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Home My WebLink AboutPermit Mechanical 2007-5-11 ~~ ~J (D) -,)1 _~tl J~~ dyjJ ~ ., ,.--Ij 'r--1j ~l ~ ~~j _ f l j ~j ~( ~ .'.,-.Jj I~ ....- ~~ ~~ ~ ~~~ ~ Contractor Info~l!,0'- rj'(;) '-- ~\ I( Contractor: CV\< \ S W IV\ S low \') BAY e. .~~~1~~~ [> ~ P ~l Address: S I a, 0 5 ~a" i S50v'> P-.~, '~-r-0 :,.0 ro.~ ~0 _<f' ~ne: 12..(,,- J 38 L ~l City: C-""'~I~\\ ~O~,'Q1>t~t~~,iftd~....~ Zip: C\ 7Lj l.l.. ~, - ~ 0 v .~ ~ :"'i; l>'" / r;--' ,\construction Contractor's Registration #: S ,AA-';::> ~ f'~ .S.~ "I" Expires: / /%A ~' -.J.J'::!'~' \S v ",-v ~ (, I "- h!!G . 0 'IJoQ!'...0 S)" 'S'-,,--O..;5 ('. ~~ ' ~) . ~~ 4 (Y" no: ,0'; " ^ J' ,('; ." f!!!!ll~ _~ I,". , \ - , /S ~.... V. s)" d" q;.' !$' , &, ~ ~~ (!]J)) ,Av ...~ ~ s;1 ~ ~ ~0 ," "-~ ,~ r:h B I signing this permit/applicati~,~~49 ~11 f9"r l~ inspection(s) as required~729-.~7<S9). ~l I ;tate that all information on thiS..w~~\YP#I~flS correct and that I was,.m.<,oVja~d~ith :::: j le Wood Stove Safety information~~ kSt~g appliances and prelim,-~a~)'ln'S#tion i\ I. I! standards as set by the Oregon Depa~ ~8f~ironmental Quality or QwFed~I'at~ ::::---. Environniental Protection Agency and f1gre provide the testingap~1j)val&U1~I~r to the , ~ inspector at the time of inspection. I also un erstand that if I ~X:re\l~stiu--g> a'p"l:eliJninary ~. inspection, the wall covering may be required to be remove~~ ~<Y<<:-'~<$> <::::,'1:- {f-\:;j e) ~~~ ~<<:;:~"-' ~<<. ~ -" ,-$!- ~<<:, ~ ~ ~~~ r~/~ Signature: ~~___--;;::;. ';:;-:::. <.. '~~~ '" --5/ 1110 7 \ ." . CITY OF Sl-gJNGFIELD, OREGON 'U SPRINGFIELD ~_. ", ' I, -:~.::..i_ "..' ~..~.,....~ '--"'_~..,/ ~- ~ --- "" ~<.,,' ~J1l ~~ ZZ5 nrrH STREET. SrRINGfIELD, OR 97477. rH:(541)7Z6.375:~ . FAX: (541)7Z6<~68~) Cily Job Number C OM zoo 7-e::x::> b 7 b Job Location: ..., ~ \ 1-\-~'1 LVI BY-I~p 1\ l,... ( p Assessor's Map: 1703 U (z. I ,--,- .::::?,k\y 11/1/'::\ B -€(J- 0 ~ I v Tax Lot: O/l..{O"?:." Owner: SC""~1 P,r-on SOV\ Address: ., ~ I 14-G.~cl.<Vl B r\~..e. .p \ ct~ City: So!' r i "'j f'l et c\. State: rhone: q S 3 -q 5 2.. L oR Zip: q,4" Preliminary Inspection is $45.00 (prior to insert) Wood Stove/Fellet/lnsert Fermit is $6Z.65 (includes Fermit, Issuance Fee, Slate Surcharge and Administrative Fee). FOR OffiCE USE ale of Application: ~/~'7 ( ~ hecked for Delinquencies: ~~cked for Historical Status: Shared Drivc(T:)IBuilding Forms.lWood Slove PcrmiI3..04-04.doc Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Pbone - 541-726-3676 Fax 541-726-3769 Inspection Line . SITE ADDRESS: 761 HAYDEN BRIDGE PL ASSESSOR'S PARCEL NO.: 1703261201403 PROJECT DESCRIPTION: Woodburning insert I CONTRACTOR INFORMATION Jlres you \V N'Oregon law 10,", U'ilitV Contractor ATTENTIO. ted IWC'eii~reg('E'x.~\~ion Date CHRIS B WINSLOW tollow ru\e~~~~r ,.~8Irule~ ?~ ;,,-9];),0/2008 I Bl1i~]jiNG:1NI{OR;M~l'i&*~~Y~ ~ the ruies ' "I~I. OOll:,,,.\!.,!Ile, hone onon Yoll may 'Note' the te ep _ vwt1f ::;torrAle center. \ '. . NotiMl.!$)'.e: If~b9~ trWil.!'~regon Ut~,~~ ^ ~\ Sq Ft 1st Floor: IJ)IflelO~ eat: - - ~ 'Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Patb: Sq Ft Otber: Sprinkled Building: n/a Occupant Load: Owner: SANDRA BRONSON Address: 82155 N BEAR CREEK RD CRESWELL OR 97426 Contractor Type Mecbanical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VB Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00676 ISSUED: 05/11/2007 APPLIED: 05/11/2007 EXPIRES: 11/11/2007 VALUE: Springfield TYPE OF WORK: Wood Stove TYPE OF USE: New Residential Pbone Number: 541-953-9522 Phone 541-895-3593 I DEVELOPMElNTIINRORMATlON I THIS PERMII ~HALL tXPIRE IF THE ~RED PARKING Overlay.,QijiiORIZED UNDER THIS PERMIT lfo~~T # StreetTrIi~'~lI,dJED OR IS ABANDONED FOOndicapped: Paved Dr~J'" ~~~:nAY PERIOD. Compact: % of LJ'r Coverage: I PUBLIC IMPROVEMENTS I Sidewalk Type: DownspoutslDrains: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa~e" of2 . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00676 ISSUED: 05/11/2007 APPLIED: 05/11/2007 EXPIRES: 1I/1I/2007 VALUE: Status Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description ......Mechanical Issuance Fee- + 10% Administrative Fee + 5% Tecbnology Fee + 8% State Surcbarge Inspection - Preliminary Minimum/Adjustment Mecbanical Wood StovelInsert Amount Paid Date Paid Receipt Number SIO.OO 5/11/07 1200700000000000561 $4.50 5/11/07 1200700000000000561 $4.50 5/11/07 1200700000000000561 $3.60 5/11/07 1200700000000000561 $45.00 5/11/07 1200700000000000561 $15.00 5/11/07 1200700000000000561 $30.00 5/11/07 1200700000000000561 Total Amount Paid $112.60 I Plan Reviews I 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 work day. Wood Burning Insert: After installation. Preliminary Inspection: Prior to tbe installation of solid fuel appliance wbicb will be vented tbrougb an existing cbimney. By signature, I state and agree, tbat I bave carefully examined tbe completed application and do bereby certify that all information bereon is true and correct, and I further certify that any and all work performed sball be done in accordance with the Ordinances oftbe City of Springfield and tbe Laws oftbe State of Oregon pertaining to tbe work described berein, and tbat NO OCCUPANCY will be made of any structure witbout permission oftbe Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure tbat all required inspections are requested at the proper time, tbat eacb address is readable from the street, that tbe permit card is located at the front of tbe property, and the approved set of plans will remain on tbe site at all times during construction. ( --... _.......-::. ~'-- ---' ~ .5/1//07 Owner or Contractors Signature Date Pa2e 2 of2 : 225 Fifth Street : Spring(ield, Oregon 97477 541-726-3759 Phone iriiPlao , . r-__.-..... '.. IIiiL . , . ..i . .. - . - .," ..,' Caof Springfield Official Receipt _Iopment Services Department Public Works Department , Job/Journal Number COM2007-00676 COM2007-00676 COM2007-00676 COM2007-00676 , COM2007-00676 COM2007-00676 COM2007-00676 , Payments: Type of Payment Check cReceinll RECEIPT #: 1200700000000000561 Date: 05/11/2007 Description Inspection - Preliminary Wood Stove/Insert Minimum/Adjustment Mechanical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee -Mechanical Issuance Fee- Paid By YE OLD TOWN SWEEP Item Total: l.:heck Number Authorization Received By Batch Number Number How Received djb 18840 In Person Payment Total: Page I of I 10:57:30AM Amount Due 45.00 30.00 15.00 4.50 3,60 4.50 10.00 $112.60 Amount Paid $112.60 $I1Z.60 5/11/2007