HomeMy WebLinkAboutPermit Mechanical 2004-11-23
.
. CITY OF ~nuriGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01443
ISSUED: 11/23/2004
APPLIED: 11/23/2004
EXPIRES: OS/23/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1452 FAIRVIEW DR
ASSESSOR'S PARCEL NO.: 1703273200165
Springfield TYPE OF WORK: Wood Stove
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install woodburning insert
Owner: ADAMS BONITA T
Address: 1452 FAIRVIEW DR SPRINGFIELD OR 97477
S~I.1'Uo.DCo'R
~
Contractor Type
Mechanical
I CONTRACTOR INFORMATION I
Contractor ATTEN110N: ;~~onsb~w rE!flU~iri~~UJ~ate
follow rules ad ~~ Dy the Or 0 m
CHRIS B WINSLOW "~''''~''''~~ ,.~_ _~ "M~ ...I~~ ~ ~/J M ~
I BUlLDlMJINF9KMlWllIIN, through OAR 952,001.
1.11111 .
0090. VOU may obtam copies of the rules by
# of SlUing the center. (Note: the I<lItJ~~l1e
Heigb~!lf~e Oregon Utility (lj9tll~iJlIpor:
Type of Heat: Center Is 1-800-332'23~1l)ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Patb: Sq Ft Other:
Sprinkled Building: nla Occupant Load:
Phone
541-895-3593
# ofUnils:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VN
I DE"r.LunvIEN. mruRMATION I
Frontyard Setback:
Side 1 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:
Storm Sewer Available:
Special Instruction:
Description
Type of Construction
Sidewalk Type:
Downspouts/Dra~y.'t. \}lO~~
't.'/..?\?'t. \ \'11\\ \'0 ~
~O\\C\\'1I\\ S\-\fI.\.~?. \\-\\'0 ?~~'t.\) to?"
\\-\\~.:';"'\lr..D _\l~~ IS fI.'OfI.~D
;" ... , ~\Jt.v - \C)\J.
I Valuation Descrintioh~\t~(') DfI.'i ?r..\\
1'-\""
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Value
Date Calculated
Notes:
Total Value of Project
Page 1 on
.
. Ll1:f VI' ~rtuNGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01443
ISSUED: 11123/2004
APPLIED: 11/23/2004
EXPIRES: OS/23/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fees Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Minimum/Adjustment Mechanical
Wood StovelInsert
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$15.00
$30.00
11/23/04
11/23/04
11/23/04
11/23/04
11/23/04
Receipt Number
1200400000000001650
1200400000000001650
1200400000000001650
1200400000000001650
1200400000000001650
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 Insnections I
Wood Burning Insert: After Installation.
By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all
Information hereon Is true and correct, and 1 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 bereln, 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 eacb address Is readable from the
street, tbat the permit card Is located at the front of the property, and tbe approved set of plans will remain on the site at all
times during construction.
f~ ~ ::>
///2 '3/oL(
I
Owner or Contractors Signature
Date
Pal!e 2 of2
225 Fifth Street
Springfield;Oregon 97477
541-726-3759 Phone
J'
.
Job/Journal Nnmber
COM2004-01443
COM2004-01443
COM2004-01443
COM2004,01443
COM2004-01443
Payments:
Type of Payment
Check
11/23/2004
RECEIPT #:
"p.~'_'I'1"'" , ,_, .;,
1Iit:' ,
, >
,,-
JilY of Springfield Official Receipt
Wvelopment Services Department
Public Works Department
1200400000000001650
Date: 11/23/2004
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Wood StovelInser!
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
YE OLD TOWN SWEEP
Item Total:
Check Number Authorization
Received By Batcb Number Number How Received
djb 16395 In Person
Payment Total:
Page I of I
2:0l:35PM
Amount Due
3,15
4.50
30.00,
15.00
10.00
$62.65
Amount Paid
$62,65
$62.65