HomeMy WebLinkAboutPermit Mechanical 2005-02-09Building/Combination permit
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
SITE ADDRESS: I169 36TH ST
ASSESSOR'SpARCELNO.: 1702304302401
PROJECT DESCRIpTION: Install replacement wood stove
P-ERMIT NO: COM2005-00151ISSUED: 02t09t2005APPLIED: 02t08/2005EXPIRES: 08/09/2005
VALUE:
Owner:
Address:_ryrgryDAY MELVTN G & ROSA LEEI169 N 36TH ST
SPRINGFIELD OR 97478
Springfield TYPE OF WORK: Wood Stove
TypE OF USE: Repair Residential
Phone Number: 54l-726_403g
Phone
541-688-r090
Contractor Tyrre
Mechanical
# 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 lnstruction:
Notes:
Contractor
EMERALD SWIMMING POOLS OF ORE
Notifi
R-3 in
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
OTIGE:
License Expiration Date
lo 10t22t2005
are set lorth
0 through
Ft 2nd Floor:
Ft Basement:
Ft Garage/Carport
Ft Other:
Sprinkled Building: n/a Occupant Load:
OAR952'0$1t,r".
olthe rubqryF't tsr Ftoor:
VN
RE IF THE WORK
REQUIRED PARKING
Total:
Handicapped:
Compact:
HI1
COMMEN CED OR
bnv Prn r0D
AB Sidewalk
D IOR
Type:
Downspouts/Drains:ANY 180
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
IN A
Description Type of Construction
Pase I of2
Value Date Calculated
-
Valuation Description I
Buildin g/Com bin ation permit
Status: Issued
?11\i!th Streer. Springfietd, oR541-726-3753 phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ lioh Administrative Fee
+ 7o/o State Surcharge
Minimum/Adj ustment Mechanical
Wood Stove/Insert
PERMIT NO:
ISSUED:
APPLIED:
EXPIRES:
VALUE:
coM2005-0015t
02t09t2005
02/08/200s
08t09t2005
Total Value of project
Amount Paid Receipt Number
2200500000000000r52
2200500000000000r52
2200500000000000152
2200500000000000r52
2200500000000000152
Total Amount paid $62.65
To Request an inspection cail the 24 hour recording at726-3769. All inspection requested before 7:00will be made the same working day, inspections req a.m.
day.
uested after 7:00 a.m. will be made the foltowing work
Wood Stove: After Installation.
By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that allinformationhereon is true and correct, and I further that any d all work performed shall be done in accordance withcertifyan
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and thatNO OCCUPANCY will be made of anv structure without permission of the Community Services Division, Bu ilding Safety. Ifurther certify that only contractors and em ployees 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 thestreet, 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.
$r0.00
$4.50
$3.15
$r5.00
$30.00
Date Paid
2/9/05
2t9/05
2/9/05
2/9t05
2/9/05
2
PIan
Owner or
Pase 2 of 2
Date
rfsllulfeo rnsDecuons
225 Fiftk Street
Springfield, Oregon 97 477
541-726-3759 Phone
C;+v of Springfield Official Receipt
^ _- elopment Services Department
Public Works Department
RECEIPT #: 2200500000000000152 Date: 02109/2005 2232:26PM
Job/Journal Number
coM2005-00151
coM2005-00151
coM2005-00151
coM2005-00151
coM2005-00151
Description
+ 7o State Surcharge
+ 10o Administrative Fee
Wood Stove/lnsert
Minimum/Adjustrnent Mechanical
-Mechanical Issuance Fee-
Amount Due
3.l5
4.s0
30.00
15.00
10.00
Item Total:$62.6s
Payments:
Type of Payment
Check Number
Received BY Batch Number Number How Received Amount PaidPaid By
Check EMERALD SWIMMING
POOLS
djb 51120 ln Person $62.6s
Payment Total:$62.6s
21912005
Page I of 1
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Authorization
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225 TII'TII STREET o SPRINGNELT), OR 97477 o PH:(541)726 -13753 o IA-\: (SaD 726-3689
CityJob Number C<:*tZ-c: c, i -
Job Location:5--9
Assessor's Map: l7 O Z 3<rQ 3 O Tax l.or C: 2 e16;
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Owner:
Address:
Clity:_c"
36 3&
State:zip:
lr-etllnilaV fnspecfion is $45.OO (prior to insert)Wood Stove/pefletlrnsert permit ii iei.6s-?ii"r"a",Permit, Issuance Fee, state surcharge and Adminisfrative Fee).
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Contractor:q"
Construction
Si.gnature:
C-ontractorlnformation
State:
Phone:Aa&
zip:
Expires:
Address:
City:
6
Re5;istration #:o
By signing this penrrit /applicatiorr, I a.gree to call for aninspection(s) as requir ed (726_5Z6g).I state that all inforntation on this appiicationzp..nritlr-"o..."t and thag was providecl withthe wood Stove Safety info*,atio" iJ. *ooa Py*iri ipptiun"rrand prelinr inaryi,spectionstandards as set bv the.oregon Departnrent of rnvirJnrir6ntal quality or the FederulEttvirontrtental Protection.igency triii ugrr"to provide the testing approvahumber to theinspector attheti,teof inspEction. iurro"ra.rsiand thatif ra,rrequestingaprelinrinaryinspection, the wall covering,ray be r:Lquired to O. ."nr*.a.
Date:u-
DateofApplication: Z* ? -Ct
Checked for Historical Status:Checked for Delinquencies:
Sharcd Drive(T:)lBuilding FormsNVood Stove Pemit 3-M-O4'doc
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FOR OTTICE USE