HomeMy WebLinkAboutPermit Mechanical 2009-11-19
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SPR, IN G, F~eL,D,:
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City Of Springfield
225 Fifth 81
Springfield. OR 97477
Phone: 541-726-3753
EmaiJ: permitcenler@ci,springfield.or.!Js
',~,~l.~~':'-,"';-~:~:K\TYP,EiOF.':WORK -0f;:h<';:."^~;;~~,~~,;:~~;;'::f~W~ J)!j
o New Construction
IKl Addilion/allerationlreplacement
it""\i::~~};~~~~~,!~F~A rEG'ORY:0~\CONS'iRVGj:19N~t4;i;:.pr~'~\~.~-~~~1.
I 00 1 or 2 family dwelling 0 Multi.family 0 Commercial D Accessory
~'! c~.;: JOB:SITE:INFORNIA TION-ANO:tOCATION'
I Job Address: 474 715T 5T
I City/StatefZIP: SPRINGFIELD, OR 97478
I Sultelbldg./apt.no.:
I Project Name: Simons Job
I Cm~. Suaa"d;,.,tion. to Job ,It"
I Tax map/parcel no.: 1702352401900
I~ild; ii!k~.~;lt~h :_~;t:~j,c-Q~~sJ~Ri-p;1]QNJOE:WQf{jS'~,~'~~~:~'.:..:~~i4: -c'j
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Installing new pellet stove fireplace insert
Ik;:~Jt~~yJ~~-}3~;' ~~.;"i~1iii;j~SIT-gCONTACT._~~;;/~~~~f~t::-". r~i1;,I~:_fd
I Name; Jim Beck
I Phone: 541-747-8600 Fax; 541~747-8400.
I Email:
'Ii,~' ,; :'t\~#c.r~ "1!.\.~I':;E.'r;~ " 'CONTRACioR-f,j:;~/Af~tf;<(;'f1'j~..:c.;~~t~'~
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I THI€ PP~Mff~All ~Uw"YiP\1IQI1(
I Bu,;ness lI.'~lmJ'tmBElfTHIS PEMIIr..,..
I Contao', COMMENCED OR IS ABANDUftilJrut\ ,
I Add,ess, AM'liu~\IJiIAM'~f(IUU.
I CitylStatelZlP: SPRINGFIELD, OR 97477
I ph6ne: 5417478600 Fax: 5417478400
I Email;thestovedoctor@netzerO.net
I Metro lie. no.; City lie. no.:
Upon review and approval by your local Jurlldlction, your permit will be e.mlllled or faxed
within one bUllnes& day, with In&tructlonl on how to Ichedufeyour In Ipectlon.
Residential Mechanical Authorization To Begin Work
69600-BMC-09-00166
Approval Code: 003613 11/19/2009 8:41 am
E-mailedTo:thestovedoctor@netzero.net
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IOih.~'rJ:uel:B-l!rQ,ing::ApPlia~t;:es~~,\:r"~";'<-~f~~'!''-:':,:..:~" ~-';) }..~~.
I Chimneylliner/flue/vent I $17.00
I~inimum Fees::~':~~~JL ~ .:
I First Appliance Fee I
I~e~h~iji,c~i~eiml{f.ees~;. . .~'Cj: .
I Subtotal
I State surcharge (12% of permit
total)
I Technology fee (5% of permit tolal)
I TOTAL PERMIT FEE
Total 'I
.,;1
$17,00 I
,'i.-f;]1
~1. .
$79,00 I
"1
.1
$96.00
$11.52
$4.80
$112.32
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ATTENTION: Oregon law requlrel you"
follow rules adopted by the Oregon Utility
Notification Center. Those Rll8ll are I8l fortIt
In OAR 952.oot.oo10through OAR 852.oot-
0090. You may obtain copies of the Rllea IIr
calling the." ;,;,~ (Note: the telephant
IlUmber for the Oregon Utility NlltI1If-Hoft
Genter II t -iOll 112-2344).
NOTE; This Authorization To Begin Work expires within 180 days If a permit Is not obtained.
The locat building department may determine thllt an Authorlzlltlon To Begin Work Is null and . _ ~
void If It does not meet applicable land use laws and local ordinances. ~ ..
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Inspecti~'ns Pho~e: 541-726-3769
This Authorization To Begin Work ":lust be posted at the job site until replaced by a Permit
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01671
ISSUED: 11/19/2009
APPLIED: 11/19/2009
EXPIRES: 05/19/20]0
VALUE:
Status. Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541,-726-3769 Inspection Line
SITE ADDRESS: 474 71ST ST
ASSESSOR'S PARCEL NO.: 1702352401900
Springlield TYPE OF WORK: Pellet Stove
TYPE OF USE: New
PROJECT DESCRIPTION: Installing new pellet stove Iireplace insert in residence.
Residential
Owner: SIMONS MICHAEL L & KIMBERLEE A
Address: 474 71ST ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION'
Contractor Type
Mechanical
Contractor License
JACC ENTERPRISES 162960
r BUILDING INFORMATION I
Expiration Date
01/28/2011
Phone
541-747"8600
# 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 Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION'
.
,.
REQUIRED PARKING
Frontyard Setback: Overlay Dist: Total:
Side I Setback: ',..,;;-",\",;;",1,"# Street Trees Rqd: ,ATTENTION: Oregon ~_V!'U.to
Side 2 se_1CE' . Drive Rqd: follow rules adopted bydbltJP,fASon Utility
Rearya'r, t 'Il'JiR" MTf SHAlt iXP\RE \f tKI.. Lot Coverage: Notification Center. Those rure& are ntforth
Solar SetillJ: rt: . R THIS IlERNltr u i' In OAR 952-OO1-o010through OAR 952.00'-
" .l1Tl-lnRI(FOUNDE ~...":. nnon Vn'lmAyobl8l'1'lopiesoftheruI8lbr
, COMMENCED OR I:; I\D I PUBLIC IMPROVEMENTS ~ling the center. (Note:.tne 1elepnone
11 ~IV 111n nAY PERIOD." lumber lor the Oregon Utility NoIifIoatIoft
Street Improvem'l'lft,r: S~l1IGI<lti~D-332-2344).
Storm Sewer Available:
Special Instruction:
, Downspouts/Drains:
. ~",'.~."-:
Notes:
I V aluation De,scriDt~o~ ,I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page 1 of 2
r
2,15 Fifth Street
S'pringfield, Oregon 97477
54,1-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1200900000000001269
Date: 11119/2009
9:05:03AM
Job/Journal Number
COM2009-0 1671
COM2009-0 1671
COM2009-0 1671
COM2009-0 1671 '
Description
I sl Appliance
Pellet Stove/Insert
+ 5% Technology Fee
+ 12% State Surcharge
Payments:
Type of Payment
ONLINE CHGS
Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
79.00
17.00
4.80
11.52
$112.32
Amount Paid
ONLINE PERMIT CHGS
KR
ONLINE lACC ENT. Online
Payment Total:
$112.32
$112.32
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cReceintl,
Page I of I
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II II 9/2009
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