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HomeMy WebLinkAboutPermit Mechanical 1999-09-15WOOD STOVE/INSERT INSPECTTON CITY OF SPRINGFIELD COMMUNITY SERVICES DTVTSTON - 225 Fifftr Street Springfield, Oregon 97 47 7 SP,lINGF'ELI' APPLICATION ATT'E'i\-I* BUILDING SAFETY Office: 726-3759 INSPECTION Lll{E: 7 26 -37 69 CITY OF OREGON nu torth€ (]t'e ori ("Itiiity Notificatior Job \O Assessors Map #/Llfia3 3)Tax Lot#: 0 C-t o owner: Tco O\r..--(- Address: Value of Wood Type oflnspection aJe,** Preliminary lnspection is $15.00 (prior to installation "tilnI-CI:.-wood Stove/peuet/rnserr pernit is $15.00 .1. 0H;;:.tiii6fru,ufrH'frhhPXE{BFETI-*EilmRT Issuance' AUTHoRIZED UNDERTHIS PERMIT ls Nor state: f)C- Phone#: (please circle appropriate appliance) ISABANDONEDFOR toD. COMMENCEDOR Contractor:L\"*^.-{ r Address: Z\I ai€-+- Phone#: Ctty: Construction Contactors 6T L% By sigring this permit/application, I agree to call for an inspection(s) as required(726-3769). I state that all infonnation on this application/permit is correct and that I was provided with the Wood Stove Safety information for wood burning pretiminary inspection standards. I furttrer state that the appliance'I am installing standards as set by the Oregon Departnent of Environmental Protection Agency and I agree to provide the testing approval at of inspection. I also understand that if I am requesting a preliminary the wall to be removed. q Date FOR OFFICE USE REQUTRED INSPECTION(S): WOODSTOVE/PELLET/TNSERT PRELIMINARY Date of /S 11 lob #:?rzs Totat Amountcottectea: 26- 5"7) Receipt #, C35tt/Issued Checked for Checked for Historical Stafus: