HomeMy WebLinkAboutPermit Mechanical 2006-05-17Status 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: COM2006-00581ISSUED: 0511712006
APPLIEDT 0511712006
EXPIRESz llll712006
VALUE:
SITE ADDRESS: 2783 20TH ST
ASSESSOR'S PARCEL NO.: 1703244205000
PROJECT DESCRIPTION: Install wood stove
Springfield TYPE OF WORK: Wood Stove
TYPE OF USE: New Residential
PhoneNumber: 541-345-3411Owner:
Address:
Contractor Type
Mechanical
RICHARD HANES
2783 20TH ST
SPRINGFIELD OR 97477
Contractor
CHRIS B WINSLOW
License
52381
Expiration Date
0l/10/2008
Phone
541-89s-3s93
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# 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:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
R-3
VN
nla
[ 1HE
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PFR\
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
DEVELOPMENT INFORMATION
Description Type of Construction
Pase I of 2
Value Date Calculated
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Valuation Description I
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Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2006-00581ISSUED: 0511712006
APPLIEDz 0511712006
EXPIREST llll712006
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ l0oh Administrative Fee
+ 87o State Surcharge
Minimum/Adjustment Mechanical
Wood Stove/lnsert
Total Amount Paid
Amount Paid
Total Value of Project
Date Paid
sn1/06
5n7t06
5lt7106
5n7t06
5n7t06
Receipt Number
1200600000000000664
1200600000000000664
1200600000000000664
1200600000000000664
r200600000000000664
$r0.00
$4.s0
$3.60
$15.00
$30.00
$63.10
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
wilt be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
Wood Stove: After Installation.
Reouired Insnections
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.
n t4*-:
Wsignature
Paee 2 of 2
Date
ltees Pard I
225fIF-fH STREET . SPRINGFIELD,OR97477 o PI'l:(541 726-'.175i. o FAX: (541 726-3689
CityJob
Job Location: Z?93 ?
Number CC .4 zoo L-C>o Se/
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Assessor's Map:t2o3 Z vr{ z Tax Lot:O Sc)o <s
Owner:4./\.72
2on Phone:
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zip:
Address:
SCity:
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State: O r-
Freliminary Inspection is $45.OO + tO% Administrative Fee (prior to insert)
Wood Stove/Pellet/Insert Permit is $63.10 (includes Permit, Issuance Fee, State Surcharge artd Administrative Fee)
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Contr actor Information
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Construction Contractor's Registration #:fzTe(
Phone:8qr- e r7 5
State: o..-
By sigrring this permit /application,l agree to call for atr inspection(s) as required (726-3769)
t itate thit all information on this application/pernrit is correct and that I was provided with
Signature:
fiate of Application:
rOR OrtICE USE
Date:
o G
-/'---- Checked for Historical Status:Checked for Delinquencres:
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Shared Drive(T:)tsuilding Foms,{Vood Stove Pemit l -06.doc
CITY OF GFIELI},
rter. (I
Zip: ? qz +
Expires: | -f 1o t
the Wood Stove Safety infornration for wood burr-ring appliances
standards as set by the Oregon Departtrtent of Environuteutal Quality or
Environrrrental Protection Agerrcy and I agree to
inspector at the time of inspection. I also
inspection,the wall coverinS may be required to
180 D NY
I
225 Fifth Street
Springfield, Oregon 97 477
54t-726,3759 Phone
C"v of Springfield Official Receipt
- telopment Services Department
Public Works Department
RECEIPT #: 1200600000000000664 Date: 0511712006 e:16:46AM
Job/Journal Number
coM2006-00581
coM2006-0058r
coM2006-00581
coM2006-00581
coM2006-00581
Description
+ 8%o State Surcharge
+ l0%o Administrative Fee
Wood Stove/Insert
Minimum/Adjusfment Mechanical
-Mechanical Issuance Fee-
Amount Due
3.60
4.50
30.00
15.00
10.00
Item Total:$63.10
Payments:
Type ofPayment Paid By
Check Number
Received By Batch Number
Authorization
Number How Received Amount Paid
Check YE OLD TOWN SWEEP djb 17904 In Person $63.10
Payment Total:
-56TiT-
cReceint I Page I of I 511712006