HomeMy WebLinkAboutPermit Mechanical 2003-03-17Status: Issued
225Ftrth Streef Springfield, OR
541:726-3753 Phone
541-726-3676Fa;x
541:726-37 69 Inspection Line
Building/ Comb in atio n Permit
PERMIT NO: COM2003-00179ISSUED: 0311712003
APPLIEDz 0311712003E)3IRESz 0911712003VALUE: $ 1,550.00
SITE ADDRESS: 888 S 46TH ST
ASSESSOR'S PARCEL NO.: 1802051207500
PROJECTDESCRIPTION: Installwoodstove
Owner: SOULIA FRANCES D & ROBERTL
Address: 888 S 46TH ST SPRINGFIELD OR 97478
Springfield TYPE OF
License
19364
TYPE OF USE: New
Wood Stove
Expiration Date
10t20t2003
Residential
Phone
541-343-ll3l
Contractor Tvpe
Mechanical
Owner
Contractor
MIDGLEYS
SOULIA FRANCES D & ROBERT L
TION
# of Buildings:
Primary OccupancY GrouP:
Secondary OccuPancY
Primary Construction TYPe
Secondary Construction
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
\T.{
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport:
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street
Storm Sewer Available:
Speciat Instruction:
Notes:
Description Tvpe of construction $ Per Sq Ft square Footage
lof2
Value Date Calculated
S
Status: Issued
225 Fifth Streef Springfield, OR
541.:726-3753 Phone
541-726-3676 Fzx
541:7 26-37 69 Inspection Line
FIE
Buildin g/C ombin ation Permit
PERMIT NO: COM2003-00179ISSUED: 03fi7t2003APPLBDz 03fi7t2003E)PIRES: 09tt7t2003VALIIE: $ 1,550.00
Amount Paid
Total Value ofProject
DateFee Description
-Mechanical Issuance Fee-
+ liYo Administrative Fee
+ 7Yo State Surcharge
Minimurn/Adj ustment Mechanical
Wood Stove
Total Amount
$r0.00
$4.50
$3.15
$1s.00
$30.00
3lt7t03
3fi7/03
3ll7t03
3n7/03
3n7/03
Receipt Number
1200200000000000840
1200200000000000840
r200200000000000840
1200200000000000840
1200200000000000840
$62.65
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. AII 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.
I Wood Stove: After Installation.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certiff 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
hereirq and that NO OCCUPANCY will be made of any structure without permission of the C-ommunity Services Division,
Building Safety. I further certiff 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.n4,- -9.*,t-,a R-t
ons
Owner or Contractors Signature
2of2
Date
3/t7tzbt"3
2:05:O7I uI
City of Springfield
Development Seroices Department
Public Works Department
Oflicial Receipt
225 Fifth Street
Springfield, Oregon 97 477
541:726-3759 Phone
Receipt #z 1200200000000000840
Date: 0311712003
Line Items:
Amount Paid
Job/Journal Number
coM2003-00179
coM2003-00179
coM2003-00179
coM2003-00179
coM2003-00179
Wood Stove
Minimum/Adj ustment Mechanical
-Mechanical Issuance Fee-
+ lYo State Surcharge
+ l\Yo Administrative Fee
30.00
r5.00
10.00
3.15
4.50
Line Item Total $62.6s
Pavments:
Type ofPayment Paid BY Received By Check Number Confirm No How Received Amount Paid
i
djb In Person 62.65CheckFRANCES SOULIA
Total:$62.6s
Page 1 of I cReceipt.rpt
Description
225 IIFIH STREET . SPRINGFIELD,OR 97477 r lH:(541)726-3753 o FAX: (S41)726-g6g9
City Job N'mber &tu< Zoo) - c)o t-/ 1
Job Location s
Assessors goZ o-st'L
sr 'fltNho€tEt-t)
Lot o'7to()
Owner (oB SouLt A
Address 9lR .S 4c *t, Sr Phone 147-0O f(
Zip Qzlz g
(please circle appropriate appliance)
City S Przrnt G Ft €u>StateI
Value Wood
Preliminary Inspection is $45.00 (prior to insert) *'/tr:-
Wood Stove/Pellet/Insert Permit is. $61€lincludes Permit,
l_- L
fuo* zZ- p7-
Issuance Fee, State Surcharge & Admin Fee.)
Address
Nlr L6l 5
C €
Construction Contractors Registration
AV€
inspector at the time
the wall covering
I l+oz
03
3769). I state that all
ood Stove Safety
as set by the Oregon Department
and I agree to provide the testing
that if I am requesting a
- tt Tt
IDatet1 o
OL
I (,
\t
By signing this permit/application, I agree to call
information on this application /permit is correct
information for wood burning appliances
of Environmental Quality or the Federal
for an
that
approval number to the
preliminary inspection,
\$$
For Office Use
03 llo=
Checked for Delinquencies \,/ .lnecked
Shred Drive(I:)/Building Forms/Wood Stove Pemitl -02.doc
Date of Application
for Historical
CITY OF SPBINGFIE,LD, OREGON
t,,
OL
C o ntr acto r I rtfo rm ati on
\$
<\x\
ef\'
.{
5E q..-"^7ir