HomeMy WebLinkAboutPermit Mechanical 2001-10-09SPRIiIGFIELD
Job# 01-01112-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
Job Number: 01 -01 112-01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot #: 03600
Subdivision:
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1042 00007th St Spr
AssessorsMap#: 17033512
Lot: Block: Addition:
ctTY oF SPRTNGFiELD, OREGO^
Owner: Gerald Wagner
Address: 10427th Street
Scope Of Work: Wood or Pellet Stove
Pellet stove
541-741-1948
Springfield, OR97477
Value: $0
Phone Number:
City/State/Zip:
New
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at726-3769. 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
working day.
Required lnspections
Mechanicil
Freestanding Pellet -After installation.
Area (Sq. Feet)
Main:Accessory:
# Of Stories: Height (feet):
Current Units: Proposed Units
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit
Administrative Fee - Mechanical
Freestanding Pellet Stove
Mechanical lssuance
10t09t2001
10t09t2001
10t09t2001
10t09t2001
6944
6944
6944
6944
$15.00
$3.60
$30.00
$10.00
1,300
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? !
2-0111-0101ob#J
Page 2 of 2
ValuelQuantitY Fee Amount
Paid On ReceiPt#
Fee
State Surcharge - Mechanical
Total Mechanical
10/09/2001 6944
Grand Total
By signing this permiUapplication, I agree to callfor an insPection(s) as required (726-3769)' I state
that all information on this application is co rrect. I further state that the appliance I am installing
meets smoke emission standards as set by the Oregon DePartm ent of Environmental QualitY or the
Federal Environmental Protection cy and I agree to provide the testing approval number to the
inspector at the time inspectio also understand that if I am requesting a preliminary inspection,
the wall u to be removed
$3.15
$61.7s
,/a
$61.75
.WOOD STOVB/I}'ISERT INS?ECfiON APPLICATION
CITY OF SPRINGFELD
co\lsvluNlrY stLrcE,s orVSrON - BUILDING SISETY
SPR$TGfTEI.D
Qfr
Oi[ce: 126-3'159
INSPECfiON LINE: 776.3769225 Fiffh Street
Springf,eld, Oregon 97477
)
/'o 4> ,t/ Ta-5rJob
Assessors Map 3 Ss-t C}60O
? /v 77h
5/e p
Value of Wood (please circle appropriate appliance)
ereHminary tnspection is $45.00 (prior to installation of insert)
Wood StovelPetletllnsert Permit is $6f .75 (includes Permiq Issraoce Fee, State Surcharge & Admin Fee).
Tlpe oflnspection
Construction Contractors
By signing this permit/application, I agree to call1'sr an in$ection(s) as requfued (726:3769\. I strate tbat
all information onthis application/permit is correct and that I was provided with the Wood Stove Safety
information for wood bruaing appliances aad preliminary inspection standards. I further state that the
appliance I aminstalliagmeets smoke enrissionstardads as setbythe OregonDeparhent of
Environmental Quality or the Eqvironmental Protection Agency and I agree to prwide the testing
approrzal inslreCtOr the time sf inlpectioL I also understand that if I ar:r reEresti4g a
maybe reqrired to be rernoved.
FOR OEr|ICE USE
a
REQUIRED INSPECTION(S) :
Date of o Job o/-o I,-o(
Checked for Delinguencies: \-.__,, Checked for Historical Status:
VALIDATION: