HomeMy WebLinkAboutPermit Mechanical 2009-11-17
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01662
ISSUED: 11/17/2009
APPLIED: 11/1712009
EXPIRES: 05/1712010
VALUE:
225 Fifth Street, Springfield, OR
541:726-3753 Phone
541-726-3676 Fax
54 I -726-3769 Inspection Line
SITE ADDRESS: 1928 D ST
ASSESSOR'S PARCEL NO.: 1703361310600
Springlield TYPE OF WORK: Heating System
TYPE OF USE: New
PROJECT DESCRIPTION: ' Install tankless water heater and connect gas to fireplace insert
Residential
Owner: SULLlV AN LIVING TRUST
Address: 1928 D ST
SPRINGFIELD OR 97477
Phone Number: 541-747-5320
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:
BUILDING INFORMATION I
# of Stolie . ultes yOU to
R-~""'ON: Of~lllgm,<< r ~Y6t\U" Uti\~
I-iiE'" .. dopiwMlll 1:. areset 101111
toI\t\'IB,~\es ~ntewtIe9SP.J !OAR 962-001-
Notiflcatlo~~01..o1i1A1\lf~~ 01 the lules bY
~OAR~~m~o~AA~a!~e~~~~
00901'\'09 the ceOtllfri.ww'Uij~liicaUOI' n/a
~I J_:"'ftOtBgO _~u
IlUff\lI"'tQm\eB:l!JOf~lt'rh IN-FORMATION .
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Front yard Setback:
Si4e I Setback:
Side 2 Setback:
Real)'ard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Notes:
I PUBLIC IMPROVEMEIHS I .
NOTICE: ' IRE 'FlMIWORl<~idewalk Type:
THIS PERMIT SHAll ~S PERMIT" NOTpownspoutslDrains:
AUTHORIZED UNDER ^ BANDONED FOR:;tL'
COMMENCED OR IS" . ....,.,.:.:,'.::.
ANY 180 DAY PERIOD. " ,
Street Improvements:
Storm Sewer Available:
Special Instruction:
I Valu~tion DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of 2
Status
Issued
Lll t OF SPRINU:J<H.,LlJ'
Building/Combination Permit
PERMIT NO: COM2009-01662
ISSUED: . tl/17/2009
APPLIED: 11/17/2009
EXPIRES: 05/17/2010
VALUE:
225 Fifth Street, Springlield, OR
541-726-3753 Phone
54i-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees PaidJ
$16.44
$6.85
$79.00
$19.00
$39.00
11117/09
11/17/09
11117/09
11117/09
11117/09
Receipt Number
2200900000000001302
2200900000000001302
2200900000000001302
2200900000000001302
2200900000000001302
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
FiXture
M'inimum/Ad)ustment Plumbing
Amount Paid
Date Paid
Total Amonnt Paid
$160.29
I Plan Reviews ,
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: wilLbe made the following
work day. . ,
Rer/llired'lnsnp~tions I
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plnmbing work is complete,
Rough Gas: After line is installed and reqnired 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 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, Bnilding Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 wiU,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.
~~, </ ~r ,.r ~r::" / /r.---p./"--
Ow.ner or Contractors Signature
"i:
/ / ,~ / 7 - ?? 9'
Date
"
Page 2 of2
225 Fifth Street
Springfield, O'regon 97477
541-726-3759 Phone
;f~~;~:a, "'\
~; ."., '.
~
City of Springfield Official Receipt
Development Services Department
Publie Works Department
Job/Journal Number
COM2009-0 1662
COM2009-0 1662
COM2009-0 1662
COM2009-0 1662
COM2009-0 1662
Payments:
Type of Payment
CreditCard
cReccintl
RECEIPT #:
Date: 11/17/2009
2200900000000001302
Description
Fixture
Minimum/Adjustment Plumbing
1st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
CHARLESSULLlV AN
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
022893 In Person
Payment Total:
Page I of I
12:02:51 PM
Amount Due
19.00
39.00
79.00
6.85
16.44
$160.29
Amount Paid
$160.29
$160.29
11/17/2009