HomeMy WebLinkAboutPermit Mechanical 2009-10-19
Status
Issued
CITY OF SPRINGFIELD
. Building/Combination Permit
PERMIT NO: COM2009-01531
ISSUED: 10/19/2009
APPLIED: 10/1912009
EXPIRES: 04/19/2010
VALUE:
225 Fifth Street, ~pringfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 920 DARLENE AVE
ASSESSOR'S PARCEL NO.: 1703272100500
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: Move
Residential
PROJECT DESCRIPTION: Gas Insert
Owner:
Addr~ss:
BECKER NEVA PATRICIA
920 DARLENE AVE
SPRINGFIELD OR 97477
Phone Number: 541-342-2560
! CONTRACTOR INFORMATION'
Contractor Type.
Mechanical
Contractor License
EMERALD SWIMMING POOLS OF ORE IN 11294
BUILDING INFORMATION I
Expiration Date
10/22/2009
Phone
541-688-1090 '
# of Units:
Primary Occupancy 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 GaragelCarport
Sq Ft Other:
Occupant Load:
nla
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 IMP~OVEMENTS I
Street Improvements: Sidewalk Type:
Storm Sewer Available: ^TTERl'm~~iiiw requires you.~G
Special Instruction: follow rules adopted by the Oregon Utility
N nTH~ E' Notification Center. Those rules are set forth
Notes': . IF THE WORK In OAR 952-001-0010 through OAR 952-001.
THIS PERMIT SHALL EXP~R~ ;,., ""T . nORo, Vou mayoblalncoples of the rules by
AU I HUKILtU UI~ucn I rll" , EJ.I.1\, Y.: ..~. cahlng tne center. \'~U'''..,,,,, '''''':'''''~':~
COMMENCED OR IS ABANDONED FOR I Valuation Descri~tion I number for the. Oregon Utility Notification
ANY 180 DAY PERIOD. . . , Center IS 1-800-332,2344).
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Description
Tvpe of Construction
Value
Date Calculated
Paee I of 2
-~~~~~~~~,~;;.,;~,:!~I.I!'i~~;L, '
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~i;
CITYOF SPRINGFIELD
Building/Combination Permit
Status
Iss u ed
PERMIT NO: COM2009-01531
ISSUED: 10/19/2009
APPLIED: \0/19/2009
EXPIRES: 04/19/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Valne of Project
Fees, ~aid ~
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
10/19109
10/19/09
10/19/09
10/19/09
I.
2200900000000001197
2200900000000001197
2200900000000001197
2200900000000001197
Total Amount Paid
$100.62
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. .AlI 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 ,~e()~,~ired l~,sne~ti?ns I
Rough Gas: After line is installed and required testing and capped if not attached 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'imd 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 the site at all
times,during construction.
1<\i)t1\ f~t6~LlJ IO/I?//{Yl
. , .
Owner or Contractors Signature
Date
Page 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Nurn~er
COM2009-01531
COM2009,O 1531
COM2009,O 1531
COM2009-01531
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Desc~iption
Gas Outlets 1-4
1 st Appliance
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
NEVA p, BECKER
"'J;.Q..~~..,aLD. 'iiI-'...."ioiiI."~~:~,I' '....
,t- ..
l1li:...',
. " ,\ ' ',.
,---- ..;,' ',-
,,, ",....... ........ - .-
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001197
Date: 10/19i2009
1:49:53PM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
7,00
79,00
1032
4,30
$100.62
Amount Paid
nJm
0099370 In Person
Payment Total:
$100,62,
$100.62
Page 1 of 1
10119/2009