HomeMy WebLinkAboutPermit Mechanical 2003-11-25
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Status
Issued
.. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01180
ISSUED: 11/25/2003
APPLIED: 11/25/2003
EXPIRES: OS/25/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4855 CAMELLIA ST
ASSESSOR'S PARCEL NO.: 1702324403500
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install gas fireplace
Owner: JUDITH FERRY
Address: 4855 CAMELLIA ST SPRINGFIELD OR 97478
Phone Number: 541-746-7393
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
MARSHALLS INC
License' 'Expiration Date
25790 12/23/2003
BUILDING INFORMATION'
Phone
541-747-7445
# 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 GaragelCarport
Sq Ft Other:
Impervious Surface Area:
R-3
SETBACKS
I DEVELOPMENT INFORMATION'
Front yard 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: 'NOR\<-
Storm Sewer ~UQ%iii~:'. 5\1f\ll E~P\RE \r :; \5 N01
Special Instruc~m PERN\\1 ~DER 1\1\5 pER rOR
~U1\10R\IEO lIOR \5 M~f\NOONED
Notes: ~^W\ENCED 0
COWl P1'\ nl.\'{ PER\O .
I\N' \v-
Description
Type of Construction
Sidewalk Type: to
D t' In'' ...~nU\res \}OU.,'t'l
- own~p.~'l.~/Luvams: On Uti \
~-rn:.Nl\ON..or ~t~d b\} tne ore~re set to\1
to\\OW f.u\eS ~~~~r. 1nOse ru~e~~R 952-00'
\otiticat\on C "\ -00"\ 0 \n\o~g t tne fU\es \
_ ~ nt::.?-OO . _ "\'nOleS 0 _ _.......nA
- , ...... . - \/ OUlo.'" . +1ne \\7\'OY"-
... -n '(ou roal 'Note: III 'f ation
Valuation Descri 'Wml). tne center. , Uti\iW Not\ IC
lia.dlng i r tne oregon "3?-2344).
$ Per Sq Ft SquanUFlo~filg~O t"\~,:,r is 1.VROIO-.:> - D C I I d
It' I' B'd A 't ,.,. a ue ate a cu ate
or mu Ip ler or I moun
Total Value of Project
Pa2;e 1 of 2
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CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-01180
ISSUED: 11/25/2003
APPLIED: 11/25/2003
EXPIRES: OS/25/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid'
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Gas Fireplace
Gas Outlets 1-4
Minimum/Adju~tment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$15.00
$4.00
$26.00
11125/03
11/25/03
11/25/03
11/25/03
11/25/03
11/25/03
Receipt Number
1200200000000002516
1200200000000002516
1200200000000002516
1200200000000002516
1200200000000002516
1200200000000002516
Total Amount Paid
$62.65
I Plan Reviews I
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 ReQuired Insnections I
1 Rough Mechanical: Prior to Cover
2 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 of the property, and the approved set of plans will remain on the site at all
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Owner or Contractors Signature Date
Pa2;e 2 of 2
L~
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-01180
COM2003-01180
COM2003-01180
COM2003-01180
COM2003-0 1180
COM2003-0 1180
Payments:
Type of Payment
Check
Receipt #: 1200200000000002516
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Gas Outlets 1-4
Gas Fireplace
~Mechanical Issuance Fee~
Minimum! Adjustment Mechanical
Paid By
MARSHALLS INC
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 11/25/2003
2:50:44PM
Amount Paid
Item Total:
3.15
4.50
4.00
15.00
10.00
26.00
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65