HomeMy WebLinkAboutPermit Mechanical 2003-6-16
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 553 EDGEMONT WAY
ASSESSOR'S PARCEL NO.: 1703341300500
.' CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00503
ISSUED: 06/16/2003
APPLIED: 06/16/2003
EXPIRES: 12/16/2003
VALUE:
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install gas stove and gas piping
Owner: BROWN SUZANNE
Address: 553 EDGEMONT WAY SPRINGFIELD OR 97477
Contractor Type
Mechanical
Owner
Contractor
MIDGLEY'S
BROWN SUZANNE
# of Buildings:
Primary Occupancy Group: R-3
Secondary Occupancy Group:
Primary Construction Type VN
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Tvpe of Construction
I CONTRACTOR INFORMATION I
~s ,/oU to
e License,QUlrExpiration Date
^..-rEN \ 101'1:\)1 goi936,$le oregU\ I ilizo/2003
,,' , dDpteu -, are 5""
.~lInW rules a .__ 'ThOSe rule: "~oc;?-OO'
BUlIlDlNG 'n;Ji?ORMA:,l1I@N'1 O~91~~; t\1e rules p.
in u"" :- - ay obta\l' ",DPI~ \1e telep\10~e
#,;oJ:Stories':'.~~ center. ~Note. \ Nb!!t,Siie:Jn
Height 'of Slrudur't, Oregon UtIlI\)' 3ASq Ft 1st Floor:
TYP'~.!'f'Heat\on[\;iS 1_BOO-332-2 S'.i'Ft 2nd Floor:
Water Type~e!lte Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Impervious Surface Area:
Phone
343-1131
I DEVELOPMENT INFORMATION ,
REQUIRED PARKING
Overlay Dist: Total:
# Street Tre.MR;rJ:CE: SHfl.LL EXPIRE IF IJIt\iiIWlP~~:
Paved Drive ~16 PERMIT R THIS PERf:illlpji!qooT
^";r,~ORIZEO UNOE R
% of Lot cOCO~MENCEO OR IS fl.BANOONEO FO
...v illn nAY PERIOO.
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
DownspoutslDrains:
I Valuation Descriotion I
$ Per Sq Ft
Square Footaee
Value
Date Calculated
Paee I of2
.'
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Appliance Vent
Gas Fireplace
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Total Amount Paid
.
. CITY 01' ~ndNGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00503
ISSUED: 06/16/2003
APPLIED: 06/16/2003
EXPIRES: 12/16/2003
VALUE:
Total Value of Project
Fp.p.s Paid I
Amount Paid
Date Paid
Receipt Number
2200200000000001065
2200200000000001065
2200200000000001065
2200200000000001065
2200200000000001065
2200200000000001065
2200200000000001065
$10.00
$4.50
$3.15
$6.00
$15.00
$4.00
$20.00
6/16/03
6/16/03
6/16/03
6/16/03
6/16/03
6/16/03
6/16/03
$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 Rp'l1uirp.d Tmnectinns I
1 Rough Mechanical: Prior to Cover
2 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.
3 Final Mechanical: When all mechanical work is complete.
By signature, 1 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.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 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
".:;;;;:;ru:'.~ ~ (oj; (,10 ~
Owner or Contractors Signature Date
Pal!e 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00503
COM2003-00503
COM2003-00503
COM2003-00503
COM2003-00503
COM2003-00503
COM2003-00503
Payments:
Type of Payment
Check
6/16/2003
PaidDy
MIDGLEYS
1O:20:40AM
,
City of Springfield'
Development Services Department,
Public Works Department'
Official Receipt
Receipt #: 2200200000000001065
Description
Appliance Vent
Gas Outlets 1-4
Gas Fireplace
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
djb
Date: 06/16/2003
Amount Paid
Item Total:
6,00
4.00
15,00
20.00
10.00
3.15
4.50
$62.65
.
Check Number Conlirm No
How Received
In Person
Payment Total:
Amount Paid
62.65
$62.65
.
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cReceipt.rpt