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Home My WebLink AboutPermit Mechanical 2004-01-13Status Issued 225 Fifth Street, SPringfield' OR 541-726-3753 Phone 541-726-3676Bax 541-7 26-37 69 InsPection Line B uildin g/ C o mb in atio n P e r mit PERMIT NO: COM2004-00043ISSUED: 0111312004 APPLIED: 01/1312004 EXPIRESz 0711312004VALUE: $ 2,700.00 SITE ADDRESS: 2555 15TH ST ASSESSOR'S PARCEL NO.: 1703243200316 PROJECT DESCRIPTION: Freestanding pellet stove Owner: NICKLOS MILLETT Address: 255515TH ST SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential Contractor Tvpe Mechanical Contractor MIDGLEY'S License 019364 1BO D Square Footage or Bid Amount Expiration Date lyl312004 Phone 343-1131 # of Units: 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 tollow lres you IU on UtilitY e rules are set for OAR 952-0c # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Vo oflot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/CarPort Sq Ft Other: Impervious Surface Area: Sidewalk Type: REQUIRED PARJilNG Total: Handicapped: Compact: IF THE WORKInstrffip11ONOregon dby iaw requ the Oreg rules adoPte ER MIT tS NOT ONED FOR 6q Ft'or multiplier Total Value of Project Page 1 of2 Notes: rlotification Genter . Thos Value Date Calculated Phone Number: 541'726'6797 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax S4l -7 26-37 69 Inspection Line Building/Combination permit PERMIT NO: COM2004-00043ISSUED: 0111312004APPLIED: 01/1312004 EXPIRESz 0711312004VALUE: $ 2,700.00 Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 7o/o State Surcharge Minimum/Adj ustment Mechanical Pellet Stove/Insert Total Amount Paid Amount Paid $10.00 $4.s0 $3.15 $1s.00 $30.00 $62.6s Date Paid ut3t04 ut3t04 Ut3t04 Ut3t04 ut3t04 Receipt Number 2200400000000000027 2200400000000000027 2200400000000000027 2200400000000000027 2200400000000000027 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 Freestanding Pellet 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 stree! 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 /-t7-D/ Owner or Contractors Signature Date Paee2 of2 T Iees ralo I Keourreo lnsDecuons I 225 Fifth Street Springfield, Oregon 97 47 7 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #z 2200400000000000027 Date: 0111312004 10:40:47AM coM2004-00043 coM2004-00043 coM2004-00043 coM2004-00043 coM2004-00043 Pellet Stove/Insert Minimum/Adj ustrnent Mechanical -Mechanical Issuance Fee- + l0oA Administrative Fee + 7Yo State Surcharge Item Total:---T62.6-5- 30.00 15.00 10.00 4.50 3.15 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check NICKLOS L MILLETT dlm 5981 In Person Payment Total: $62.6s )$62.6s )