HomeMy WebLinkAboutPermit Mechanical 2004-10-26Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Rax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-01317ISSUED: 1012612004APPLIEDz 1012512004
EXPIRESz 0412612005
VALUE:
SITE ADDRESS: 820 S 43RD ST
ASSESSOR'S PARCEL NO.: 1802052108502
PROJECT DESCRIPTION: Install gas fireplace
Owner: MyRNA BUSS
Address: 820 S 43RD ST SPRINGFIELD OR 97478
ATTENfION:
Hlor rules
C ontldUit#ion Center.Those
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New Residential
oAR es2-sitenseContractor Type
Mechanical
0 through Expiration Date
08/31/2005
Phone
541-683-2590odfzs
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
344)
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
o//o
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
S
VN
nla
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
SH
REQUIRED PARKING
Total:
Handicapped:
q$q{Pact;
ALL EXP\RE
M\1,S PER
IF lHE
\S NOI
\S AB
ANY 180 DAY Sidewalk Type:
Downspouts/Drains:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
DEVELOPMENT INFORMATION
Description Type of Construction
Page of
Yalue Date Calculated
{
calling the
Valuation Description I
Status 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: COM2004-01317ISSUED: 1012612004
APPLIEDz 1012512004EXPIRESt 0412612005
VALUE:
Fees Paid
Fee Description
-Mechanical Issuance Fee-
+ l0o/o Administrative Fee
+ 77o State Surcharge
Gas Fireplace
Gas Outlets 1-4
Minimum/Adj ustment Mechanical
Total Amount Paid
Amount Paid
$10.00
$4.s0
$3.15
$15.00
$4.00
$26.00
$62.6s
Date Paid
r0t26t04
10t26t04
r0t26t04
10t26t04
10t26t04
10t26t04
Receipt Number
1200400000000001521
120040000000000152r
120040000000000rs21
1200400000000001521
1200400000000001521
1200400000000001s21
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 Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
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 OCCUPAITCY 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 located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
/0v
//Owner or Contractors Signature Date
Pase? of2
Keourreo InsDectrons I
225 Fifth Street
Springfield, Oregon 97 477
541-7264759 Phone
^ity of Springfield Official Receipt
---evelopment Services Department
Public Works Department
RECEIPT #: 1200400000000001521 Date: 1012612004 2:30:58pM
Job/Journal Number
coM2004-01317
coM2004-01317
coM2004-01317
coM2004-01317
coM2004-01317
coM2004-01317
Description
+ 1Yo State Surcharge
+ ljYo Administrative Fee
Gas Outlets l-4
Gas Fireplace
Minimum/Adj ustment Mechanical
-Mechanical Issuance Fee-
Amount Due
3.l s
4.50
4.00
15.00
26.00
10.00
Item Total:$62.6s
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check ASSOCIATED HEATING djb 12199 In Person 962.65
Payment totat: --56ffi
1012612004 Page I of I
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