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Home My WebLink AboutPermit Mechanical 2004-5-21 '. . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00608 ISSUED: OS/21/2004 APPLIED: OS/21/2004 EXPIRES: 11/21/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4364 DAISY ST ASSESSOR'S PARCEL NO.: 1702323404319 Springfield TYPE OF WORK: Wood Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Install wood burning insert Owner: WALKER TIMOTHY J & NANETTE R Address: 4364 DAISY ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION' Contractor Type Mechanical Contractor CHRIS B WINSLOW License 52381 Expiration Date 01/10/2005 Phone 541-895-3593 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type R-3 - VN Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: # of Bedrooms: REQUIRED PARKING Total: Handicapped: Compact: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Description Type of Construction I PUBLIC IMPROVEMENTS I Q1ICE: l ffJ'\\'.i.SjfI~ ~ \S ~t.RWl\1 S\\~~R 1\\\S -~Pf6wnrains: ' ~~n-\QR\1.t.O U~~ \S F\B~~OOtl~\) CQWiWlE~COt.~ i>>t.R\OO. hto..\'l '~\I I Valuation Description I $ Per Sq Ft Square Footage or multiplier or Bid Amount Value Date Calculated Street Improvements: Storm Sewer Available: Special Instruction: Notes: Total Value of Project Pa2e 1 of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00608 ISSUED: OS/21/2004 APPLIED: OS/21/2004 EXPIRES: 11/21/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I F~es Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Minimum/Adjustment Mechanical Wood Stove/Insert Amount Paid Date Paid $10.00 $4.50 $3.15 $15.00 $30.00 5/21/04 5/21/04 5/21/04 5/21/04 5/21/04 Receipt Number 1200400000000000777 1200400000000000777 1200400000000000777 1200400000000000777 1200400000000000777 Total Amount Paid $62.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.Q1. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Re{\uired Insnections . , 1 Wood Burning 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 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. ~~,----,---=- . ~ 7,/2; / c:; t-f Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541~726-3759 Phone . VAINGEIa:D" 1 ,ty of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 1200400000000000777 Date: OS/21/2004 11:05:19AM Job/Journal Number COM2004-00608 COM2004-00608 COM2004-00608 COM2004-00608 COM2004-00608 Description + 7% State Surcharge + 10% Administrative Fee Wood StovelInsert Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Payments: Type of Payment Check Paid By YE OLD TOWN SWEEP Received By djb Item Total: Check Number Authorization Batch Number Number How Received Amount Due 3.15 4.50 30.00 15.00 10.00 $62.65 Amount Paid 15919 In Person Payment Total: $62.65 $62.65 5/21/2004 Page 1 of 1