HomeMy WebLinkAboutPermit Mechanical 2000-3-9
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I Job# OO.Q0376.Q1 I
Page 1 of ~RANS#: 01-0000876
DA TE : MAR 09 2000
AMT RECD:2 $ 41.50
CHANGE:
CASHIER:059
SPRINGFIELD
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CITY OF SPRINGFIELD~ OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00376-01
225 North Fifth Street
Springfield. OR 97477
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 7606 McKenzie Hwy Spr
Assessors Map#: 17023541
lot: Block: Addition:
Tax lot #: 01200
Subdivision:
Owner:
Ronald & Marci Sather
Phone Number: 541-746-2878
City/State/Zip: Springfield. OR 97478
Alteration Value: $1.700
Address: 7606 McKenzie Hwy
Scope Of Work: Wood or Pellet ,Stove
Contractor Type
Contractor - ROW
Contractor
Midgleys
1678 West 7th Avenue, Eugene, OR
97402
Registration #
19364
Expiration Date
12/6/00
Phone
541-343-1131
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
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
working day.
Required Inspections
I Mechanical I
Preliminary Inspection -Prior to the installation of solid fuel appliance which will be vented through an existing chimney.
Insert -After installation.
. NOTICE: .' .......\V".ul"guloiawrequlresyoul
Construcbon-M~RMIT SHALL EXPIRE IFTHEWORK 1"1; I ~~u'les adopted by the Oregon Utilit,
occupa.nc~ G.lJ~!WibRIZED UNDER THIS PERMIT IS .NOT N~if?~Lqn Center. Those rules are set fO~
# Of BUlldlng~OMMENCED OR IS ABAND~er,!f~:n OAFffl!ll!!!tdfes..~? thro~gh OAR 952.()0 .
# Of Bedrooms: Current Units: 0090. f\Jg~cll1lmts:oples of the rules t.
Handicap Accfe"~~? ~A Y PERIOD. Census Code: Does not ap~lIing the center. (Note: .t~e tele.~hone
Area (Sq. Feet) number tor the Oregon Utility Notlflcalior
I" . I CA~I".;' 1 .f"'''', ~~".':''l.<lll\
I Main: Accessory: Total: .
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Job# 00-00376-01
Paid On Receipt#
Mechanical
03/09/2000 876
03/09/2000 876
03/09/2000 876
03/09/2000 876
03/09/2000 876
Fee
Minimum Mechanical Permit
Mechanical Administrative Fee
Wood stove
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
Preliminary Inspection for Insert
Total Permits w/o Srchg
Grand Total
A) f1JtM~ lfaihv
Signature
Permits w/o Srchg
03/09/2000 876
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Page 2 of2
Value/Quantity Fee Amount
I
,1,700
$.00
$.45
$15.00
$10.00
$1.05
$26.50
1
$15.00
$15.00
$41.50
3-f-(f7)
Date
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SPRINGFIELD
WOOD STOVElINSERT INSPECTION APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION - BUILDING SAFETY
225 Fifth Street
Springfield, Oregon 97477
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Owner: ROn (Llll { Ma rei Sa'+hPr'
Address: 110 0 ~M rk e,n2~( AJU
city:~/d State: Oe..
Value of Wood StovelPellet Stove tJ 17 {J[\ $
Assessors Map #:
Office: 726-3759
INSPECTION LINE: 726-3769
30n fl.Cl ~el d oR.
J- I . -
Tax Lot#: () I J.O D
Phone#: 7 J.(-fp - i8 35
Zip: 9i1:/7g'
(please circle appropriate appliance)
~ Preliminary Inspection is $15.00 (prior to installation of insert)
4WOOd StovelPellet/lnsert Permit is $15.00 + 1.00;, state surcharge + $.45 Administrative Fee + $10.00
Issuance. .
Type of Inspection Reque~ted: Th.5.1' X t
Contractor:
N\ Id'n leV1 b
1&;1'6 Vv,lth f+ve.
State: ()t2-.
Address:
City: F_LJ3' hP
Construction Contractors Registration#:
Expires:
Phone#: 3 '-f 3 -1/3/
Zip: q 7 '-J{J :J-
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. I further state that the
appliance 'I am installing meets smoke emission standards as set by the Oregon Department of
Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing
approvall\umber to the inspector at the time of inspection. I also understand that if I am requesting a
preliminary inspection, the wall covering may be required to be removed.
Ma1LA; 5f;; /Hv/u
Signature
FOR OFFICE USE
REQUIRED INSPECTION(S): WOODSTOVElPELLET/INSERT
Date of Application: ~ ( qt 0 0 Job #:
Total Amount Collected:
Receipt #:
Checked for Historical Status:
Issued By:
Checked for Delinquencies:
!hfJ/r/ .h/tZIPD
Date
PRELIMINARY
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