HomeMy WebLinkAboutPermit Mechanical 2002-10-8
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City of Springfield
Mechanical Permit
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: MEC2002-00103
ISSUED: 10/8/2002
APPLIED: 10/8/2002
EXPIRES: 4/8/2003
SITE ADDRESS: 2056 HARBOR DR
ASSESSOItS PARCEL NO.: 1803112203600
Springfield
TYPE OF WORK:
TYPE OF USE:
New
Residential
PROJECT DESCRIPTiON: Install pellet stove
OWNER! APPLI CANT:
CALOIA NEAL J & HEATHER R
2056 HARBOR DR
SPRINGFIELD OR 97477
CALOIA NEAL J & HEATHER R
2056 HARBOR DR
SPRINGFIELD OR 97477
54\-988-4967
MECHANICAL CONTRACTOR:
MARS HALLS INC
4110 INDUSTRIAL AVENUE
SPRINGFIELD OR 97478
CCB # 25790 Expiration Date: 12/23/2003
541-747-7445
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To Request an inspection call the 24 hour recording at 726~3769~~Ij;in~<>~tib~,re99~Ste,~/.1iefore 7:00 a.m. will be made
the same working day, inspections requested after 7:00 a.m~{Vi!\'b~~~d~ll1,e;fgll2..WingJw'6iking day.
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1 Freestanding Pellet Stove: After installation. ~\..\.. ~i-'\'~ ,\,~~~<i) '(I\:)~
By Signature, I state and agree, that I have carefully examined the com ,1dJ: Rt\c~~~'ild~lPe~y certify that all
infonnation hereon is true and correct, and I further certify that any and all ~ ~~~~one in accordance with
the Ordinances of the City of Springfield and the laws of the State of Grego ~scribed herein. I
further certify that only contractors and employees who are in compliance witll-'Q) ~. ~~m\be used on this project. I
further agree to ensure that all required inspections are requested at the proper t~.lt.~Jnjb~ach address is readable from the
street, and that the approved set of plans, ifapplicable, will remain on the site at al+llmes during construction. '
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Date 'I '
Desc rintion
Amount Paid
+ 8% Administrative Fee
-Issuance Fee-
Pellet Stove/Insert
Minimum! AdjuSbnents -
+ 7% State Surcharge
3.60
10.00
30.00
15.00
3.15
Reauired Insnections:
1 of I
225 F1rrH STREET. SPRINGFIELD, OR 97477 . PH:(54 J)72G.g75g . FAX: (54 J)72G.gG89
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Y slgnmg t IS penlll app !Calton, agree to ca Jor an mspectlOn s as. reqUIre . . state t at a
information on this application /permit is correct and that I w~.s$~ovil:Ied with the Wood Stove Safety
~ information for wood burning appliances and preliminary inspection standards as set by the Oregon Department
~ of Environmental Quality or the Federal Environmental Protection Agency and I agree to provide t~esting
~ approval number to the inspector at the time of inspection. I also understand that if I am re.9.ql''''~~~"\
~ preliminary inspection, the wall covering may be required to be removed . ~ \~ \t\~\~~
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o Date of Application 1 ( ) ! 't I ~ ~~l
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City Job Number 'f\A. E-C ;:lJYJ;::L. eo I D 3
JobLocation~osto HC\" hll ill l L
Assessors Mar i ~()3 II ;:;;)ri, Tax Lot
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Address ~()SG, <Wn k Y:::ill ()r.
City ,5;9n U - , StateJJe
Value of Wood Stove/Pellet StovelInsertdJ J l.(1 ro
Phone
Qgg - LJq(OI
Zip q,lV')')
(please circle appropriate appliance)
Preliminary Inspection is $45.00 (prior to insert)
Wood Stove/Pellet/Insert Permit is $61.75 (includes Permit, Issuance Fcc, State Surcharge & Admin Fee.)
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Shared Drive(T:)lBuilding FormslWood Stove Pennitl-02.doc