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Home My WebLink AboutPermit Mechanical 2007-01-03FIELD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007-00016ISSUED: 0110312007 APPLIED: 01/0312007EXPIRES: 0710312007 VALUE: SITE ADDRESS: 2180 19TH ST ASSESSOR'SPARCELNO.: 1703252101900 PROJECT DESCRIPTION: Install pellet insert Springfield TYPE OF WORK: Pellet Stove TYPE OF USE: New Residential Owner: Address: BATEMAN DONALD R & MARILYN J 2180 19TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Mechanical Contractor EMERALD SWIMMING rrl ltsNirr-ri,l"L. follow rules ado # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: SoIar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of ffi$iry the cernt*r. {t'Jote:the Height of Structure Oregon Utility Type of Heat: Water Type: ter is 1-8 he rough oAR 952-001 copies of the rules b; Ft Basement: Sq Ft Garage/Carport Sq Ft Other: nla Occupant Load: REQUIRED PARKING Phone 541-688-1090 R-3 VB Range Type: Energy Path: Sprinkled Building: IH S # $ Per Sq Ft or multiplier o//o of Lot Coverage: PERMIT IS N DONED FOR Sidewalk Type: Downspouts/Drains: IT SHALL EXPIR fils ABAN D Square Footage or Bid Amount E IF THE WO rifotal: ft$ndicapped:vCompact: PUBLIC IMPROVEMENTS Valuation Descrintion Description Type of Construction Page I of2 Value Date Calculated G Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2007-00016ISSUED: 0110312007 APPLIED: 01/0312007 EXPIRESz 0710312007 YALUE: Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Minimum/Adj ustment Mechanical Pellet Stove/Insert Total Amount Paid Amount Paid $10.00 $4.50 $2.25 $3.60 $15.00 $30.00 $6s.3s Total Value of Project Date Paid U3t07 u3t07 1t3t07 u3t07 u3107 u3t07 Receipt Number 2200700000000000009 2200700000000000009 2200700000000000009 2200700000000000009 2200700000000000009 2200700000000000009 Fees 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. Pellet Insert: 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 Cify 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 properfy, and the approved set of plans will remain on the site at all times during construction. ot lozio-t or Contractors re Pase 2 of 2 ;;;r t I nh -l Keourred lnspectlons I 225 Fifth Street Springfield, Oregon 97 477 541-716-375Y Phone Ci-' of Springfield Official Receipt L clopment Services Department Public Works Department RECEIPT #: 2200700000000000009 Date: 0110312007 10:3e:30AM Job/Journal Number coM2007-00016 coM2007-00016 coM2007-00016 coM2007-00016 coM2007-00016 coM2007-00016 Description + 5%o Technology Fee + 8% State Surcharge + llYo Administrative Fee Pellet Stove/Insert Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- Amount Due 2.25 3.60 4.50 30.00 15.00 10.00 Item Total:$6s.3s Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check EMERALD SWIMMING POOLS OF OREGON djb 6359 r In Person Payment Total: $65.35 $65.35 cReceint I Page I of I l/312007 225ElFfH STREET . S|RINGFIELD,OR97477 o S4t)ZZ6_gTSii o FA)L (54 1 )726-3689 CityJobNumber COvt't,ZoO7- OO...j^ I L Job Incation:1,t1 Assessor's Map:2o37s L \Tax Lot:nt90<3 Owner: Address: ,/ City: Phone: State: A?zip: Preliminary Inspection is $55.35 (prior to insert). Wood Stovl/peilet/Insert Permit i; $65.35 (includes applicable fees and surcharges) e Ore "" .YLrtl rugo -_itrlcofi# C3t)rp{ t-{a(') ,!-l dtr.{crp{.+J () ()n.i*tta -1t{ir.{ {Jl-((Ja t-'ti-{lri C) c -{q)(n FfLJoc JIes are n Uility hoA sel fort of the Phone ephone;zrp: ru C--ontractor: Address: nCity:ln^ir32_Contractor's Registration #: By signing this permit/application,l agree to call for au inspectiot-t (s) as required (726-3769\ I state that all iuforuratiou on pernrit is correct and that I was provided with the Wood Stove Safety wood burning appliances and preliminary inspection standards as set by the Oregon tal Quality or the Federal DEnvironmental Protectiou inspector atthe time of i inspection, the wall coverinS v a nunrber to the a preliminary cr loz loz I also ru I t0D 0R Signature:Datc: Checked for Historical Status:/--/ FOR OFTICE USE IDate of Application: Checked for Delinquencies: zooa Shared Drive(T:)iBuilding FormslMood Stove Permit 08-06.doc CITY OT OREGON rt iEr adopted 1 /o/22, ?