HomeMy WebLinkAboutPermit Mechanical 2009-9-23
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City of Spring'iield ,
Mechanical Authoriiation To Begin Work
E-~ailed To: lindsey@marshallsinc.com
Ch'eck on status of permit
~y Phon~: 541:726-3753 or Email: perrnitcenter@ci.springfield.or.us
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New Construction ""
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o Accessory Building
I Job Address: 1023 NANCY AVE
I City/State/ZIP: SPR!NpFIELD, .OR 97477 ;",
I Suite1bldg./apt.Do.:.:.: ""'..'; ':"
I Project Name: peppl~~ ':
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install water heater and gas piping
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Name: marilynn pepple
Phone: 541-746-4265
Fax:
Email:
I CCBlic. no.: 25790
I Business Nllme: MARSHALLS INC
I Contact: .'
I Address: 4110 OLYMPIC 5T
City/State/ZIP: SPRINGFIELD, OR 974785620
Phone: 541-747-7445
Fax: 541-74]"0821
Email:
Metro lie. DO.:
City lie. DO.:
Upon review and approval by your local Jurisdiction, your pennit will be
e-mailed or faxed within one business day. with Instructions on how to
schedule your inS~ctI0n:
NOTE: This Authorization To Begin Work expires within 180 days if a permit is
not obtained. '
The local building department may detennine that an Authorization To Begin
Work Is null and void if it does not meet applicable land use laws and local
ordinances
IGasPiping -tirst four
I First Appliance Fee
surcbarge(12%6fpennit
ITecbnologytee-(5%O[permit
tolal) "
I TOTAL PERMIT FEE
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69600-BMC-09-00 133
9/23/2009 3:40 pm
Approval Code: 05826D
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This Authorization To Begin Work must be posted at the job site until ~eplaced by a Permit
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Status
Iss u ed
CITY OF SPRINGFIELD
, Building/Combination Permit
PERMIT NO: COM2009-01418
ISSUED: 09/24/2009
APPLIED: 09123/2009
EXPIRES: 03/24/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1023 NANCY AVE
ASSESSOR'S PARCEL NO,: 1703272206700
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: install water heater and gas piping
Owner: PEPPLE MARILYN J
Address: 1023 NANCY AVE
SPRINGFIELD OR 97477
Phone Number: 541-746-4265
I CONTRACTOR INFORMATION'
Contractor Type
Mechanical
Contractor
MARSHALLS INC
License
25790
BUILDING INFORMATION'
Expiration Date
12/23/2009
Phone
541-747-7445
# of Units:
Primary Occupancy Group:
Secondary Occnpancy 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 GarageiCarport
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 Improvements:
Sidewalk Type:
, '
Downspouts/Drains:
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center, Those rules are set forth
in OAR 952-001-001 0 throuah OAR 952-001-
E' ;;;;;;;; You may obtain copies ottne rUles oy
NOTle , I ,Valuation DescriotiOlullng the center. (Note: the telephone
THIS PERMIT SHALL EXPIRE Ir ' IIUIIloer tor the Oregon Utility Notification
. , ~UTHOTRIZED .I~NDER Tt1IS PER$'Ve.J~q~]$lT Square Foo~g~lter is 1-800-332-2344).
DeSCrIptIOii' M Yli'p~cill onstrU,C!IOI!'Do.,rn r"lt"'i I' B'd A t Value Date Calculated
COM t ,(;cU K I~ l\l:ll-Il' l\mt.mu pIer or I moun
ANY 180 DAY PERIOD.
Storm Sewer Available:
Special Instruction:
Notes:
Page 1 of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01418
ISSUED: 09/24/2009
APPLIED: 09/23/2009
EXPIRES: 03/24/20]0
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fe"., Paid I
II...
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Gas Outlets 1-4
Amount Paid
Date Paid
Receipt Number
$10.32
$4.30
$79,00
$7.00
9/24/09
9/24109
9/24/09
9/24/09
3200900000000000666
3200900000000000666
3200900000000000666
3200900000000000666
Total Amount Paid
$10Q.62
I Plan Re,views ,
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 Renuired h'sne~~ions 1
Rough Gas: After line is installed and required testing and capped if not attach~d to an appliance.
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 1 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 Services 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 setof plans will remain on the site at all
times during construction. '
Owner or Contractors Signature
Date
.Paee 2 of 2
225 Fifth Street
Springfield, Oregon 97477.
541-726-3759 Phone~ .
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3200900000000000666
Date: 09/24/2009
6:57:3IAM
Payments:
Type of Payment . !,aid By
ONLINE CHGSONLINE PERMIT c;HGS
Item Total:
Check Number Authorization
Received By Biltch Number Number How Received
Amount Due
7,00
79.00
4,30
10.32
$100.62
Job/Journal Number
COM2009-01418
COM2009-0 1418
COM2009-01418
COM2009-01418
Description,'" .
Gas Outlets 1-4;'
1 st Appliance
+ 5% Technology Fee '.'
+ 12% State Surcharge
Amount Paid
njm
ONLINE marshalls In Person
Payment Total:
$100.62
$100.62
i
cReceintl
Page I of I
9/24/2009