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Home My WebLink AboutPermit Mechanical 2001-11-27SPRINGFIELD Job# 01-01308-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page Job Number: 01-01308-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 07600 Subdivision: of2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1298 00008th St Spr AssessorsMap#: 17032643 Lot: Block: Addition ctTY oF SPRINGF1EL4 OREGOAT Owner: Dulcie Chatwood Address: 1298 Bth Street Scope Of Work: Wood or Pellet Stove lnstall woodstove Phone Number: City/State/Zip: New 541-736-8976 Springfield, OR97477 Value: $0 Contractor Type MechanicalContr Contractor Ye Old Town Sweep 81905 Davisson Rd, Creswell, OR 97426 Registration # Expiration Dateh29zl I- lD'0L Phone 541485-4957 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: roup: urce: Range: To request an inspection call the 24 hour recording at a.m. will be made the same working day, inspections requ working day. requested before 7:00 a.m. will be made the following trts Required Inspections Mechanical # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total: Wood Stove Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main: -After installation. Accessory Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit 1112712001 7348 $15.00 Footage: Job# 01-01308-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Administrative Fee - Mechanical Woodstove Mechanical lssuance State Surcharge - Mechanical Total Mechanical Mechanical 1112712001 11127t2001 11t27t2001 11t27t2001 7348 7348 7348 7348 $3.60 $30.00 $10.00 $3.15 $61.75 895 Grand Total By signing this permiUapplication, I agree to callfor 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 covering may ired to be removed Signature $61.75 1',-e--Ct Date WOOD STO]IEIINSERT INSPECTION APPLICATION CITY OF SPRINGFIELD COMMI]NITY SERVICES DIVISION - BUILDING SAEETY 225 Fifth Strcet Springfleld, Oregon 91 417 SPFTilGFIELEI Office: 7264759 INSPECTION LII{E: 1 26-31 69 /r, Job Assessors lvIap 1-Ta:r co A,r,r-... l1 A 7 q/l' <4nool 6 7 o6.Is--il#",",Stwetinsert: S fi q 5 (pleasecircleappropriateappliaace) + Preliminary Ins[rection is $45.00 ofinsert) Wood StovelPellet/Insert Permiq Issnance Fee, State Surcharge & AdminFee). type of In$ection (r)c:ari g tov e € Value 05 Construction Contractors Registratiot# : C C b 5 ) 4 I expnes , i O ttt . I 0, 2 CIO ? By signing this permit/application" I agree to call for an inspection(s) as reErired Q26-316g). I state that all information on this application/p€rmit is correct and that I unas provitled with the Wood Stove Safety information for wood burning alpliances and prelininary inspecdon standards. I firther state that the appliance I am installing meets smoke emission standards as set by the Oregon Deparment of Environmental Qr:ality orthe Federal Euvironmental Protection Agency and I agree to provitle the testing apero\ral ngmber to the iqspector at tle time sf inspection. I also understand that if I am reEresting a in|pectiorq wall cwering may be reErired to be removed. FOR OFFICE USE 4 z f ffi S-25:Qz s61.75 REQUIRED INSPECTION(S) : Date of o Job #: Ol Checked for Historical -o t30E -ol 4 rr /a6 /a/--ffi Checked for DelinEtencies : - VALIDATION: Statrrs: