HomeMy WebLinkAboutPermit Building 2003-12-8
CITY OF SPRINGFIELD
Building/Combination Permit
I.',
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2003-01222
ISSUED: 12/08/2003
APPLIED: 12/0812003
EXPIRES: 06/08/2004
VALUE:
SITE ADDRESS: 2782 BURLINGTON AVE
ASSESSOR'S PARCEL NO.: 1703244103019
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Repair
Residential
PROJECT DESCRIPTION: Replace gas furnace
Owner: GILMAN ALLEN R & RITA A
Address: 2782 BURLINGTON AVE SPRINGFIELD OR 97477
'14 ~.4e,f\4 ,
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
COMFORT FLOW
License
460
BUILDING INFORMATION.
Expiration Date
06/27/2005
Phone
541-726-0100
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
. Impervious Surface Area:
R-3
SETBACKS
I DEVELOPMENT INFORMATION I
..,
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
ATTENTION:Oregon law reqUires you to
follow rules adopted by the Oreaon Utilitv
\Jotlflcatlon Cenier. Those rL :c.:> cu v ;:,t:::i iur
.n OAR 952-001-0010 throug! 1 MaluationrDescri
0090. You may obtain copies of the rules I
D .. calliran +h'f.rj"...+'~r '1\1"'+e' tlo..$ Rteli/ SqLFt
escnptIon 'J.ype1o '.::onstructIon'L . 118 ti 8!"nOne
n b. f th 0 ' .01' multIplIer.
urn "ler or e reg on Utllny (\fOrnication
r.nr,t(~\r i~; '1-800-332-2344).
NOTICE:
THIS PERMIT SHALL
AIITwnol,,?iD !I'J"'_- ~XPIRE IF THE WORk
. .,,-- vr ULn In/\) PtKMIT /S N
tio lj MMENCED OR IS ABANDONED FOR OT
Y 180 DAY PER/DO.
Square Footage
or Bid Amount
Value
Date Calculated
Notes:
'.t..
Total Value of Project
Pa!!:e 1 of2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Furnace - up to 100,000 btu
Minimum/Adjustment Mechanical
Total Amount Paid
L Fees Paid I
Amount Paid
$10.00
$4.50
$3.15
$12.00
$33.00
$62.65
I Plan Reviews . I
Date Paid
12/8/03
12/8/03
12/8/03
12/8/03
12/8/03
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-01222
ISSUED: 12/0812003
APPLIED: 12/08/2003
EXPIRES: 06/08/2004
VALUE:
Receipt Number
1200200000000002565
1200200000000002565
1200200000000002565
1200200000000002565
1200200000000002565
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I Reouired Insoections .
1 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 of 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 ofthe property, and the approved set of plans will remain on the site at all
times during construction.
\ \ O~ 00 ""'\.\9_0_\ 'W,-d f
Owner or Cont;tctors Signature
"
/
Pa!!:e 2 of2
. \Vli! 60
~
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 1222
COM2003-0 1222
COM2003-0 1222
COM2003-01222
COM2003-01222
Payments:
Type of Payment
Check
Receipt #: 1200200000000002565
Description
Furnace - up to 100,000 btu
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee~
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
dIm
Check Number
Batch Number Authorization Number
Paid By
COMFORT FLOW
24089
City of Springfield Official Receipt
Development Services Department
Public Works Department
. .
Date: 12/08/2003
1:31:30PM
Amount Paid
Item Total:
12.00
33.00
10,00
3.15
4.50
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65