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Home My WebLink AboutPermit Building 2003-6-19 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00534 ISSUED: 06/19/2003 APPLIED: 06/19/2003 EXPIRES: 12/19/2003 VALUE: Status Issued 225 Firth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 718 EDGE MONT WAY ASSESSOR'S PARCEL NO.: 1703341305800 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: AUeralion Residential PROJECT DESCRIPTION: install gas w/h and fireplace insert Owner: KEMP JOHN G Address: 718EDGEMONTWAY SPRINGFIELD OR 97477 I CONTRACTOR.lNFORMATION I Contractor Type Mechanical Owner Contractor MARSHALLS INC KEMP JOHN G License 25790 Expiration Date 12123/2003 Phone 541-747-7445 BUILDING INFORMATION I # 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: Gas Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: SETBACKS I DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk Type: Storm Sewer Available: Special Inslruction: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK ., ,~, 'fV..'~rn ,""'CD TUIC: D~rlM1T I~ NOr nv . , ."", ..--- - --- COMMENCED OR IS ABMILV'~t.~ti~ri'DescriDtion , ANY 180 DAY PERIOD. Description Tvpe of Conslruction $ Per Sq Ft Downspouts/Drains: An t.l'lll hJI'Il,ulUyulI.aw ,tlqUIIU.o ~ lJl), " follow rules adopted by the Oregoll Uti I , Notification Center. Those rules ate ~~t h; ;n OAR 952-001-001 0 through OA.=1 (b~-O. 0090. You may obtHln COP"-"j UI III''; ""~.. calling the center. (Note: the teI3,~llo~e number for t:le Oregon Utility i'Jotillc:atlo ' , 1 ann "lM) "n.l~\ Square Footaee CVahj"l~ -'" 'Date Calculated Notes: Paee I of2 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspeetion Line Total Value of Project I Fees Pair! I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Appliance Vent Gas Fireplace Minimum/Adjustment Mechanical Amount Paid Date Paid $10.00 $4.50 $3.15 $6.00 $15.00 $24.00 6/19/03 6/19/03 6/19/03 6/19/03 6/19/03 6/19/03 Total Amount Paid $62,65 I Plan Reviews I . CITY OF SPRINGFIELD C Building/Combination Permit PERMIT NO: COM2003-00534 ISSUED: 06/19/2003 APPLIED: 06/19/2003 EXPIRES: 12/19/2003 VALUE: Receipt Number 1200200000000001590 1200200000000001590 1200200000000001590 1200200000000001590 1200200000000001590 1200200000000001590 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. IRel1lJirer!~ 1 Rough Mechanical: Prior to Cover 2 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 Ihe City of Springfield and the Laws ofthe State of Oregon pertaining to the work descrihed 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 readahle from the slreet, 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. ~~~ K//(~ Owner or Contractors Signature Paee 2 of2 Date ~7ft3- 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00534 COM2003-00534 COM2003-00534 COM2003-00534 COM2003-00534 COM2003-00534 Payments: Type of Payment Check ~""'IELD if".!.'..'"'-',"",=,~,.... "".',0"'_ : ! .. """A!.r' i ~j'-_< 1 ~ . .. .~ 'l>>""",,-' ~. Receipt #: 1200200000000001590 Description Appliance Vent Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Gas Fireplace + 7% State Surcharge + 10% Administrative Fee Received By dim Check Number Batch Number Authorization Number Paid By MARSHALLS INC 17319 City of Springfield Official Receipt Development Services Departm~) Public Works Departmen! Date: 06/19/2003 11:40:11AM' Amount Paid Item Total: 6,00 24.00 10.00 15.00 3.15 4.50 $62.65 How Received In Person Payment Total: . Amount Paid $62.65 $62.65 .