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HomeMy WebLinkAboutPermit Mechanical 2000-7-12 ;::.. ," . I Job# 00-01085-01 I . Page 1 of 2 TRANS#:01-0002543 DATE:JUL 12 2000 ANT RECD:2 $ 26.50 CHANGE: CASHIER:061 BPRINQPlBLD ~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-01085-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 5300 Leota St Spr Assessors Map#: 17023331 Lot: Block: Addition: Tax Lot #: 05300 Subdivision: Owner: John Coghill 5300 Leota St Phone Number: 541-741-8090 City/State/Zip: Springfield, OR 97478 New Value: $1 Address: Scope Of Work: Wood or Pellet Stove install used pellet stove Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq, Footage: To request an inspection call the 24 hour recording at 726-3769. All inspections 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 working day. Pellet Insert I -After installation. Required Inspections Mechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D IAr~a (Sq. r.-1) I Main: ,. Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: , Total: Fee Paid On Receipt# I Mechanical 07/12/2000 2543 07/12/2000 2543 07/12/2000 2543 07/12/2000 2543 Value/Quantity Fee Amount Minimum Mechanical Permit Mechanical Administrative Fee Pellet Insert Mechanical Issuance 1 $.00 $.45 $15.00 $10.00 ;;. . Fee State Surcharge For Mechanical Permit Total Mechanical Grand Total Job# 00.Q1085.Q1 Paid On Receipt# Mechanical 07/12/2000 2543 . Page 2 of 2 Value/Quantity Fee Amount $1.05 $26.50 $26,50 By signing this permiVapplication, I agree to call for an inspection(s) as required (726-3769). I state that all information on this application is correct I further state that the appliance I am installing meets smoke emission standards as set by the Oregon Department of Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing approval number to the inspector at the time of inspection. I also understand that if I am requesting a preliminary inspection, the wall covering may be required to be removed. ~l 10..\\) ..0. 0 1.. ~.( rr()\.l-l ~ ~natu~ 7-/ 1.-c),) Date ~ . . StlOFIELD WOOD STOVE/INSERT INSPECTION APPLICATION CITY OF SPRINGFIELD COMMUNITY SERVICES DIVISION. BUILDING SAFETY 225 Fifth Street Springfield, Oregon 97477 Office: 726.3759 INSPECTION LINE: 726-3769 c,O -0108$"-0\ Job Location: 53Cf:.) (Q~ Assessors Map #: 1'/ 0 '2 'S ~ ~ I Owner: ~O~"" ~ \rY\\jf'k ~ f JC'f;j""-\ ~ \. Address: S '2>00 Le.. m 0.... si), City: :::Y;)('\ N,f;:'\P \d. State: CJKeG::DN I \. J <Xl. Value of Wood Stove7 ,ruet Stov~ert: /~O~ Tax Lot#: OS3cr-0 Phone#: 7<-1/- [)090 Zip: Cf7 "-tl P--- '" (please circle appropriate appliance) '-- . , Preliminary Inspection is $15.00 (prior to installation of iusert) Wood Stove/Pelletllnsert Penn it is $15,00 + 1.0';) state surcharge + $.45 Administrative Fee + $10.00 Issuance. Type of Inspection Requested: Contractor: IlL! F Pbone#: Address: City: State: Zip: Construction Contractors Registration#: Expires: By signing this pennit/application, I agree to call for an inspection(s) as required (726-3769). I state that all infonnation on this applicationlpennit is correct and that I was provided with the Wood Stove Safety infonnation for wood burning appliances and preliminary inspection standards, I further state that the appliance" am installing meets smoke emission standards as set by the Oregon Department of Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing approvall\umbcr to the inspector at the time of inspection. I also understand that if I am requesting a 11~m:~Q:: ~~ ~all?::~C; 1 JUired to be removed. 7-( 2-00 ~~ 0 ' Date FOR OFFICE USE REQUIRED INSPECTION(S): WOODSTOVElPELLET/INSERT PRELIMINARY Date of Application: D -f. ~u Job #: 00 ~C> 10 8 5 ~ 0 r Total Amount Collected:_Z6 0..-- _Receipt #: ;:: 5 <-( ~ Issued By: ~ Checked for Deliuquencies: Cbecked for Historical Status: :D ~o;;;:J :D:D :::0 -i Z /Tl /Tl CD C"J..# C"J C~.. :D .. C::O t.(' !'oJ...... ::I: I ~("')t4"""'0 rr1 ::c I"..J 0 AlDN 0 .. ZO'!'oJ!'oJ Qen_ OtJ1 Cl'mc..no~ .........OOt.,...,l