HomeMy WebLinkAboutPermit Mechanical 2003-09-26F
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54l-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-00966ISSUED: 0912612003APPLIEDz 0912512003
EXPIRESz 0312612004
VALUE:
SITE ADDRESS: 33710TH ST
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION:
Springfield TYPE OF WORK: Wood Stove
1703351415300
TYPE OF USE: New
Install wood stove-requires wood stove application
OwneT: CHERRY CHRJSTIAN B
Address: 337 10TH ST SPRINGFIELD OR 97477
Contractor Type
Mechanical
Contractor
MARSHALLS INC
Expiration Date
12t23t2003
Residential
Phone
54r-747-7445
License
25790
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
R-3
VN
torthe
Center
Lot Size:
Sq Ft lst outo
Total:
Handicapped:
Compact:
E \I lHE
irntutr
l
PARKING
WORK
IS NOl
1
is1
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
DONED t0R
Total Value of Project
Page I of2
PUBLIC IMPROVEMENTS
Description Type of Construction Value Date Calculated
Building/Combination Permit
UUN I lNli(rt:UuArr[rN I
l, U lLfrll\ tr I1\ r' !=lr(rvrA r rUN-]
UtiltU
.u t 1r"
\iiiS P
ANY 1u0
Valuation Description I
DAY
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2003-00966ISSUED: 0912612003APPLIEDz 0912512003EXPIRESz 0312612004
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ l0oh Administrative Fee
+ 77o State Surcharge
Minimum/Adj ustment Mechanical
Wood Stove
Total Amount Paid
Amount Paid
$10.00
$4.50
$3.1s
$rs.00
$30.00
$62.6s
Date Paid
9t26t03
9t26t03
9t26t03
9t26t03
9t26tl3
Receipt Number
2200200000000001590
2200200000000001590
2200200000000001590
2200200000000001590
2200200000000001590
Plan Reviews
To Request an inspection call the 24 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 Wood Stove: After Installation.
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 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 located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
4-u,oq
or Contractors Signature Date
Pase2 of?
hees raro I
Keoulreo lnspecuons I
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City 0f Springfield Official Receipt
Development Services I)epartment
Public Works Department
#z 1590 Date:2:43:26PM
coM2003-00966
coM2003-00966
coM2003-00966
coM2003-00966
coM2003-00966
+ 7o/o State Surcharge
+ l0o Administrative Fee
Wood Stove
Minimum/Adj ustment Mechanical
-Mechanical Issuance Fee-
Item Total:$62is
3. l5
4.50
30.00
15.00
10.00
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check MARSHALS INC djb In Person
Payment Total:
$62.65
$62.65
225 l'lFfll STREET . SPRINGFIDLD, OR 97477 r PH:(541)726-3753 r FAX: (541)726-11689
City Job Number @naZoc>3 '' OC ?66
3-3-7 t a+L S
.lob Location
Assessors ?o'3 t/Lot /5 3cr <3
ST *r"/Owner
Address 33 2 tr>y'L E=+Plione
zip 7-7V7 7
(please circle appropriate appliance)
o-{1-
City /Ltt\( G Fr ez*J,State
Value of Wood Stove/Pellet Stove/ln <i
Preliminar-v Inspection is $i45.{}0 (prior to insert)
Woocl Stove/Pelletilnsert Permit is $62.65 (includes
\o
Surcharge & Admin tsee.)
gI
t' o n tracto r; I rtfo r mo ti o tt
Address
tltto a
Construction Contractors Registration
o(bt
lication, I agree to .for an ln
\ne L7 t'Ln to(1 O
ZS17O
?tq z <<
tz-z)-c)l
1\\E 3169). I state that all
ood Stove Safety
as set by the Oregon Department
'Agency and I agree to provide the testing
that ifl am requesting a
\
C At-
-71
By signing this pemit/app
infbnlation on this application ipermit
information for wood burning appl
of Environmental Quality or the Federal
approval number to the inspector at the
preliminary inspection, the wall covering be removed
'. z q-Lb*o)
Date
For Office Use
Checked for Delinquencies
7-Zs-oE
ChaobpA
Shared Drive(T:)/Building FomsVood Stove Pennitl -03.doc
Date of Application
for Historical Status-
rltrl
Orp{p
s3
Orfi
F{p*
r),l-t
CIFIA\Jrp{#
()
()
(1,t-l
U)
(-'{
FItl-{
I
$-,(
()
(A
dF{
lri(
()
os
V)
!5
Cc
F
CIry OF SPRINGFIELD, OREGON