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HomeMy WebLinkAboutPermit Mechanical 1990-01-30T !-CITY OROF SP RIN SPFINGFIELO \,IOOD STOVE/INSERT INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION w 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' Zi p z 77r' zz 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 Zi 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: \---' ox 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