HomeMy WebLinkAboutPermit Mechanical 2009-8-20
City of Springfield
Mechanical Authorization To Begin Work
E-mailed To: mightymouse541@hotmaitcom
69600-BMC-09-00090
SnOn009 5:35 pm
Approval Code: 192640
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Check on status of permit
By Phone: 541-726-3753 or Email: permitcenter@ci.springfield.or.us
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I D New Construction 0 Addition/alteration/replacement
I~Yi1L,,\~l;:!'J'~W'i\'~cATEGORY!OF;coN5'fRUCTION~~,,~~~~1
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1~~~~OB"SiTE~NF.ORMATiONfAN6YlfOCATION'i...~~l~A~~1
Job Address: 4424 DAISY ST
City/StatelZIP: SPRINGFIELD, OR 97478
Suite/bldg.lapt.no.:
Project Name: viking instrt#l
CrouStreet/directioos to job site:
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;c~~~~"VL~~~~DES'CRIF;TION:O'F:!WORR;~~~~~.g~
remove old wood insert and install new wood insert and new flex chimney liner
1~~~di~~Jl:~~1SITEiCO.NTAc;-1;~~!'i~IttJ~~:r~~~
I Name: Steve Holley
I Pbone: 541.285.7734 Fax:
I Email:
1~'i'.k~~f;b"l.1l~ONTRACJ.oR~~~~~~:i.~f'
I CCB Ii~ no.: 177142 I
Business Name: MDK CONSTRUCTION LLC I
Contact: I
Address: 565 HUGHES ST I
City/Statr/ZIP: EUGENE, OR 97402 I
Phone: 541-556-9422 Fax: I
Email: I
Metrolic.no.: Citylic.no.: I
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 de~rTnlne that an Authorization To
Begin Work is null and void If it does not meet applicable land use I~ws
and local ordinances
1~l!..~~litEE'scHE6u-~E~;2~-';;;;;:~1
I Description J Qty. I Ea. I Total ,
lo.tbef~i}lu~"'ap.Pi!~W~tj$~~$~$~~]!E
IChimneY/liner/flUe!vent J I L $17.00 J $17.00.
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!\-I!.I?-.I!!!~.m.E.e~:-5;;n.,~,r~~~.~~~l}gi.tlt.-{~'ft-,~.",,~~.~
I First Appliance Fee 'J I $79.00,
~l~~~@~!~}J:PER.'lit:f!~,S~~~~~~t:f:.~~~
I Subtotal $96.001
1 State surcnarge (12% of penn it SII.521'
total)
1 Technology fee (5% of penn it $4,80 I'
total)
I TOTAL PERMIT FEE SIIz,3z1
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This Authorization To Begin Work must be posted at the job site until replaced by a Permit
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Status
Issued
CITYOF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01231
ISSUED: 08/21/2009
APPLIED: 08/21/2009
EXPIRES: 02/21/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726.3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 4424 DAISY ST
ASSESSOR'S PARCEL NO.: 1702323404420
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE:
PROJECT DESCRIPTION: Installation of wood insert and chimney liner.
Residential
Owner: PHIBBS DONNA
Address: 6099 FERN HILL LOOP
SPRINGFIELD OR 97478
1 CONTRACTOR INFORMATION'
Contractor Type
Mechanical
Contractor
MDK CONSTRUCTION, LLC
. License
177142
Expiration Date
11/04/2010
Phone
541-556-9422
I, BUILDING INFORMATlONJ
# of Units:
Primary Occupancy Croup:
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;t 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 Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street 1mpro, ,y.ements;, .0
' '-'V I IVI,l' r I
fnlln ... '_ . egon aw requires you t
Storm ~ewer.lAvailahle;jOPted by the Ore U" .a
. ~ot'tl,...~";int"'l C . gon tJllty
Special, nst~\nctlOn: enter. Those rules are t f NOTICE.'
In U",H 952-001-0010 throu se orth
Notes.0090. You may obtain co ,gh OAR 952-001_ THIS PERMIT "
. ~~::!!~~J t.he center. (Not~l:et~~ft~~::~~~:_by AUTHOR/Zm /~~~~~ ~~[:;R.EIF THE WORK
. -'c';~t'''o. U""fjon Utility Notifl"auon ~ :';:'::;,;c,NCED OR IS . ,,"u C 'inlvII I /:5 NOT
er IS 1-800-332-2344). Valuation Desc"iD1io~), DAY PERIOtBANDONED FOR
$ Per Sq Ft Square Footage
or mnltiplier or Bid Amount
Sidewalk Type: .,
'.
Downspouts/Drains:
Description
Type of Construction
Value
Date Calculated
Paee I of 2
_$~~'fi~Iii:\~P,,,, ,.. c.
~. ,,'
Status
Iss u ed
225 Fifth Street, Springfield, OR .
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspecti(jn Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appli.nce
Heat Pump
Amount Paid
$11.52
$4.80
$79.00
$17.00
Total Amouut Paid
$112.32
Tot.1 Value of Project
Fee. Paid ~
Plan Reviews I
Date Paid
8/21109
8/2 1109
8/2 1109
8/2 1109
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01231
ISSUED: 08/21/2009
APPLIED: 08/21/2009
EXPIRES: 02/21/2010
VALUE:
Receipt Number
,.
3200900000000000598
3200900000000000598
3200900000000000598
3200900000000000598
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.
Reouire( . . ~Dections I
11,,111 11111 I. ...,1111 I
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signature, 1 state and agree, that I h.ve carefully examined the completed application and do herehy certify that all
iuformation hereon is true .nd correct, and 1 further certify that any and all work performed sh.lI: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, .nd
th.t NO OCCUPANCY will be made of any structure without permission of the Community Servites Division, Building Safety.
1 further certify that only contractors and employees who .re in compliance with ORS 701.005 will be used on this project.
I further .gree to ensure that.1I required inspections are requested at the proper time, th.t e.ch .ddress is readableJrom the
street, that the permit card is located .t the front of the property, and the approved set of plans wilJ remain on the site at all
times during construction. .
Owner or Contractors Signature
Paee 2 of 2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01231
COM2009-01231
COM2009-01231
COM2009-0l231
Payments:
Type of Payment
ONLINE CHGS
cReceintl
RECEIPT #:
Description
.lst Appliance
Heat Pump
+ 5% ,\echnology Fee
,+ 12% State Surchar,ge
Paid By
ONLINE PERMIT CHGS
,
,
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City of Spri~gfield Official Receipt
Developmeljlt Services Department
Public Works Department
3200900000000000598
Date: 08/21/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njrn ONLINE mdk const Online
Payment Total:
Page 1 of I
10:SO:03AM
Amount Due
79.00
17,00
4.80
11.52
$112.32
Amount Paid
$112.32
$112.32
8/21/2009