HomeMy WebLinkAboutPermit Mechanical 2005-10-27
..
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
~
'f
. Ll1}' OF SPRINGFu'LU
Building/Combination Permit
PERMIT NO: COM2005-01529
ISSUED: 10/27/2005
APPLIED: 10/27/2005
EXPIRES: 04/27/2006
VALUE:
Status
Issued
SITE ADDRESS: 2370 LOCH DR
ASSESSOR'S PARCEL NO.: 1703251101100
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
PROJECT DESCRIPTION: InstaU propane fireplace, venting and piping
Residential
Owner:
Address:
JUNE ROBERTS
2370 LOCH DR
SPRINGFIELD OR 97477
Phone Number: 541-746-7911
'"
Contractor Type
Mechanical
-..oS ~u"':'\""'~
I CONTRACTOR IJSF0RMAT<I0N..\\'(\
olegO'" 'I \'(\e v'c ~Ie "~~.I)()\'
Contractor ~\O~" AO\J\erJ. '0 se \u\eLic.eiise' s I;;Expiration Date
THERMAL RE~(lfUf{~l'l$J'INC~"'I. \'(\~_d'Ug'(\ 1~~~6(u\~"e 10/2912006
'O\VI:~Bmi;DiNG'INFORMATION' e,,;'c. 'iJ.\\o(l
~IO~':' 0\\'\
I~ "'~ ."J- 'iJ.'l u~. ~U'- .~\\'l"
\(lONI) ifl>'.lf'Storie1:e\. e,,00 \.\~" .23/),/),')' Lot Size:
()~. ,""~ ("II"" ?>-,,,
R-3 I) ai\\!i~i.gft(oJ,Stl'~~!~J:€l- ,Sq Ft 1st Floor:
C _Ty.pe c;lf.H,\'-lit: Sq Ft 2nd Floor:
\),(\\"'~ rel\\.
(I Watet Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: nla Occupant Load:
Phone
S41-343-1131
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Conslruction Type:
# of Bedrooms:
VN
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Scthack:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handi~~rped:
co~~
' "\~\. ~'\:)"\
.o.t ~ ,,~'\ ~Q,.
I PUBLIC tMPROVEMENTS I *,,,\"\. ~~,~ ~~~\)'
"-\~'(,. ~~ ~~~~~~:
~\\' ~~~ c.'i)W-':::~\l5
~,~ ~1.'\. ~~ rains:
'\: ~~'\~~~~c.~ ~ ~ _
c.'\:)~ \~~ \}
~~
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
, Storm Sewer Available:
Special Inslruction:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa~e I of2
:,
"
i.l
.
. CITY VI' ~rKll'1u1<lELD
Building/Combination Permit
PERMIT NO: COM2005-01529
ISSUED: 10/27/2005
APPLIED: 10/27/2005
EXPIRES: 04/27/2006
VALUE:
"
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
, Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Appliance Vent
Gas Fireplace
LP Gas Tank & Piping
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$6.00
$15.00
$12.00
$12.00
10127/05
10/27/05
10/27/05
10127/05
10/27/05
10/27/05
10/27/05
Receipt Number
2200500000000001510
2200500000000001510
2200500000000001510
2200500000000001510
2200500000000001510
2200500000000001510
2200500000000001510
Total Amount Paid
$62.65
I Plan Reviews I
To Request an inspection caIl the 24 hour recording at 726-3769. AIl 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 foIlowing work
day.
Renuired I~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signatnre, 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
tbat NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety,
I further cerlify 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 Ihe permit card is located at the front of the property, and the approved set of plans will remain on tbe site at all
times during construction.
~~
o
w!?--zjOJ
Owner or Conlrnctors Signatt1e
Date
Paee 2 of2
-IT--
"
.'
225 Fifth Street
Spdngfield, Oregon 97477
541-726-3759 Phone
-.
8r~..'!......'?,...,~;.. -, .
~.
IIIIILti. :
.JIi.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
RECEIPT #:
2200500000000001510
Date: 10/27/2005
2:26:02PM
R
.~ Job/Journal Number
;, COM2005-0 1529
COM2005-0 1529
COM2005-0 1529
'" COM2005-01529
,\
{;COM2005-01529
'a.
"COM2005-01529
t COM2005-0 1529
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Appliance Vent
Gas Fireplace
LP Gas Tank & Piping
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Payments:
,
Type of Payment Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
3.15
4.50
6.00
15.00
12.00
12,00
10,00
$62.65
Amount' Paid
Check
MIDGLEYS
djb
2194
In Person
Payment Total:
$62,65
$62.65
.'
:-: l
~
,
"
,
,':.'.
..I :,
,~ t
.
';
,.
,.!
.,
~ \ t
" it
"
.,
r. .
'-3';.
- ,
,
...
'J
"
"
t'..
:(
10/27/2005
Page I of I