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Home My WebLink AboutPermit Mechanical 2005-10-10Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01411ISSUED: 10/10/2005 APPLIED: 10/1012005 EXPIRESz 0411012006 VALUE: SITE ADDRESS: 712 S 37TH ST ASSESSOR'S PARCEL NO.: 1702314304003 PROJECT DESCRIPTION: Freestandingwoodstove Springfield TYPE OF WORI(: Wood Stove TYPE OF USE: New Residential PhoneNumber: 541-337-8816" Owner: Address: LEE ROTHROCK 712 S 37TH ST SPRINGFIELD OR 97478 Contractor OWNER Expiration Date PhoneContractor Type Mechanical V nofi. o(egr -0010 \s 1- 6oP\es."^ $l'i,'li'l 800-sc' - OAR # of Units: Primary 0ccupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: e Ore Energy Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 \n VN nla Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: REQUIRED PARIilNG Total: Handicapped: Compact: \$ r0$ $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Pase I of2 Value Date Calculated UU1\II(AUIUI TNI'(,ryJ o{ t [1, Y lrt-(rrryll,l\ I rl\ r (r-l(rYrA r rur\ | Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspeetion Line PERMIT NO: COM2005-0I411ISSUED: 10/10/2005 APPLIED: 10/1012005 EXPIRESz 0411012006 VALUE: Total Value of Project Date Paid Fee Description -Mechanical Issuance Fee- + l0o Administrative Fee + 77o State Surcharge Minimum/Adj ustment Mechanical Wood Stove/Insert Total Amount Paid Amount Paid $10.00 $4.50 $.r5 $15.00 $30.00 $62.6s 10/10/05 10/10/0s 10i10/05 10/10/0s 10/10/05 Receipt Number 220050000000000r407 2200500000000001407 2200500000000001407 2200500000000001407 2200500000000001407 Fees Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. witl be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Wood Stove: After Installation. Reouired Insoect 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 alt 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 /0-/o-o, Signature Pase2 of2 Date Construction Contractors Board Permit #:COmZoc- -O lL'll I 700 Summer St ftE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:ry[91@!4 Ad&ess:17L -s 37lL :1- Issued by:\4 1aDate:01 Statement: lnformation Notice to Property Owners About Gonstruction Responsibi lities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed wtth the Construction Contractors Board to sigtt thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submtt this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, antd either box 3A or 38: l. I own, reside in, or will reside in the completed structure 2. I understand that I must become licensed as a construction contractor if the strucfure is sold or offered for sale before or on completion. tr 3A. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately noti$r the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Construction Responsibilities on the reverse side of this form. (6 /o of )ofpermit applicant) (ll/hite copy to issuing agency permilfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 38. I will be my own general contractor. 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Oflicial Receipt relopment Services DePartment Public Works DePartment RECEIPT #: 2200500000000001407 Date: 10/10/2005 1:14:53PM Job/Journal Number coM2005-0141I coM2005-014l l coM200s-0141I coM2005-0141I coM2005-0141I Description + 7%o State Surcharge + l0% Administrative Fee Wood Stove/Insert Minimum/Adjusment Mechanical -Mechanical Issuance Fee- Item Total: Amount Due 3.15 4.50 30.00 15.00 10.00 $62.65 Check NumberPayments: Type ofPayment Paid By Received By Batch Number Number How Received Amount Paid CreditCard LEE ROTHROCK djb 164624 In Person Payment Total: $62.6s -$62J-t 't i ,l t0/1012005 Page I of I '.D'TIOTBA