HomeMy WebLinkAboutPermit Building 2003-12-1
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. CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2003-01192
ISSUED: 12/01/2003
APPLIED: 12/01/2003
EXPIRES: 06/01/2004
VALUE:
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Status
Issued
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
54i-726-3769 Inspection Line
SITE ADDRESS: 1625 HENDERSON AVE
ASSESSOR'S PARCEL NO.: 1703344313302
Eugene
TYPE OF WORK: Single Family Residence
TYPE OF USE:
Alteration
Residential
PROJECT DESCRIPTION: Replace furnace
Owner: DIANE EV ART
Address: 1625 HENDERSON AVE. F9 EUGENE OR 97403
Phone Number: 541-747-3938
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor License
ASSOCIATED HEATING & AIR CONDITIO 106275
BUILDING INFORMATION I
Expiration Date
08/3112004
Phone
541-683-2590
# of Units: .
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:
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~ '\ ~'I~DEVkLOPMENTINFORMA T10N I 0" '': ~
SETBACKS "'9.~\~~\l '" x~ ~0'" '\ "REQl}IRED PARKING
~T- S' ~~\; c),\>\ 00 ~ \"
Front yard Setback: ~'v'v '\~ ,~.:\)'\j Overlay Dist: ,l\ ~e O~e($ e '1'l>~al:~
Side I Sethack:~. ~ S~~'\)~~ ~~'f' # Street Trees Rqd: ICo \7>' "S'0 0'" ~ 0Hiikd!!:apped:
Side 2 Setbackr... (_~~ \) \S R-o \S ~ Paved Drive Rqd: 0~0~0 0'0'\ 0 ~\>" O~ "Gom~aci:
l\\~ 'c_ Qv ~~ '\) '\j ~'\j . ~. ~e 0'" ,:,~'(\ ~ ""- R"v' '1..\00
Rearyard $.('~ljack\)~ ~\,,~ <X<{;' % of Lot Coverag~O 'l}OO~ ~.~'(\ "S'~O \0",0 \e\0 .~\c,7>'
Solar Setbacks1''<',~'V~ '\)~ A~'\;" \>\e"'G00\.e R)"S) c,O~. "S'0 ~O'"
'r ~..,,, nC\ ~' ., ~ _ . .0 .:,0. ~,0' .,\,-"\ .11.\.
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Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPRO.ViNtEN,iS11\)v'l},\ 0\>~e~'~-00 ~--;?-?;~
-4,V - M' ,:, <!0 re0 r.<e($ ",,--
or -{O "S'0 Sidewalk,Type:
o f?l\)' '1Co~ < ""'-,\,,,"
\)<:l r~\\ 0~\ODo:wnspoutslDrains:
v ~'O Ge"
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Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pa~elof2
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01192
ISSUED: 12/0112003
APPLIED: 12/0112003
EXPIRES: 06/0112004
VALUE:
'\
~
Status
Issued
.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I F~~s ~
Fee Description
-Mechanicallssuance Fe....
+ 10% Administrative Fee
+ 7% State Surcharge
Furnace - up to 100,000 btu
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$12.00
$33.00
12/1/03
12/1/03
12/1/03
12/1/03
12/1/03
2200200000000001820
2200200000000001820
2200200000000001820
2200200000000001820
2200200000000001820
Total Amount Paid
$62.65
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 Reouired Insnectinns I
1 Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
By signature, ) state and agree, that) have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and) 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.
) further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
) 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 propl)rty, and the approved set of plans will remain on the site at all
times during construction.
J~ nLI;.J:(]~~
Owner or Contractors Signature
Idj'/IJ?
Date
Paee 2 of2
~
o ASSESSORS MAP:
.0 CITY:
~ DESCRIPTION OF WOFI'.
..~~
~ CONTRAcrOR'S NAME
~
~:::H::IGAL'PERMiT"';:'
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Vent Fan No.
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1 State Issuance
~ J; Administrative Fee
" State Surcharge
o Total MiscelIapeous Permits
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. Shared Drive(f:)lBuilding FormslPermit Worksheetl"{)2.doc
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-' , ..: . CiTY' OF'SPIDNGFrnLI) ~OREGON':'''--). :~"",
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225 FIITH STREET . SPRINGFIELD, OR 97477. PH:(541)726-3753 . FAX: (54])726-3689
City Job Number Co M. 20:'3>'0 1\ q L..-
LOCATION OFPROPOSED WORK: 1&;)--5: J.I~J'r..- 1tU/-l..- fl' PO)
TAX LOT: \10~~44-~\3~OL.
OWNEP' f} I~ ~/AAJ
ADDRESS:I{,J~ ~O,/,- ~# r'1
f2u~
PHONE:
7lf? -3f-?f
IX--
ZIP: ,!)yo~
Sf ATE'
fl .U;;!/1.r'd
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NEW: _ REMODEL:_ ADDITIO!\l:
.111(
OTHER:
VALUE:
DEMOLISH'
ADDRESS
CONSf.
CONTRAcrOR #
PHONE
EXPIRES
GENERAL:
PLUMBtNG'
MECHANICAL:t::t5'~t?(- .
/ () S-.t:J ~CA-
/tJb~7S~
bf5 'l-:;!S"fo
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PLUMBING PERMIT
ITEM
FEE
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Wood Stove/Insert/Fireplace Unit
Fixtures
Residential Bath(s) No.
Sanitary Sewer .IT.
Water IT.
Storm Sewer IT.'
Mechanical Permit
State Issuance
Administrative Fce
State Surcharge
Total Mechanical Permit Fees
Plumbing Permit
Adminislrative Fee
State Surcharge
Total Plumbing Fees .
.
Total Mechanical Permits
I; I\i.J~FEf!0J~Jj;9.Q,~:i)q~qn;~f::, ~~;:~?::
Demolition
'.j
>.,
Total Plumbins Permils
Total Miscellaneous Permits
roTAL
225 Fifth Str(,~t
Springfield, Oregon 97477
541-726-3759 Phone
JoblJournal Number
COM2003-0 1192
COM2003-0 Iln
COM2003-01192
COM2003-01192
COM2003-011n
Payments:
Type of Paymenl
Check
,. ~Ai\I
'.liIi.,....~==_..~~.. .~, ...!
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Receipt #: 2200200000000001820
Description
Furnace - up to 100,000 btu
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
jmp
Check Number
Batch Number Authorization Number
Paid By
ASSOCIATED HEATING
010979
City of Springfield Official R,eceipt
Development Services Department
Public Works Department
Date: 12/0112003
2:16:28PM
Amount Paid
Item Total:
12.00
33.00
10.00
3.15
4.50
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65 .
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