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Home My WebLink AboutPermit Mechanical 2004-12-02Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-01475ISSUED: 1210212004APPLIEDz 12/02/2004 EXPIRESz 0610212005 VALUE: SITE ADDRESS: ?LL?YOLANDA AVE ASSESSOR'S PARCELNO.: 1703244300700 PROJECT DESCRIPTION: GAS FIREPLACE INSERT Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential Owner: RODNEy WORI(MAN Address: 2II2YOLANDA AVE SPRINGFIELD OR 97477 PhoneNumber: 541-746-6689 Contractor Type Mechanical Contractor MARSHALLS INC Expiration Date 12t23t2005 Phone 541-747-7445 License 25790 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: # Street Paved Drive 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: N0t /csrHB A(/rf ANY ,IFNC Pt8Itt r nla tt BO Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: P€S/ /s0,4y P54 REQUIRED PARIilNG Total: Handicapped: Compact: / $ Per Sq Ft or multiplier Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: Total Value of Project Description Type of Construction Page Value Date Calculated rYl\-l L\ L UlLtrIl\ t rr\ I (rllLlYr4fllzll l /s Nor GFEI],t.CFISI-D Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-01475ISSUED: 1210212004APPLIEDz 1210212004 EXPIRESz 0610212005 VALUE: Fees Pa Amount Paid Date Paid Receipt Number 1200400000000001683 1200400000000001683 1200400000000001683 1200400000000001683 1200400000000001683 1200400000000001683 1200400000000001683 Fee Description -Mechanical Issuance Fee- + l0Yo Administrative Fee + 77o State Surcharge Gas Fireplace Gas Outlets 1-4 Minimum/Adj ustment Mechanical Minimum/Adj ustment Mechanical Total Amount Paid $10.00 $4.s0 $3.rs $rs.00 $4.00 $1.00 $2s.00 t2t2t04 t2t2t04 t2l2t04 t2t2t04 t2t2t04 t2t2t04 t2t2t04 $62.65 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. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Reouired Insnect 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 70f .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 0 or Contractors Signature Ptge2 of2 Date 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone rrty of Springfield Official Receipt velopment Services DePartment Public Works Department RECEIPT #: 1200400000000001683 Date: 1210212004 2:t7z22Pll Job/Journal Number coM2004-0147s coM2004-01475 coM2004-01475 coM2004-01475 coM2004-01475 coM2004-0147s coM2004-01475 Description Gas Outlets l-4 Gas Fireplace -Mechanical Issuance Fee- Minimum/Adj ustment Mechanical Minimum/Adjustment Mechanical + 7Yo State Surcharge + lUYo Adminishative Fee Amount Due 4.00 15.00 10.00 25.00 1.00 3.15 4.50 Item Total:$62.6s Payments: Type ofPayment Paid By UheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check MARSHALLS INC DLM 18332 In Person $62.65 Payment Total: -56ffi t2t2t2004 Page I of I SFeliloPllLo