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Home My WebLink AboutPermit Mechanical 2003-09-11Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00891ISSUED: 0911112003APPLIEDT 0911112003EXPIRES: 03/1112004 VALUE: SITE ADDRESS: 7r2 S 37TH ST ASSESSOR'S PARCEL NO.: 1702314304003 PROJECT DESCRIPTION: Install propane range, tank, and line. Owner: THOMpSON ROBERT J Address: 712 S 37TH ST SPRINGFIELD OR 97478 Springfield TYPE OF WORK: Mechanical Onty TYPE OF USE: Addition Residentiat License Expiration Date PhoneContractor Type Mechanical Contractor OWNER TION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: R-3 VN Heat: Type: Type: Energy Path: Structure Square Footage or Bid Amount Lot Size: Sidewalk Type: Downspouts/Drains: tlo.."us$Area: PARI(ING Total: Handicapped: Compact: $ Per Sq Ft or multiplier Total Value of Project Page I of2 ION PUBLIC IMPROVEMENTS Description Type of Construction VaIue Date Calculated ruH L(r1\ Overlay # Street DrivePaYed LotofY" Valuation Description I Building/Combination Permit Status Issued 225 Fifth Street, Spring{ield, OR 541-726-3753 Phone 541-726-3676Fax S4l -7 26-37 69 Inspection Line PERMIT NO: COM2003-00891ISSUED: 0911112003APPLIEDz 0911112003EXPIRES: 03/1112004 VALUE: Fees Paid Fee Description -Mechanical Issuance Fee- + l0o/o Administrative Fee + 77o State Surcharge LP Gas Tank & Piping Minimum/Adj ustment Mechanical Total Amount Paid Amount Paid $10.00 $4.50 $3.1s $12.00 $33.00 $62.65 Date Paid 9nu03 9fiu03 9nu03 9ny03 9nU03 Receipt Number 1200200000000002105 120020000000000210s 120020000000000210s 120020000000000210s r20020000000000210s 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. I Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2 Rough Mechanical: Prior to Cover 3 Final Gas: When all gas work is complete. 4 Final Mechanical: When all mechanical work is complete. nsnections 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 Springlietd 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 all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is at the front of the property, and the approved set of plans will remain on the site at all times during q il c3 Orvner Pase2 of2 Date M( i-?,2 lqr\ 225 FIFTII STREET o SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541)726-3659 City Job Number -oo gg Date q /[ o3EI & 2 Family Dwelting or Accessory tr New Construction tr Multi-Famity tr AdditioniA.lteration/Replacement tr tr n Commercial/Industrial tr JobAddress 7f L J'. 372* Tenant Improvementrf Bldg No. Tax Map/Tax Lot Demolition Other Suite No. Lot - Block Subdivision Project Name Description of Work/location on premises/special conditions tNtTAtt ffto26a4 {?[uGF, Tfi/vE, L/1tt* Otoner Name ILUP M.o tP oc Mailing Address >228 AJ .tr. Z>New Dwelling Area City Poer.r,n^"o State O.4 Zip q 7'2 lZ-SaragelCarportArea phone (50 3) Z8i 31l\ ru*Other Structure Area Owner Representative Total Value Phone Fax t&zFannilgDwelting SQ Ft x $/sQ Ft Value ita x $/sQ Ft Value Applicant Name LsE Ia 0 T\4 ga)C < Mailing ciryg ?EJ-@.-?!E!-2- state o 2- zip Q 7178 Phon"741 /QA2- Fu* tr Ar ehit e ct / D e s i g ner / E ng ine er Name Address City State zip Contact Person Phone tr Contractor(s) Contractor's Name SQ Ft Existing Building Area _ New Building Area Total Value Existing New Occupancy Group(s) Const. Type(s) Fax Number of Stories CCB#Expiration Date Phone # General Plumbing Mechanical Electrical n Cornmercial/InclustrialPrajec* n Resirlentfclh'oiects Has site review application been submitted? Heat Source: Primary E ves E No fl Nln If so, Name of Planner Water Heater Range Do you require any of the following for this project? Over-width or Second Driveway Temporary Power Secondary Energy Puth _ Ives Exofl Yes E No Journal Number Notice: All contractors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon under ofORS 701 and be to be licensed in the urisdiction where work is BUILDTNG PERMIT APPLICATION For Ollice Use Onlg BY IMPDATEo5_\\-o3{bL. bs RCPT#PLAN CHECK FEE Shared Drive(T:)iBuilding Forms/Building Pemtit Application l0-02.doc CITY OF OKTGON 225 Fifth Street r Springfield, Oregon 97 477 541-726-3759 Phone o City of Springfield Official Receipt Develop ment Services Department Public Works Department 0000000000210s z 0911112003 ,, coM2003-00891 coM2003-00891 coM2003-00891 coM2003-00891 coM2003-00891 Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- LP Gas Tank & Piping + 7%o State Surcharge + l0% Administrative Fee 33.00 10.00 12.00 3. l5 4.50 Item Total:$62.65 Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid CreditCard LEE R ROTHROCK j..,p 000165 135759 In Person Payment Total: $62.6s $62.6s C