The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2004-02-02F SPRIN Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-00138ISSUED: 0210212004APPLIED: 0210212004EXPIRES: 08/0212004 VALUE:V \ SITE ADDRESS: 332 7TH ST ASSESSOR'S PARCEL NO.: 1703352411900 PROJECT DESCRIPTION: Wood insert Owner: HAyES JERI S Address: 332 7TH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential Contractor Type General Contractor CHRIS B WINSLOW Expiration Date 0u10t2006 Phone 54t-942-3452 License 52381 CONTRACTOR INFORMATION # 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: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Other: Surface Area: R-1 VN s PARJilNG Street Storm Sewer A Special Instruction: Notes: $ Per Sq Ft or multiplier c Square Footage or Bid Amount Total Value of Project Page I of2 DEVELOPMENT INFORMATION Description Type of Construction Value Date Calculated I,utt Lru\u rNr uKrvrA,! fgN_l Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line SPRIN Building/Combination Permit PERMIT NO: COM2004-00138ISSUED: 0210212004 APPLIEDz 0210212004 EXPIRES: 08/0212004 VALUE: Fee Description -Mechanical Issuance Fee- + l0o Administrative Fee + 7%o State Surcharge Minimum/Adj ustment Mechanical Wood Stove/Insert Total Amount Paid Amount Paid Date Paid 2tzt04 2t2t04 212104 2t2t04 2t2t04 $10.00 $4.50 $3.1s $15.00 $30.00 Receipt Number 2200400000000000084 2200400000000000084 2200400000000000084 2200400000000000084 2200400000000000084 $62.65 Plan Reviews To Request an inspection call the24 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 Wood Burning Insert: After installation. Reou 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. Z 2 o Owner or Contractors Signature Date Pase? oI2 rees raro I City of Springfieid Offlcial Receipt Development Services Department Public Works Department 225FlL;th Street Snringfield, Oregon sZt-lze-1759 Phone 97477 138 coM2004-00138 coM2o04-00138 coM2004-00138 coM2004-00138 Wood Stove/Insert Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- + 1oh State Surcharge + l}oh Adminishative Fee Item Total:$62.6s 30.00 15.00 10.00 3. l5 4.50 Paid By Received By Batch Number Authorization Number lfow Received Amount Paidof Check YE OLD TOWN SWEEP lmp 15664 In Person Payment Total: s62.6s $62.6s ( L>.9> >-<8, - +b2-\ 225 FIF|H STREET r SPRINGfliILD, OR 97477 o PII:(541)726-375i1 ' fAX: (541)726-3689 City Job Number eoN( zmlt - oo (?b Job 3 2_1*9 Assessors Map Tax Lot l-t, 09 9 "-+ r\qoo Owner Address 35 Z 1Y <-1,Phone 1q1- 9r 3Lt zip q1q -7 7rln(oCityState Value 3 (please circle appropriate appliance) Preliminary Inspection is $45.00 {prior to inserti \Voocl Stove/Pelietilnsert Permit is $62.65 (includes Permit, Issuance Fee, State Surcharge & Admin Fee.) C o ntractor I nfo rm oti o n YE OLD TOWN SUJEEP riHc r p.{#-aLU Urfi t-{n,t-l (t\ ttlll{ c'1?rlor 1:{U O(Jn,l-!a 1-iFt Fq{s $<(J (n f-{F{t{ () A\./ {J{r) FF{LIcAtJ F 81905 DAVISSON HD lzto-1 38 Z-Address eRESWEIE On gZ+26 Construction Contractors Registrati on* 5 2 3cQ I pxpires a-/o OG By signing this pemrit/application, I agree to call for an inspection(s) as required (726-3769). I state that all information o, ihir application /permit is correct and that I was provided with the Wood Stove Safety information for wood burning appliances and preliminary inspection standards as set by the Oregon Department of Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing approval number to the inspector at the tinie of inspection. I also understand that if I am requesting a preliminary inspection, the wall covering may be required to be removed . For Office Use Date of Application Checked for Delinquencies Checked for Historical Shared Drive(T:)rBuilding FomrslWood Stove Permitl-03.doc I ^^^+:^- City State--Zi+ sisnatrre out" z/z/a i Q+-+' ' o Q'. 5 5 e*'Page I of4CCB - Find A Licensee - Resl" Find A Licensee - Results LICENSE NUMBER: NAME: ADDRESS: WORK PHONE NUMBER: LICENSE STATUS: EXPIRATION DATE: DATE FIRST LICENSED:1t8,t1987 52381 CHRIS B WINSLOW 81905 DAVISSON RD CRESWELL OR 97426-9303 5419423452 Not Active - ENTITY Sole Expired TYPE: Proprietor LICENSE General CATEGORY: Contractor/Al I EMPLOYER STATUS: Non-Exempt (Has Employees - Must Have Workers' Comp Coverage) BOND COMPANY COLONIAL AMERICAN CASUALry & SURETY co BOND AMOUNT:$ 1s000 BOND EFFECTTVE 111012004 TO: Associated Name lnformation License Number 52381 52381 INSURANCE TRUCK INS COMPANY: EXCHANGE INSURANCE AMOUNT:$ s00000 INSURANCE EFFECTIVE 1I612005 TO: Name YE OLDE TOWN SWEEP ALL SYSTEMS HEATING Description Doing Business As Doing Business As Bond lnformation License Number: 52381 Company Name: 400 - COLONIAL AMERICAN CASUALTY & SURETY CO Bond Number: LPM4049383 Bond Amount: $15,000 Bond Effective Date: lll0l2000 Cancellation Date: http://ccbed.ccb.state.or.us/new_web/asp/new_search_resultsgint.asp?regno:s2381 21212004 CCB - Find A Licensee - Rest"'Page2 of 4 License Number: 52381 Company Name: 318 - STAR INSURANCE COMPANY Bond Number: SA5091604 Bond Amount: $ 10.000 Bond Effective Date: ll5ll999 Cancellation Date: 1 I 1012000 License Number: 52381 Company Name: 318 - STAR INSURANCE COMPANY Bond Number: SA5091604 Bond Amount: $5,000 Bond Effective Date: lll0l1997 Cancellation Date: License Number: 52381 Company Name: 342 - MARKEL INS CO Bond Number: 96048804 Bond Amount: S5,000 Bond Effective Date: lll0/1996 Cancellation Date: License Number: 52381 Company Name: 135 - CLARENDON NATIONAL INS CO Bond Number: 94032816 http://ccbed.ccb.state.or.us/new-web/asp/new_search_resultsjrint.asp?regno:523g 1 2/2t2004 CCB - Find A Licensee - Rest"' Bond Amount: $5,000 Bond Effective Date: lll0ll995 Cancellation Date: Page 3 of4 License Number: 52381 Company Name: 25 - CONTINENTAL CASUALTY COMPANY Bond Number: BNS12984660503 I Bond Amount: S5,000 Bond Effective Date: lll0l1993 Cancellation Date: License Number: 52381 Company Name: 195 - INDEMNITY CO OF CALIFORNIA Bond Number: 953594C Bond Amount: $5,000 Bond Effective Date: lll0l1989 Cancellation Date: License Number: 52381 Company Name: 195 - INDEMNITY CO OF CALIFORNIA Bond Number: 953594C Bond Amount: $5,000 Bond Effective Date: l/8/1988 Cancellation Date: http://ccbed.ccb.state.or.us/new_web/asp/new_search_resultsjrint.asp?regno:s2381 21212004 CCB - Find A Licensee - Rest"' lnsurance lnformation Policy Number 034864780 034864780 Policy Amount 500000 '100000 Effective From 1/6t2002 Page 4 of 4 Effective To 1t6t2005 9/9/1999 License Number 52381 52381 lnsurance Company 52381 92 - TRUCK INS EXCHANGE 92 - TRUCK INS EXCHANGE 370 - FARMERS INSURANCE EXCHANGE 034864780 500000 21611999 21612001 Specialized Training lnformation Name No records retumed. Description DISCLAIMER: lnformation concerning contractor credentials and specialized training has been obtained by the Construction Contractors Board (CCB) from contractors who want this information noted in their licensing records. The contractor must also notify the CCB if the credential has expired or terminated. As a result, the CCB does not warrant or guarantee the existence or accuracy of the information about the credentials or specialized training. SIC Codes SIC Code 1521 7349 Claims Information License Number: 52381 Name: CHRTS B WTNSLOW Claims lnquiry: Claims Pending: Claims with Order to Pay: Description Single Family Houses Chimney And Other Structural Cleaning http://ccbed.ccb.state.or.us/new_web/asp/new_search resultslrint.asp?regno:52381 2/212004