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HomeMy WebLinkAboutPermit Mechanical 2001-12-31SPRINGFIELD Job# 01-01439-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 ot 2 Job Number: 01 -01439-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 01500 Subdivision: i lrjtf ! !Tr. nrIL.UL SL t-'t lf 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1515 00006th St Spr AssessorsMap#: 17032642 Lot: Block: Addition: ctTY oF SPRfiNGFfiELq OREGON Owner: Pearl Dutton Address: 1515 6th Street Scope Of Work: Wood or Pellet Stove lnstall pellet stove Phone Number: City/State/Zip: New 541-746-0440 Springfield, OR97477 Value: $O Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: ' .\v, ,t''{n i.:$i "b'{ XU To request an inspection call the 24 hour recording at a.m. will be made the same working day, inspections working day. -.i before 7:00 will be made the following oa' Required lnspections Mechanical Freestanding Pellet -After installation Construction Types Occupancy Groups # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main:Accessory: ros # Of Stories: Gurrent Units: Census Code: Total: I\rts Units \80 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit Administrative Fee - Mechanical Freestanding Pellet Stove Mechanical lssuance 1213112001 12t3112001 1213112001 12t31t2001 7647 7647 7647 7647 2,500 $15.00 $3.60 $30.00 $10.00 'a Job# 01-01439-01 Page2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical State Surcharge - Mechanical Total Mechanical 12t3112001 7647 $3.15 $61.75 Grand Total By signing this permiUapplication, 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 prelimina ry inspection, the wallcovering may be ired to be removed. Signature $61.75 /g- J/ -d / Date WOOD STO\TEIINSERT INSPECTION APPLICATION CTTY OF SPRINGFIELD COMMUMTY SERVICES DIVISION. BUILDING SAFETY 225 Fifth Street Springf.eld, Oregot 91 411 SPFI}lCFIELI' Office: 725-3159 INSPECTION LINE: 726-3'1 69 Job Location: / 91 6*' s +- Assessors }vlap #:i)es 26"{ Z Ta:r /fx>o Paa \,1{r:r'r Address /fr f fL s*-'/6- OqqO city: SPA sute a7 7 Value of Wood StovelPe[et t *o**' ZJaO @lease circle appropriate appliance) Preliminary Inspection is $45.00 (p4-orlsin{talladon of insert) Wood StovelPelletllnsert Pd, t$fl-Js (ry)tudes Permig Issuance Fee, State Sr:rcharge & Admin Fee). !'pe of Inspection Requested: Address Citr Constnrction Contractors By sigdng this permit/application, I agree to call for an inspection(s) as requircd (726:j'769)-. I stat€ that aU infor.utio on this appUcatioolpernit is correct ard that I was prwided with the Wood Stove Safety information for wood burning appliances and preliminary insPecdotr standarats. I firrth€r state that the appliance I am installing meets smoke €mission sta[dards as set by the Oregon De,partmcnt of Enviroomeotal Quality or the Federal Ervironmental FroteCion Agency and I agree to provide the testing approval numberto the insPector at the time sf inlpection I also rmderstand that if I am reEresting a preliminary inspection,the coverrtrg maybe required to be removed. a a-rt-L Z FOROFFICEUSE '/ REQUIRED INSPECTION(S) : Date of 3/o Checked for DelinErencies:- VALIDATION: Job #:cy-otq77-ol :t>=--.i ;trrftc-f =f-J Ef .jm (3 ;|f Z. CRi+ H F-{ r:f ++ L.,.i C} :t) tri.. c);I Fr. r.."j *;lrl" {:)ff..fn *.:i r:) +l-.' Ln F-{ --f, Checked for Historical t/