HomeMy WebLinkAboutPermit Mechanical 2002-05-15SPRINGFIELD
Job# 02-00574-0'l
RESIDENTIAL PERMIT
City Of Springfield
Gommunity Services Division
Building Safety
Page 1 of2
Job Number: 02-00574-01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot#: 00201
Subdivision:
225 Fifth Street
Springfield, OR97477
Location Of Proposed Site: 157 00012th St 81 Spr
AssessorsMap#: 17033541
Lot: Block: Addition:
crrY oF SPRINGFTELD, OREGOTV
Owner: Freeman Borchardt
Address: 157 12lh Street SP 81
Scope Of Work: Wood or Pellet Stove
Phone Number:
City/State/Zip:
743
541-726-2157
hB
Expiration Date
8t26t2002
Phone
541-746-6221
S
tos
Contractor Type
MechanicalContr
lnstallwood stove
Contractor
Good Deal Metal Products lnc
5322Main St, Springfield, OR 97478-6274
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
Buildings:
Group:
rce:
To request an inspection call the 24 hour recording at 726-3769. All
a.m. will be made the same working day, inspections requested after
working day.
ng
Wood Stove
Construction Types
Occupancy Groups
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(sq.
Main
-After installation
Accessory:
Required lnspections
Mechanical
# Of Stories: Height (feet):
Gurrent Units: Proposed Units:
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit 05t15t2002 9047 $15.00
Utt\lt',
before 7:00
will
Job# 02-00574-01 Page2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
8% Administrative Fee - Mechanical
Woodstove
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
05t1512002
05t15t2002
05t15t2002
05t15t2002
9047
go47
9047
9047
1,380
$3.60
$30.00
$10.00
$3.1 5
$61.75
Grand Total
By signing this permiVapplication, I agree to call for an inspection(s) as required (726-3769). I state
that all information on this application is correct. I further state that the appliance I am installing meets
smoke emission standards as set by the Oregon Department of Environmental Quality or the Federal
Environmental Protection Agency and I agree to provide the testing approval number to the inspector
at the time of inspection. I also understand that if I am requesting a preliminary inspection, the wall
may be be
Date
$61.75
Ot'-l{--o}
225 FIFIH STREET . SPRINGFIELD, OR 97477 r PH:(541)726-3753 e FAX: (541)726-3689
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Assessors
€rre ,r',^n, 4,rncr+A 2$7Owner
Address S N 1d" s SP 7I
City ,o
Value of Wood Stove/Pellet
1$
Preliminary Inspection is $45.00 (prior
Wood Stove/Pellet/Insert Permit is $61.7
.1 acl-te J I 5
rt
Zip 924-7
(please circle appropriate appliance)
fssuance Fee, State Surcharge & Admin Fee.)
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\$
contractor G o o'D Dgr I yY E14L
)'Ci
Address '{bzL yTV)t*,) S-1-Phone
.o q
Construction Contractors Registration \r"-ab-bL
By signing this permit/application, I agree to call for an inspection(s) as required (726-3769). I state that all
information on this application /permit is correct and that I was provided with the Wood Stove Safety
information for wood burning appliances and preliminary inspection standards as set by the Oregon Department
of Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing
approval number to the inspector at the time of inspection. I also understand that if I am requesting a
preliminary inspection, the wall covering may be required to be removed .
I Date C- tr-o,
For Office Use
Date of Application
Checked for
OSrtoL
Shared Drive(T:)/Building Forru/Wmd Stove Permitl42.doc
for Historical Status a---- '
CITY OF.SPRINGFIELD, ORECON
C o n t rsct 0 r I n fa r m atio rt
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