The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2011-8-1 Mechanical Permit Application ''1\t'_'',}'<.':~''~..'<l;:l..",-i:'',,~.i'''h'_.{';'o!'''''~:; ~i.;::!iIffi..:~'Jt,,,', _l!~4-,r~.";~<,"'~',,~,; :'::'t' DEF.'ARTMEN:r;'USEiONLyP~,,1: ;.;l'jrY;:'1;Q 1!:h';-.)," _"'i.j,o;~ "~'h':!' - ~U-~'~..;'\'..'k'i",:-; '~1'i4',L 225 Fifth Street. Springfield, OR 97477. PH(S41)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. ~""> -".'" ',' '0'''7'' ,.,'-.- ',.,.. ,.- .'-_. --, -' ..~. ,---.,... -"~..,..". r., .. .-,-n.. '.. ""*'"""'-'.-~-'""""'-;<\i~H\-"'~ -' '1 "<-,.-,,,,-., -1'. :;:~'~j, ~{:,t~'CJl.;I'I=G OR,Yj]QEA'GONST-RU PJ'lqf:-lI';/":~;; ',' " esidential '0 Government 0 Commercial 1~~iT;'\t~j.Q,~~~~imE,')tNf?QRMA[IQi'l'~~NQl:;irQ'~;tlQNx.'!!Ki;'(:Iili Job site address: Taxlot,' DESCRII?TibN:(jF' WoRK,:" :,,, I IV fn4.-<..L ;V e:rc.J I't:' '"'Z-L-c. T O'<<JV t:1 ZIP: Cf/478 -srt/- 1</4-~ City: Phone: E-mail: This-in'5lallation i~ 15emg maiieon-properly""",ned b) me 01 a member of my immediate family, and is exempt from licensing requirements under ORS JffilI ,0 I 0, signatur~<----- -/1:... ~,itl~;ll'#~1i!fQr'lmRJl.<;:JlQf{~t~~t:1'~]i~~Xj9r;j;q~Wi'tf~~;;\i,}i~il1;;~j Business name: a... 4: W Address: City: Phone: ~<( 1- ("Kg- E-mail: hf0\ CCB license no,: Print name: Signature: 440-2545-J (II/DB/COM) I ~~ . '-,; "';'-':~',:,"FEE 'scHE:ijULE . "" "'/ .:. ~R~SiCi~'~'tiiilirl~lf:~~f~~tii~~~lJ;~~~;~J; ~_._ oj ~"@~t,,,; ~",~t}?Ja~;~~~ Qty:, t ""-il,"ea~..!!,":i; "<'1'.'ti:""Y"""".-',"F":n"~K."\:"_ ~_, ..,;>,;.;;"n~;~~~}'<?~\..tJ~,.i.~g:, ,0"''''''_'';1' "., ,.." .......~,.,d ~_'f.cost,.t.;" First Aopliance $79.00 $ l1'urnace/burner including ducts and vents Up to lOOk BTUlhr. $17,00 $ Over lOOk BTU/hr, $20.00 $ Heaters/stoves/vents Unit heater $17,00 $ Wood/pellet/gas stove/flue I $38,00 $38:::"- Repair/alter/add to heating appliancel 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/absorotion svstem/heat Dumn Up to 3 hp/l OOk 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 $20.00 I $ ~ ". ',' 't.' Enter total valuation of mechanical system and installation costs $ Enter fee based on valuation of mechanical system, etc. $ fMi'i;~;ti'~11~g'a;~i:f'~~1~J't~t~;H~~~jit~:~ ~~~~~i~ f~r01alYi :::,",-, Jl;~',''''~.e".",':'''_'-'-''l"'''''''''''''"'''''''J'''\'''''';:1:~,-.,1..~~lf!~:,_,:.->,9.,,: ";,',.I!,'_-i'b :,:,€cost~:';;_,;- Reinspection $58,00 $ Specially requested inspections (per hr.) $58.00 $ Regulated equipment (unclassed) $13,00 $ Each additional inspection: (l) $58,00 $ !;~~~~;.'I'~";']'!1"APfii!fc'if.Nm'~i]fsE~~~~l!l<~~~ "'-\"'~::':il'JX".,;..'t19t~ . ,,,.,,,id~hf..; _ '_ ,s_~.. ._,.. 'H__';_:Si~~ .... . ~'i;:,"';;}i .",." _ ~~Wn:t;'M>;;i;:,~, (A) Enter subtotal of above fees (or enter set 11~ minimum fee of $ 79,00) $ (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (,12 x [A+B]) $ c;'!.! (D) Seismic fee, 1%(,01 x [A]) $ (E) Technology Fee (5% of[A]) $ ?~ TOT AL fees and surcharges (A through E): $ '7 2. <!!- . S;!~l.::~L~ Wi -\\!h ,~.,.~. X OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01865 IVR Number: 811183495819 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.springfleld,or.us PROJECT STATUS: STATUS DATE: Issued 08/01/2011 ISSUED: APPLIED: 08/01/2011 08/01/2011 EXPIRES: VALUE: 01/27/2012 $0.00 SITE ADDRESS: 6330 F ST, Springfield, OR 97478 ASSES OR'S PARCEL NO: 1702342101001 SCOPE: Pellet Stove Iln.ert WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Pellet Insert Phone Number: 541-747-1414 OWNER: ADDRESS: PlUEARD KENNETH J & SHARON K 6330 F ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION ~ Contractor Type Mechanical Contractor Contractor Name EMERALD SWIMMING POOLS OF OR INC Lic Type CCB 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: Electrical Specialty Code Edition: ATTENTION: Oregon law requires you t.o Springfield Fire Code Edition: follow rules adopted by the Oregon UlIIity Mechanical Specialty Code Edition: Notific~.Ut)ll Center. Those rules are set forth Municipal I Development Code: In OAR 952-001-001? through OAR 952-00b1- " . . 0090. You may obtam caples of the rules y Plumbing SpeCIalty Code EdItion: callin the center. (Note: the telephone Residential Specialty Code Edition: num~P~or the Oregon Utility Notification Structural Specialty Code Edition: Center is 1-800-332-2344). # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire Alanns: Energy Path: Lie No 11294 lie Exp 10/23/2011 Phone 541-688~1090 Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: '-TICE: .... i~s PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ~;;. ANY 180 DAY PERIOD. Springfield Building Permit 8/1/2011 4:51:56PM Page 1 of3 SP~~N~~.. ~<~ ~OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: B11-SPR2011-01865 IVR Number: 811183495819 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 0810112011 ISSUED: APPLIED: 0810112011 0810112011 EXPIRES: VALUE: 0112712012 $0.00 SITE ADDRESS: 6330 F ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702342101001 SCOPE: Pellet Stove /Insert WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Pellet Insert Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 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 ~ DescriDtion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Descriotion ~~Iog~ fee (5% of permit total} ~__, Fi~stApplianc~~___.___,_~~___." ~te of,S?regon Surcharge (12~ of applicable fees) Total Amount Paid Amount Paid $3"95 $79"00 $9A8 $92.43 Date Paid 08/01/2011 08/01/2011 08/01/2011 Reciot # 2011002161 2011002161 2011002161 Springfield Building Permit 8/1/2011 4:51:56PM Page 2 of 3 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01865 IVR Number: 811183495819 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 0810112011 ISSUED: APPLIED: 08/01/2011 0810112011 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennitce nter@ci.springfield.or.us EXPIRES: VALUE: 01127/2012 $0.00 SITE ADDRESS: 6330 F ST, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702342101001 SCOPE: Pellet Stove f Insert WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Pellet Insert Plan Review ~ DeDartment Application Acceptance Received Due Date Corn Dieted Result 08/01/2011 08/01/2011 08/01/2011 Over the Counter Reviewer Nancy Machado Mechanical Review 08/01/2011 08/01/2011 08/01/2011 Not Required Comments: Over the counter permit Initial Review - ':';/~~..., "'<" _-08/01l20f1~0\~,2~j~1/201;~'i~-'Q~/g1f2o11g-OVe~-Gou~nfer,~ Comments: Qve"rJhe,~ounter.permit, . ,-- - .~. -'''''. ":j. - - 'i. '.- _-c~:;;__~" , ,0',' ..:, INSPECTIONS REQUIRED ~ Nancy Machado , . Nancy Machadb~-', -. ~ .,< -"",~ "- ,,~.. j ,.- .~'; -~ "i--w__..__,<>_ Inspections 2140 Peffet, Gas, Fireplace or Wood Stove 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 e p perty, and the approved set of plans will remain on the site at all times during construction. Wood Stove: After Installation. 01~ 0~/1 Owner or Contractor Signature Date Springfield Building Permit 8/1/2011 4:51:56PM Page 3 of 3 S~~~NG..~fL~ ~~ ~OREGOH TRANSACTION RECEIPT CITY OF SPRlNGFIELD 225 Fifth Sf Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01865 6330 F ST permilce nter@ci.springfield,or.us RECEIPT NO: 2011002161 t[)ESCRII~IION' ",," ,':: ,_ First Appliance Fee State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) RECORD NO: 811-SPR2011-01865 DATE: 08/01/2011 . ""';7t:J.".t::s;, '''A,CCO.UNJj:;.ODE?: i~; ,}'~A,1\II0U/liT,[)I.JE'i: -'0' J 224-00000-425604 79,00 821-00000-215004 9,48 100-00000-425605 3,95 TOTAL DUE: 92,43 /" ,:. COMMENTS~ ,:;.;;;:_".'''F,,!'...MQUN;re...l[)if~~~L . "f'] 92,43 L:lli.M~tff.t1YR!;~PAY6~"'CASHIER::NMACHA6(t',;: Check PLUEARD KENNETH J & SHAF 2985 TOTAL PAID: 92,43