HomeMy WebLinkAboutPermit Mechanical 2009-1-28
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Perin it '
PERMIT NO: COM2009-00136
ISSUED: 01/28/2009
APPLIED: 01128/2009
EXPIRES: 07/2812009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1759 S ST
ASSESSOR'S PARCEL NO.: 1703252404300
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Modify existing gas lines
Owner: BUSTER K CHARLES & EUNICE L I'
Address: 1759 S ST
, SPRINGFIELD ()R 97477
I CONTRACTOR INFORMATION 1
Contractor Type
Mechanical
Contractor
KEITH LEESMAN
License
72082
Expiration Date
04/04/2009
Phone
541-995-6157
BUILDING INFORMATION 1
#of Units: . 0 egot\ laW lequ\re1i:'~~~I~fts:
Primary OccnpaIJl;ym.l1iIflN. d~PtEl~i~Y tns Ore9fl~!&iQqtWtmctnre
Secondary OCCURl!ii~G'rll\lpl t\ter. TMse rules a~}('W~Jtfcfteat:
Primary Constl'1lttiohGJlWe'_0~1'00,~ijlrOUgn OAWlfll\\3ift:fJ":
Secondary cons~E'tio'?l ~e:aV obtait\ COpies Ollt f\!)ifa'pe:
# of Bedrooms: 0090..'<0 t:e center. (Note:the lIl\OOtil3l\th:
calling the oregon Utility rinkled Bnilding: nla
,\"mber lor ., oM_::\32-234 , . ,
vel"'" .~ . I DEVELOPMENT INFORMATION I
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occnpant Load:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback: ,
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact: '
Street Improvements:
Storm Sewer Availahle:
Special Instruction:
, ,I PUBLIC IMPROVEMENTS.
NOTIC\:: ' H~LL EXPIRE \f iHE WO%~ewalk Type:
, 1HISPE~r~6 ~NDER TH\SPERM\110S:~1wnspoutslOrains:
AUTHO D OR IS ABANDONED F '
COMMENCE '
ANY 180 DAY pERIOD.
Notes:
I Valuation Descrintion ,
Description
Tvpe of Constmction
$ Per Sq Ft
or mnltiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
$P.Rll'IlIi-ll'tm..Oi
- .tT'j.,.,..-,;..:;.oj;"'\~Y'""::;:r1';
"n'
W
Status
Issued
,;
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00136
ISSUED: 01/28/2009
APPLIED: 01/2812009
EXPIRES: 07/28/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'Total Valne of Project
, ,
Fee;~ P~i~ I
Fee Description
+ 12% State Snrcharge
+ 5% Technology Fee
1st Appliance
Gas Ontlets 1-4
Amonnt Paid
Date Paid
$10.32
$4.30
$79.00
$7.00
1/28/09
1128109
1128/09
1128109
Receipt Nnmher
2200900000000000111
2200900000000000111
2200900000000000111
2200900000000000111
Total Amonnt Paid
$100.62
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 Rellllirerl In~~I~~~ions 1
Rongh Gas: After line is installed and required testing and capped if not attached to an appliance.
Final Gas: When all gas work is complete.
By signature, I state and agree, that 1 have carefnlly hamined 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 tbe work described herein, and
that NO OCCUPANCY will he 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 witb ORS 701.005 will be nsed on this project.
I fnrther agree to ensnre that all reqnired inspections are requested at the proper time, that each address is readahle 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. "
I~ {!~ &~ ~t_,
Owner or Contractors Signat~re
)~;2'7 -67
Date
Pa2e 2 of2
225,Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.Job/Journal Number
COM2009-00 136
COM2009-00 136
COM2009-00 136
COM2009-00 136
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
1 st Appliance
Gas Outlets 1-4
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
SUNSHINE DELIVERY
SERVICE
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000111
Date: 01/28/2009
Item Total:
<":hcck Number Authorization
Received By Batch Number Number How Received
d'b
.J
4795
In Persori
Payment Total:
Page I of I
(
3:08:23PM
Amount Due
79,00
7,00
4.30
10.32
$IUU.62
Amount Paid
$100,62
$IOU.62
1128/2009