HomeMy WebLinkAboutPermit Mechanical 2003-02-14Gity of Springfield
Mechanical Permit
Status: Issued
225 Fifth Sheet
Springfield, Oregon 97 477
541-726-37 59 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
MEC2003-00010
2n4t2003
2n412003
8t14t2003
SITE ADDRESS:
ASSESSOR'S PARCELNO.:
440 35TH ST
1702312412200
Springfield
TYPE OF WORK:
TYPEOF USE:
sU to
New
Residential
PROJECT DESCRIPTION: Install Free Standing Pellet Stove .j
OWI\ER/APPLICAITIT:
ALLEN DONALD C
440 35TH ST
SPRINGFIELD OR 97478
CARTERMARIE
440 35TH ST
SPRINGFIELD OR 97478
o irrtes
st tne
\lrc
54r-744-9319
\ne \he
Amount Paid
4.s0
3.15
10.00
15.00
30.00
n Receint Number
220020000000000048 I
220020000000000048 r
220020000000000048 I
220020000000000048 I
220020000000000048 1
Descriotion
+ l0% Administrative Fee
+ 7Yo State Surcharge
-Issuance Fee-
Minimum/Adiustments - Mech
Pellet Stove/Insert
02n412003
0211412003
02114t2003
02tr4t2003
0211412003
To Request an inspection call the 24 hour recording at7264769. All inspe ctions
the same working day, inspections requested after 7:00 be
Required Inspections:
1 Freestanding Pellet
By Signafure,I state and
1
Stove: After installation
a.m. will be made
agree, that I have carefully application and do hereby certify that all
information hereon is true and conect, 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. I
further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I
fu1her agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, and that the approved set ofplans, if applicable, will remain on the site at all times during construction.
Date
lofl
3FBU{A'IILD
lEN \s
1s0
(D"#zn/A-
Owner or Contractors Signature
2/14t2003
3:19:24PM
City of Springlield
Development Serrices Department
Public Works Department
Oflicial Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #z 220020000000000048 1
Date: 0211412003
Line ltems:
Job/Journal Number Description Amount Paid
MEC2003-00010
MEC2003-00010
MEC2003-00010
MEC2003-00010
MEC2003-00010
Pellet Stove/Insert
Minimum/Adjustments - Mech
-Issuance Fee-
+ lYo State Surcharge
+ l0o/o Administrative Fee
Payments
30.00
15.00
10.00
3. l5
4.50
Line Item Total:$62.6s
Tlpe of Payment Paid By Received By Check Number Confirm No How Received Amount Paid
Check C MARIE CARTER djb In Person 62.65
Total:$62.6s
Page I of I cReceipt.rpt
.tlr*lf*crir-*Lt|
225 FIFIT{ STREET . SPRINGFIELD, OR 97477 o PI{:(541)726-3753 o fAX: (541)726-3689
Citv.loU Number tl{t<Zoot -oe/o
Job
Assessors t7oz7 Iz1 'ax Lot / zzo<)
Owner
Address Z
City {^o/tvD Q,./J State OK zip/' 6
Or4Value of Wood (please circle applopriate appliance)
Prelim ina ry In specti on i s $-15. 00,(pri dr to= inseft )
Wood Stove/Pellet/I nse rt Pe rnt(t1s $62. 65 (iucludes & Admin Fee.)
Yal\.
Address
Ci
Construction Contractors Regi stration !s
\l'str
By signing this permiVapplication, I agree
information on this application /permit is
information for wood burning appliances and
of Environmental Quality or the Federal
approval number to the inspector at the time
69). I state that all
Stove Safety
standards as set by the Oregon Department
Agency and I agree to provide the testing
I also understand that ifI am requesting a
Date OZrTof
preliminary inspection, the wall covering may be required to be removed .
(
S
For Office Use
Date of Application oztvo3
Checked for Delinquencies L/ Checked for Historical Qf efrrc
Shrcd Drive(T:),rBuilding FomsA[ood Stove Pemitl-03.doc
CITY OF SPRINGFIELD. OREGON
Phone 714 ' ? 3/ ?
7: i ,-r
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Con#actor Ixforruation
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7in-
City of Springfield
225 Fifth Street Springfield, Ox-97477
541-726-3759 Phone
541-726-3676 Fax
July 18, 2003
ALLEN DONALD C
440 35TH ST
SPRINGFIELD
Job Number:
Location:
oR 97478
MEC2003-00010
440 35TH ST
Project:Install Free Standing Pellet Stove
Dear PermitHolder:
The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid,
the work wtrictr has been authorized by the permitmustbegin wthin 180 days of the date of isuance, and an
inspection must be requested at least every 180 days.
According to our rccords, you obtained a permit for a projeet at 440 35TH ST which is set to expire on
811412003. Our records indicate that you have not requested an inspection within ttre past five (5) months. This
letter is written to notify you that your permit$) wiil be expiring shortly. If you are ready to request an
inspection for your project, please phone the inspection line at 541-726-37 69. If you do not request an inspection
prior to the expiration date, your psrmit($ will expire and additional permit fees will be required in ordsr to
complete your project.
If you have any questions, please feel free to phone me at 541 -726-3790.
Sincaely,
Lisa Hopper
Building Safety Supervisor