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Home My WebLink AboutPermit Mechanical 2004-1-28 -. . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00114 ISSUED: 01128/2004 APPLIED: 01128/2004 EXPIRES: 07/28/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5000 JASPER RD ASSESSOR'S PARCEL NO,: 1802051100900. Springfield , TYPE OF WORK: Pellet Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Install pellet stove Owner: JAMES HENDERSON Address: 5000 JASPER RD SPRINGFIELD OR 97478 Phone Number: 541-736-1532 Contractor Type Mechanical I CONTRACTOR INFORMATION I Contractor License EMERALD SWIMMING POOLS OF ORE IN 11294 BUILDING INFORMATION I Expiration Date 10/22/2005 Phone 541-688-1090 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: U to 1.I~,AA!\\\lIiU~S.Y~I1~rea: ............."nO Cl ___",nO _. I DEVELOPMENT INFORMtifto:N~,p\ed bY :';ules are set ~~ . lo\l6Je I:,. center, ,nos U9\18E@Jij)~IJ P~RKlNG '\'ca\,on O~O\\1fO tlhe rUles Overlay Dist:lo\' , p. 952-OP\-Q, , \n'co~ieS'f.o:~{~onone # Street Trees1Rqlf! '( u maY oo\a ~~o\e' tl'H'anihcll!l.P.ffi.)O , Paved Drive MdlO. .0 \\1e centef. n U\\I\qbfilF.~~I: ,.. calling \1 OfeOo 2344). % of Lot Coveral!e~ber lof \ e. e 1_BOO-3~2- \i'U ,...,..",.",'(1. # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: R-3 SETBACKS Frontyard Setback: , Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I NOllC~: Sidewalk TypeplRE IF THE WORK THIS PERM)b~~.w~~tRMIT IS NOT ~~~~~~CE~D U~R ~S ABANDONED FOR ANV 160 DAV PERIOD. Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pal!elof2 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00114 ISSUED: 01128/2004 APPLIED: 01128/2004 EXPIRES: 07/28/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line I Fee~ Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Minimum/Adjustment Mechanical Pellet StovelInsert Amount Paid Date Paid Receipt Number $10.00 $4.50 $3,15 $15,00 $30,00 1/28/04 1/28/04 1/28/04 1/28/04 1/28/04 1200400000000000122 1200400000000000122 1200400000000000122 1200400000000000122 1200400000000000122 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 rn~nection~ I 1 Freestanding Pellet Stove: 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 times during construction. ~~ c~ ( l)'~,j ('; 1../ I I c:.----- Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00114 COM2004-00114 COM2004-00114 COM2004-00114 COM2004-00114 Payments: Type of Payment Check ,f 'LP~~-~~,-, iE..-....................[. .'.. ._- ." I j: ,I -;"'_'~L ,_.f .......w.:..' -c.. Receipt #: 1200400000000000122 Description + 7% State Surcharge + 10% Administrative Fee Pellet Stove/Insert Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Received By djb <":heck Number Batch Number Authorization Number Paid By KEVIN REUTER 5260 City of Springfield Official Receipt Development Services Departmen(' Public Works Department Date: 0l/28/2004 1l:Ol:06AM Amount Paid Item Total: 3.15 4.50 30.00 15.00 10.00 $62.65 How Received In Person Payment Total: Amount Paid $62,65 $62.65 . .