HomeMy WebLinkAboutPermit Mechanical 2009-3-6
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-00308
ISSUED: 03/06/2009
APPLIED: 03/06/2009
EXPIRES: 09/06/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1353 C ST
ASSESSOR'S PARCEL NO.: 1703362310800
Springfield TYPE OF WORK: Pellet Stove
TYPE OF USE:
Residential
PROJECT DESCRIPTION: Install pellet stove
Owner: GIBB GREGORY G C & HEATHER E
Address: 1353 C ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION.
Contractor Type No-r\09tactor EXPIRE If ,HE WORK License
Mechanical TUI~JRWI\' SHf1.~l ~'~C oI=RM\l IS NO,
f1.U1HORIIEU U~~~;'d: BumrnllW; q~F\ORMA TION I
COMMENCED 0
# of Units: f1.NY i80 DAY PERIO. # of Stories:
Primary Occupancy Group: R-3 Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type VB Water Type:
Secondary Construction Type: Range Type:
# of Bedrooms: Energy Path:
Sprinkled Building: n/a
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd 'Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd: to
Pave~ l15i)','9~""W requires you. .
ATTEt%IQl'LoJ~i~Ilg.,\he Oregon ~t;~~h .
tollow rules a teT. Those rules are se ,001-
..^ti",,~IIOn Cen . ^ .~.^"nh OAR 952 .
IIPYBCJi:ii)ilif '" iMRN'FS'I~ :~I~~~'~~;'
"V;~Hing the ce~r'e~~; \Jtiiity NoS~\HR Type:
mber tor the r 332-2344\,
nu center is 1-600- Downspouts/Drains:
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriolion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Squllre Footage
or Bid Amount
Value
Date Calculated
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00308
ISSUED: 03/06/2009
APPLIED: 03/06/2009
EXPIRES: 09/06/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
3/6/09
3/6/09
3/6/09
2200900000000000236
2200900000000000236
2200900000000000236
Total Amount Paid
$92.43
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 Reouired' nsnections I
Freestanding Pellet Stove: After installation.
By signature, 1 state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and' 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 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 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
';m"'Z~i/# fq;,;9
Owner or Contractors Signature Date
Page 2 of2
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SPRINGFIELD ,~".~ -,...
III
225 Arm STREIT. SPRINGFIELD, OR 97477. PH:(541)726-3753 . FAX: (541)726-3689
City Job Number CO'"^- 'Zc><=> 't - DOJ 0 %
Job Location: r~ C 5.-
170:53 bZ~
Tax Lot
/orOO
Assessor's Map:
Owner: GRU'--cT>-l{ b,g;?
Address: /35> c... ~T
Phone: 7<17- t-,2f!>,<;
Zip: .t7?<l77
City: S~n.l.....i..<::'j~, ~
State:
OIL
Preliminary Inspection for wood burning iitserts is $66.04 (prior to insert):
Wood Stove/Pellet/Insert Pennit is $87.04 (includes applicable fees and surcharges).
",nTIr.E~ .-- r ...ut: \MnR~
THIS PERMIl.t~;~~~H\~'PERMITIS NOT
AUTHOR.I~~~J -.o:lt\9" ~MW FOR
COMM ENv1:.1JVT'
~).r'~~IY 1 An nA.Y PERIOD.
Contractor:
Address:
City:
Construction Contractor's Registration #:
Phone:
State:
Zip:
. Expires:
By signing this permit/application, I agree to call for an inspection(s) as required (726-3769).
I state that all information on this application/permit is correct and that I was provided with
the Wood Stove Safety information for wood burning appliances and preliminary inspection
standards as set by the Oregon Deparhnent of Environmental Quality or the Federal
Environmental Protection Agency and I agree to provide the testing approval number to the
inspector at the time of inspection. I also understand that if I am requesting a preliminary
inspec.tion.; the wall covering may be required to be removed~ you to
o on law reqUlr"S
ATTENTION: re{ d by the Oregon Utility
101l0w rules adop e se rules are set forth
~ ~ ~~ti1iCation Center. Tho hOAR 952.001- .
. . .0010throug
Signature: ,Y ", OAR 952-0?1 ~"."in ~nnies 01 the rUI9~p.Y''l.jlP/()9
. v U~N.. 'uu .,,~} .-.. Note: the telephOne . .
. . n.1\in.9 the center. ( , ":"'" .~l~\ljr?f I)
."'~-'i"'~~... . ... >_.......__~A,,.^.o;r-""-"""....~.".~tr-....'ily '., ... ..."".. _-. ~.. '";.
.",4,~'iifL. ''''&$'! .,,;,;numo",,,""K\:Jrp.' ~2:(1:2"'''\lIIl,+,.1!!if~! _L". .',.-.
,",- . ' ."., .,-_?'~~01t~M"m,,(,,""_i~;Ceflf~ft~IS~~-'--'-"-P~-wtl:,_.~-,~x~ "".--'- - 161
3;i~ i
V
Date of Application:
Checked for Delinquencies:
Checked for Historical Status:
v
Shared Drivc(T:)lBuilding FormsIWood Stove Permit 7-08.doc
225 Fifth Street
Springfield; Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00308
COM2009-00308
COM2009-00308
Payments:
Type of Payment
Check
cReceint I
RECEIPT #:
Description
1st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
HEATHER OIBB
~r,~~_.."" .',
.F m .....
~~.. .
~
City of Springfield Official Receipt
Development Serviccs Department
Public Works Department
2200900000000000236
Date: 03/06/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
1887
In Person
Payment Total:
Page 1 of I
1O:24:20AM
Amount Due
79.00
3.95
9.48
$92.43
Amount Paid
$92.43
$92.43
3/6/2009