HomeMy WebLinkAboutPermit Mechanical 2006-2-28
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00238
ISSUED: 02/2812006
APPLIED: 02/28/2006
EXPIRES: 08/28/2006
VALUE:
I Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
'541-726-37691nspection Line
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SITE ADDRESS: 6559 MAIN ST
ASSESSOR'S PARCEL NO.: 1702344300100
Springfield TYPE OF
Pellet Stove
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Install a pellet stove.
Owner: HINES CLYDE E & FRANCES M
Address: 6559 MAIN ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
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Contractor ~ ,<:-(J License
THERMAL RE$t1>>RC~S INC. 161946
i~>~~~UILDING INFORMATIONI
;$ ~<:1. r;::,~ ,0
, # ofUnilll: ,,<<;,,~ f:5 # of Stories: 000 .? f:S' Lot Size:
, Primary Occupancy Grou~~ {5- ~"?' Height of .;..<Vc,....,::.~"il;-....o c;,c;," ",Sq Ft 1st Floor:
Secondary OccuPll9cy ~ '-::J -\::,~ ~ ~' Type of Heat: <:f ~ ",'0 (n; ",'0 Sq Ft 2nd Floor:
Primary conS~lt1'Mi.-T:Ype' (J~ <>;,.<0 Water Type: ."q; o,q; <ij n.. c,) ::,<V .'Sq.Ft Basement:
- /:'(......-\'<," <"- 0' ~ ~ ~. \: r .
Secondary Co . ct!~" ';.,;,'<-v::\ <:1. Range Type: ,'If CiS<V .~p 0' '!:::'? , . ~q' Ft Garage/Carport
# ofBedroom~ # ~y::-<01f (J"?' Energy Patb:f -0"" ,,<v' ~ d- '. .:'Sq Ft Other:
'" ~ ,,~~ ,~<::c, SPrinkle~'<V~00 ,,-,,0 ~?~?':> nJa ,Occupant Load:
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"?' 'DEVELOPMENT INFORMATION I
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Ov(rlay>DJst:~, ,~ 0,
#'S)tr~t,t(ees)" '., C'
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Pav~.DriveRqd:
% ofLoJ C!)verage:'
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Contractor Type
Mechanical
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~ Front yard Setback:
. Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
. Street
, Storm Sewer Available:
Special Instruction:
Notes:
Description
Phone Number: 541-746-2406
Expiration Date
10/29/2006
Phone
541-343-1131
REQUIRED PARKING
Total:
Handicapped:
Compact:
IPUBLlC IMPROVEMENTS I
Sidewalk Type:
Downspouts/Drains
I Valuation DescrintionJ
Type of Construction
$ PerSq Ft
or multiplier
Date Calculated
Square Footage
or Bid Amount
Value
I of 2
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. CITY OF SPRINGFIELD .
Building/Combination Permit
PERMIT NO: COM2006-00238
ISSUED: 02/28/2006
APPLIED: 02/28/2006
EXPIRES: 08/28/2006
VALUE:
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
'.
L.Fp.p.s Pllid I
.
- Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 8% State Surcharge
Inspection - Preliminary
Minimum/Adjustment Mechanical
Pellet Stove/Insert
Amount Paid
$10.00
$4.50
$3.60
$45.00
$15.00
$30.00
Date Paid
2/28/06
2/28/06
2/28/06
2/28/06
2/28/06
2/28/06
Receipt Number
1200600000000000218
1200600000000000218
1200600000000000218
1200600000000000218
1200600000000000218
1200600000000000218
Total Amount
$108.10
I Plan Reviews I
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To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.
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Preliminary Inspection: Prior to the installation of solid fuel appliance which will be vented through an existing
chimney.
Freestanding Pellet Stove: After installation.
By signature, I state and agree, tbat I have carefully examined the completed application and do hereby certify that all
.information hereon is true and correct, and I further certity tbat any and all work performed shall be done in accordance
witb the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein,
and tbat NO OCCUPANCY wiD be made of any structure without permission of the Community Services Division,
Building Safety. I further certity tbat only contractors and employees who are in compliance witb ORS 701.005 will be used
on this project. .
I further agree to ensure tbat all required inspections are requested at the proper time, that each address is readable from
the street, that the permit card is located at tbe front of the property, and tbe approved set of plans wiD remain on the site
a:=t II times during constructilll!: _
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Owner or Contractors Signature Date
2 of 2
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SPRINGFIELD'
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225 FIITH STREET. SPRINGFIELD, OR 97477. PH:(54 ])726-:H53 . FAX: (54 ])726,3689
CiIYJobNlUnberr::ON\'Z~b - 00'23>'B ,
Job Localion: ,~ '-J-':/- <:; '7ua~ _<:J. GA'hA;1( c:. ~~. V/l. 9
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Assessor~s Map: / O~ Tax Lot:
7'f7g
Owner: ~ cf.e 9'- 'i-IJ L1A--- '1'/.: Y1; J ..J
Address: jp s?- 9 ~ ah. .
City:~prj)
Phone:
7 c/ h 'dJ/ j') h
Zip: '7 7'17~
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Slale:
Preliminary Inspection is $45.00 + 10% Administrative Fee (prior to insert)
Wood Stove/Pellet/Insert Pennit is $63.10 (includes Pennit, Issuance Fee, State Surcharge and Administrative Fee).
Contractor Information
Contraclor: ~./ dCi' j) 0./ ./, ~ )
Address: / ;;:, 7 9 0 \ AlO '7 f:J,
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CIly: ~~_. .PI
Constructib1( Con;r~c~r~. Registration #: j /_
Phone: ~t../.~-II:<'/
Zip: 9 7 L/O ;2--
Expires:
Slale: C')A~
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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 approyal number 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.
Signature:
Date:
FOR OmCE USE
Dale of Application:
Checked for Delinquencies:
Checked for Hislorical Stalus:
Shared Drivc(T:)1Building FonnsIWood Stove Pennitl-06.doc
. 225 Fifth Street
Springfield, Oregon 97477
. 541-726-3759 Phone
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Jij,ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Job/Journal Number
COM2006-00238
COM2006,00238
COM2006,00238
COM2006-00238
COM2006-00238
COM2006,00238
Payments:
Type of Payment
Check
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2/28/2006
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RECEIPT #:
1200600000000000218
Date: 02/28/2006
Description
Pellet StovelInsert
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Inspection - Preliminary
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
FRAN HINES
Received By
jmp
I of 1
Item Total:
LnecK Number AumlH1zatlon
Batcb Nnmber Number How Received
2945 In Person
Payment Total:
2:28:27PM
Amouut Due
30.00
15.00
10.00
45.00
3.60
4.50
$108.10
Amount Paid
$108.10
$108.10