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Home My WebLink AboutPermit Mechanical 2003-7-18 .. . CITY OF ~rK11~ld<mLD Building/Combination Permit PERMIT NO: COM2003-00638 ISSUED: 07/18/2003 APPLIED: 07/18/2003 EXPIRES: 01/18/2004 VALUE: I . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4548 GLACIER DR ASSESSOR'S PARCEL NO.: 1802051204000 Springfield TYPE OF WORK: Heating System TYPE OF USE: Addition PROJECT DESCRIPTION: Gas piping to fireplace insert and dryer and installation of gas insert. Residential Owner: TOBY MOORE Address: 4548 GLACIER STREET SPRINGFIELD OR 97478 Phone Number: 541-746-4293 I CONTRACTOR INFORMATION I .:2~ Contract~ .... License .R'~~.~t!P~ Date AMBAS~ PIPING ~ !:.' rff <J ~ AMBA~PIPING INC 12\469 ~ _~ ..0 o'V2:JJi~;S"g (;::~~. I BUlLDINGINFORMATlONb~-~ ~~~.f $'.#<0- ,:"',9ffJii 'll' ~ ~ ~ 0.... Qf ;:; ~~= ~~~~ ~~~ # of Buildings: ?i: (; ~ # of Stories: g ~ rt <3'~tJit.~'zs:~._~ Primary Occupancy Grou~ L~ ~R-3 Height of Structure ~ P ,~~ ~S:" '~i.:l)l troor: " ~, " ~" ~ cJ' ~~~' Secondary Occupancy Gr'!!yJ.lk:- ~ Type of Heat: p ~ "" ~. ~ ~ N.J' Floor: Primary Construction 1)i!'e~ !=? tifN Water Type: rS ~ I' ~ ~ ",~.Bt~ sement: Secondary Constructio.ltf~~ ~ Range Type: ~ rb' v'll.sS ~ ,,!>'M~arage/Carport # of Bedrooms: '. ~ <::) ~ /{i Energy Path: 0 ~ !:.' )> rt-I <S'gft Other: ti Q::' ~ ~ ~ J:: ~ if ~ ~ !Z> ~~NPervious Surface Area: ......pl.i;!f ~~ ... ....0 P' _-, ~:t:: _... ~~ ~ .&~ ~ ~ I DEVELOPMENT INFdfiAj~~i1"~" J SETBAe~ !" i .$' ~ (j ff Frontyard Setback: ~ Overlay Dist: (:' Side I Setback: # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Contractor Type Applicant Mechanical Phone 541-726-5723 541-726-5723 REQUIRED PARKING Total: Handicapped: Compact: Rearyard Setback: Solar Setbacks: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: '~ r1r Paee I of3 .', Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726.3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Appliance Not Listed Appliance Vent Gas Outlets 1-4 Minimum/Adjustment Mechanical Total Amount Paid . I Vall-'ation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00638 ISSUED: 07/18/2003 APPLIED: 07/18/2003 EXPIRES: 01/18/2004 VALUE: Value Date Calculated Total Value of Project F pp<, PIilaJ Amount Paid Date Paid Receipt Number 1200200000000001785 1200200000000001785 1200200000000001785 1200200000000001785 1200200000000001785 1200200000000001785 1200200000000001785 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. $10.00 $4.50 $3.15 $9.00 $6.00 $4.00 $26.00 7/18/03 7/18/03 7/18/03 7/18/03 7/18/03 7/18/03 7/18/03 $62,65 , Plan Reviews , , RpnnirlPlri Tn~,nection~ I I Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. Pa!!e 2 00 . . CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2003-00638 ISSUED: 07/1812003 APPLIED: 07/1812003 EXPIRES: 01118/2004 VALUE: , e' . , 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541.726-3676 Fax 541-726-3769 Inspection Line By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 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 describcd hcrcin, 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. . /I #i ~d'r/' /--/&3 Owner or Contractors Signature Date Pa~e 3 00 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20OJ-00638 COM2003-00638 COM2003-00638 COM2003-00638 COM2003-00638 COM2003-00638 COM2003-00638 Payments: Type of Payment Check Description -Mechanical Issuance Fee- Gas Outlets 1-4 Appliance Vent Appliance Not Listed Minimum/Adjustment Mechanical + 7% State Surcharge + 10% Administrative Fee Paid By AMBASSADOR PIPING, INC _~,,___~..!!!,J.!,.. .," Wi.......:.....................".......': ....-..' ! '" '_ 'l ..,. ",,, -} ,"'n....~:t -. _~ Receipt #: 1200200000000001785 Received By Jmp Check Number Batch Number Authorization Number 7036 City of Springfield Ofrn:ial.ft~ceipt Development Services Department Public Works Department Date: 07/18/2003 lO:18:56AM Amount Paid 10.00 4.00 6.00 9.00 26.00 3.15 4.50 $62.65 Item Total: How Received . Amount Paid In Person Payment Total: $62.65 $62.65 .