HomeMy WebLinkAboutPermit Mechanical 2009-6-29
City of Springfield
Mechanical Authorization To Begin Work
E~niailed To: c-hheating@comcast.net
Check on status of permit
By Phone: 541-726-3753 or Email: pcrmitcenter@ci.springfield.or.us
I D NcwConstructioll
o Addition/alteration/replacement
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Dcommercial
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INFORMATION:AND'tOCA'TION~3,',.7t'&-i?\:2:"ifu~
Job Address: 2536 16TH ST
Cit)'/StatelZII': SPRINGFIELD, OR 97477
Suile/bldg.lapt.no.;
Project Name;
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12~:ft~fE~!L~~'f:~~~f?DEsC'R1ijTI()N-!Q'F:wORK~~l'i',~~~~~'i~~~r~
alter gas piping to relocate gas meter.
I Nllmc:CharlcsOsgood
I Phone: 541-988-5674 Fax: 54]-747-7026
I Email:c-hheating@comcaSLnet
11'''';'
j CCBlic.no.: 168942
I Business Name: CHARLES ISAAC OSGOOD
I Contact:
I Address: PO BOX 70564
I City/State/ZIP: EUGENE, OR 97401
I Ph'one: 541-988-5674 Fax: 541-747-7026
I Email: c-heating@com>ca~t.net
I Melro lie. no.: City lie. no.:
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.
NOTE: This Authorization To Begin Work expires within 180 days if a
permit is not obtained.
The local building department may determine that an Authorization To
Begin Work is null and void if it does not meet applicable land use laws_
and local ordinances
loescriPtion
Appliance Fee l
lJ\lECII,(NlcALpERi\iITfF'EtS):~: -~..;,~
I Subtotal
IStlltesurCharge(12%OfPemlit
total) .
ITeChnOIOgy fee (5% of permit
total)
I TOTAL PERMIT FEE
69600-BMC-09-00008
6/29/2009 9:58 am
fJ~/\~~
$79,00
$9.48
$3.95
$92.01
This.Authorization To Begin Work. mu~t be posted at the job site until replaced by a Permit'
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination ,Permit
PERMIT NO: COM2009-00948
ISSUED: 06/29/2009
APPLIED: 06/29/2009
EXPIRES: 12/29/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2536 16TH ST
ASSESSOR'S PARCEL NO.: 1703243400108
Springlield TYPE OF WORK: Mechanical Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Gas piping for meter relocation.
Owner: LUTZ MARIAN R
Address: 7501 RAIN CLOUD DR
LAS VEGAS NV 89145
r, CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
CHARLES ISAAC OSGOOD
License
168942
Expiration Date
03/07/2010
Phone
541-988-5674
BUILDING INFORMATION I
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Strncture
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Bnilding: .
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Sethack:
Side I Setback:
Side 2 Setback:
Rearyard ~etback:
Solar Sethacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
. Handicapped:
,. Compact:
I PUBLIC IMPROV~ME~,TS I
Street Improvements:'
Sidewalk Type:
'Notes:
Storm Sewer Availahle,'
Special Instruction:
NOTICE:
[,~~~,~€RMIT SHAll CVn.__
COM;1E';;LtU UNDER TH;S'p"-EI'. ::::: ~vUKK I '!/ '- '^"'r-~""~- ,,~u to
\ ," "CEO OR IS, -1MiiIuatioIl-Descriotion ATTENTleN: ' fO' 0.. . I. ' .
/\/J'y 180 DAy ABANDONtO . fo;low rui~:; aL0;--. . : "'e", ":011 ,,~hty
. , 1 PERIOD., $ Pf..q,~ Ft Sqnare Foota eNoti1iG8.tion Cent&r. I he,s;:; p,ies ~~e '::! ,olth
DeSCrIptIOn Type of ConstructIOn I ' " B'd g , OAR 9"Value001 U thrcDafc Caiculatedl01-
. or mu tip ler or ) Amount In OoC;"."..... .,.... I b
, ' 0090. You may obtain caples of the ru es y
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1.800-332-2344),
Downsponts/Drains:
Pa2e I 01'2
_~~!;'!!,~S,~jlt~9J; ,~:!!,},~,,~\!!I:!I'
:, '
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.)
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00948
ISSUED: 06/29/2009
'APPLIED: 06/29/2009
EXPIRES: 12/29/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone ,
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees P~id I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Receipt Numher
$9.48
$3.95
$79.00
6/29/09
6/29/09
6/29/09
3200900000000000491
3200900000000000491
3200900000000000491
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:
Reouired Ins\1ections I
. ~ , .
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
,
By signature, I state and agree, that I have carefully examined 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 the work descrihed herein, and
that NO OCCUPANCY will he made of any structure without permission of the Commnnity Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 wili he used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readahle from the
street, that the permit card is located at theJront of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Page 2 of2
'c
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00948
COM2009-00948
COM2009-00948
Payments:
Type of Payment
ONLINE CHGS
cReccintl
RECEIPT #:
Description
I st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
ONLINE PERMIT CHGS
City of Springfield Official Receipt
Development Services Department
Public Works Departmcnt
3200900000000000491
Date: 06/29/2009
1O:07:0IAM
Item Total:
Check Number Authorization
Received By Batch"Number Number How Received
Amount Due
79,00
3.95
9.48
$92.43
Amount Paid
nJm
ONLINE
charles Online
osgood
Payment Total:
$92.43
$92.43
Page I of I
6/29/2009