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Home My WebLink AboutPermit Mechanical 2003-10-17 . . CITY OF ~nUl'\j\,j1<lJ'.,LD Building/Combination Permit PERMIT NO: COM2003-01059 ISSUED: 10/17/2003 APPLIED: '10/17/2003 EXPIRES: 04/17/2004 VALUE: ' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1555 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1703252200100 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: PROJECT DESCRIPTION: Install pellet insert and free standing wood stove New Residential Owner: KENOPS DARREL L & LYNN M Address: 1555 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Mechanical Contractor MlDGLEYS License 19364 BUILDING INFORMATION I Expiration Date 10/20/2003 Phone 541-343-1131 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: SETBACKS I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot C!,verage: Total: Handicapped: Compact: Street Improvements: I PUBLIC IMPROVEMENTS I Sidewalk TYI~e: I w reqUires you to ATIENRION:oregon a . . ownsp'out@~i,nS':le Oregon Utility follow ~u 1:1::; ""'VI" ~ ose rules are set fon \Iotificatlon Center. Th hOAR 952-00 2001-0010 throug \ OAR 95 - btain copies of the rules I 0090. You may 0 I "'_'^' t..... ,,,,Isphone failing "'" v~...-.. , Utility Notification N01\CE~ U ^ II EXPIRE IFI"W,iil\iIltWh DescriDtion 1Jmber lor tM Or~go;_332_2344). l\-\\S PERM\1 Sn" \-\\S PERM\ \ I:> I'U' C..n,p.r IS 1 80 .. un.cl7\:n ~DER 1 . ~,P~ Ft Square Footage Descrlptlo!l.U1 nUl~pe'Of fI1Ist..tH'tiO~DOMI \J t' I' B'd A t Value Date Calculated COMMENCED 11'11:> 'ROn 'll mu Ip ler or I moun f\NY 160 Df\Y PERIOD. Total Value of Project Paee I of2 Storm Sewer Available: Special Instruction: . Notes: . . \...11 l' 01' ~rKll~u1'lJ!,LD Status Issued Building/Combination Permit PERMIT NO: COM2003-01059 ISSUED: 10/17/2003 APPLIED: 10/17/2003 EXPIRES: 04/17/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line l..Fcc~ Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Pellet StovelInsert Wood Stove Amount Paid $10.00 $3.00 $2.10 $30.00 $30.00 Date Paid 10/17/03 10117/03 10/17/03 10/17/03 10/17/03 Receipt Number 2200200000000001668 2200200000000001668 2200200000000001668 2200200000000001668 2200200000000001668 Total Amount Paid $75.10 I Plan Reviews I 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. I RcouircrI [nsllce.ions I 1 Wood Stove: After Installation. 2 Pellet Insert: After installation By signature, 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 that NO OCCUPANCY will be made of any structure without permission of the 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 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:U~:;f2n'(~h _ . /(5/1 /~ 1 '/ ./ - ~ Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1 059 COM2003-0 1 059 COM2003-0 1059 COM2003-0 1 059 COM2003-0 1 059 Payments: Type of Payment Check Paid By MIDGLEYS ,J ~Mt,",LM' """""'-,;".',>Ii ',",'" ',. ' . ;,. i ."'... , . ., ; .,....~'."A'...;.. ,",.,< Receipt #: 2200200000000001668 Description Pellet StovelInsert Wood Stove -Mechanical Issuance Fee- + 7% State Surcharge + 10% Administrative Fee Received By dm Check Number Batch Number Authorization Number 7200 City of Springfield Official Receipt Development Services Department'" Public Works Department Date: 10/17/2003 10:58:38AM' Amount Paid Item Total: 30.00 30.00 10.00 2.10 3.00 $75.10 How Received Amount Paid In Person Payment Total: $75.10 $75.10 . .