HomeMy WebLinkAboutPermit Mechanical 2009-10-9
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;':-""'" 225 F1ITH STREET . SrRlNGFlEW,O~ 97477. rH:(541)726-3753 . FAX: (541)726-3689
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CityJobNumber COWl Z.OO ,/-OIL(? 3
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1703 z.bl( I
Tax Lot
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Address
Phone
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Cit.
Value of Wood StovelPellet~v~-;:;s~ 3./00
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(please circle appropriate appliance)
Preliminary Inspection i~ $45.00~prio . sert) , '0"9- > 51 )a,ua~ JA(\\lllil1 ,:
Wood StovelPelletllnsert Permit' . mcl~!!s\R'eiilill~!~s_ulV'ce,\Fg~, ~tl!~e;Sitrcharge & Admin Fee.)
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Construction Contractors Registration #
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P'{pires
, By signing this pei:mitJapplication, I agree to call for an inspection(s)as required (726-3769), I state that all
infonnation on tillS application /peQllit is correct and that I was provided with the Wood Stove Safety
infonnation for wood burning appliances and preliminary inspection standards as set ~y the Oregon Dep~ent
of Environmental Quality or the Federal Environmental Protection Agency and I agree to provid~ t~te~
approval number to the inspector at the time of inspectioll, I also understand that if lam ~~~'lfsn~a;~~ ~
preliminary inspection, the,wall covering may be required to be removed , 'C\)~ ,,\) C?i ~'d\)\\)..~ l..
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For Office Use I'
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Date of Appliption
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rhecked for Historical Statuf
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Checked for Delinquencies
Shared Drive(T:VBuilding FonnsfWood Stove Pennill.03.doc
Status Issued. u,. ; " :,,:
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225 Fifth Street; Springfield, OR
541-726-3753 Phone',
541-726-3676 Fax ,(
541-726-37691nspection Line
CITY OF SPRIl"lIt...Hl',LD .
Building/Combination Permit
PERMIT NO: COM2009-01493
ISSUED: 10/09/2009
APPLIED: 10/09/2009
EXPIRES: 04/09/2010
VALUE:
SITE ADDRESS: 1319 QUINALT ST
ASSESSOR'S PARCEL NO,:. 1703264115600
Springfield TYPE OF WORK: Wood Stove
Residential
PROJECT DESCRIPTION: Wood insert
TYPE OF USE: New
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Owner: MARTHA F MEIER LIVING TRUST
Address: 1319 QUINALT ST' ,.
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
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Contractor Type' ' ' Contractor
Mechanical .~1. ~. CHRIS B WINSLOW
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms: !
~:
Frontyard Setback:
Side 1 Setback: ., , '
Side 2 Setback::' . .I' ,:
Rearyard Setback:
. Solar Setbacks:<i .
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Street Improvements:
Storm Sewer Available:
Special Instruction: '
Notes:
..
License
52381
BUILDING INFORMATION I
# of Stories:
R-3 Height of Structure
Type of Heat:
VB Water Type: la,\Ja0 "\Jl!\\J
, 51 Ila",
Rang'\l!,ype: . al.\\)O 6\J\\\"60
,f\1\1,,(Ei1~Vgy.df"'th';l \laO al.\\ ' . 0600
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a :\:DE:v.EEO-piViEN;r\INF(;RMATio~NjIJ\
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1-\\\\\ o~ s~:~treet Trees Rqd:
0\ !\ Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Expiration Date
01110/2010
Phone
541-895-3593
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type: .,'"
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Downsp.oUO\;gj~i~S1(\ () 3~~O'.)
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I Valuatioll Descriutlo:'riC'1\ 31-11-
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee I of 2
Value
Date Calculated
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fa,x;; ,J
541-726-376911ispectio'n'Line
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CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01493
ISSUED: 10/09/2009
APPLIED: 10/09/2009
EXPIRES: 04/09/2010
VALUE:
Status
Issued
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Total Value of Project
Fees Pair! I
. ,-" ,(
Fee Description:' ,:" ';';'
+ 12% State Surcharge
+ 5% Technology Fee'
1st Appliance :
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Amount Paid
Date'Paid
Receipt Number
$9.48
$3,95
$79,00
10/9/09
10/9/09
10/9/09
1200900000000001128
1200900000000001128
1200900000000001128
Total Amount Paid
$92.43
I Plan Reviews I
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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 R,>,r ired Insoections I
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Wood Burning Insert: Afterinstallation.
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By signature, 1 state and agree, that 1 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 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 set of plans will remain on the site at all
,,"0 '"no m'ru '"<bJ-\ / ( 0/1 ! 0 q
ow~er or c/"ctors Signature r Date
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Paee 2 of2
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225 Fifth Stree(, " ,
Springfield; OregoU:' 97477
541-726-3759 Phone ,.
Job/Journal Number; :'.
COM2009-01493 .
COM2009-01493
COM2009-01493 'ii'"
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
.l?esc,~jption
, t:]st Appliance
'+ 5% Technology Fee
,'",+ .12% State Surcharge
.,~ ~. ' , .
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Paid By
YE OLD TOWN SWEEP
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Cit): of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000001128
. Date: 10/09/2009
Item Total:
Check Number Authoriz.dion
Received By Batch Number Number How Received
djb
20761
In Person
Payment Total:
Page I of I
1I:17:12AM
Amount Due
79,00
3.95
9.48
$92,43
Amount Paid
$92.43
$92.43
10/9/2009