HomeMy WebLinkAboutPermit Mechanical 2001-10-01SPRIilGFIELD
Job# 01-01069-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
Job Number: 01 -01 069-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00332
Subdivision:
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2445 00017th St Spr
AssessorsMap#: 17032434
Lot: Block: Addition:
ctTY oF SPRINGFTELD, OREGON
Owner: Byron Buss
Address: 2445 17th Street
Scope Of Work: Wood or Pellet Stove
Pellet stove insert
Phone Number:
City/State/Zip:
New
541-747-8639
Springfield, OR97477
Value: $O
Contractor Type
Mechanical Contr
Contractor
Midgleys
1678 W 7th Ave, Eugene, OR 97402
Registration # Expiration Date Phone
541-343-1131
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
\SNOl
FOB
Sq. Footage:
To request an inspection call the 24 hour recording a1726-3769. 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 Inspections
Mechanical
Pellet lnsert -After installation.
Construction Types:
Occupancy Groups
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
Main Accessory:Total
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit 1010112001 6854 $15.00
i$ \'Ei\[[\'t
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Job# 01-01069-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Administrative Fee - Mechanical
Pellet lnsert
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
10t0112001
1010112001
10t01t2001
10t01t2001
2,250
$3.60
$30.00
$10.00
$3.1 5
$61.7s
6854
6854
6854
6854
Grand Total
By signing this permiVapplication, I agree to callfor 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 may be required to be removed
$61.75
/o^ o 1-o/
Si Date
WOOD STO\TEANSERT INSPECTION APPLICATION
CITY OF SPRINGFIELD
COMMI]MTY SERVICES DTVISION -BUILDING SAFETY
225 Fifth Street
Springfi.eld, Oregot 91 417
SPFINGF!ELD
Offi,ce: 726-3'759 .
INSPECTION LINE: 726'37 69
Job Z t-l -rct
l"O3 Z"t 94 oo33 ZLo#:
Owner: 3{(o O B.rss
Address:
c-tr
Value of Wood
Preliminary Inspection is $45.00
7Ys-
D Rr36'o,.)
zz ,OO (please circle appropriate appliance)
of insert)
Pemit, Issuance Fee, State Surcharge & AdminFee).Wood StovelPelletllnsert
Tnoe of Insoection Reouested:
l\l f)GL€Q<.
$6r.7s
1 U\)Tt{UC 3,1 3-/13t
orJ : Q-zLloz
Constnrction ContractorsRegistratior#: Expiret,.--=
By signing this permit/application, I agree to call for an inspeaion(s) as required (126'3769). I strate that
all inforrnation onthis apptication/permit is correct and that I was provided withthe Wood Stove Safety
information for wood burning appliances and preliminary inspection strndarrls. I further state that the
alryliance I am installing meets smoke emission standards as set by the Oregon Deparment of
Euvironmental Quatity or the Federal Euvironmental Protection Agency and I agree to prwide the testing
approval number to the inspector at the time sf inspectioL I also undersEnd that if I am requestiug a
preliminary inspectio& the wall covering may be required to be removed.
-** "4!lO- / -otilDate
FOROFFICE USE
REQIJIRED INSPECTION(S)
Date of
Checked for Delinguencies :
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VALIDATION:
C Checked for Historical Status:
Assessors }vlap