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HomeMy WebLinkAboutPermit Mechanical 2001-10-250Job#1 -0 1 1 183-0 Page 1 of 2 ilii*ii5#: Giil&if:{j$rir,i F,'Fi.n,,r: rLL;IJ. L RESIDENTIAL PERMIT Gity Of Springfietd Community Services Division Building Safety 225 North Fifth Street Springfield, OR974t7 Location Of Proposed Site: 2Z9O OOOOgth St Spr AssessorsMap#: 17032612 Lot: Block: Addition: Job Number: 01-01 1 83-01 Office:726-3T59 lnspection Line: 726-3769 Tax Lot#: 01317 Subdivision: Owner: Tiffanie Soper Address: 2290 Bth Street Scope Of Work: Wood or Pellet Stove Pellet stove Phone Number: City/State/Zip: New 541-736-0626 Springfield, OR97477 Value: $O Contractor Type Mechanical Contr Contractor ABC Stove Service PO Box 108, Dexter, OR 97431 Registration # Expiration Date \ )..N{ Phone 541-937-8618 Office Use - Quad Area: # Of Units: Gonstr. Type: Water Heater: Land Use: Zonino Code: Bedro-oms: UO' Range: tON S\ roup: Sq'. To request an inspection callthe 24 hour recording at 769, All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day Required lnspections Pellet lnsert Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq Main:Accessory -After,nr,r,,r,,on 3t,'j3$:,1t*'- :llY'i.$:Siliil"*1,. i'l-.1"'ur.?!:*:*:.'' ication # of{ arr-*, Census Code:Does not apply Total: Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit 10t25t2001 7087 $15.00 CITY OF OREGON Fee Job#01 -01 1 83-0 1 Page 2 of 2 Administrative Fee - Mechanical Pellet lnsert Mechanical lssuance State Surcharge - Mechanical fotal Mech anical Paid On 10t25t2001 10/25/2001 10t25t2001 10t25t2001 Receipt# Va Fee Amount $3.60 $30.00 $1O.OO $3. r5 $61.75 7087 7087 7087 7087 1,995 Grand Total By signing this permiVapplication, I agree to call for an inspection(s) as required (726-3769). I state that all information on this application is correct. I further state that the appliance I am installing meets smoke emission 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 time of inspection. I also understand that if I am requesting a preliminary inspection, the wall covering may be uired to be removed. $61.7s tflzs/n Datd WOOD STOYE/INSERT INSPECTION APPLICAIION CITY OF SPRINGFIELD COMMUMTY SERVICES DIVISION. BUILDING SAI'ETY 225 Fifth Street Springf.eld, Oregot 91 417 SPFT}lGFIELD Off.ce: 726-3'759 INSPECTION LINE: 726-3769 Job Assessors Map Ta:r Owner: Address: Citj4 Value of Wood Contractor: ?3(o.LL (please circle appropriate appliance) Preliminary Tnipection is $45.00 GfiofToinstallation of insert) Wood StovelPelletllnsert Permit t$61.?5 (incluttes Permit, Issuance Fee, State Surcharge & Admio Fee). dr CrV Citr 7 efl-- Construction Contracton By siming this permit/applicatior;I agree to call;or ao in$ection(s) as reErired (726-3769). I state that all information on this application/permit is correct aod that I was provided with the Wood Stove Safety infsrmation for wood burning alryliances and preliminary inspection stadads. I firther state that the appliaocc I aoinsa[ingmeets smoke emission standads as setbythe OregonDeparmcot of Environmelrtal Quatity or the Federal Environmental ProtectionAgeocy and I agree to provide tle testing app:roral number to the inspector at the time sf inspection-I also understand that if I amrequesting a preliminary inspection, the maybe required tobe removed. FOROFFICEUSE -.>'42r REQUIRED INSPECTION(S):WOOD STO\IEIPELLET/TNSERT Date of Applicatim:Z;a/Job ol -o/ ( y3 -o Checked for DelinErencies: VALIDATION: :f,}Llf J.ts*r rJrn- ;1_1 :E! (:' m f T;pe of Inspeaion Reqr:ested: c/ tdlzs/stDT' Checked for Historical Staflrs:-:E>=-{-t E, ;tlT) f) rrt rn c.,frf." ++c,l=,.,.. rf cff'J -"1 F-.l{r+ f'.J C:)ur 4:)|}.CFr r..J --l -.I t3 EO