HomeMy WebLinkAboutPermit Mechanical 2003-11-17
., CITY OF SPRIrlju)< IItLD
Building/Combination Permit
PERMIT NO: COM2003-01149
ISSUED: 11117/2003
APPLIED: 11/17/2003
EXPIRES: 05/17/2004
VALUE:
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1013 DARLENE AVE
ASSESSOR'S PARCEL NO.: 1703272203100
Springfield TYPE OF WORK: Heating System
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AnENi\ON:Oregcfn'E'~El:O.RMI!lNtjINFORMATlON .
SETBACKS '\lOW rules adopteu - e rules art:l ,,,,. ,-"
to .' center. ihOS .,.., ~R 052-00 .
Front yard Setback:lotiticatlOn 1-001 0 thrOU~@verlay }list:e", \
Side 1 Setback: 1 OAR 952-00. btaill Copil#!Sf:.'.ft Tf~JJs RHd:
Side 2 Sethack: 0090. You may 0 t r (NO\e:pavei1~1:iy~('Rh'a:
II' g the cell e . UI"'tv NO\I\1CatIOll
Rearyard Sethack: ca 111 tor the oregoll % .o~~?t Coverage:
Solar Sethacks: Ilumber 'S 1_800-332-;1. /-
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I PUBLIC IMPROVEMENTS I
nU/ll.t' .
THIS PER' SIdewalk Type:
AUTHORI MIT SHI1I..-&r6li~rYlr
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TYPE OF USE:
PROJECT DESCRIPTION: Install gas insert and piping
Owner: BARBARA SEGER
Address: 1013 DARLENE AVE SPRINGFIELD OR 97477
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I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
MARSHALLS INC
License
25790
BUILDING INFORMATION'
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
R-3
VN
"
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
1 Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
"
Total Value of Project
Paee 1 of2
New
Residential
Phone Number: 541-726-7046
Expiration Date
12/23/2003
Phone
541-747-7445
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
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. CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2003-01149
ISSUED: 11/17/2003
APPLIED: 11/17/2003
EXPIRES: 05/17/2004
VALUE:
Is5ued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I F....s Paid I
~
Fee Description
-Mechanical Issuance Fe.....
+ 10% Administrative Fee
+ 7% State Surcharge
Gas Fireplace
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Numher
$10.00
$4.50
$3,15
$15,00
$4.00
$26.00
11/17/03
11/17/03
11/17/03
11/17/03
11/17/03
11/17/03
1200200000000002478
1200200000000002478
1200200000000002478
1200200000000002478
1200200000000002478
1200200000000002478
Total Amount Paid
$62.65
Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Insnections I
I Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
2 Rough Mechanical: Prior to Cover
3 Final Mechanical: When all mechanical work is complete.
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.
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Owner or Contractors Signature
1\-\1~ DO
Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-01149
COM2003-01149
COM2003-01149
COM2003-01149
COM2003-01149
COM2003-01149
Payments:
Type of Payment
Check
.A
sr~''!J!I,!>.I;lf!LD'__' . . ,.,
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Receipt #: 1200200000000002478
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Gas Outlets 1-4
Gas Fireplace
-Mechanical Issuance Fee-
Minimum/Adjustment Mechanical
Paid By
MARS HALLS INC
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Departmen\
Date: 11/17/2003 2:01:5SPM
Amount Paid
.
Item Total:
3.15
4.50
4.00
15.00
10.00
26.00
$62.65
How Received
In Person
Payment Total:
Amount Paid
.
$62.65
$62.65
.