HomeMy WebLinkAboutPermit Mechanical 1990-01-30T !-CITY OROF SP RIN
SPFINGFIELO
\,IOOD STOVE/INSERT INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
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225 Flfth StreetSpringfield, 0regon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
Job Location:
Assessors Map #:Tax Lot #.L)Cr3=[ o
Owner:
Address:
City:
Value
State:
/*nsed:rcle appro pr a app ance
Phone #: 746 /7tr'
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11 .aD filur fw*
P.rel iminary_Inspect'ion is $15.00^lprigl to instal lation of insert)wood stove/Insert Permit is $15.00'+ $0.75 state surcnirge
Type of Inspection Requested:
r't( )/).(oh),,Contractor:
Addres s :Phone #: 314-.2
City:State:
Construction Co bractors Registration #:
gna ure
FOR OFFICE USE
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By signing.-!!il_pgyit/applicat'ion, I agrge to calt for an.inspectiorequired (726-3769). I aiso state-that-all information on tnii-apprpermit is correct and that I was provided with the wood stove sar'elyfor wood burning appliances and prel.iminary inspection standards.
Ex pi res :
/-3o -/o
n(s) as
i cat'ion /
information
I NSERT a-/
Daf
PREL IM I NARYREQUIRED INSPECTION (S ):
Date of Application:
Total Amount Collected:
Receipt #:
Job #:
I
Issued By:
OOD STO
Checked for De1 inq uencies:'hecked for Historical Status: \---'
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I
I
-ADDRESS-
1830 YEMA AVE
DRSCR:PELLET ['i@D STOVE
URBAN GROWTTT BOUNDARY
-C[{NER-
SAI{DRA HUBBS 746-47L4
1830 YENTA
SPRTNGFTELD, ORECOI{ 97 477
-INFO-
NEl^/
RESIDEMIAL
1111
REPT CAT #942
-UILDING DIVISION JOB+ 9OOI5O
-LECAL-IO(I BI.OCK
F'INAL
.VALUE-
L777
L703243400356 900130 / 900202
-ENERGY- -STATS-HEATI- 2.V{ BLre ZCI{E
H2O. STORTES FTOODPIAIN
RATiGE- BEDRM rcC GRP
TJNITS
SQ FEET
C(NST TTPE
{OIVTRACTORS-
GM{L{IRCI,E S
M{TRACTOR PHSIE-34 4-558 2
PLMB-
EI,ECT-
MECH-
DESGiI-
001-026-l'imNTovE 15.00 0.75 900130 15912 $ r,777
sEQHt{rNn'lL5'l TNSPECTTCI{S + REqJTREIIEMS----- ----E)(P DATE--ACT DATE-
001-032+imD s:rovE
SEQ'-INSPECTICT{S------{OI,II{E[iITS .--.---DATE----R&SULT--INSP--
001-032-IrrcD s[ovE o^iMR ro rRIItt TREE FROM cHil,,l. 900202 oBs 25