The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2006-09-15{8p&t+at3Ft€*xt Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2006-01201ISSUED: 0911512006 APPLIED: 09/1512006 EXPIRES: 03/1512007 VALUE: SITE ADDRESS: 220 25TH ST ASSESSOR'S PARCEL NO.: 1703361415500 Springfield TYPE OF WORK: Pellet Stove TYPE OF USE: New Freestanding pellet stove Residential PhoneNumber: 541-746-9668Owner: Address: Contractor Tvpe Mechanical DARWIN WINN 220 N 25TH ST SPRINGFIELD OR onc caillltv' nurnber Contractor AMBASSADOR PIPING INC License 121469 Expiration Date 03t27t2007 Phone 54r-726-5723 TION # of Unitsr Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: REQUIRED PARKING Total: Handicapped: Compact: R-3 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 'h of Lo\ Coverage: Sidewalk Type: Downspouts/Drains: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INFORMATION Description Type of Construction Page 1 of2 Value Date Calculated a h PROJECT DESCRIPTION: \su rnaY Noi \t cn I' U ILUII\ U II\ T (JKIVIA I T('I\ \\Lt6\' Valuation Description I Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 I nspection Line PERMIT NO: COM2006-01201ISSUED: 0911512006APPLIED: 09/1512006 EXPIRES: 03/1512007 VALUE: Fee Description -Mechanical Issuance Fee- + l0o/o Administrative Fee + 57o Technology Fee + 87o State Surcharge Minimum/Adjustment Mechanical Pellet Stove/Insert Total Amount Paid Amount Paid Total Value of Project Date Paid 9nst06 9n5t06 9/15t06 9nst06 9nst06 9n5t06 Receipt Number 1200600000000001423 1200600000000001423 r200600000000001423 1200600000000001423 1200600000000001423 1200600000000001423 $10.00 $4.s0 $2.25 $3.60 $15.00 $30.00 $65.35 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. Freestanding Pellet Stove: After installation. I Insnections 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. fffu= Owner or Contractors Signature Paee2 of 2 Date ?-/n& qt ffiL.i -rees ralo I 225 Fifth Street Springfield, Oregon 97 477 541-72G-3759 Phone C;-' of Springfield Official Receipt L ;lopment Services Department Public Works Department RECEIPT #: 1200600000000001423 Date: 0911512006 l:52:03PM Job/Journat Number coM2006-0 r 201 coM2006-01201 coM2006-01201 coM2006-01201 coM2006-01201 coM2006-01201 Description + 570 Technology Fee + 8% State Surcharge + 10o/o Administrative Fee Pellet Stove/lnsert M inimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 2.25 3.60 4.50 30.00 r 5.00 10.00 $6s.3sItem Total: Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard MATTHEW CLEMENT djb 041 l0B In Person Payment Total: s65 .3 5 -ffis cReceint I Page I of I 911512006 *FnrildFr*LD 225 Fl['lH STREET r SfRINGfIELT),on sr74zz o I'H:(541)726-375 3 o FAX: (541)726-3689 CilyJob Number Corrtzoo6 '- OIZ <)( /u 25 4 s/Job location: Assessor's Map:7cl33 G tLl rax Lot / SSOO Owner: Address:7o Phone:7v6 Zf zip: ?'a/) )City:Statc: Preliminary Inspection is $55.35 (prior to insert). w".J st"rl/fetfylnsert Permit ii $es.sS (includes applicablefeex and srrcharges)' 11i-( C)rfi#d () o 1-{ F{n,l-((1i*( e1tr{cr qr{# () () e.ar<l-{i:i +Jk()a t?1)-iFr{ () \J€ CN Ec .\J F Contractor: Address: City: Construction Contract or o&Con Information Registration #:Atqb 7 L I Phone: State: f) f ,ZiP: a).-w ',, Expires: By signirrg this permit /applicatronrl agree to call for an inspection(s) as required (J26-3769) I state thatallinfomration on this appication/pernit is correct andthat I was provided with the Wood Stove Safety inforrrration ior wood burning appliances and preliminary inspection standards as set by th! Oregon Department of Environmetrtal Quality or the_Federal Environmental protection igency'andl agree to provide the testing approval nuurber to the inspector at the time of inspiction. I also undersiand that if I aur requesting a prelir-ninary inspection, the wall covering may be required to be removed' @"r,Signature: Date of Application:7-rt -oQ L/ Checked for Historical status:Checked for f)elinquencres: Shared Drive(T:)/Building Fomrs.'Wood Stove Pennit 08-06.doc OREGONCITY OF tification Center. Tho les by one IF THE WORKHT PE NDO TOROITICEUSE