HomeMy WebLinkAboutPermit Mechanical 2008-11-3
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Status
Issued
225 Fifth Street, Springfield, O'R
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01613
ISSUED: 11/03/2008
APPLIED: 11/03/2008
EXPIRES: 05/03/2009
VALUE:
SITE ADDRESS: 4093 E ST
ASSESSO'R'S PARCEL NO'.: 1702322300800
Springfield TYPE O'F WO'RK: Pellet Stove
Residential
PRO'JECT DESCRIPTION: New pellet stove insert
O'wner: ESTES JAMES T & KA THALEEN M
,Address: 4093 E ST
SPRINGFIELD O'R 97478
ATTE~I-'-CONi-RA"CT()R'.INF_(),RMA:TiQ~
follow ,~.._- --- -,.... -, ~. ,
C . [Jotification Center. Those rules ar:b~et forth'
ontracto In OAR 952-001-001 0 through OAR ~!f$!lll~-
1111011 Vn,' m~\1 nht~in r.ooies of the rules by
callin!jJ IBBfL9'lING i;Nr0-":;':A~'i:ONtne
. numbE-;, ,"" U! .Lt- -.J Ion
Cent~r i..""I-RDO-332-2344).
'1t Ol~ ones:
Height of Structure
Type of Heat:
Wat~r Type:
Range Type:
Energy Path:
Sprinkled Building:
Nu I h..q;DEVELOPMENT INFORMAT~9~( I
THIS PEF\lVII] 0nl-lLL ",,'r In'-" ,'11'- ',,'
AUTHORIZED Ul'l:9Ji,\\J!i\l~lERMIT IS NOT
COMMENCED O~s~A~~\lwPk~ FOR
ANY 180 DAY PIiG\Q@Vdve Rqd:
% of Lot Coverage:
Contractor Type
# of Units:
Primary Occupancy Group:
Secondary O'ccupancy 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:
Description
R-3
VB
':.:"-..o...;".i~:-;'-
. I PUBLIC IMPROVEMENTS ,.::"
I V aluation Descr~Dtion I
$ Per Sq Ft
or multiplier'
Square Footage
or Bid Amount
Tvpe of Construction'
Paee'l of 2
TYPEO'F USE: Alteration
Expiration Date Phone
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft O'ther:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact':
"
'Sidewalk Type:
Downspouts/Drains:
Value
Date Calculated
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Minimnm/Adjustment Mechanical
Pellet StovelInsert
Total Amonnt Paid
Amount Paid
$21.00
$5.20
$6.24
$2.60
$18.00
$34.00
$87.04
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-0I613
ISSUED: 11/03/2008
APPLIED: 11/03/2008
EXPIRES: 05/03/2009
VALUE:
Total Value of Project
Fees Paid'
Date Paid
Receipt Number
11/3/08
11/3/08
11/3/08
11/3/08 .
11/3/08
11/3/08
1200800000000001103
1200800000000001103
1200800000000001103
1200800000000001103.
1200800000000001103
1200800000000001103
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made thefollowing
work day.
Pellet Insert: After installation
I Renuired I nsnections I
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 withont permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance withpRS 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 Uring~:7i1~ .
Owner odontractors Signat<6re I Date
Paee 2 01'2
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225 FlITH STREET. SPRINGFIELD, OR 97477. PH:(541)726-3753 . FAX: (541)726-3689
City Job Number
Job Location: if 0 q ~
F .sf
Assessor's Map:
'Tax Lol:
E S:t?-?S
Address: 40Q3 ~ So r
City:' S p Q..j V\.(,Cd .f! ( &_
Owner:
31vli\
.
Stale: (Y(
Phone: 7d-IJ d-/3'V
Zip: q 7<) 71r
--
Preliminary IiIspection for wood burning inserts is $66.04 (prior 10 insert).
Wood Stove/Pellet/Insert Permit is $87.04 (includes applicable fees and surcharges)_
Contracto! jnformation
/)(on!. MA-IIL--
Address: c; ~ 6-"2-- lIV1 f>4- ( Vl
City: < j t? (v,aiL I' pi J..
, { . -
Construction Contractor's Registration #: "(2 b ') l/ =:-
Contractor: r000 b
State:
.f!J If_
Phone: 7'1.( 6 -~ LZ. !
Zip:O! 7Y>r
Expires:
ii
. By signing this permit/application, I agree to call for an inspection(s) as required (726-3769).
I state that all information on this application/permit is correct and that I was provided with
the Wood Stove Safety information for wood burning appliances and preliminary inspection
standards as set by the Oregon Department of Environmental Quality or the Federal
Environmental Protection Agency and I agree to provide the testing approval number to the
inspector at the time of inspection. I also understand that if I llm requesting a preliminary
inspection, the wall covering may be requITed to be removed. .,
Signature:
#rPhf
r
o:P
. ,
Date: fic/
Date of Application:
Checked for Delinquencies:
Checked for Historical Status:
Shared Drive('f:)/Building FormsIWood Stove Permit 7-08.doc
225 Fifl'lt Street
Sp,il1gfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM200S-01613
COM200S-0 1613
COM200S-0 1613
COM200S-0 1613
COM200S-0 1613
COM200S-01613
Payments:
Type'of Payment
CreditCard
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200800000000001103
1I:10:2IAM
Date: 11/03/2008
Item Total,
Check Number Authorization
Received By Batch Number ~umber How Received
Amount Due'
21.00 .
34.00
18.00
2.60.
6.24
5.20
$87.04
Description
-Mechanical Issuance Fee-
Pellet Stove/Insert
Minimum/Adjustment Mechanical
+ 5% Technology Fee
+ 12% State Surcharge.
+ 10% Administrative Fee
Paid By
GOOD DEAL METAL
Amount Paid
CJc
530411 In Person
Payment Total:
$S7.04.
$87.04
Page I of I
11/3/200S