HomeMy WebLinkAboutPermit Mechanical 2009-4-23
Mechanical Anthorization To Begin Work
E-maiiedTo:Stfrdml@peoplepc.com
Receipt # EC550492
4/23/20096:17:27 PM
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City of Springfield
Check on status of perin it
By Phone: (541)726-3753 or Emaii: permitcenter@ci.springfield.or.us
10 New construction
lliJ Addition/al\l:ration/replacement
I Description Qty. Ea. Total
1~'iieatingj~oo'lin1tUppHances"i\'<.:?':~~~-,*,#;r~;Gi1~'o"", ~,i
,.",c. .,1>d.... ... "'.."'.... ...... ,,"',!,.,- -.. ~"."".r.....I",I~ '~'-'._._f1: J. .
.1 Furnacc- up to 100,000 BTU I
I Furnace - above] 00,000 BTU
I Electric Furnace I
I Duct <llterations and additions I
Gas heater units/ in-wall, in-
duct. suspended. clel
Venl, nue, liner for above
I [K] 1 or 2 family dwelling D Multi-family 0 Accessol)' Building
I :0~4J;~"7::~~-,f9T.':f _:&:'02J5B~SITE:INf6RMATIOtitANiS'EOCATr(rN0:~~~~~?~~~'
,.1" _.... .', /' '. _ ',: 'u'l':.J:!"... .1.:",,' '~""\._~'~_"""_ ~ , .~._._..,.~"_.,, '",,,,,,,,~^,_,,, ,_'."''''' ~=-."~ ~_.,' ,,'".,..,~ ,,'fJI. .;;~~
IJobno.: IJobaddress: ]628 CARTERLN
I City/State/ZIP: SPRINGFIELD. OR 97477-3325
I Suitc/bldg.lapt.no.:
!I'rojcct name: Rupe
Cross streel/directions to job site: Mohawk blvd. tu M, st. to Caner
IWatcrheater
I Gas tlreplilcelinsertlstove
I Gas log/log lighter
I Gas clothes dryer
I Gus stove/range
I Pool or spa heater, kiln
I Wood/pellet stove/insert
I Wood fireplace
I Chimneyllil1L:rlfluc/vent wlo
[looliam:e
1..'EritfrolllTlcnial\extiausij\ND.ventililfion~~f" ~".'?~~;~"~.!C::i~~,?f'iOF:~
.''''''''~'''''''''':''''",,,_._..,,.~,,,..-.,..,. """,co", =".=C'n "w ''''''..,:;4 e,,?'''~S. <V""", ".'..~...,~.s..I;"..
$38.00
$3800
I Subdivision:
I Tax map/parcel no.: 1703253215700
ILot no.:
InstallingA Wood burning Fireplace Insert
I i\amc: Ed & Angclia Kupc
I Phone: (541) 744-2806
IEmail:
IF""
I Runge hood
I Clothes dryer exhaust
I Single~dllcl exhaust (bathrooms,
toilet compartments, utility
rooms)
ICCBlic.no.: 171110
I Business Name: MICKEY LAWRENCE-STAFFORD
I Contact: Mickey
!Address: 90090 KILLIAN LN
I City/State/ZIP: ELMIRA, OR 974379604
I Pholle: (54 I )':J356012 I Fax: None
I Email: Stfrdml@peoplepc.com
IMl.'tro lic. no.: I City lie. no.:
fans
Upon review and approval by your local jurisdiction, your
permit will be e-mailed or faxed within one business day,
with instructions on how to schedule your inspection.
upto first 4 outlets(enter Qty=l) I I
I each additional outlet
1~>2~~~::!:~.~~t:~~1!]~~I~K~fB'~~Mij;{llit~'!~~~1~t:~t~~~i '
I Subtotal $38.00-
I City Of Springfield Firsl Appliance fee $79.00 I
I Slate Surchllrge(]2% of permit fee) $14,04 I
I City OrSpringlield fl>cs" $5,85 I
I TOTf\L P~I{1\lIT FEE $136,89 I
.. City or Springfield fe~s: 5% Techno]ogy fee
NOTE: This Authorization To Begin Work expires within 180
days if a permit is not obtained.
Co/y} .:<'0-:' ;1 -- Dc).s ~ :7
L/_ ,:) y: _ () '7
/V/J/1
The local building department may determine that an
Authorization To Begin Work is null and void if it doe~not .
meet applicable land use laws and local ordinances.
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This Authorization To Begin Work must be posted at the job site until replaced by a Permit
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00549
ISSUED: 04/24/2009
APPLIED: 04/24/2009
EXPIRES: 10/24/2009
VALUE:
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1628 CARTER LN
ASSESSOR'S PARCEL NO.: 1703253215700
Springlield TYPE OF WORK: Mechanical Only
TYPE OF USE: . New
Residential
PROJECT DESCRIPTION: Wood Iireplace insert
Owner: RUPE RONALD E & ANGELA G
Address: 1628 CARTER LN
SPRINGFIELD OR 97477
Phone Number: 541-744-2806
I CONTRACTOR INFORMA nON I
Contractor Type
Mechanical
Contractor
MICKEY LA WRENCE STAFFORD
License
171110
Expiration Date
07/12/20 I 0
Phone
(541) 736-0018
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2iId Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Sethacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Sidewalk Type:
ATTENTIOD'I: OrP.oontsl/QD", reaulres you to
f II I ownspou rams: Ut.I't
o ow ru es aaop,ea oy Ine uregon II y
Notification Center. Those rules are set forth
Notes: NOTICE:. XPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-
THIS PERM__lrT S, ,H,,~~.lD ET"I" PERMI1T IS NOT 0090. You may obtain copies of the rules by
_ ,,,_ H :--. ,...QUinn tho ("onter (f\lnto' tho tpl&:lnhnnA
AU I HunNILC'-EuOvOR IS ABANOONE1;:' ;~:. . . . nunlber for the Oregon Utility Noliflcation
COMME 00 ValuatIOn DeSCrIDtlOn Center is 1-800-332-2344).
ANY i 80 OAY PERI .
Description Type 01 Construction $ Perls.ql~t squBa:dcAFootage Value
or mu tip lef or I mou~t
Storm Sewer Available:
Special Instruction:
Date Calculated
Page 1 of 2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Wood Stove/Insert
Total Amount Paid
Amount Paid
$14.04
$5.85
$79.00
$38.00
$136.89
Total Value of Project
Fees Paid I
" (
Date Paid
4/24/09
4/24/09
4/24/09
4/24/09
I Plan. Reviews I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00549
ISSUED: 04/24/2009
APPLIED: 04/24/2009
EXPIRES: 10/24/2009
VALUE:
Receipt Number
3200900000000000270
3200900000000000270
3200900000000000270
3200900000000000270
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 Rellllired Insnections I
W?od Bnrning Insert: After installation.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is ti.ue 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 the work described herein, and
that NO OCCUPANCY will he made of any structnre without permission of the Community Services Division, Building Safely.
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
times during construction.
Owner or Contractors Signature
Pace 2 01'2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00549
COM2009-00549
COM2009-00549
COM2009-00549
Payments:
Type of Payment
ONLINE CHGS
cReceintl
RECEIPT #:
Description
1 st Appliance
Wood Stove/Insert
+ 5% Technology Fee
+ J 2% State Surcharge
Paid By
ONLINE PERMIT CHGS
~-~
City of Springfield Official Receipt
Development Services Department
Public Works Department
3200900000000000270
Date.: 04/24/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
NJM
ONLINE MICKEY L. Phone
Payment Total:
Page 1 of I
8:06:42AM
Amount Due
79.00
38.00
5.85
14.04
$136.89
Amount Paid
$136.89
$136.89
4/24/2009