HomeMy WebLinkAboutPermit Building 2002-10-17
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.~CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2002-01223
ISSUED: 10/17/2002
APPLIED: 10/17/2002
EXPIRES: 04/17/2003
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1453 FAIRVIEW DR
ASSESSOR'S PARCEL NO.: 1703273200141
PROJECT DESCRIPTION: Pellet insert
Springfield TYPE OF WORK
TYPE OF USE: New
Owner: FIELDS LYNN S & TONI M
Address: 1453 FAlRVIEW DR SPRINGFIELD OR 97477
Contractor Type
Mechanical
Owner
I Contractor Information I
Contractor License EX~ltation Date
JAMES ALLEN MCGREW 11143 A\}\les 'I ~/2004
FIELDS LYNN S & TONI M t\\~'tlle r'\teQ,ofl _,,\\Q(\~
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I 8UILDlNl>IN~URMt'l.'rurlld6~1 e~\es Jl.~96" s'O'l
J {l,( ~es,].1 I ,\,,0'0 IJ9J" 0 \\\e ~\e
# of8.~~ ~cefl\e 0,\0\,,10 xe$O\k,~r:e ~
H~lRI.\\\lf3\i~C)'l..oO,\.lJ b\~fI CO~e..\"el:Rt.~\~loor:
1Ypel1~i>f.\} (f\~'l 0 ~el. ,~o u\\\i\'l t,2nd Floor:
Wa'iQ..~~'lI:O \"erjafl OleQ,ofl 3'?>'l.'~ t Basement:
Ran~l.\f~~~Q, \Ol\"e. ,\.eor:::r Sq Ft Garage/Carport
Energy ~\\\I,l'Del cefl\e\ \$ Sq Ft Other: '
1m pervious Surface
Phone
541-942-2941
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
P'rimary Construction Type
Secondary Construction
# of Bedrooms:
" _.~_.
SETBACKS
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
. ..\'~D.'t-
Overlay Dlst: \\'t. 'I' I:
# Street Trees \~'t. \~ ~,,\'\ \~ andicapped:
Paved Drive Rqd: \.. 't.i.'? ~ '?'t.~\~'S) ~l;)l(sompact:
% of Lot ~.ra~~ ~\\t>-\.) ~ '\\\~ 'i:Jl;)v.~
~~~ o't.~~~('\ 'Uv.~~c. ~'Ot>-~
IPUBLlC IMl\R,~~~'{Sr~~~\l;)\)'
\--oc,Q~~\;~ ~f.: Sidewalk Type:
~v."i '\ Downspouts/Drains
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
Description
I Valuation Description I
Tvpe of Construction $ Per Sq Ft Square Footage
Value
Date Calculated
Total Value of Project
1 of 2
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.
CITY OF SPRINGFIELD
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Building/Combination Permit
PERMIT NO: COM2002-01223
ISSUED: 10/17/2002
APPLIED: 10/17/2002
EXPIRES: 04/17/2003
VALUE:
Fee Description
+ 7% State Surchar~e
+ 8% Administrative Fee
-Mechanical Issuance Fe....
Minimum/Adiustment Mechanical
Pellet Stove/Insert
I Fees Paid I
Amount Paid Date
$3.15
$3.60
$10.00
$15.00
$30.00
10/17/2002
10/17/2002
10/17/2002
10/1712002
10/17/2002
Receipt N urn ber
1200200000000000089
1200200000000000089
1200200000000000089
1200200000000000089
1200200000000000089
Received By
dib
djb
djb
djb
djb
Total Amount
$61.75
Total Fees Paid Prior to 9/30/02
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. AIl inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I Required Inspections I
1 Pellet Insert: After installation
By signature, I state and agree, that I have carefuBy examined the completed application and do hereby certil)' that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division,
Building Safety. I further certil)' that only contractors and employees who are in compliance with ORS 701.005 wiD be
used on this project.
I further agree to ensure that~1I re uired inspections are requested at the proper time, that each address is readable from
the street, that the permit card' cated at the front of the property, and the appy:;ov s~t plans will remain on the site
at all times during construction. /1/_ /? ) //J /7 10 s-
f ~~/n~~~ ~ . ~
Owner or Contractors signajle' , Date
2 of 2
225 F1ITH STREb, . SPRINGfIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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~ Address /4.'13 '"tt/.;ta.~"u/u..uJ~. Phone' 73~-.s"'BB5
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< Cit:' ~.A'-lA'1JG/~ i~/.-.I State..#-' Zip q7~'?7
I' 'lou\~
Value of Wood Stove/Pellet Stove/Insert: /?Oc::J - r...~\~9~~'O~le appropriate appliance)
~ f Of' \~. 'O(~1:l \\0(\\\
~ 1,,~'.O(eg nb'4\"e \..c;9.(e:~".o()'\'
~ ~\::.\f';- e$ g.ou;.e ",OSI:) , <l ~ OJl<~:'- u\eS tl'i
..~ Preliminary Inspection is $45.00 (prioriii~)e:. Ge~e(' q\"(Ou~ ~ \"e ( ooe
~ Wood StovelPelletlInsert Permit is $61. ~~~~tt\~l~~~9.~l!fCharge & Admin Fee.)
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t Construction Contractors Registration #
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o Date of Applicatior
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CITY OF SPRINGFIELD, OREGON
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City Job Number CoVV1 'ZOo 'Z. - 01 ZZ-:s.
Job Location /7'53 /A/f -1a~ ;d,,,,,,,,J ZJ;I(.,
Assessors Map /703 z. 7:;' Z Tax Lot
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By signing this permit/application, I agree to call fO'{~~I~b)!i~~-3769)' I state that all
information on this application /permit is correct an~Q.1 ~ ' Jl the Wood Stove Safety
information for wood burning appliances and preIim~ ~ i~ ards as set by the Oregon Department
of Environmental Quality or the Federal Environmentpltft~ ion Agency and I agree to provide the testing
approval number t the inspector at the time of inspection. I also understand that if I am requesting a
preliminary ins fcti ,the wall covering may be required to be removed .
dit%.uJ
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Datg /p 17)o.!:-
SignaturP
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For Office Use
Checked for Historical Status
Shared Drive(T:)lBuilding FormslWood Stove Pcrmitl-02.doc