HomeMy WebLinkAboutPermit Mechanical 2009-9-9
City of Springfield
Mechanical Authorization To Begin Work
E-mailed To; lindsey@marshalJsinc,colll
69600-BMC-09-00121
9/9/2009 10:37 am
Approval Code: 04548D
Check on status of permit
By Phone: 541-726-3753 or Email: pennitccnter@ci.springfield.o.r.us
I D NewConstruction
o Addition/alteration/replacement
I Description
Total
I First Appliance Fcc
o J or 2 family dwelling
DMUlti-familY
DCommercial
DACCeSsoryBUilding
I Cm" S.",t1d',,"'o", to job ;it" "oth 720d " to holly
I Tax map/parcel no.: \
I Subtotal
Fi'~~~~~iJoB'"!sITitiNtoFtMATiONrAND1i!oCATfoN{)~~td.--i!'~~fl~~1 I Sial~ surcnarge (]2% of perin it
Job Address: 7273 HOLLY ST I
1~;:~)nOIOb'Yfee(5%OfPermit
City/Stille/ZIP: SPRINGFIELD, OR 97478 I. tota!)
Suite/bldg.lapt,no,; I I TOTAL PERMIT FEE ,
i e,q-\33a-.~ g\q\09
I .
$3,95
$92,43
Project Name: HANSEN
install,woodstove
\
Name: CHET HANSEN
Phone:
Fax:
I Emllil:
CCBIi"OO,'2i7J?~Il;_t:... --, i: l~ -:-IIE 'N00l(
I BusinessName~~,JU't{As~~N&l t)HA~~ :.~:.~ ~.-n~IIIT Ie t\I(IT
I C"otO~I' AUTHORILtU UI~Ut:n IIIIV ,).., ..... ,-.
. - "'E;J,.r8 f"D
I Address: 4110 c&~~f.IR~SJNCtU UK I\) J-\D/"\l~ ....... ~,.
I City/Stale/ZIP: ,S~~i~Gfi].(D,l.OR\'974its~30U u.
I Phone: 541-747-7445 Fax: 541-741-0821
I Emoil,
Metro lie. no,:
City lie, no.:
ATTENTION: Oregon law requires you to
follow rules adopt~d by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR.952-001-
0090" You may obta.in copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
k;"O"~~
~ f.t)O \.\~Y
<'\.~ \"
,\0" ~
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 pennit 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
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01332
ISSUED: 09/09/2009
APPLIED: 09/09/2009
EXPIRES: 03/09/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 7273 HOLLY ST Springfield TYPE OF WORK: Wood Stove
ASSESSOR'S PARCEL NO.: 1802021203700
'" TYPE OF USE: New
PROJECT DESCRIPTION: Installwoodstove in residence.
Residential
Owner:
Address:
HANSEN CHESTER E & LAURIE C
1010 SE 8TH AVE
OAK HARBOR WA 98277
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
MARSHALLS INC
License
25790
BUILDING INFO~A TION I
Expiration Date
12123/2009
Phone
541-747-7445
# of Units:
Primary Occnpancy 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 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft C!ther: '
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
ATTENTION: Oregon law requires you to NOTICE: "REQUIRED PAR\1:{~G
, " I d t db 'he Oreg-~ 11';lil\b' T SHALL EvolRf IF THE WO
Front yard Setbac'k:Ow ru es a op e y I Overlay ist: THIS PERMI ,Total:' T IS NOT
Side 1 Setback: Notification Center, Those rules arli s~;J~'Trees Rqd: ,..tITH()Rr~ED UNDER ~H~'iid7fa~Wd:
Side 2 Setback: In OAR 952-001-0010 through OARp'1i'V:eil D~,ve Rqd: ~ ';' ;~ '''EO OR IS A'Gbih'j\liJ/!=D ~OR
0-~90 You may obtain caples of tho ru'os OV~ r; 1[\llt!\l".. ' .
Rearyard SetbaCK: " . % on':ot-t-overage: ,:', ' ,,'r " ,'1 DERIOO
S I S tb k. calling the center., (Note: the teleflllone ,. ,'", ,,1'., , :'
o ar e ac s. 0 U 'I' N t'f' t'
number for the regon tllty 0 Ilca Ion
Genter IS l-t;UU-;J'I'PUBL1C IMPROVEMENTS I
Street Improvements:
Storm Sew,er Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation DescriDtion I
, Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value.
"
Date Calculated
Paee I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/CQmbination Permit
PERMIT NO: COM2009-01332
ISSUED: 09/09/2009
APPLIED: 09/09/2009
EXPIRES: 03/09/2010
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
$9.48
$3.95
$79.00
9/9/09
9/9/09
9/9/09
Receipt Number
1200900000000001042
1200900000000001042
1200900000000001042
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Total Amount Paid
$92.43
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769, All inspections requested before 7:00
a.m, will be made the same working day, inspections requested after 7:00 a.m. wilPbe made the following
work day,
I Rrllllired Inspections"
Wood Stove: After Installation.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Servi~es Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this projeCt.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on thc site at all
times during construction.
Owner or Contractors Signature
Date
Pae;e 2 of2
22$ Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
job/Journal Number.
COM2009-01332
COM2009-01332
COM2009-01332
Payments:
, Type of Payment
ONLINE CHGS
cReceintl
RECEIPT,#:
. Description
1st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
ONLINE PERMIT CHGS
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000001042
1I:10:16AM
Date: 09/09/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
79,00
3.95
9.48
$92.43
Amount Paid
KR
ONLlNEMARSJ-lAL Online
LSlNC
$92.43
Payment Total:
$92.43
Page 1 of I
9/9/2009