HomeMy WebLinkAboutPermit Mechanical 2006-3-31
. CITY OF SPKlIliul'lJ'.LD
Building/Combination Permit
PERMIT NO: COM2006-00356
ISSUED: 03/31/2006
APPLIED: 03/2712006
EXPIRES: 09/30/2006
VALUE:
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
" 541-726-3676 Fax
. 541-726-3769 Inspection Line
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,. SITE ADDRESS: 2555 HAYDEN BRIDGE RD
, ASSESSOR'S PARCEL NO.: 1703244100200
Springfield TYPE OF WORK: Pellet Stove
PROJECT DESCRIPTION: Pellet insert
TYPE OF USE: New
Residential
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Owner: JOE WALLACE quireS'IOuto
Address: 2555 HAYDEN BRlDGE-RD,;)ofl laW re 90fl utM'I
SPRlNGF~~IlDJ6~~h1tj;;tedb'l_::'~ l~r: are S~~ \~~~_
'O\lU~", center.' .':- ._, .nh Of\f'\ ;;.....:- _ \-0.\1
NO\i\icatIO;,oo~_oo~o I' CONTRACT0R"INFORMATlON I
'(1 O{>,I'\ 95 obtal(1 --, h telef'''-'
I _ ",,1\ f!1a'l ,Note: t"e '\' atiO(1 .
Contractor Type OlGo!.lt.r_a~tl1r;;eflter" ,__ \ Itilit'! Notl IC LIcense
Mechanical 1,nJj,~M,~S0U~<;;E~JJ'IgJ44). 161946
(1U"'~-ce(1te( IS '-j 'BUILDING INFORMATION I
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':..# of Units:
'('
,. Primary Occupancy Group:
,
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
VN
, Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
; Solar Setbacks:
I, DEVELOPMENT INFO~ATl0l\.1
NOi\Ct'. \-1\\1 ~\-1P,LL E~P,\K~E~Mr{ IS ~Ol
1\-1\S pER 0 ~es~ I)IS~~ ()~EO fOR
p,\l1\-10RIIE ~~ J;lJiellRqo:
CO\-l\\-I\ENCE~ ,\~o~e Rqd:
P,N'I180 OI\M~ ot Coverage:
,,~Street Improvements:
,
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS I
Notes:
"
, Description
,
I Valuation DescriotionJ
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Type of Construction
Paee 1 of2
Phone Number: 541-988-9173
Expiration Date
10/29/2006
Phone
541-343-1131
nla
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
Value
Date Calculated
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. CITY OF SPRINGFIELI);'
Building/Combination Permit
PERMIT NO: COM2006-00356
ISSUED: 03/31/2006
APPLIED: 03/27/2006
EXPIRES: 09/30/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fp.p.s Paid I
-;- Fee Description
~;. -Mechanical Issuance Fee-
+ 10% Administrative Fee
"'. + 8% State Surcharge
;: Inspection - Preliminary
Minimum/Adjustment Mechanical
Pellet Stovellnsert
Amount Paid
Date Paid
$10.00
$4.50
$3.60
$45.00
$15.00
$30.00
3/31/06
3/31/06
3/31/06
3/31/06
3/31/06
3/31/06
Receipt Number
2200600000000000416
2200600000000000416
2200600000000000416
2200600000000000416
2200600000000000416
2200600000000000416
e
Total Amount Paid
$108.10
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.
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. Preliminary Inspection: Prior to the installation of solid fuel appliance which will be vented through an existing
chimney.
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 during construction.
...
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Owner or Contractors Signature
'7!'7I!'iJ(,
Date
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Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541 -726-:{759 Phone
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1itJ..ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Job/Journal Number
, c;0M2006-00356
C,OM2006-00356
COM2006-00356
COM2006-00356
COM2006-00356
COM2006-00356
Payments:
Type of Payment
Cpeck
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3/3112006
RECEIPT #:
2200600000000000416
Date: 03/31/2006
Description
+ 8% Slate Surcharge
+ 10% Administrative Fee
Pellet StovelInsert
Minimum! Adjustment Mechanical
Inspection - Preliminary
-Mechanical Issuance Fee-
Paid By
MIDGLEYS
Item Total:
Check Number AuthoriZation
Received By Batcb Number Number How Received
djb 2918 In Person
Payment Total:
Page 1 of 1
2:18:51PM
Amount Due
3.60
4.50
30,00
15.00
45.00
10.00
$108.10
Amount Paid
$108.10
$108.10