HomeMy WebLinkAboutPermit Building 2003-7-9
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Status
Issued
*"
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00604
ISSUED: 07/09/2003
APPLIED: 07/09/2003
EXPIRES: 01109/2004
Y ALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4434 JESSICA ST
ASSESSOR'S PARCEL NO.: 1802052402100
Springfield
TYPE OF WORK: Single Family Residence
TYPE OF USE:
Repair
Residential
PROJECT DESCRIPTION: Replace gas furnace
Owner: MILLER DONNA J
Address: 4434 JESSICA ST SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Owner
Contractor
MILLER DONNA J
License
Expiration Date Phone
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:
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
, Sq Ft Other:
Impervious Surface Area:
SETBACKS
, DEVELOPMENT INFORMATION 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:
Sidewalk Type:
Storm Sewer Available: N01\CE: Downspouts~m~": THE WORK
Special Instr!,~,tl~!I:.1! IIUI\' VI uguII law re4uII "5 you tv 1H\S PERM\1 SHP,~~ V'HIS PERMI1 \S N01
Notes: follmJ rules adopted by the Oregon Utility p,mHORIZEO UNO<en OONED FOR
~o~f~~J~?;~ ~~~t;~..~~~~: r~~e;: ~~ens~e: ~o! r.OMMENCE~ ~R \~~Bfo.N
--, -, -- - -- .. .. ,-' -- - .:"-- -" ' - -; ..~ I\ir, ~tlU u".r H't,
0090. You rT,lay obt<lln copies IJy"'t'" "t'."" D 't' .
. a ua IOn escrm IOn I
calling the center. (Note: tk. ._._,..______
. numberforthe OreQqn Utilit}S'Pe;.'Sq<F'ton Squ~re Footage
Description Tvp~of Construc!lon>32 n ~ . "It' Ii B'd A Value Date Calculated
vv-lllt:"' 1,:- :~O\/~I~V .~or~mu Ip er or I mount
Total Value of Project
Paeelof2
..'
.
. Lll l' OF ~rK11~GFIELD
Building/Combination Permit
PERMIT NO: COM2003-00604
ISSUED: 07/09/2003
APPLIED: 07/09/2003
EXPIRES: 01109/2004
V ALirE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fp.p.s Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Furnace - up 10 100,000 blu
Minimuml Adjustment Mechanical
Amount Paid
Date Paid
Receipt Numher
$10,00
$4.50
$3,15
$12.00
$33,00
7/9/03
7/9/03
7/9/03
7/9/03
7/9/03
2200200000000001201
2200200000000001201
2200200000000001201
2200200000000001201
2200200000000001201
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 Rellll'I',~(1 Insnections .
11111..1111
1 Final Mechanical: When aU mechanical work is complete.
By signature, I state and agree, tbat I have carefully examined the completed application and do hereby certify that aU
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 aU 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,
yjA~~~~
Owner or Contractors Signature
?,/-YD3
Dale
Pal!e 2 00
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00604
COM2003-00604
COM2003-00604
COM2003-00604
COM2003-00604
Payments:
Type of Payment
Check
_~""'.'?."u!l '
Li4..,...'..'..'.........,
~-""""
Receipt #: 2200200000000001201
Description
Furnace - up to 100,000 btu
Minimumi Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
, + 10% Administrative Fee
Received By
dim
Check Number
Batcb Number Authorization Number
Paid By
ASSOCIATED HEATING
10500
City of Springfield Official Receipt
Development Services Department
Public Works Department \)
Date: 07/09/2003
11:18:1SAM
Item Total:
Amount Paid
12.00
33.00
10.00
3.15
4.50
$6Z,65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$6Z,65
JI
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