HomeMy WebLinkAboutPermit Mechanical 2007-12-7
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225 FilTH STREET. SPRINGnELD, OR 97477. PH:(54 1)726,3753 . FAX: (541)726-3689
SPRINGFIELD .
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City Job Number C/31iV\ Zcx::>7 -0 ( 7 'J b
Job Location \';r~<\ L S+Y"U.\- SfV'^'\=',P'\&
/')03, 2 bYL{ <....)
()'I{J.... C(1l.{1l
() i'3ao
Tax Lot:
Assessor's Iv1.ap:
Owner LO'l"\"Vv\\l'j CV'Id.. 'S\r,p'.\r, C~'p,/,
Address: \'l~q L S\-1'~t-+
City: S\~V'; "..!ri Q ,\rQ Stale: E)Q...
, U
Phone: lfttUSlo - So s 3.
Zip .SCll./,/_
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Preliminary Inspection for wood burning inserts is $61,50 (prior to insert),
Wood Stove/Pellet/Insert Permit is $71.50 (inc1ude.s~~pplicable fees and stu'charges).
-
~~ Contractor Information
COlllr.c!o; t'\\&o.. \t-J. <:.., - 71klt..,.1r1~{ \28~
Address / b 7 gJ &J 7+/;... Jtlf~
City: ~&E-"'t:- St.le: DCL
IN 9''Ib.
Construction Contractor's Registration #;
3(('] - //3/
Zip 'j 7ltD z..
Expires: /0 - Z 'I -0 ~
Phone:
.
.
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 thc Oregon Department of Environmental Quality or thc Federal
Environmental Protection Agency and I ~s.ree to.rrovide the teJilrt~aJ'cllr~O~1 number to the
inspector at the time of inspection,m~l\IuI,Qfl!Ht'!i~!Ill'\Tr",'5f~~'o~tit'f a preliminary
inspection, the wall covering ma)l~<?~~~~tP.cU1Y~1 rego tf rth
Notification Center. ftiose ru es are se 0
In OAR 952-001-0010 through OAR 952-001-
~ 0090. You may obtain copies of the rules by
, < calling the center. (Note: the telephon '
SlgllHture \( ~~~lll"..r for the Oregg" Utility NOlfIlcatio\ 'J.-l- 0-,
il7"Y;;0~",~-,0"-C~f~~~!-J~:~~.:.-~)~:~",u",,~,;'"'
i~~:rl.~:~~~:;a:<e:f~~r:::"~~:'~;'''!J~1t~r-!:i::i;;i'>f J$:"t~:t'l~ ~~)}T~I_ ~r!~ ~~~~\ .. ._t, :c.~.-::~::~:~.:f~( .-', / .::.)
Date of Application:
12--7-07
Checked for Delinquencies:
~
NOTICE:. - ' ' -', ".".,,",.. ,,',
THIS PERMIT SHAll EXPIRE IF THE WORl(
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMi:Nt;iLfU1\''lWMflBONEDnFO~d'"
ANY 1 80 DAY PERIOD.
I _____'
Checked for Historical Status:
_~Plll .N, 'tlI1i'1 ~"iiI, ','.. ,."',,,',
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01796
ISSUED: 12/0712007
APPLIED: 12/07/2007
EXPIRES: 06/07/2008
VALUE:
SITE ADDRESS: 1239 L ST
ASSESSOR'S PARCEL NO.: 1703264408300
Springfield TYPE OF WORK: Pellet Stove
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Pellet insert
Owner: LORI KELLEY
Address: 1239 L ST
SPRINGFIELD OR 97477
Contractor ,_"Il): License
THERMAL RESOURC~{~~r1tl)_ 161946
~~~~>~8RMATlONI ..
!~.r'! \ \. II Ili."-1.
"'0 '&$ '() .0.0 ~u"
1):111;~ Ji,6~~l}tel,' ~(/ 6;<1""" Lot Size:
~6Jfetg~(lti}~;90VlJ1flo861 tl}e ~f.lq61 Sq Ft 1st Floor:
::ffl;;;;.!/ll;JoJ;:~(% tl}l'o~ 'VIe '/'611)0'8 YOf.l Sq Ft 2nd Floor:
~J(fiJ.G. (~/k)/Jlll}o'8l1l'(18.'I) lItt./~q Ft Basement:
Rang;,t.sr1~o" ate.. 11,'8 0, ~-9 ~ et~ ~q Ft Garage/Carport
Energy P~ 0~. (1 tel, 6l1'f.lt-oo"/1J Sq Ft Other:
Sprinkled Bui~1Y "'0,,~/J1}8:e..r 6,.' Occupant Load:
\7..,. 7R., \')_ T
" ""'....f
I DEVELOPMENT INFORMA'f10N"f
Contractor Type
Mechanical
# of Units:
Primary Occnpancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Pbone Number: 541-520-5053
I CONTRACTOR INFORMATION'
Expiration Date
10/29/2008
Phone
541-343-1131
R-3
VB
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
M
~ 0"".
4u78 ~LtiLIC IMPROVEMENTS'
Co liOt> foil"
-4 'Ii4/t..1E,'iI<EO {j,u'/i4ll Sidewalk Type:
Ny lOa /veEo a '/VOEIl f:PIIlE Downspouts/Drains:
041' 'illS HIS If: rf/,
PEIlloo. 484A10;~Il/t..1lr ~ WOIl/(
'Eo POR AlOr
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Value
Date Calculated
Paeelof2
lii.=~
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01796
ISSUED: 12/0712007
APPLIED: 12/07/2007
EXPIRES: 06/07/2008
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
-Mechanicallssnance Fee-
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Minimum/Adjustment Mechanical
Pellet StovefInsert
Amount Paid
Date Paid
Receipt Number
$20.00
$5.00
$2.50
$4.00
$17.00
$33.00
12/7/07
12/7/07
12/7/07
12/7/07
12/7/07
12/7/07
2200700000000001799
2200700000000001799
2200700000000001799
2200700000000001799
2200700000000001799"
2200700000000001799
Total Amount Paid
$81.50
, Plan Reviews ,
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.
I Reouired Tnsnf.ctio~s ,
Pellet Insert: 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 furtber certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I furtber agree to ensure that all required inspections are requested at tbe 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.
1(')
-~
\2. ,- 01
Ow;er or Contractors Sig~e
Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
~
Iii: .
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-0 1796
COM2007-0] 796
COM2007-0] 796
COM2007-0 1796
COM2007-0] 796
COM2007 -01796
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
2200700000000001799
Date: 12/07/2007
Description
Pellet Stove/Insert
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
LORI KELLEY
Item Total:
<';heck Number Authorization
Received By Batch Number Number How Received
djb 2212 In Person
Payment Total:
Page] of I
11 :44:48AM
Amount Due
33.00
17,00
20,00
2,50
4,00
5,00
$81.50
Amount Paid
$81.50
$81.50
]2/7/2007