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Home My WebLink AboutPermit Mechanical 2008-5-27 225 FIITH ~ SPRING~~7477 -_PH (541)7:::753 0 FAX (541)726-3689 o /E"LLc::.- / 0/ oVC a CIty]obNumber COJlVt ZOO tf'-OO tlf 3 · ~ ]obLocatIon 2J/33 L)WNAr;5 :5?.e/4~'F/~.() ~ Assessor's Map I 70 J Z:> C-{ L( Tax Lot C:) " ....... ~/ ~ ~ <' ~ o " "....( .J..-.Jk ~ (j) 0.J rn c. ~~ ~ ~ (J) 00 ~ ~ ~ <1l > o ~ r:/'l SIgnature \j Q OJ ~ ::::::::::::uenc", SP~iNGIFEELD of!-~ DOlO' ~,,___ ...... I Owner ;/?/CK. ~ 0,/J-.MC Address .3 9'96 7 L7CG~~~ CIty ,-) P..R/~cF/EL-O ~;;fr~;~/Cj J<...D Phone 7 Z6 2-6 S' .3 ZIp ?77' 78 State 0/0, ~ ,Iit,._. .... I,~_l_... ......,.......',".oii."",~"_I'..l._..ll;IooI.I;j~_...J Prelumnary InspectIon for wood bunnng mserts IS $63 50 (pnor to msert) Wood Stove/Pellet/Insert Pernut IS $83 50 (mcIudes apphcable fees and surcharges). ;<2??MC/#~ ~ .,Bt:tR#OfJ:- //O.;5&T ~'p~ . ..::::>7?:Jc.f& ,...""'_........"L~.'."'.....,,...",.. "....,,,... ,,,', ,"".,.~..~.. ......, "...."...."""",..,...'..,,,' ''',,' ',"'.."..."."'...,_...... , "'''''''"""",,, ,...... ....".," ~\,e" 'fu~~,\"" \9."" ,eO; teQpf\ ~ \O~'" .(@ft~~f.~g;~~~()()\. Contractor ~ /VI fi 1-~~e ~~~~~:" Address ::z 7ff7/~~\~~'e~"A\e\e~~~'l\ot\ Phone 7~ S72-3 CIty . <5r~r"J~~~-~~'l o'O~f" ~~o~~~L ConstructIon Contractor's RegIS~~i~M~~\'\I~~'fl.~~ ce: :oe{ \0\ -at'S \ 1\U({\ r.e(\\; II ."",........,. "......,,',~....'...~. ,".,'0.". I ~.,..,;.' ,.....,,,.....;I..;';,.__~~.......J:.......,..... .",.,...l.............. 0.',...",.""...".._ ""... "011.,1' ..Ii..... .;;;..' "".;...,..~"....,.,., ..ll."....'..'"..,,,,:....,,,..,, "".'_."__._....;1."... ZIp ExpIres By sIgnmg thIS permIt/apphcahon, I agree to call for an mspechon(s) as reqUired (726-3769) I state that all mformahon on thIS apphcahon/permIt IS correct and that I was provIded WIth the Wood Stove Safety mformahon for wood burnmg apphances and prehmmary mspechon standards as set by the Oregon Department of EnVIronmental Quahty or the Federal EnVIronmental Protechon Agency and I agree to provIde the teshng approval number to the mspector at the hme of mspechon I also understand that If I am requeshng a prehmmary mspechon, the w vermg may be reqUired to be removed d/~~~~~ti!~g - ",~'~~i~\) ~ ~ \Cb ..'0 . \ ~\~O~ Cff:S> 0 ~\O"O. ~ ~~'t.~ ~ V~ tJG \~() ~ ~~'{ Checked for HIstoncaI Status s/z 7/01 / I L.~ L- Shared Dnve(T )/Bwldmg FormslWood Stove Perrmt 1-08 doc Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00743 ISSUED: OS/27/2008 APPLIED: OS/2712008 EXPIRES: 11/27/2008 VALUE: 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon Lme SITE ADDRESS 2433 DUMAS DR ASSESSOR'S PARCEL NO. 1703234400107 Sprmgfield TYPE OF WORK' Pellet Stove TYPE OF USE New ResidentIal PROJECT DESCRIPTION' Pellet stove msert Owner JOHNSON RICKEY F & MARY JANE Address' 39967 DEERHORN RD SPRINGFIELD OR 97478 Phone Number' 541-726-2683 I CONTRACTOR INFORMATION. Contractor Type Mechamcal Contractor AMBASSADOR PIPING INC License 121469 Expiration Date 03/27/2009 Phone 541-726-5723 BUILDING INFORMATION I Frontyard Setback Side 1 Setback: Side 2 Setback .,Rearyard Setback: Solar Setbacks: # of Umts. # of Stones' PrImary Occupancy Group. R-3 Height of Structure Secondary Occupancy Group. Type of Heat. PrImary ConstructIon Type VB Water Type Secondary ConstructI~ION: Oregon law re~. ~4o # of Bedrooms. follow rules adopted by the ~M1 RJtthty NotIficatIon Center. Those rul~fliikUd tMhImg k: ,).\R Q8~ OO~ 0010thrnllgh OAR Q!=i?..nn1. 0090. You mayobtai'l ~~~PM~.@IwORMATION I calling the center. (nULl;;. L.,g L6,,,,...I,ul'" number for the Oregon UtilitY.. NO.!lflcatlon Center Is 1-800-332-:!8lPJ]PY Dlst # Street Trees Rqd. Paved DrIve Rqd % of Lot Coverage: Lot Size Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement. Sq Ft Garage/Carport Sq Ft Other' Occupant Load' nla REQUIRED PARKING Total Handicapped Compact: I PUBLIC IMPROVEMENTS. Street Improvements Storm Sewer AvaIlable. SpecIal InstructIOn: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type Downspouts/Drams Notes I Valuation Description I DeSCrIptIOn Type of ConstructIOn $ Per Sq Ft or multIplIer Square Footage or Bid Amount Value Date Calculated Pae:e 1 of 2 Status Issued 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon Lme Fee DescrIptIon -Mechamcal Issuance Fee- + 10% AdmmlstratIve Fee + 12% State Surcharge + 5% Technology Fee Mlmmum/Adjustment Mechamcal Pellet Stove/Insert Total Amount PaId CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00743 ISSUED: OS/27/2008 APPLIED: OS/27/2008 EXPIRES: 11/27/2008 VALUE: Total Value of Project Fees Paid' Amount Paid Date PaId Receipt Number 1200800000000000559 1200800000000000559 1200800000000000559 1200800000000000559 1200800000000000559 1200800000000000559 $20 00 $5,00 $600 $2.50 $17,00 $33.00 5/27/08 5/27/08 5/27/08 5/27/08 5/27/08 5/27/08 $83.50 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. Pellet Insert After mstallatIon Reouired Insnections I "By sIgnature, I state and agree, that I have carefully exammed the completed applIcatIon and do hereby certIfy that all mformatIon hereon IS true and correct, and I further certIfy that any and all work performed shall be done m accordance with the Ordmances of the CIty of Sprmgfield and the Laws of the State of Oregon pertammg to the work descrIbed herem, and that NO OCCUPANCY wIll be made of any structure wIthout permiSSIOn of the Commumty Services DIvIsion, Buddmg Safety I further certify that only contractors and employees who are m complIance with ORS 701 005 wIll be used on thiS project I further a ree to ensure that all reqUIred mspectIons are requested at the proper time, that each address IS readable from the streetr' hat t permit card IS located at the"~ront of the property, and the approved set of plans wIll remam on the site at all tImes dUrIng c nstructIon. } s=- Z- ?- C(} Date Pal!e 2 of 2 225 Fifth Street Spnngfield, Oregon 97477 541-726-3759 Phone CIty of Sprmgfield OfficIal ReceIpt Development ServIces Department PublIc Works Department Job/Journal Number COM2008-00743 COM2008-00743 COM2008-00743 COM2008-00743 COM2008-00743 COM2008-00743 Payments Type of Payment CredltCard cRecemtl RECEIPT #: 1200800000000000559 Date: OS/27/2008 DescriptIon Pellet Stove/Insert MInImum! AdJustment MechanIcal + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstratIve Fee ~MechanIcal Issuance Fee~ Paid By RICKEY JOHNSON Item Total Check Number AuthorizatIOn ReceIVed By Batch Number Number How Received dJb 02951C In Person Payment Total Page 1 of 1 1 13 36PM Amount Due 3300 1700 250 600 500 2000 $83 50 Amount Paid $83 50 $83 50 5/27/2008