.....,-... ...'.. '. _ -', ... _', Residential 0 Government o Commercial ~('i:rif'}jOB);'~J"fE'TIN~9RiYi~tI9~I:AND;1:i!QG}l.j;'iqNf~t'~'""i Job site address:t{6? S . City ~;AJ.. 2- Taxlot.' DESCRIPTioN. OF WORK " .-f/,u; EL C UJ'ttA.c .<...-. t~~?.J.~~~~;:<<~~~f~?',~'~Jt{~.Fi~B1;Yi~~9W.~:~R~~~t~~?~0!f:!~;~~~:1:~'f~~~ Name: ~Wlq t3Gcf.5'<!~ Address: 'Ii 0 5 .. C 7ft, J-t- City: ,',.., - C -~ (e,( O(Z ZIP: '1 Ntr Phone: )"1(-19'1 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. :",,;+-~,,:.., C("(6r E-mail: CCB license no.: Print name: ~ Signature: f L--,AJJ N JtJc:r - Alo ::C=S..5i( e=....s- . '1AZA :SvlJl3-S fI'/J _ "'" d-: c- vJ 0 f-J::::S-- - )./ 0 r VI vvr ~5~S Bl3i;J ~5PN 440-2545-J (] ]/08/COM) FEE SCHEDULE . ~B~~J#,~~~i!~"l?,~~;~iit~~\;'~~~"l,:,::::~jt~t~:;,:~,(~)/:: 9~, ;"." ;(:ost"1 .,.'fotili,j ~~:!~\ ea~' :.~;~\. l~'1'"C'oSt; ;-, :., 'v First Appliance I $79.00 $.r ."'" urnace/burner including ducts and vents C-? ---c::-1' ~ Up to lOOk BTU/hr. $17.00 $ Over lOOk BTU/hr. $20.00 $ Heaters/stoves/vents Unit heater $17.00 $ Wood/pellet/gas stovelflue $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 Upto 10,000 CFM I I $11.00 I $ Over 10,000 CFM I I $20.00 I $ Compressor/absorntion svstem/heat numn Up to 3 hpll OOk BTU $17.00 $ Up to ]5 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 $20.00 I $ ::~C:oirimerclaJ~,~:~~.-~_x:~~:~t'ft?~\;.;::dj:;l;~~:~~;;\")\'~~:!f<i;Y~'-;'\\;:?~;(~:~:f~'~-P :(~-! -." """ Enter total valuation of mechanical system and installation costs $ Enter fee based on valuation of mechanical syst.em, etc. $ ~~~)#F~ll,~~.e.:2~~~.i.:,~:~.~JWMf~t\~~tf~~~~~f: :~~T~ ~~;~'~~~~j~Z;i~ ~,;~;~.~~~~~~}t. Reinspection . $58.00 $ Specially requested inspections (per hr.) $58.00 $ Regulated equipment (unclassed) $13,00 $ Each additional inspection: (I) $5800 $ 1~~lWi~*{~lfJki{~~~I~~~:tke:R:i$'C~J~~jJ~iiI(~fEJf~{?Yf~~fi~~~~;~~.~~! (A) Enter subtotal of above fees (or enter set $ qq ,to minimum fee of $ 79.00) (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ "f.~ (0) Seismic fee, ]%(.01 x [A]) $ (E) Technology Fee (5% of [A]) $ 3. ~5 TOTAL fees and surcharges (A through E): $Q2..13 i. '" \' SP~:I:~~ ~~ ~OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01645 IVR Number: 811138845340 www.cLspringfietd.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.OLUS PROJECT STATUS: STATUS DATE: 06/30/2011 06/30/2011 155 ued 06/30/2011 ISSUED: APPLIED: EXPIRES: VALUE: 12/26/2011 $0.00 SITE ADDRESS: 460 S 67TH ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702344401600 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Electric Forced Air Furnace Phone Number: OWNER: ADDRESS: BASSETr ANNETTE L 460 S 67TH SPRINGFIELD OR 97477 BASSETT JAMES N 460 S 67TH SPRINGFIELD OR 97477 OWNER: ADDRESS: Phone Number: CONTRACTOR INFORMATION I Contractor Type Contractor Name APPLIED REFRIGERATION TECHNOLOGY INC Lic Type CCB # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Forced Air Electric 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 Lic Exp 10/29/2012 Phone 541-830-5513 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Fl Basement: Sq Ft Garage: Sq Ft Carport: Sq Fl Other: 0 Occup~ncy Load: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: ~'an GE: Land Hazard Area: IHIS PERMIT SHALL EXPIRE IF THE WORK Retaining Wall: . ',UTHORIZED UNDER THIS PERMIT IS NOT SOils Report Required: COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 6/30/2011 2:00:04PM ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification 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). Page 1 of 3 ... 'i www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01645 IVR Number: 811138845340 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: STATUS DATE: Issued 06/30/2011 ISSUED: APPLIED: 06/30/2011 06/30/2011 EXPIRES: VALUE: 12/26/2011 $0.00 SITE ADDRESS: 460 S 67TH ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702344401600 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: New Electric Forced Air Furnace DEVELOPMENT INFORMA TION ~ 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 ~ Descrietion Tvee of Construction Unit Amount Unit Tvee Unit Cost Value FEES PAID ~ Descriotion Technology fee (5% of permit total) First Applianc~ Fee__._"___",~__,.,___,_.,,._" State of Oregon Surcharge (12% of applicable fees) Total Amount Paid Amount Paid $3.95 $79.00 $9.48 $92.43 Date Paid 06/30/2011 06/30/2011 0613012011 Reciot # 2011001845 2011001845 ---- 2011001845 Springfield Building Pennit 6/30/2011 2:00:04PM Page 2 of 3 . www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01645 IVR Number: 811138845340 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: STATUS DATE: Issued 06/30/2011 ISSUED: APPLIED: 06/30/2011 06/30/2011 EXPIRES: VALUE: 12/26/2011 $0.00 SITE ADDRESS: 460 S 67TH ST, Sprin9field, OR 97478 ASSES OR'S PARCEL NO: 1702344401600 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Electric Forced Air Furnace Plan Review I DeDartment Permit Issuance Received Due Date Comoleted Result 06/30/2011 06/30/2011 06/30/2011 Issued Reviewer Kip Kaufman Initial Review 06f3012a11 06/3012011 06/30/2011 Over the Counter Kip Kaufman Comments: Over the counter permit :APPlit:atj"on'Acc-eptance:';""ir:: .- "06/3012011" Jo6i36720r{,::406/30/2011"_;~~ Over the Counte{ +.% ~. ~Klp Kaufman. - ~ rl.........,~..~....,:',' .--~,_.. -- '.;--'.--_.~'_.~ ',',~''-''"7:::^''''-:' ':..;"'''~':-i' ,~':.':"- ?~,-~~' .,',0~< ..;.i-,'.~,:~" :~":'w:."'!m.",::,c",.,'r.',~: ~ ..."._ _' <;;::,:",~_-,,~_--,,:,:,~~,~, '",,"' ".. " __,..;J;-'" -J rr"'\"'Li '..(' "''''TC~ '",I , , __J INSPECTIONS REQUIRED ~ Inspections 2300 Rough Mechanical 2999 Final Mechanical 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 wiff remain on the site at all times during construction. own;rorC:nat~ 2(X?/ t/' Springfield Building Permit 6/30/2011 2:00:04PM Page 3 of 3 sr.~:~:~~ ~~ ~OREGON TRANSACTION RECEIPT CITY OF SPRiNGFIELD 225 Fifth 81 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01645 460 S 67TH ST pe rmitcenter@ci.springfield,or.us RECORD NO: 611-SPR2011-01645 DATE: 06/30/2011 ;, -':;" _ c-- '""---;" I: ~. ACcQUiIl:tcOOE: ..". ,.-AM0UN"T~I).UE . . 224-00000-425604 79.00 621-00000-215004 9A6 100-00000-425605 3.95 TOTAL DUE: 92.43 r'-PAJM~NT)m~E:~"j>A'Y0R""';' -;;.CASHIE~rKKAlI~MA~_',,:_.CbMMENtS::y~ii<; .', ~._-""."AlvfOON"TPAil)t-"-.f;;:'2::J Check Applied Refrigeration Technology, ck#1939 $92.43 INC RECEIPT NO: 2011001645 lOESCRIf1.TION '. "-j-.., First Appliance ,"Fee State 01 Oregon Surcharge (12% of applicable fees) Technology lee"(5% 01 permit total) '-....1 1939 TOTAL PAID: $92.43