HomeMy WebLinkAboutPermit Mechanical 2009-10-26
Residential Mechanical Authorization To Begin Work
69600-BMC-09-00167
Approval Code: 01789C 10/26/2009 5:12 pm
E-mailedTo:marketing@emeraldpool.com
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City Of Springfield
:.;. 225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Email: permitcenter@ci.springfiefd.or.us
I 0 New Construction IX] Addition/alteration/replacement
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lR]1 or 2 family dwelling D Multi.family "0 Commercial 0 Accessory
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Job Address: 2211 BEVERLY ST
City/State/ZIP: SPRINGfiELD, OR 97477
Suite/bldg./apt.no.:
Project Name:
Cross Street/directions to job site: :.
~a~ map/parcel no.:
1703272207506
Installing new Gas insert
,
I Name: Michelle & Todd Glenz
Phone: 541-915-2389
Fax;
Email: marke_ting@emeraldpool.com
CCB lie. no.: 11294
Business Name: EMERALD SWIMMING POOLS OF OR INC
Contact:
Address: 1885 HIGHWAY 99 N
I City/State/ZIP: EUGENE, OR 97402.1694
I Phone: 5416881090
I Ernai!:
I Metro lie. no.:
Fax:.
City lie. no.:
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 Wol1t expires within 180 days if a permit]s 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 taws and local ordinances.
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Description
First Appliance Fee
Total
$79.00
$79,00
$9.48
State surcharge (12% of permit
total)
Technology fee (5% of permit total)
$3,95
$92.43
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Inspections Phone: 541-726-3769
This AuthorizationTo Begin Work must be posted at the job site until replaced by a Permit
TOTAL PERMIT FEE
Status
Issued ..
. .~;'."
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01566
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 04/27/2010
VALUE:
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225 Fifth Street, Springfield, OR: ::
541-726-3753 P~one; ,.' .
541-726-3676 Fax
541-726-3769Inspectioripne
SITE ADDRESS: 2211 BEVERLY ST
ASSESSOR'S PARCEL NO,: 1703272207506
Springlield TYPE OF WORK: Pellet Stove
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PROJECT DESCRIPTION:, G~~ Insert installation
TYPE OF USE: New
Residential
Owner:
Address:
GLENZ TODD R & MISHELL
2211 BEVERLY ST'
SPRINGFIELD OR 97477
Phone Number: 541-9152389
., I CONTRACTOR INFORMATION I
,
Contractor Type
Mechanical
..:Contractor License
'. EMERALD SWIMMING POOLS OF ORE IN 11294
~U1LDING INFORMA T1<?:, I
Expiration Date
I 0/23120 II
Phone
541-688-1090
1..'
# of Units:
Primary Occupaney 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 Other:
Occupant Load:
n/a
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:
I ~U.BLlC IMPROVEMENTS I
Sidewalk Type:
NTL<'IM'a&""~aw requires yru'D
Am I'IOW On raW~:Ore('or, l_!!,:lr,,' '
" follow rules ad pte y I I" .J '
Notification Center, Those rules are s"et to, \h
Notes: . - . " In OAR 952-001-0010 through OAR 9;)2~001-
~;~~.~~~~'nIT ~HALL EXPIRE IF ::~; ~?t~~ . 009~:;,:O~~~~~~~ai\,~~!:::rh~\I~~:~~~~ebY
"UTHORIZEO UNDER THI::i n:.ri c:nQ} . . X'mb:r tor the Oregon Utility Nollllcallon
'~OMMENCEb.OR IS ABAN90NE'Qal~~'tIon DescnotlOn'J' Center is 1-800-332-2344).
D 'I' ANY 1 Rn DAVcPERtIODt;, .. $ Per Sq Ft Square Footage
eSCrtp IOn Type <if ons ruc IOn I . I' B'd A Value Date Calculated
or mu tip lef or I mount
Street Improvements:
,"\ ~
Storm Sewer Available:
Special Instruction:
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Page I of 2
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Status ' Iss~ed
225 Fifth Street;SpringfieId, OR.;
541-726-3753 Phone '
541-726-3676 Fax'
541-726-37691nspection Line
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Fee Description
+ 12% State Surcharge
+ 5% TechnoIogy Fee
1st AppIiance
TotaI Amount Paid
PeUet Insert: After instaUation
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Amount Paid
co $9.48
$3.95
$79.00
$92.43
Total VaIue of Project
Fees Paid I
. ,
I Plan Reviews I
Date Paid
R..eou.j~ed ~n~rectio~\.I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01566
ISSUED: 10/27/2009
APPLIED: 10/27/2009
EXPIRES: 04/27/2010
VALUE:
Receipt Number
10/27/09
10/27/09
10/27/09
3200900000000000730
3200900000000000730
3200900000000000730
By signature, I state and agree, that I have carefuUy examined the completed appIication and do hereby certify that all
information hereon is true and correct, and I further certify tbat any and aU work performed shaU be done in accordance with
the Ordinances of the City of SpringfieId and the Laws of the Stale of Oregon pertaining to the work described herein, and
that NO OCCUPANCY wilI be made of any structure without permission of the Community Services Division, BuiIding Safety.
I further certify that only contractors and empIoyees who are iu compIiance with ORS701.005 wilI be used on this project.
I further agree to ensure that aU required inspections are requested at the proper time, that each address is readahle from the
street, that the permit card is Iocated at the front of the property, aud the approved set of pIans wilI remain on the site at aU
times during construction.
Owner or Contractors Signature
, ,
.,
Page 2 of2
Date
225.Fifth ~treetc".. ,\ ,. ",
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Springfield, Oregoti9ii:t77;,:,[";" .
541-726-3759 Phone ". c," ';.
City of Springfield Official Receipt
Development Services Department
Public Works Department
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RECEI~T,#::, 3200900000000000730
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Job/Journal Number'~;" "pesc~ipti~~ ... .~',~ <: f
COM2009-0 1566 . . I st Appliance '
COM2009-0 1566 ','+ 5% Technology Fee
C0M2009-01566 '+12% StateSuicharge
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Payments:
Type of Payment
Paid By
ONLINE CHGS ONLINF; PERMIJ.,9.HGS
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cReceintl
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Date: 10/27/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
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ONLINE
emerald Online
swim
Payment Total:
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.Page I of I
7:37:3IAM
. Amount Due
79.00
3.95
9,48
$92.43
Amount Paid
$92.~3
$92.43
10/27/2009