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HomeMy WebLinkAboutPermit Mechanical 2009-10-22 Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01554 ISSUED: 10/22/2009 APPLIED: 10/22/2009 EXPIRES: 04/22/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phoue 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1066 L ST ASSESSOR'S PARCEL NO,: 1703264406301 Springfield TYPE OF WORK: Pellet Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Install freestimding pellet stove Owner: APPEL CALEB Address: 1066 L ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION i Contractor Type Mechanical Contractor OWNER License Expiration Date Phone # of.Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ATT C:B'l!JI'lJBIflIf..,JNfO~~ TI\lN II fOlio.. . u:"'~ ~Clo i db I. . " -- 'You to NotificatiO'lll9flst.frj;Th y the Oregon Utility R_{n OAR 952Hlf1gta(of~t~~.:1:'.Ies are set forth 'u090. You 1j'lftYe<lb1H1fp ~!JII OAR 952-001_ calling th troples of Ihe rules b VB number fo~~~ote:. ~he telephone Y , K"I'l;....''YtI''n UtIlity N I'fi Ce'l!Il~/~1~2_23~: cation Sprinkled Building: n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport, Sq Ft Other: Occupant Load: I. DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: IPU~LIC IMPROVEMENTS I NOTICE: ' ,', .". c"'SidewalkType: THIS PERMIT SHALL EXPIRE IF ilihlin'l/,Q~Drains: AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS' ABANDONED FOR ANY 180 DAY PERIOD, Notes: I Valuation DescriDtion I it{\.....~. Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amonnt Value Date Calculated Paee 1 of 2 -~~! ~:," CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01554 ISSUED: 10/22/2009 APPLIED: 10/22/2009 EXPIRES: 04/22/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project F~e~ P~id I Fee Description + 12% State Surcharge + 5% Technology'!'ee 1st Appliance Amount Paid Date Paid Receipt Number $9,48 $3.95 $79,00 10/22/09 10/22/09 10/22/09 2200900000000001211 ' 2200900000000001211 2200900000000001211 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, wilf be made the following. work day. I Rellllired Insoeet'rns ~ III I 1 r.,.huI.Y !'reestanding Pellet Stove: After installation, By siguature, 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 Services Division, Building Safety. I further certify that only coutractors 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 ofthe property, and the approved set of plans will remain on the site at all '. times during construction. > ~A~.L \'O-lL-D~ Owner or Contractors Signature Date Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone A."._ "c.u;g~I...IIU>...'.,.4iJj.. ."... iL,. · ..".,..,'.....................,., City of Spr~ngfield Official Receipt Development Services Department. Public Works Department' RECEIPT #: 2200900000000001211 Date: 10/22/2009 1:22:0SPM Job/Journal Number Description Amount Due COM2009-01554 1st Appliance 79,00' COM2009.0 1554 + 5% Technology Fee 3,95 COM2009-01554 + 12% State Surcharge 9.48 Item Total: $92,43 Payments: t:heck Number Authorization Type of Payment Paid By Received By Batch Number Number How "Received Amount Paid: Cash CALEB APPEL djb In Person $100,00 Change CALEB APPEL djb In Person ($7,57) Payment Total: $92,43: Job/Journal Number Description Amount Due COM2009-01554 1 st Appliance 79,00; COM2009-0 1554 + 5% Technology Fee 3,95 COM2009-01554 + 12% Stare Surcharge 9.48 Item Total: $92.43 Payments: Check Number Authorization Type of Payment Paid By Received By Batch Number Number How Receive~ Amount Paid Cash CALEB APPEL djb In Person $100,00 Change CALEB APPEL djb " In Person ($7,57) Payment Total: $92.43 cReceint 1 , Page 1 of 1 10/22/2009 = 0> ..~4 ~ ~, ~ -'~4 ~ ~ ~ ~: =' o "~4 1$ ~ ~ $!,-,,- 4 ..-4 . 4 ~l ~ ~4 ~ ~l r,i!!'l~ ~~ ~' ~ ~/ ~ tC)) ~ rtIlJ ~ e> o ~ ~",',::.~:~~i~::~' .. . By signing thi~ perrm.'t/.application, I agree to call for ~n inspection..(. S)3.~'ir~&lriitea:<..t~"'~6. 9). I state that all mforma~on on thIS apphcatIon/per~t IS corre~t ~pd)hatI w, ~~~~ the Wood Stove Safety mformatIon for wood burmng apphances a~d '\'~~c~~'i1 standards as set by the Oregon Department of En~tal.li~ \'tl~O~;;,:, Environmental Protection Agency .and I agree to ' ~ ~~ ~ra ti1?er to the inspector at the time of inspection. I also unders ~q ~ ng a preliminary inspection, the wan covering may be required ,to b~1ld '&w:.'f-'U \,t.?\O'U. , " . . ,c,Q\It\,,\'O\) 'U~ __ ' , . ~~'l , Signature: ~ .~ 225 Firm STREET - SPRINGFIELD, OR 97477- PH;(541)726-3753 - FAX: (541)726-3689 City Job Number Job Location: COwtZdO'7 -01 SSL( /Obb L s.. +- '703. Zb4Lf Tax Lot: Assessor's Map: Owner: r. () i....\-, ~ \'1' p\ AddTess: \ 0\..0\0 1_ <..h-u>-I- City: _ ~1"\n",Q:.Jd. 11 J OU ..- o.uiles'I \j\i\i\'i '..,. , . .,.... ., "'.:, (i\e'dv"':':\~:''"' ;'::\e""~' Preliminary Inspection for wood ~g it=,rtS is--I$66.~Jl~!~~~\' Wood Stove/Pellet/Insert Pennit is $87;01.~q'1cludes'l~~R.li~f~\il . ~'i , V),\~, ", \iOn G~ 00\0\n1 ieS 0\ ~ ~O{le "-'nti\,,,a ~<? nO'- 'I"" cO?,,,,.. tete? .ft.,nn ,..IL "H 1~1,11 (il, .L JI_ , 01"" - (1'\a~~' 't-lU1"; "" I"u" . Il\ () 'IoU 'el\\el., {I \j\\\"!..,Ll,) 009 ;\i(l9\~~.~~~_qte90~z"t.""'".. cean,~ lfl'ic'..'hl)J2..on (lU\\\" cel' Phone: State: OR Contractor: (),~) l\oE AddTess: Phone: City: Construction Contractor's Registration #: State: Zip: Expires: .".\' Date: ob~O( , Zip: ot7'-l1l ",-0> - J 0 ~ 21- - ()q Date of Application; /0 -ZZ -0 ~ ~ Checked for Delinquencies: Checked for Historical Status: ~' Shared Drive(T:)lBuilding FonnsIWood StoVe Permit 7-08.doc , '