HomeMy WebLinkAboutPermit Mechanical 2004-1-20
.' CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00079
ISSUED: 01/20/2004
APPLIED: 01/20/2004
EXPIRES: 07/20/2004
VALUE:
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2161 DEBRA DR
ASSESSOR'S PARCEL NO.: 1703261101500
Springfield TYPE OF WORK: Wood Stove
TYPE OF USE:
PROJECT DESCRIPTION: Install wood insert
Owner: DOLORES FORD
Address: 2161 DEBRA DR SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
MARSHALLS INC
License
25790
'. BUILDING INFORMATION I
"
# of Units: # of Stories:
Primary Occupancy Group: R-3 Height Q(lit~re
Secondary Occupancy Gronp: la'll r\l"t'JiI\r~e'&nIiW
Primary Construction Type :TIO\'l:IDNlQOf\ \tl~t~e: \~.t\
Secondary Construct\Oil'~: S adopted bY e ~1\!Ill~ ..00'
# of Bedrooms: tollO'll r~la caoler. itlos ~~\Pml~.& \:
,,0\i\ica\IO~-oo~_OO~OU\fODie8 01 the fUMe
' ~:;:Uma~;ir~~~;li~~:~TION I
SETBACKS calling t\"le Qf&gQ\l l!! \ ;'344).
tof t\"le 00-332-"
Frontyard Sethack: f\Utllber r"n'''' Ie: 1-8 Overlay Dist:
Side I Setback: ' # Street Trees Rqd:
Side 2 Setback: Paved Drive Rqd:
Rearyard Setback:
Solar Setbacks:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS'
NOTICE: .
THIS PERMIT SHAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD,
New
Residential
Phone Number: 541-747-0981
Expiration Date
12/23/2005
Phone
541-747-7445
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
Notes:
I Valuation Descriotion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Total Value of Project
Pal!elof2
Value
Date Calculated
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00079
ISSUED: 01120/2004
APPLIED: 01120/2004
EXPIRES: 07/20/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
, Fees Paid J
Fee Description
-Mechanical Issuance Fee-
+ 10% Administ,ative Fee
+ 7% State Surcharge
Micimum/Adjustment Mechanical
Wood StovelInsert
Amount Paid
Date Paid
$10,00
$4.50
$3.15
$15.00
$30,00
1/20/04
1/20/04
1/20/04
1/20/04
1/20/04
Receipt Number
1200400000000000080
1200400000000000080
1200400000000000080
1200400000000000080
1200400000000000080
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.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I Reouired fir. srJl~etions ~
1IIIIIr..
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
'~;-~~JM;: # /- 20-(JY
o ner or Contractors Signature Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00079
COM2004-00079
COM2004-00079
COM2004-00079
COM2004-00079
Payments:
Type of Payment
Check
.f
~-,~,,''''''''~,-','~~'' '
C l,.,,~'? ~...
,
Receipt #: 1200400000000000080
,f
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Wood Stove/Inserl
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Check Number
Received By . Batch Number Authorization Number
Paid By
MARSHALLS INC
djb
City of Sprifigfield Official Receipt
Development Services Departmenv
Public Works Department
Date: 01/20/2004 2:00:38PM
Amount Paid
Item Total:
3.15
4.50
30,00
15,00
10.00
$62.65
How Received
Amount Paid
In Person
Payment Total:
$62,65
$62.65
.
.