HomeMy WebLinkAboutPermit Mechanical 2009-11-25
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01702
ISSUED: 11/25/2009
APPLIED: 11/25/2009
EXPIRES: 05/25/2010
VALUE:
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753 Phone '
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5769 KALMIA LN
ASSESSOR'S PARCEL NO.: 1802041403500
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
PROJECT DESCRIPTlON~ Install propane fireplace
Owner: KIRBY MICHAEL J & DONNA M
Address: 5769 KALMIA LN
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
OWNER
License
# of Units:
Pr,imary Occupancy Groul~:
Secondary Occupancy Gropp:
I)rimarv Construction Type
S~cond~ry Construction Type:
# 'of Bedrooms:
I BUILDING INFORMA TlON ~
# of StoE''\~ 'eQ\I\~~ofUu'\\1.
R 3 O.g~ \OIY'
- ;fi\:.\-li'O~1f ~~\esafe~..oo\'
V ''\IOVl f\lleSII()llQl\ O~e tu\e9 tJ'I
:O\if\Ce.\\~~~ (i~o~\es O~ ~"on8
\fIO"'\'.~O\l_ ' !,I~~O\e:~N~
0090.. \~ . P\4).' n/a
,..al\\I'IQ \1'" 1hJl ''1 .
~~.p.I'Jij[~T~INFORMATlON I '
I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
, Paved Drive Rqd:
% of Lot Coverage:
Residential
Phone Number: 541-726-9335
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq Fl 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
....-.
I PUBLIC IMPROVEMENTS I .., ~,...O~
,Ce. SidewNl. _\V.~~..,,\t ~ ~
~ o"{~' ft' S\-\p.\,; ~ "..Y"" f01\
i\\S ?c?>lJ\UO\)\lft)t\i\s ~~~i."
"'\ \\O?>\~" ~ \S ~~
~\.\~W\c~C~~ ~a'-\O\)' '
Cf>..~'/ '\ \)Q np'
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I V aluation D~scriDtion ,
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Paee 1 of 2
Value
Date Calculated
Status
Issued
CITY OF SPRIl'olJJ< I1!..LD
Building/Combination Permit
PERMIT NO: COM2009-01702
ISSUED: 11/25/2009
APPLIED: 11/25/2009
EXPIRES: 05/2512010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fp.p.s PaitlJ
Fee Description
+ 12% State Surcharge
+5% Technology Fee,
1st Appliance
LP Gas Tank & Piping
Amount Paid
Date Paid
Receipt Number
$11.52
$4.80
$79.00
$17.00
11/25/09
11125/09
11/25/09
11125/09
2200900000000001329
2200900000000001329
2200900000000001329
2200900000000001329
Total Amonnt Paid
$112.32
Plan Reviews I
To Request an inspection call the 24 hour re,cording 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. will be made the following
work day.
I Re'l'lir~t1 Inspecti,!n~ 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: Whe-n all mechanical work is complete.
B~ signature, I state and agree, that I have carefully examined the completed application and do bereby certify that all
in:formation hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
t~:e 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 contractors and employees who are in compliance with ORS 701.005 will be nsed 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.
~rvv), ~~\}\
Owner or ~ont~act~rs Sig~atu~,
.,,-,
\\-A~-tH
Date
,0
Page 2 of2
225Fifth Street I,
.' < -
Springfield, Oregon 97477
541-726-3759 Phone '
Job/Journal Number
COM2009"0 1702
COM2009,0 1702
COM2009-0 1702
COM2009-0 1702
Payments:
Type ~f Payment
CrediiCard
cReceintl.
RECEIPT #:
Description
I s\ Appliance
LP Gas Tank & Piping
+ 5% Technology Fee
+ 12%.S\ate Surcharge
Paid By
DONNA KIRBY
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001329
Date: 11/25/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
154732 In Person
Payment Total:
Page I of I
I :44:28PM
Amount Due
79,00
17.00
4.80
11.52
$112.32
Amount Paid
$112.32
$112,32
11/25/2009