HomeMy WebLinkAboutPermit Mechanical 2000-7-12
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I Job# 00-01085-01 I
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Page 1 of 2
TRANS#:01-0002543
DATE:JUL 12 2000
ANT RECD:2 $ 26.50
CHANGE:
CASHIER:061
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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
;;.
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Fee
State Surcharge For Mechanical Permit
Total Mechanical
Grand Total
Job# 00.Q1085.Q1
Paid On Receipt#
Mechanical
07/12/2000 2543
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Page 2 of 2
Value/Quantity
Fee Amount
$1.05
$26.50
$26,50
By signing this permiVapplication, I agree to call for an inspection(s) as required (726-3769). I state
that all information on this application is correct I further state that the appliance I am installing
meets smoke emission standards as set by the Oregon Department of Environmental Quality or the
Federal Environmental Protection Agency and I agree to provide the testing approval number to the
inspector at the time of inspection. I also understand that if I am requesting a preliminary inspection,
the wall covering may be required to be removed.
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7-/ 1.-c),)
Date
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StlOFIELD
WOOD STOVE/INSERT INSPECTION APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION. BUILDING SAFETY
225 Fifth Street
Springfield, Oregon 97477
Office: 726.3759
INSPECTION LINE: 726-3769
c,O -0108$"-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---
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(please circle appropriate appliance)
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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:
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