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Home My WebLink AboutPermit Mechanical 2011-6-28 Mechanical Permit Application ,-;.; ','_::""c ~_,_,'p-",.,:;.;_,..:"" {~,,~._-,.,:~:. <.",. c:._"":_',:,'" ';. -'- ":""~""'~'".':':" ,: ;":',DEPARTMENT USE ONL'l""S'{: . ... ". ,,:, .b.... (-~ Permit no.: 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 Date: 6--U- J-.t 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 :"""ii,';':;-,CATEGORYi"QF?CoNsTRUC"rIOrif",:'", / ?,' FEE SCHEDULE ',' ~ 1l:!' Residenti,al I 0 GoveIllffient ,I o ,Commercial , / ~J~e~J#~r~!~h&~~i;;;::i!i';F;(::$j;:;;;/Q~, ;iz,~~~!i;~, ,';;\1b~\j ) 4I:~::i)P)$QI3V$J:fE',:II'W9RM)!;tlqNi91,Nbl;~qGil.II6N:~&~r'?'i,\ First Annliance $79,QO $ ~rnace/burner including ducts and vents h ~/_" I ,.-c' 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: ii~t~\~,l%;~~t\HGQiiI;rRACliibR;;jN$'TAliliAi:IQf\i},N!'::1<:: "h'c," Business name: Hrr-/ll. 'A ~ '...-. Ch',.- <. / Lc' Address: 9c:Q?91l ~;J;C;.N' LA:.,), City: Y//n, '"..,._ I State: C?/( I ZIP:/:>'.,/ Phone5-r1 -9? s- /../)/~ Fax: - - ' E-mail: </ /': '/?'7 / ~ 4_ /7/,:: A', ~. CCB license no.: ) '7// /1"5 I f Print name: m,~c..k-';" u .- / L:"'"c:~,.j Signature:;:;;lf: ~;' ~ ;/ 440-2545-J (1 1/08/COM) ~ , , Up to lOOk BTU/hr. Over lOOk BTU/hr, Heaters/stoves/vents Unit heater $17.00 $20.00 $17.00 $38.00 Wood/pellet/gas stove/flue Repair/alter/add to heating appliancel 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 Additional outlets (each) Air-handling units, including ducts Up to 10,000 CFM $11,00 Over 10,000 CFM $20.00 Comnressor/ahsorntion svstem/heat numn Up to 3 hp/I OOk BTU $17.00 Up to 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 $58.00 $13.00 $ $9.00 $ $13.00 $ $58.00 $ $7.00 $ $4.00 $ Incinerators Domestic incinerator $ $ $ $<:<i?";;' $ $ $ $ $ $ $ $ : ''''', $20,00 $ "',',.,-,- Enter total valuation ofmechanicaJ system and installation costs $ Enter fee based on valuation of mechanical syst.em, etc. $ ~f~.i#.9~fr#'~,~9.~~J:~~~!:::W}~{:H.;:t~1~\~~~~ ~~~.Tl ~~~.~~~~~:~~~~ :;~-~~~~~,};:;~: Reinspection '$58.00 $ Specially requested inspections (per hr.) $58.00 $ Regulated equipment (unclassed) $13.00 $ Each additional inspection, (1) $58.00 $ \~~;;~J&~t!}~~;Y~11~:Jt1~f;'~_FiffiCA&t.~jJ,s~ElF~:~~#f~~~~I:~'fu*ii11 (A) Enter subtotal of above fees (or enter Set minimum fee of $ 79.00) (B) Investigative fee (equal to [A]) (C) Enter 12% surcharge (.12 x [A+B]) CD) Seismic fee, 1% (.01 x [A]) (E) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through E): $ '10 cf} $ -C~ $d_~ $ D $ .~ At' $ <(2~3 .. .~ SPRING, FI,E~ 11..~'" , ,tb "'" OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01610 IVR Number: 811157547163 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 06/28/2011 ISSUED: APPLIED: 06/28/2011 06/28/2011 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 ' permitcenter@cLspringfield,or.us EXPIRES: VALUE: 12/24/2011 $0.00 SITE ADDRESS: 2655 70TH PL, Springfield, OR 97478 AssEsOR's PARCEL NO: 1702353406704 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: . Wood stove- Zero Clearance Phone Number: OWNER: ADDRESS: LOWRY NATHAN A & VICTORIA L 265 5 70TH PLACE SPRINGFIELD OR 97478 Contractor Type Contractor Name CONTRACTOR INFORMATION I Lie Type Lie No Lie Exp Phone # of Units: BUILDING INFORMATION ~ # of Stories; Height of Structure: Type of Heat: Wood Stove Water Type: Range Type: Hazmat: o Occupancy Type Construction Type R-3 Type VB # 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: Lot Size: sq Ft 1st Floor: sq Ft 2nd Floor: Sq Ft Basement: sq Ft Garage: sq Ft Carport: sq Ft Other: 0 Occupancy load: 2008 Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: :~OnCE: Soils Report Requiredi'HIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 6/28/2011 11:53:08AM 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 .;o.. -.. www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01610 IVR Number: 811157547163 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe rmitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 06/28/2011 ISSUED: APPLIED: 06/28/2011 06/28/2011 EXPIRES: VALUE: 12/24/2011 $0.00 SITE ADDRESS: 2655 70TH Pl, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702353406704 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Wood Stove- Zero Clearance DEVELOPMENT INFORMA nON ~ 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: DownspoutfDrains: Valuation Description I Description Type of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID I Description Amount Paid Firs~pplian~ Fee $79.00 "!:;;:~~.ology fee (5% of permit t~t~_I). ____.___~3.95 State of Oregon Surcharge (12% of applicable fees) $9.48 Total Amount Paid $92.43 Date Paid 06/28/2011 06/28/2011 --~.,..,....,--..--,--,...- 06/28/2011 Reciot # 2011001816 2011001816 2011001816 Springfield Building Permit 6f28f2011 11 :53:08AM Page 2 of 3 .-~ .-~, SP~:~. ~~EL~ lk~ .X%. OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01610 IVR Number: 811157547163 www.ci.springfield.or.us 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: 06/28/2011 06/28/2011 155 ued 06/28/2011 ISSUED: APPLIED: EXPIRES: VALUE: 12/24/2011 $0.00 SITE ADDRESS: 265 S 70TH PL, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702353406704 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Wood Stove. Zero Clearance Plan Review ~ Deoartment Application Acceptance Received Due Date 06/28/2011 06/28/2011 Completed 06/28/2011 Result Application Accepted Reviewer Kip Kaufman Mechanical Review 06/28/2011 06/28/2011 06/28/2011 Approved ,----:-66128/201-1 _ '06/28/2011 ~06/28/2011, '. - - ..,. "_' :;r~~1' . "". .. ~ $'C_~.... ,::":_:'~,1L".'" '" "Approvecf,::::.;' ,~'" ',Kip Kaufman- .;~_:0.::~~__. ~i-J.:::7~r~:~f~~;::_:~i~~:~d,. _'~'~' -', -: '- ;~ _'~:2.i ll~itial Reviewf".,:~ L___~~ ~ _;~o'" Kip Kaufman ",",,=.. ~-~,,:- '" ~-'fl'1 -, C!j'i';'fiJ INSPECTIONS REQUIRED I 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 aff 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. ~.6/_~~C; Owner oyc6ntractor Signature h'-.;2g--// , Date Springfield Building Permit 6/28/2011 11 :53:08AM Page 3 of 3 SP1~~....G...:L~ ~ ~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01610 265 S 70TH PL permitcenter@ci,springfield.or.us RECEIPT NO: 2011001816 lDESCRIP.JION~--':':-' First Appliance Fee ~tate ?.!..?regon Surcharge (12% of appli~able fees) Technology fee (5% of permit total) .' ,"'" ~ '. RECORD NO: 811-SPR2011-01610 DATE: 06/28/2011 -",~2. " 'Acco(iNLCODE~':~~:V""1i_:.:____AMOUNLDllE 224-00000-425604 79.00 821-00000-215004 9A8 100-00000-425605 3.95 TOTAL DUE: 92.43 ";':. ./ ,<. ..' .AMOUNTPAID 92.43 -, " , .,'" :. ..... 'r" . " -, .."" . ',' .....""'. "- -. ',';--'.". .. ...- L_.I?A\'-'\i1.I::NTTYE.~.,-,,~YOR" CASH1~~'KKAUFMAN.",~1'--, COMMENTS Check Fireplace Specialties ck#883 883 , - , ---' TOTAL PAID: 92.43