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Home My WebLink AboutPermit Building 2007-12-28 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO' COM2007-01872 ISSUED. 12/28/2007 APPLIED 12/18/2007 EXPIRES: 06/28/2008 VALUE $ 1,050.00 225 FIfth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 5150 FORSYTHIA DR ASSESSOR'S PARCEL NO 1802042101600 Sprmgfield TYPE OF WORK SlIIgle F,lmdy ReSidence TYPE OF USE AlterJtlOn ReSidentIal PROJECT DESCRIPTION Owner QUESADA JOE L & MARGARITA Addres; 5150 FORSYTHIA DR SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type MechJmcal Contractor OWNER License ExpIration Date Phone BUILDING INFORMATION I # of Umts PrImary Occupancy Group Secondary Occupancy Group PrImary ConstructIOn Type SecondJry ConstructIOn Type # of Bedrooms # of StorIes HeIght of Structure Type of Heat Watel Type Range Type Energy Path SprInkled Bu,ldmg Lot SIze Sq Ft I st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Carport Sq Ft Other OccupJnt Load n/a I DEVELOPMENT INFORMATION I Frontyard Setback SIde 1 Setback SIde 2 Setback RearyJrd SetbJck SolJI Setbacks OverlJY Dlst # Street Trees Rqd Paved DrIve Rqd % of Lot Coverage REQUIRED PARKING Total Handllapped Compad I PUBLIC IMPROVEMENTS I Street Improvements Sldew Jlk Type Storm Sewer A vadable SpeclOll nstructlon DownspoutslDralns DeSCriptIOn ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth !Jl:1.%I.&E ... - --- :)81 ee1~''-."''3hnARQ<;?-Il111. narr . IIIVI"\I~VUz. - THIS PERMIT SHALL EXPIR.lIVT.uClM()C;l( I 0090 You mayobtalO copies of the rules by tI I\, amllH'lORll!JescrwtlOn II the center (Note the telephone AUTHORIZED UNDER THIS Pl:hlVlI1 I" I~U I cam'~2r for the Or~gon Ulilily Notlflcalion COMM~~~Q&.lIitIlJi\ANDcJ!t.JIro ~l!Jllt Square Foot~ CenteVl8u'l-800-332-~ie4c.lculated ANY 180 DAY PERIOD. or multiplIer or BId Amount Notes Pa2e I 012 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO. COM2007-01872 ISSUED: 12/28/2007 APPLIED. 12/18/2007 EXPIRES' 06/28/2008 VALUE $ '1,050 00 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectlOn LIDe Total Value of Project Fees PaId I Fee DeSCrIptIOn -MechaDlcallssuJnce Fee- + 10% Admmlsll Jllve Fee + 5% Technology Fee + 8% State SurchJrge MIDlmum/AdJustment MechaDlcal Wood Stove/Insert Amount PaId Date Paid Receipt Number $20 00 $500 $250 $400 $17 00 $33 00 12118/07 12118/07 12118/07 12/18/07 12/18107 12/18/07 1200700000000001507 1200700000000001507 1200700000000001507 1200700000000001507 1200700000000001507 1200700000000001507 Total Amount Paid $8150 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. I RellUlred InsnectIons I Wood Stove After InstallatIOn By signature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby cerllf} that all IIltormdtJOIl hel eon IS tJ ue dud correct, and I further eel tlfy that ,my Jnd all WOI k performed shdll be done ID dccord.lDce With the OrdIDances of the CIty of SprIngfield and the Laws of the State of Oregon pertammg to the work deSCrIbed herem, and that NO OCCUPANCY wIll be mJde of any structure ,,,thout perml>slOn of the CommuDlty Services Dn ISlOn, BUlldIDg Safety I further certIfy thJt only contractors and employees who are ID comphance With ORS 701 005 WIll be used on thiS project I further agree to ensure that all requlI ed mspectlOns are requested at the proper lime, thJt each Jddress 's readable from the street, that th emIt rd 's I ated a ont of the property, and the approved set of plans w,lI remam 011 the site at all "mo'", , "m .." ]:I " ,;;;./i'q ~7 er or Contractor~ Date I / l/ Pa2e 2 of2 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone ~ CIty of Sprmgfield OfficIal Receipt Development ServIces Department PublIc Works Department Job/Journal Number COM2007-01872 COM2007-01872 COM2007 -01872 COM2007-0 1872 COM2007-01872 COM2007-01872 Payments Type of Payment Cash cRccuntl RECEIPT #. 1200700000000001507 Date 12/18/2007 Description Wood Stove/Insert Minimum/AdJustment Mechanical + 5% Technology Fee + 8% State Surcharge + ] 0% AdministratIve Fee -Mechanical Issuance Fee- PaId By RICHARD QUESADA Item TotJI Check Number AuthOrizatIOn Received By Batch Number Number How Received dim In Person Payment Total Page I of I 1 47 34PM Amount Due 3300 1700 250 400 500 2000 $8150 Amount Paid $81 50 $8150 12/18/2007 ~l ~l 0; '.'!'!'!!"l' I;?) dYj' . ~ ~ ." 'r-I~ '. Il ~\ ~j ~ ~~~ - (I I ~l ~l ~ ..'!'!'!!"l' c'; U; ~ t?"I, ~~ Citi1l ~l ,..:::) rr="1 ~J ~l ~ r:(llJ ~, ~j " ~ ~ e;>) 1;0 rtP)J ~ o o ~ ". ",'CIT"" olfsPiuNGEIE1;otORED'i:)N ':'"", ' :~; ~ ~_ _. __"' _0- .,_.;-_ _" . '- :..., SPRINGFIELD. 1-^1\-~ ~-" 225 FIFTH STREET. SPRINGFIELD, OR 974 77. PH (54 ])726-3753 . FA:'{ (54 ])726-3689 City Job Number Job LocatIOn c.7 - /~72- -S-/C;;/) ,~S"~T#/?f-. /9,0 ? CJ ~ 2-/ r dX Lot O/(;(1c"7 Assessor's Map Owner '-1fJ;arrl l2n!:e./!]ZL~;L ~-r-O J:;Y'<;: ~ -/i,J'k 0/. 9x/~./2" fd Stdte Zip ~S-~ -C}-;?2/ q 7 '(771' Addre>> Phone On~V1 City Prelntllnary Inspechon for wood burnmg mserts IS $61 50 (pnor to msert) Wood Stove/Pellet/Insert PermIt IS $81 50 (mcludes apphcable fees and surcharges) Contractor Information .IYM-- j ,Q\,( / A )Fr( .... Contractor Address City ConstructIon Contractor's RegIstratIon # Phone ~t"te Zip fxplre~ By slgnlllg thiS pernllt/apphcalIon, I agree to call fOI an lIlspectlOn(s) as requned (726-3769) I state that aIllllfotmalIon on thiS applIcalton/pelmltls COllect and that I was provided with the Wood Stove Safety lIlfotmalton for wood bUlnlllg applIances and ptelImlllaty lIlspectlOn standards as set by the Olegon Department of Envnonmental QualIty ot the Fedelal EnVironmental PlOteclIon Agency and I agtee to plOvlde the testlllg applOval numbel to the lIlspector at the lIme of lIlspeclIon 1 also undelstdnd that If I am lequestlllg a plelImlllary lIlspeclIon, the wall coverIng may be lequlled to be removed Signature Date I ~7 f FOR OffiCE USE ----I , Date of Apphcalion /2-// g, /a ? I Chec~ed for Delmquencles Checked for I hstonca! Status Shared Dnve(T )/Bmldlllg formslWood Sto~e Penml II 07 doc