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HomeMy WebLinkAboutPermit Mechanical 2001-9-11 -.} ~. I Job# 01-00981-01 I .. Page 1 of 2 TRANS#: 01,-0006663 DATE:SEF' 11 2001 AMT REeD:l $ 61.75 CHANGE: CASHIER:061 .1 , r' '. ' CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00981-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 location Of Proposed Site: 5335 Daisy St 62 Spr Assessors Map#: 17023300 lot: Block: Addition: Tax lot #: 01300 Subdivision: Owner: Address: Barbara Koroush Phone Number: 541-747:'5656 City/State/Zip: Springfield, OR 97478 New Value: $0 5335 Daisy sp 62 Scope Of Work: Wood or Pellet Stove Install woodstove ,..IO<:(..'f' Office Use \x '\\-\<(;. ~~ ~Q'\ Quad Area: land Use: # Of)'BUilttings,:\CO CJ-.\ O' c.W'" 9... # Of Units: Zoning Code: c;(\(i"'~. ~,.l~'0occup'~acy Gr.o~u"""p: 1:l..\1R\ \ \Y 0'{ 0" n --:'(,\ .....,,\'(:~ Constr. Type: Bedrooms: \~v X\w.' \ ~ltIeat Source:' Water Heater: Range: -<,\\'0 \'~ \"'I~~ \J~ S\~. l~t;ge: \ '(\ . "o.:\t.- ~Q.. ~ , \\ '(\v X;.\.l '" ~, To request an inspection call the 24 hour recording at 726-3769. AIIfiD~R~cti~S"ie:(u~~ed before 7:00 a,m. will be made the same working day, inspections requested aftef.Jioo f\::.'J'~~ill be made the following working day. t>-\,\i Wood Stove I -After installation. Required Inspections Mechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D -Area (Sq. Feet) Main: Accessory: \0 '0\\ -:\~2f) 0~.\\\~....~ ov'., -\',\ "or. ,,,,}I\I ~, I ~\e~~ ~~/..i\' ro.r;}'\ # ^~ .,,.'" \. ,,\3 ,n#v "r.-~" 0,'\'\'\'" . ~ ~ c::J:Jr-- '0'1 ~.~3' '(:JC.....) :l d.) ~~ \)v<,~ ..;-:.\0\ ~ 6'j~)~:; ,,\',",OS ~~"\ 0 \'(\0 ~ o<{\e ~€ ~'V\9~.r~ef\\e",~.\(). '{{\\Cl '~\ef> c~ \o\Ov-r: ~~o'{\ # Of Stories: ~O\\O~ ,\o'{\H~ignt'(~e,~t)':')~o.,\'{\e ....\0\\\\0 \ .'\c'O' n.IJV ....'0\:0. .,,,-\"" .\",~ \'" '\ Current Units: "'\0\\" a ~()(Pr.op'osed .l!Inits;)\\\\' nn./},~n" \" 1'4'{' 't\'-' 'f!:.~;..-' ell' 1)0(,..;.1 Census Code: Does 'Qo?ap'ply")\} \'(\e oe O"eQl ~\y'!J'!)"'" ~r'\t!Ju ~X\'{\~ it '\.'(\e . '" '\#'21 o'(j, e'\ \0 r<!;~ '\.;) Total: '{\\}'{\\'O ce~ Fee Paid On Receipt# Mechanical 09/11/2001 6663 09/11/2001 6663 09/11/2001 6663 09/11/2001 6663 Value/Quantity Fee Amount Minimum Mechanical Permit Administrative Fee - Mechanical Wood stove Mechanical Issuance 999 $15.00 $3,60 $30.00 $10.00 -I l..)" . Job# 01-00981-01 Paid On Receipt# Mechanical 09/11/2001 6663 . Page 2 of 2 Value/Quantity Fee Amount Fee State Surcharge - Mechanical Total Mechanical Grand Total 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 is correct. I further state that the appliance I am installing meets smoke emission 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. fj~_ K~ q-/I-oj Signature . . Date $3.15 $61.75 $61.75