HomeMy WebLinkAboutPermit Mechanical 2009-11-24
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2009-01698
ISSUED: 11/24/2009
APPLIED: 11124/2009
EXPIRES: OS/24/2010
VALUE:
SITE ADDRESS: 6199 Thurston Rd
ASSESSOR'S PARCEL NO.: 1702342403700
Springfield TYPE OF WORK: Mechanical Only
PROJECT DESCRIPTION: Replace gas fireplace
TYPE OF USE: Remodel
Residential
Owner:
Address:
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
X "r r -. .'. "T"...____...___~,..........~f........+h
in -oA~~!iFi~-.;o::L-if''::~'\'J r\~".~~-
0090. ,,~Tl (~.r~:niR/~ct:\)~''i'-qoUY
calling the center. (Note:. ~e tel!lphone
Contractor number for the Oregon Utility ~tlOn
AMERICAN GAS AP~n ,~r.a~1{i21
BUILDING INFORMATION I
Contractor Type
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type c,
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
NOTICE: Energy Path:
THIS PERMrr 9JPAMsIE/l:BffilitAfgTHE WO~a
2~~~~'~f(M~~~'~~'
ANY 180 DAY PERIOD.
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
!~;.,.-
I PUBLIC IMPROVEMENTS I
Expiration Date
10/31/2010
Phone
541-954-4686
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
"
"
oi'
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Description
Type of Construction
Paee I 01'2
Value
Date Calcnlatcd
,
"
it
CITY OF M'KINGJ.<lELD
)',
Building/Combination Permit
PERMIT NO: cOM2009-01698
ISSUED: 11/24/2009
APPLIED: 11124/2009
EXPIRES: OS/24/2010
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...., Paid I
Fee Dcscription
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
11124/09
11124/09
11124/09
1200900000000001284
1200900000000001284
1200900000000001284
Total Amount Paid
$92.43
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. will be made the following
work day.
R..fJui "..d Insfl.,l,tinns I
I . 11 ;' I.. ~ JiIiiiiiii.I
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 accord~lnce with
the Ordi~lances 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 used on this project.
I further agree to cnsure 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~;a 1l24-O/
Owner or Contractors Signature
Date
,,~ ,
,
Paee 2 01'2
225 Fifth Street
Spriftlgfiel~, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 1698
COM2009-0 1698
COM2009-0 1698
Payments:
Type of Payment
Check
cRcceintl
RECEIPT #:
Description
I st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
AMERICAN GAS APPL
i;.:~~;M;
.....~ - .
~
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000001284
. Date: 11/24/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cjc
6396
In Person
Payment Total:
Page I of I
3:08:29PM
Amount Due
79.00
3.95
9.48
$92.43
Amount Paid
$92.43
$92.43
11/24/2009