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Home My WebLink AboutPermit Mechanical 2007-9-25 ~ o . ,..-j ~ ~ u . ,..... , ...1 0.,,1 n r.. ,\ ~ ~ o .~ ~ u 0) 04 Cl!1 ~ ~ ~ ~ OJ r.FJ. ~ ~~._~ ............... (l) > o ~. CI) o o ~ 225 FIFTH STREET _ SPRINGFIELD, OR 97477. PH:(541)726-3753 · FAX: (541)726-3689 City Job Number Job Location: CO&I\A~C7- 0 14 S-L{ 38/0 r..(A-f:'vLO ~~ /8cZ06{ r Tax Lot: O!j~ ~L Assessor's Map: -.......i;..,...'1...oi.lil.....~....... .-. . 11..IIlI~1 II. lill.. I....~....._ij;. ,I ,III ,............... 111000000011Il_'~'_..Il1I1;;:..........J.."Ii.~. ..;.. iiiiii . a....... __ ..i.... .i,~.Jjl... "I ,.~ I ,,' I I.~ I _ ~., II.IIUlil'iMllIlll" I. III.. I ~,j,11 I.lU.,...I"_" ".,,~l.. ,II Owner: Address: Phone: City: State: Zip: II."'.... .,,,,,..,,,,,..,,...,..,. ,., .. '-'- ",.. . ."',"~", .._.,..;,,,,",~.... '."'.- -."',', ~,.,." .... ,,,,.,,,, ",-" ..,......."" .-'"''''''''.''''''''''' "', ,,' ,,,,,-,,,.,,,,...,," ..... ............, ~ . ............. ..1 Preliminary IpspectiQn for wood burningjnserts is $61.50 (prior to insert). Wood Stovc/Pellet/II)sert Permit is.$-1r:-50 (includes applicable fees and surcharges). ----- 8/~ . M'. ".., ".,""~"'~,,~.,.,, ._.. ,'..,... .,'"".... ~.s .-- Contractor ~ation Dt,A/ At c- fL lVI'Oi/,!.;,6Irt0At ~ ... 'Olifi~"!I.. ,,""_ ~ iillione: OD2,14i17;.,,~1 srfJ(J by"~. -..t-~'C&,.n.o. th".. 11:1,,_ o,.~~ ... t:eJ!!n ~ "'~~~th. - ~~ I ,...~ ~r". ~~~~Q ""..,--etttir ~ ,"~ ~,., _ .!4b~--.!1oti. ~ --" __"_"". ..___n -....._."-~~'~Jfeg~,;;;~1ii,~"~,,.-"'_. By signing this permit/application, I agree to call for an li!~' .~;'26-3769). I state that all information on this application/permit is correct an ~vided with the Wood Stove Safety information for wood burning appliances and pre Iminary inspection standards as set by the Oregon Department of Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing approval number to the inspector at the time of inspection., I also understand that if I am requesting a preliminary inspection, the wall covering may be required to be removed. Contractor: Address: City: Construction Contractor's Registration #: N'lTJt- . THIS p t. AUTfl~~.r.rlt. / c~IvJMi!llEiTuNo~ ~IRt" '7/ Z~, ~ ~IIIS ~~~~IJI/Mr:f,,~ I ( ii;1011 FVtiUUIVED Fn fir Checked for Delinquencies: ~ Checked for Historical St~us: Signature: Date: Date of Application: v-/" Shared Drive(T:)/Building FormslWood Stove Pennit?-O?,doc Status Issued, 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01454 ISSUED: 09/25/2007 APPLIED: 09/25/2007 EXPIRES: 03/25/2008 VALUE: SITE ADDRESS: 3810 CHEROKEE DR ASSESSOR'S PARCEL NO.: 1802061101500 Springfield TYPE OF WORK: Pellet Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Freestanding pellet stove Owner: ROBERT THOMAS Address: 3810 CHEROKEE DR SPRINGFIELD OR 97478 Contractor Type Mechanical Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction Phone Number: 541-736-8898 I CONTRACTOR INFORMATION. License Expiration Date Phone R-3 -I BUILDING INFORMATI.QliI t AI rcm\ON: ureamrmw requires you. ~ # cf6tJmrimes adopted by the Orego't t ~. ~fi~~r. Those rules are Floor: TI-~"()()1'()010through OAR · Floor \7J1' btaI' of the I . WlOO9J'''~ may 0 n copies 1\ Ii sement. Ra~U1HJ#1e cent~r. (Not~.:;;::: arage/C~rport En.rplt~ the r~.2344).Jq Ft Other: Sprinkled ~mnrJ.8 1 -... -fila Occupant Load: VB I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I ~ NO"\CE~ ~~te~e~ ,Q \\Q' lH\S PER~~ ~MD'!ftv1i~iuV~ l"o~ AUtHOR\ CEO OR \S ~9~t\O ' COMW\;ONOt\'1 PER\O\). I\NY 1 g I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line t. i CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01454 ISSUED: 09/25/2007 APPLIED: 09/25/2007 EXPIRES: 03/25/2008 VALUE: Status Issued Total Value of Project Fees Paid' Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Minimum/Adjustment Mechanical Pellet Stove/Insert Amount Paid Date Paid Receipt Number $20.00 $5.00 $2.50 $4.00 $17.00 $33.00 9/25/07 9/25/07 9/25/07 9/25/07 9/25/07 9/25/07 1200700000000001233 1200700000000001233 1200700000000001233 1200700000000001233 1200700000000001233 1200700000000001233 Total Amount Paid $81.50 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will he made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reouired Insoections , Freestanding Pellet Stove: After installation. 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 lfurther 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 on~'y contI)actors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to en~unrthat 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 _~m~ruct;oo. 9-0,- -<>7 Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street . ' Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT#: 1200700000000001233 Date: 09/25/2007 1 :23:22PM Paid By ROBERT THOMAS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 053158 In Person Payment Total: Amount Due 33.00 17.00 2.50 4.00 5.00 20.00 $81.50 Job/Journal Number COM2007-0 1454 COM2007-01454 COM2007-01454 , COM2007-01454 COM2007-01454 COM2007-01454 Description Pellet Stove/Insert Minimum/Adjustment Mechanical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee ~Mechanical Issuance Fee~ Payments: Type of Payment CreditCard Amount Paid $81.50 $81.50 cReceintl Page 1 of 1 9/25/2007