HomeMy WebLinkAboutPermit Mechanical 2000-9-5
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I Job# 00-01351-01 I
Page 1 of2
TRANS~:01-0003127
DATE:SEP 05 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 061
CITY OF SPRINGFIELD, OREGON
225 North Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01351-01
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 5790 Highbanks Rd Spr
Assessors Map#: 17023311
lot: Block: Addition:
Owner:
BLAKE HASTINGS
Address: 5790 Highbanks
Scope Of Work: Wood or Pellet Stove
new wood stove
Contractor Type
General Contr
Tax lot #: 00184
Subdivision:
Phone Number: 541-744-2816
City/State/Zip: SPRINGFIELD, OR 97478
New Value: $1
Contractor Registration # Expiration Date
Ye Old Town Sweep
81905 Davisson Rd, Creswell, OR 97426
Phone
541-485-4957
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. A~irJ.llp.ections requested before 7:00
a,m, will be made the same working day, inspections requestedlb'ffiJr:~dO;a,m, will be made the following
working day. THIS PERMIT SHALL EXPIRE IFTHEWORK
R . d I .t.~, 'or''7C'''IMm::I'lTI-II~PERMITISNOT
equlre nspec Ions "
M h . " 'U"''"'I' '. I'INCED OR IS ABANDONED FOR
ec anlca J IVIlV''t
ANY 180 DAY PERIOD.
Wood Stove
I
-After installation.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
iArea (Sq. Feet)
I Main: Accessory:
Fee
Minimum Mechanical Permit
# Of Stories: ;-\ rrENTIt!m\l9k(~naw requires you ~l,
Current Units: follow rule&~t:lptbeOregon Utility
Census Code: DoeSJI!Rll~I!ln Center. Those rules are set forti,
- AR952-G01-0010throUghOAR952-001-
Total: ~O$O. You may obtain copi9softhe rules by
_&11'-: .........n..u. /NntE!:thete~phone..
. nu....hA{rDLIneUIIl1'.l.l/tl~~:IG2.'!I::
Paid On 'r<ecl!le!K...,~ . _~l\l\!; . I. Fee Amount
I Mechanical' I
09/06/2000 ,3127 $.00
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Job# 00-01351-01
Paid On Receipt#
Mechanical
09/06/2000 3127
09/06/2000 3127
09/06/2000 3127
09/06/2000 3127
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Page 2 of2
Value/Quantity Fee Amount
Fee
Mechanical Administrative Fee
Woodstove
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
Grand Total
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.
.-?-",~ L2 ~'" -... 0/'-/00
h/~R-- ///~ -- _ - ::0. , LY
Signature Date
1
$.45
$15.00
$10.00
$1.05
$26.50
$26.50
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WOOD STOVEI1NSERT INSPECTION APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION - BUILDING SAFETY
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: 5 -, 9 a
1-li~h'ba\flKS k?~.
~t" \11\3 \:':YP \d-. I 0 Y<
Assessors Map #:
Tax Lot#:
Address:
(3\~ Ke. \-\o.o;-\-\ V\n s
---.l
S -, q 0 H-l~ '^ 1st"'., \<'5
.sp't\>'\ ~ \=" {, \ A
(.:( tI .
State: of<.
Phone#: 7 L/ 4 - 28 I G:,
Zip: q'( YIA
Owner:
City:
Value of Wood Stove/Pellet Stove/Insert:_ _C;. 000
(please circle appropriate appliance)
Preliminary Inspection is $15.00 (prior to installation of insert)
Wood StovelPelletllnsert Permit is $15.00 + 1.0';) state surcharge + $.45 Administrative Fee + $10.00
Issuance.
Type of Inspection Requested: Ne w l>.> oo"'S+O~e.. (jJ /..e- C(e>vc1C-e... c.\""^, ""-~ L ,""-.... S'ls't-e.v--. '
I ,
Contractor: YE OLD TOWN~WEEP ->'>!':r-..; <" \N 1~ ~\O\N J 6 '-"i "",^,...:rN51ellkv-
485-4957 942-3452 f"'-.-. '
Address: ~'905 DAVI!':~".. !'l:)-. Phone#: ---, 2(0 -/38 Z
vRESWEllOR' 97426
City: State: Zip:
Construction Contractors Registration#: 52 3B \ Expires: //10/2. = I
By signing this permit/application, I agree to call for an inspection(s) as required (726-3769). I state that
all information on this application/permit is correct and that I was provided with the Wood Stove Safety
information 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
approval "umber to the inspector at the time of inspection. I also understand that if I 8m requesting a
preliminary inspection, the wall covering may be required to be removed.
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Signature
9/' IDa
Date
FOR OFFICE USE
REQUIRED INSPECTlON(S): WOODSTOVElPELLETIINSERT
./ PRELIMINARY
Date of Application: 0 9 0 GOO
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Tolal Amount Collecled: 2[':> Receipt #:
Job#:
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Issued By: b ~
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