HomeMy WebLinkAboutPermit Mechanical 2003-10-31
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...
Status
Issued
'*
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-01107
ISSUED: 10/31/2003
APPLIED: 10/31/2003
EXPIRES: 04/30/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1401 LA WNRlDGE AVE
ASSESSOR'S PARCEL NO.: 1703252206000
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install flue liuer and insert
Owner: JOYCE KOSTEN BAUER
Address: 1401 LA WNRIDGE SPRINGFIELD OR 97477
Phone Number: 541-746-9068
I CONTRACTOR INFORMATION I
"
Contractor Type
Mechanical
Contractor
SEAN LEE BUNTIN
License
156852
Expiration Date
08/29/2005
Phone
541-736-1224
BUILDING INFORMATION I
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secoudary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat: '
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
R-3
'\
I DEVELOPMENT INFORMATION I
SETBACKS &. ~\)~'V'\
Froutyard Setback: ~ '\~ (\ \~Overlay Dist:
Side I Setback: 'X~Y.- Y.-~'*' ~'Ib\Street Trees Rqd:
Side 2 Setback: \.. Y.-~,,,\<o ~ ,,~Y.-\) Paved Drive Rqd:
,"~\; '\" ~\'V'V
Rearyard Setback:~, (\ <0" I::>Y.-~ ~~~ % of Lot Coverage:
Solar Setbaeks::\\IV <.~'*' C\ '0~ n. \<0 ~
....\\l O~ ""~v ('.'<" ('\~.
. '0YJ ~'0'- 'X.\) ~'("~
'\ ~\~ &.~\j ~ ~
~ .~~ ~ 'V
Street Improveme.e~: \'()
,"'~
Storm Sewer Available:
Special Instruction:
REQUIRED PARKING
Notes:
Total:
Handicapped:
'lo\:C~mpact:
\J\~eS \)\\\\\'1
>tl ~eO: Q,o'\l \\0(\
0'\1\'3' eO~e ~ese 00
__",0; ._" \~ ,nS '3' _ n~?: ,
I PUBLIC IMPROYEl\:'IENlil\>\e~~oSe ~~~ Or~~e ~\J\~~e
0..' . "\"- :l.e~' .re .~~o ~ '" 0 'e9~ . 0'\1
r >tl ~v Ce'\l O,,<>idewalkCTyp.e:,e'.. Ce.\\
\0\\0 .\0(\ "".0, \(\Vv, .'\.1,,, '0\\\'
. ,'re.' ..,O\', ....~, ._.e. m'~\
'0\\'\" 9~"" 'e.'l o"u~~spoe,~, ra,&!;\.
:\ O~~"-'O\J ~ ce'\l\e 'eQ,O(\ '\?J'2-.'2-?J
, 0' \~e O~ ().J
009 ~\\\(\Q, \O~ \~e . e., ".'0'"
c :oe~' ,p' ,.
,,\J~ \.""
I Valuation DescriDtion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
~,
Total Value of Project
Paee I of2
'i
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01107
ISSUED: 10/31/2003
APPLIED: 10131/2003
EXPIRES: 04/30/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I F....~ Paid'
"
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Miscellaneous Mechanical
Wood Stove
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$15.00
$30.00
10/31/03
10/31/03
10/31/03
10/31/03
10/31/03
1200200000000002403
1200200000000002403
1200200000000002403
1200200000000002403
1200200000000002403
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 ReouiredTnsnection'jJ
1 Wood Burning Insert: After installation.
2 Rough Mechanieal: Prior to Cover
3 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 the City of Springfield and the Laws of the State of Oregon pertaining to the work deseribed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 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.
---- ~
\0/>., / -zl7f.J~
Date
.,
Owner or Contractors Signature
Paee 2 of2
225 Fifth Street .,P
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-01107
COM2003-01107
COM2003-01107
COM2003-0 1107
COM2003-0 II 07
Payments:
Type of Payment
CreditCard
WiIt~~~,~',~ ". ..,i,,'
'. "~A!:: I
'!I!IlI" i
h~.." .".' _ .
Receipt #: 1200200000000002403
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Wood Stove
Miscellaneous Mechanical
-Mechanical Issuance Fee-
Paid By
SEAN BUNTIN
Received By
djb
Check Number
Batch Number Authorization Number
000209 348873
City of Springfield Official Receipt
Development Services Department
Public Works Departme~t
Date: 10/31/2003
2:29:35PM
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
$62.65
.
.
225 FIrrH STREET 0 SPRINGFIELD, OR 974 77 0 I'H:(541)726-g75:~ 0 fAX: (541 )726-%89
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OJ r~Jl Job Location
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~ Assessors Map
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.,
. . , CITY OF SPRINGFIELD, OREGON
City Job Number COWl Z-OO:S ~O 110 7
)t-lO I L;4/fJ!Ii (L.( de, p-
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170S Z$""Z- L
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Tax Lot
06000
00-re-tF
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l::'o s ~ ~ A lA.1=--iL
Phone
7l(b ~ 90(;g
77'(77
ILfOI lAvV""r~,L,w
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Sfl~0 -
AJE
State 0 fL
Zip
5oo~
(please circle appropriate appliance)
. Preliminary Inspection is $45.00 (priQr.!olnsert)
Wood Stove/Pelletllnsert Permit ~ncludes Permit, Issuance Fee, State Surcharge & Admin Fee.)
SL4A/' ~. t5WV,u...r
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Addres~ 5'2-6 5 -s~~~s _ c.. + Phon~ 73 b"" 12 Z. l(
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Cit" s? r.~ o,<() ~y'Y "tat~ 0 rL Zi'1 77Lf 7 g
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Construction coo~~ ~~~~ration iJ / S"b '6'!:Z "'"Ul~~"~~'\rZ-7 CJ ')
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B~~~~""'~'.!!("I'f'hcatlOn, I agree to call for an lI1spectlO~~,a!>,reqlilre#-'?!J?~7t~9). ~ state that all
infom~t(<$~<Olls~~lication Ipermit is correct and that I "i.aP.~Ij\>i(l~~~lhh~\w,.(~H~'~fP~e Safety
inform?'h~'b~r~d burning appliances and prelimina!'X.Jfsip&~oq(S1.~.d~~~!;~~~~bcl'~tli'e Oregon Department
of EnvlrohlU@tal Quahty or the Federal Envlronmenta~Protecl1Bn'A~nGy:al19..I'?~e~~9.\prOvlde the testmg
approval nu~ber to the inspector at the time of inspcl;)ig&~tfiGp.u~d~~d~th~~ff !<.Sm requesting a
Preliminary inspection, the wall covering may b~reqti~ed)iO b&'.,.'em'lWed.~"o<' n..~rv
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rhecked for Historical Status
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