HomeMy WebLinkAboutPermit Mechanical 2007-11-6
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2007-01647
ISSUED: 11/06/2007
APPLIED: 11/06/2007
EXPIRES: 05/06/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
54] -726-3769 Inspection Line
SITE ADDRESS: 607 D ST
ASSESSOR 'S PARCEL NO.: 1703352408800
Springfield
TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install gas fireplace
Owner: MARY BROADHURST
Address: 607 D ST
SPRINGFIELD OR 97477
Phone Number: 541-746-4502
I CONTRACTOR INFORMATION.
Contractor Type
Mcchanical
Contractor .
AMBASSADOR PIP]NG INC
License
]21469
Expiration Date
03/27/2009
Phone
541- 726-5723
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Sc(.'ondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bcdrooms:
VB
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
R-3
nla
1~~T INFORMATION I
b\~O~~~~~:: bY th9 feare set iortV\\
Front yard Setba~'O\\\1Ii'l\ll~@IDcenter. Those ru'e~A.~~~QjBt:
Side 1 Setback: ~oiji\cat\O~..oC1-Oo1othrOugh ~t.\ewtedFies Rqd:
Side 2 Setback: UIlU O~ e5 'ffl~ obte.\n COP\~~h~ t~~ve Rqd:
Rearyard Setb~c~. ~~h@ cemsli'. lNO\uimt'1 ~U<<c:m\~verage:
Solar Setbacks: @Sll\mQ1 ~i ~s Oregon at,lg_~).
~~. -l'" ",.ROO..."."
\b1i~"ev- I PUBLIC IMPROVEMENTS.
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street I mprovemerits:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
I Valuation Description I
W Ol~C\E~ ~\RE \f THE WOR\{
iH\S PERM'" ~~~~~ TH\S PERM'T IS NOT
AIITHOR\ZEO _... t ~'\tlDn\\n:n FOR
CQMMENGk:U un 1\01 r1
ANY 180 DAY PERIOD.
Notes:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
"
Date Calculated
Pa2e 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
+ 5% Technology Fee
+ 8% State Surcharge
Appliance Vent
Fireplace (Listed)
Gas Outlets ]-4
Minimum/Adjustment Mechanical
Total Amount Paid
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2007-01647
ISSUED: 11/06/2007
APPLIED: 11/06/2007
EXPIRES: 05/06/2008
VALUE:
Total Value of Project
Fees Paid J
Amount Paid
Date Paid
Receipt Number
$20,00
$5,00
$2.50
$4.00
$7.00
$17,00
$5,00
$21.00
11/6/07
11/6/07
11/6/07
11/6/07
11/6/07
11/6/07
11/6/07
11/6/07
1200700000000001374
1200700000000001374
1200700000000001374
1200700000000001374
1200700000000001374
1200700000000001374
1200700000000001374
1200700000000001374
$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 be made the same working day, inspections r~quested after 7:00 a.m. will be made the following
work day.
L Reouired InsDections I
Rough Gas: After line is installed and required testing and capped if not attached to an appliance,
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signatu re, 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.
~llJ ~~
Owner or don-tracbrs Signature
/1/ '" //1 '7
F /-
Date
Pa2e 2 of2
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fifth Street
Springfield; Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01647
COM2007-01647
COM2007-0J647
COM2007-0 1647
COM2007-01647
COM2007-0 1647
COM2007-0 1647
COM2007-01647
Payments:
Type of Payment
Check
cRcceintl
RECEIPT #:
1200700000000001374
1:]0:52PM
Date: 11/06/2007
Description
Appliance Vent
Gas Outlets 1-4
Fireplace (Listed)
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Amount Due
7.00
5.00
17.00
21.00
20.00
2.50
4.00
5.00
$81.50
Paid By
MARY BROADHURST
Item Total:
Check Number Authorization
Received'By Batch Number Number How Received
Amount Paid
djb
In Person
Payment Total:
$81.50
$81.50
2137
Page I of I
11/6/2007