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Home My WebLink AboutPermit Mechanical 2007-11-13 I .' o~ 0) ..~! 1"~3 ~: "'~,! ~) .;;~j ,,' "~I~ ~, I,,'(k ~.~ Ql 0; .,) , I,Ji ~) t)~ ../ (jJ)1 n"k riLl, ' fl') t :,,"'~; i '1 t~ ~' 00) ~'~ ,;...~,..,~; ~) ~~; >. 0) ~; 00;,,:,,:, , f ~ , I _1 ;~} 0,; 0" ~ 5fF!'lRlfiWl@JlJ"firEll..[o) 225 FIFTH STREET. SPRINGFIELD, OR 97477. PH:(541)726-3753 . FAX: (541)726-3689 ~' City Job Number Job Location: COvV\ 'Z-O'o 7-0 /6bY' 19sC; It ~ Sir -ee I / /7- () 3, ;;"C;:~JI-6~J. 0 (j Assessor's Map: Tax Lot: Owner: /JPI1,/ y SI, e r/ )/( ~ 0 rP' /95-5 /h~ .5Ire'el- ~ r r '\/11 f; e { J' O(C Phone: t, sY () / '9 '-I Zip: Cf7f 77 Address: City: State: 1I1,..,mlilllllll 1"11_.1111111' II 111~iiiIiIl;lIl1l1l1ll1l1. 11,lIi1iiill1iil~I.lill,..IIINiIII_,IIIIi1..liI;11I1 liilill;;jlliii,ill~i, ;~IIIII_""'- .... I!!!II"-,,--,",~,-,,," Preliminary Inspection for wood bu~~ inserts is $61.50 (prior to insert), Wood Stove/Pellet/Insert Permit is r,;,~O (includes applicable fees and surcharges). fJ I ~ ATTENTION: Oregon law requires you ,t.o fOllOW i'Dlil rmop,g.J<k,.Nu.'G"':~3nn ,- Notification Center. Those rules are set forth 2-J)S)1-OO10through OAR 952-001- contractoJ'W&i\tt~ity obtain copies of the rules by Contractor: Em e rt:"Z I j Po~ J v.. ~ ~ ~Ing the center. (Note: the t,el~pho!,'e Address: /g?S- j-!W}/ <=L9~er_forthe~~eg<m.~~~~,}~~:7096 f !. / '\ltllIlvl (j(j.\.;).;) oAf, 7 City: ~Dr.~ f't.,,/J State: CJJ!.. Zip: 9?.,. 7/ Construction ctontracfor's Registration #: //~ 9 f Expires:. /6 - 2'Z - 0 1 By signing this permit/application, I agree to call for an inspection(s) as required (726-3769). I state that all information on this application/permit is correct and that I was provided with the Wood Stove Safety information for wood burning appliances and preliminary 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. ~{?~9 ~~~R~l~MIT'SmU.-~"~F~flli::9Jql!1< L/ AUTHORIZEDUNDEBTHISPERMIT IS NOT FOR OffiCE ustOMMENCED OR IS ABANDONED FOR /; . /. ANY 180 DAY PERIOD. II 13/zo07 , Checked for Delinquencies: V- Signature: Date of Application: Checked for Historical Status: ~' Shared Drive(T:)/Building FormslWood Stove Permit 7,07.doc .~,J Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01668 ISSUED: 11/13/2007 APPLIED: 11/13/2007 EXPIRES: 05/13/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1955 16TH ST ASSESSOR'S PARCEL NO.: 1703252402200 Springfield TYPE OF WORK: Wood Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Install woodstove Owner: NEAL MOORE Address: 1955 16TH ST SPRINGFIELD OR 97477 Phone Number: 541-654-0184 I CONTRACTOR INFORMATION. Contractor Type Mechanical Contractor License EMERALD SWIMMING POOLS OF ORE IN 11294 I BUILDING INFORMATION I Expiration Date 10/22/2009 Phone 541-688-1090 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: n/a Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: ~j[~MPROVEMENTSI THIS PERMIT SHALL !Xp Sidewalk Type: AUTHORIZED UNDER THI~:~.!Drains: COMMENCED OR 'S ABANDONED FOR ANY 180 DAY PERIOD. Notes: I Valuation DescriPtion' 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 Minimum/Adjustment Mechanical Wood Stove/Insert Total Amount Paid Amount Paid $20.00 $5.00 $2.50 $4.00 $17.00 $33.00 $81.50 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01668 ISSUED: 11/13/2007 APPLIED: 11/13/2007 EXPIRES: 05/13/2008 VALUE: Total Value of Project Fees Paid I Date Paid Receipt Number 2200700000000001696 2200700000000001696 2200700000000001696 2200700000000001696 2200700000000001696 2200700000000001696 11113/07 11113/07 11/13/07 11113/07 11113/07 11113/07 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 requested after 7:00 a.m. will be made the following work day. Wood Stove: After Installation. Reouired'Insoections I 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 per~i card is locat~eat th front of the property, and the approved set of plans will remain on the site at all times during copsfru tion. -;Z; '?' C?X..- 11- / 3- tJ7 Owner or Contractors Signature . I Date Paee 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726':3759 Phone / Job/Journal Number COM2007-01668 COM2007-01668 COM2007-01668 COM2007-01668 COM2007-01668 COM2007-01668 Payments: Type of Payment CreditCard cReceintl City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200700000000001696 Date: 11/13/2007 8:24:11AM Description Wood Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Amount Due 33.00 17.00 20.00 2,50 4.00 5.00 $81.50 Paid By SHERI MOORE Item Total: Check Number Authorization Received By Batch Number Number How Received djb 692959 In Person Payment Total: $81.50 $81.50 Amount Paid Page 1 of 1 11/13/2007