HomeMy WebLinkAboutPermit Mechanical 2009-12-10
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City Of Springfield
225 Fifth 51
Springfield, OR 97477
Phone: 541-726-3753
Email: permilcenler@ci.springfield.or.us
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"r7~f~::'IY:PE.OF..!WORK;lJ; :*~~~?-'~~~;< :;~)'!?;t'i'y{~~l'tfC/::{ 1~:?#i
lRl Addition/alteration/replacement
New Construction
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o Multi-family
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o Accessory
1 or 2 family dwelling
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JOB'siTE INj:(YRMATioN'ANbX6cAfION:S'f;~,.;< .,
Job Address: 2588 17TH 5T
City/State/ZIP: SPRINGFIELD, OR 97477
SuiteJbldg.fapt.no,:
Project Name: Wasson
I Cross S'reeUdirec'ion, to job ,ite:
I Tax mapfparcel no,: 1703243400130
I; .:':'1'>';'.,' ."~~"~':,r5ESC8:IPTlorf6EWORK~J:..:~~r~'*i~:J~-;:'>.~",,;o'1
Install wood insert and liner
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I Name: Lisa Wasson
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Phone: 541-988-1461
Fax:
Email:
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, ~,:r.fi:CON:fRACTOR
CCB lie, no.: 161946
Business Name: THERMAL RESOURCES INC
Contact:
Address: 1678 W 7TH AV
CitylStatelZIP: EUGENE, OR 97402
Phone: 5413431131
Fax: 5416875979
Email: mike@midgleys.com
, Metro lie. no,;
City lie. no.;
Upon review and approval by your local Jurisdiction, your pennit will, be a-mailed or faxed
wit~ln on; business day, with instructions on how to schedule your Inspection.
NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained.
The local building department may determine thai an Authorization To Begin Work Is null and
void if it does not meet applicable land use laws and local ordinancos.
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[11. 17ft!
Residential Mechanical Authorization To Begin Work
69600-BMC-09-00212
Approval Code: 029619 12/10/2009.9:44 am
E-mailedTo:deanne@midgleys.com
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$79.00 I
IF~:~::t~iTitiI/c~~~~~::Ji~;J3~~~.:~9~HgDU~~"it~";,';~;~~~;~~~\.' :~
I Description I Qty. lEa, Total
IMIr1lmu'$~Fges.' ';~:~~;~<'~I;'~~?;;;'~;" n ,'f~~
I First Appliance Fee J J
IM9C.t!~~ic~I:~ermit;F~es:.~:(;:tL;:~;"'i' :";., '~ --"~\:..
I Subtotal
I Slate surcharge (12% of permit
total)
I Technology fee (5% of permit tolal)
I TOTAL PERMIT FEE
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$79.00
$9.48
$3,95
$92.43
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Inspections Phone: 541.726.3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01761
ISSUED: 12/10/2009
APPLIED: 12/10/2009
EXPIRES: 06/10/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2588 17TB ST
ASSESSOR'S PARCEL NO,: 1703243400130
Springfield TYPE OF WORK: Wood Stove
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install woodstove insert and liner
Owner: WASSON JEFFREY A & LISA M
Address: 2588 17TB ST
SPRINGFIELD OR 97477
Phone Number: 541-958-1461
I CONTRACTOR INFORMATION I
Contractor Type
Mechanicnl
Contractor
TBERMAL RESOURCES INC
License
161946
Expiration Date
10/2912010
Phone
541-343-1131
BUILDING INFORi\1A TION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Beight of Structure
Type of Beat:
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:
nhl
I DEVELOPMENT INFORMATION I
Front yard .setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
IYo of Lot Coverage:
REQUIRED PARKING
Total:
Bandicapped:
Compact:
Notes:
NOTICE:
'_'" ,on"ites you to
I PUBLIC IMPROVEMENTS IATTENT',ON~~~~fevcibY the 6rego~~\~rth
'ollow ~u es ThOse rules are 2-001-
. ~og~~~;~~'~ thr~~i~~ ~~~e9;u\es by
0090 V8'8ffill.Y~~ote' the telepho~e
caliing the cen~~~~on Utility NotilicatiOn
numbef IOf 1he\S . -800-332-230\4).
centef ·
Street Improvements:
Storm Sc\-\'er Available:
Special Instruction:
Description
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.UTHOBiZED UNDER THISI f\ERI~Hillilrm1crilJtion I
'OMfV1ENCED OR IS ABANiJum:u run
',11''' 1 Rl1flicW Dt:QI(\n $ Per Sq Ft Square Footage
'. vpe 0 "onstr-uctlOil"
. or multiplier or Bid Amount
Value
Date Calculated
I'age I on
Status
Issued
CITY OF SPRINGFIELD'
Building/Combina tionPermit
PERMIT NO: COM2009-01761
ISSUED: 12/10/2009
APPLIED: 12/10/2009
EXPIRES; 06/10/2010
VALUE;
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Valne of Project
Fees Paid'
Fee Dcscl'i'ption
+ 12o!tl Stilte Surcharge
+ SIX, Technology Fee
1st Appliance
Amonnt Paid
Va te Pa id
Receipt Number
$9.48
$3,95'
$79,00
12/10/09
12/10/09
12/10/09
32009000000000(080)
32009000000(000080)
3200900000000000801
Total Amonnt Paid
$92.43
I 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,
I.. Rep},dred I ~sn~ctions I
Wood Bnrning Insert: After installation,
. By signatnre, I state and agree, that) have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I fnrther certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Law,~ of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any strnctnr,'withont permission of the Community Services Vivision, Bnilding Safety,
I fnrther ccrtify that only contractors and employees who arc in compliance with ORS 701.005 will be nsed on tbis project.
I further agree to ensure that all required inspections arc requested at the proper time, that each 'address is readable from the
street, that the permit card is located at the froIlt ofthc'propertYl and the approved set of plans will remain on the site at'all
times during construction.
Owner or Contractors Signature
Vate
Pa2e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/.Journal Number
COM2009-0 1761
COM2009-0 1761
COM2009-0 1761
Payments:
Type of Payment
ONLINE CHGS
cRcccintl
RECEIPT #:
Description
151 Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
ONLINE PERMIT CHGS
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3200900000000000801
City of Springfield Official Receipt
Development Services. Department
Public Works Department
Date: 12/10/2009
10:51:06AM
Amount Due
79.00
3.95
9.48
$92.43
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
NJM
Page 1 of 1
Amount Paid
ONLINE THERMAL Online
RESOURCE
S
$92.43
Payment Total:
$92.43
12/1 0/2009