HomeMy WebLinkAboutPermit Mechanical 2006-12-6
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~" Address:~ ~1(\..' ~-\t,v\ n ~C~
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Z25 FIFTH STREET . Sf'RINGFIELD, OR 97477 . f'H:(54 1) 726-3753 . FAX: (541)726-3689
City Job Number COM ZC1C> b - 0 I S- b (
b > 7 Cc:,,^-A'l::."l-\""-,,.4- (
\70s Zbl.{]
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Tax Lot:
12.,00
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f'hone:
L\\P\ OG~
Zip: C\1411
State:
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Preliminary Inspection is $55.35 (prior to insert).
Wood Stove/Pellet/Insert Permit is $65.35 (includes applicable fees and surcharges).
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Contractqf rt!fotw.~~ITt~~
Contractor: 000Ll '<U cJ- vY\i~JJ'YtD6lXi& l V\G '
Address: v('J-(l/7/ V\~OJUf\~' '~')/d> f'hone: '1t\tpLP'l-Z- \
City: ~n\f\(,~f1,{ld\., ,,:~.'c;;r',> St&: oJs~;'~~ ' Zip: (n411S
Construction conrlactor',s"~Y;~? t> < 2 b 7 (.(~"j{p <',p ; <+'" Expires: 8.VZ uO g
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By signing thi~ permj~(~~~~M19 call fo~' ~n inspect~~~},.quired (~26-3~69).
I state that all mformahO~~.i~Il:6.~rr.i)?ernllt IS correct an~,ll ~f~.-A-s provIded WIth
the Wood Stove Safety ihtO~li.tiOt:t ' ~~~cgning appliances an~l~Ii~ary inspection
standards as set by the o'i'~~~. ~~~ironmental Quality or ili'e Federal
Environmental Protection ~\ll;t.'!n. ~~~ide the testing approval number to the
inspector at the time of inspe~. ~II~ ~'~~hat if I am requesting a preliminary
inspection, the wall covering n~~4 ~.l1.ir~'l6>~~lOved.
\(~ o~'~.A: ~ ~<2 '0"', ~
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Signature: 0fl~6VLui0J {ill (u),
Date:
rvl ~ l DV
Date of Application:
/2 -6 ...-D b
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Checked for Delinquencies:
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Checked for Historical Status:
Shared Drive(T:)/Building Forms/Wood Stove Permit 08.06,doc
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2006-01561
ISSUED: 12/06/2006
APPLIED: 12/06/2006
EXPIRES: 06/06/2007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 637 CENTENNIAL BLVD
ASSESSOR'S PARCEL NO.: 1703264312100
Springfield TYPE OF WORK: Pellet Stove
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Freestanding pellet stove
Owner: MONICA TARRANT
Address: 637 CENTENNIAL BLVD
SPRINGFIELD OR 97477
Phone Number: 541-461-0582
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
GOOD DEAL METAL PRODUCTS INC
License
26743
Expiration Date
08/26/2008
Phone
541-736-9876
VB
BUILDING INFORMATION I
ftUr'l.r .
~ Jf srt.ies: Lot Size:
T H~iilftf3M~ft9}tm'EL Sq Ft 1st Floor:
ALmYP~;~Ufe~tUNDE EXPIRE IF THE WW1{ (2nd Floor:
CO>>iJlv''E'Nfr-pr R THIS PERMIT I.~){' .'Basement:
ANlJ.,ange If~~: OR IS ABANDONED FO&qlt Garage/Carport
EJJ~ylM\'hF.'ER/OD. I~q Ft Other:
Sprinkled Building: n/a Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
I DEVELOPMENT INFORMATION.
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
A/fEN rOyerlar Dis~:,
follow rUIIf.#t~{fjws Rqlolrequlres YOU to
Notificatlon~:~O:}l"h~ Oregon Utility
in OAR 952-001-001 0 th:~'~es are set fortt
0090, VI'\\.L.D""'r s'-' _ . oU9 OAR 952-001
car:r'I\\J)n~ _~''''!!I t.. ~"-l@fi. he rules bj
"turn ror eo lephone -
C te regon Utility Notific~id~walk Type:
en r Is 1-80()..332 Ifon
-2344). Downspouts/Drains:
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa\?:e 1 of 2
Status
Issued
.ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-01561
ISSUED: 12/06/2006
APPLIED: 12/06/2006
EXPIRES: 06/0612007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
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
$10.00
$4.50
$2.25
$3.60
$15.00
$30.00
12/6/06
12/6/06
12/6/06
12/6/06
12/6/06
12/6/06
3200600000000000607
3200600000000000607
3200600000000000607
3200600000000000607
3200600000000000607
3200600000000000607
Total Amount Paid
$65.35
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 Reouired Insoections I
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 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
times during construction.
lv.lL(otp
Owner or Contractors Signature
Date
Page 2 of2
225 Fifth Street
Springfield, Qregon 97477
541-726-3759 Phone
Citu of Springfield Official Receipt
D ,opment Services Department
Public Works Department
Job/Journal Number
COM2006-0 1561
COM2006-0 1561
COM2006-0 1561
COM2006-0 1561
COM2006-0 1561
COM2006-01561
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
3200600000000000607
Date: 12/06/2006
Description
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Pellet Stove/Insert
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
MONICA TARRANT
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
1257
In Person
Payment Total:
Page 1 of I
II :55:12AM
Amount Due
2.25
3.60
4,50
30.00
15.00
10.00
$65.35
Amount Paid
$65.35
$65.35
12/6/2006