HomeMy WebLinkAboutPermit Mechanical 2009-1-5
,
1}uiIding/Combination Permit
PERMIT NO: COM2009-0001I
ISSUED: 01/05/2009
APPLIED: 01/0512009
EXPIRES: 07/05/2009'
VALUE:
Status
Issued
225 Fifth Street, Spriugtield, OR
54]-726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
, CITY OF SPRINGFIELD
SITE ADDRESS: 717 64TH ST
ASSESSOR'S PARCEL NO.: 1702341300502
Spriugfield TYPE OF WORK: Heating System
PROJECT DESCRIPTION: Installlp fireplace insert
TYPE OF USE: New
Residential
Owner: KRISTY ROBERTSON
Address: 717 64TH ST
SPRINGFIELD OR 97478
I CONTRACTOR ~NFORMATlON ,
Contractor Type
Mechanical
Contractor License
AMBASSADOR PIPING INC 12]469
I BUILDING INFORM!\T'fOiiill
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lDEV~L1)~MENT INFORMATION 1
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side] Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Phone Number: 54]-654-0]74
Expiration Date
03/27/2009
Phone
54] -726-5723
n/a
Lot Size:
Sq Ft ]st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
\
\
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS' f "{\\'t. \NO"'~
ltO~~~~~\i S~;~~~:~~9:0
~i\-lO~ll~\\)O~ IS f>,'<<~
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f>,~'/ ,\~Q ~
Street Improvements:
Storm Sewer A vaiJable: ,
Special Instruction:
Notes:
I ,Valuation Desc~iptio~ I
Description
$ Per Sq Ft
or multiplier
Sq uare Footage
or Bid Amount
Tvpe of Construction
Page] of2
Value
Date Calculated
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00011
ISSUED: 01/0512009
APPLIED: 01/05/2009
EXPIRES: 07/05/2009
VALUE:
225 Fifth Street, Springlield, OR
54]-726-3753 Phone
54] -726-3676 Fax
54]-726-3769 Inspection Line
Total Value of Project
Fees Paid ,I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
]st Appliance
LP Gas Tank & Piping
Amount Paid
Date Paid
$1I.52
$4.80
$79.00
$17.00
1/5/09
1/5/09
1/5/09
1/5/09
Receipt Number
2200900000000000009
2200900000000000009
2200900000000000009
2200900000000000009
Total Amount Paid
$112.32
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 the following
work day.
I ~e'1':1ired I n~p~c~ions I ,
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is compleie.
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 aU 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 he 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 plaus will remain on the site at all
times during construction.
Ku~ R .c-JAJ~A-rn
O~ne~ or co~iJctorS~.Signature .
Date
Page 2 01'2
225 Fifth Street'
Springfield, bregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-000 11
COM2009-000 II
COM2009-000 11
COM2009-000 11
Payments:
Type of Payment
CreditCard
cReceint 1
RECEIPT #:
Description
1st Appliance
LP Gas Tank & Piping
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
KRlSTY ROBERTSON
/
City of Springfield Official Receip~
Development Services Department
Public Works Department
"
2200900000000000009
Date: 01/05/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
219236 In Person
Payment Total:
Page I of I
]] :46:0SAM
Amount Due
79,00
17,00
4,80
11.52
$112.32
Amount Paid'
$112.32
$112.32
1/5/2009