HomeMy WebLinkAboutPermit Mechanical 2009-12-10
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City Of Springfield
225 Fifth 51
Springfield, OR 97477
Phone: 541.726-3753
Email: permitcenler@ci.springfield.or.us
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, Residential Mechanical Authorization To Begin Work
69600-BMC-09-00211
Approval Code: 005731 12/10/2009 9:30 am
E-mailedTo:deanne@midgleys.com
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I 0 New Construction [K] Addition/alteration/replacement
I ~ " or 2 family dwell;:~ CA ~G~:~~~;;Cd~S;o:~:~:~~ . D Accesso~
I: . ,JOB SITEINF"ORMATION,ANO:i:ifcATION ',.'; it', "
I Job Address: 2867 WAYSIDE LOOP
I CityfState/ZIP: SPRINGFIELD, OR 97477
I Suitelbldg.lapt.no,:
Project Name: David Wilson
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I Description j Qty. I
I!VIJniili.l!~Fees'l:( ;'-~'i~Srh~J_:'-\.:~,' ~:::,: '~~. I.
I First Appliance Fee l
11VI.~nimical:Perrij!f~~~s. ~~;/ ,,';~'~" ~.:;::. '1
I Subtotal
I Stale surcharge (12% of permit
totaH
I Technology fee (5% of permit total)
I TOTAL PERMIT FEE
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Total
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$79,00
$79.00
$9.48
$3.95
$92.43
Cross Street/directions to job site:
Tax map/parcel no,:
1703224102100
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Install pellet insert and liner
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Name: David Wilson
I Phone: 541-554-8606
I Email:
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Fax:
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eeB fie. no.: 161946
Business Name: THERMAL RESOURCES INC
Contact:
Address: 1678 W 7TH AV
CityfState/ZIP: EUGENE, OR 97402
Phone: 5413431131
Fax: 5416875979
Email: mike@midgleys.com
Metro lie. no.:
City lie, no,:
60J/12,(;V 9 -()/7~ 0
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Upon review and approval by your local jurisdiction, your permit will be e,mailod or faxed
within one business day, with instructions on how to schedule your inspection.
NOTE: This Authorization To Begin Work expireli within 160 days if a permit is not obtainod,
The local building department may determine that an Authorization To Begin Work Is null
void if it does not meet applicable land use laws and local ordinances.
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: COM2009-01760
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: 2867 Wayside Lp
ASSESSOR'S PARCEL NO,: 1703224102100
Springlleld TYPE OF WORK: Pellet Stove
TYPE OF USE: New
Residential
PRO,IECT DESCRIPTION: Install pellet insert and liner
Owner: WILSON SHELLEY A & DAVID A
Address: 2867 WAYSIDE LP
SPRINGFIELD OR 97477
Phone Numher: 541-554-8606
I CONTRACTOR INFORMA TlO~ I
Contractor Type
Mech~lnical
Contractor
THERMAL RESOURCES INC
License
161946
Expiration Date
10/29/20 I 0
Phone
541-343-1 \3]
BUILDING ]NFORMATlON I
# 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:
Ra'nge Tyj,e:
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 ]NFORMATlON I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overhl)' Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
". Sr9~('''' low (An11trAA you to
A,') ,,",mo. . Ut Illy
I PUBLIC IMPROVEM!!t" ules adopted by the Oregon tll rth
. " C ter Those rules are se 0
NolllcatlOn -O~-M'%'!~Rl\l9h OAR 952-001-
~~~R ~;u2 rtIllI,M\~li\s;mi,R9.p:1 the rules by
llin the center. (Note: (fie tele~hone
:mb~r lor the Oregon Utility Notlllcatlon
Center is 1_800-332-2344).
Storm Sewer Avlana"le: .
''''I'!''E'
Special Instruction: v .
THIS PERMIT SHAll EXPIR: IF THE WORK
.'IUTHORIZED UNDER THIS PERMIT IS NOT
::mnfi/lr:filrr:n no 1<: Ml8~lnnfilr:n r:no
Notes:
ANY 180 DAY PERIOD,
I Valuation pescriution I
Descriplion
Tn,e of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calcnlated
Paee ] 012
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01760
ISSUED: 12/10/2009
APPLIED: 12/10/2009
EXPIRES: 06/1012010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees ,P~id I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Aniouut Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
12/10/09
12/10/09
12/10/09
3200900000000000800
3200900000000000800
3200900000000000800
Total Amount 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.
Reouired I"Sllectio"s I
Pellet Insert: After installation
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By signature, I state and agree, that 1 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 ~,II \\-'ork performed shall be done in accordance with
the Ordinances of the City of Springlield and the Laws of the State or 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 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.
Owner 01' Contractors Signature
Date
Paee 2 of 2
225 Fifth Street
Springfield,. Oregon 97477
541-726-3759 Phone
Job/Journlll Number
COM2009-0 1760
COM2009-0 1760
COM2009-0 1760
Payments:
Type of Paymcont
ONLINE CHGS
cRcceintl
RECEIPT #:
Description
1 st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
ONLINE PERMIT CHGS
3200900000000000800
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 12/10/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
NJM
Page 1 of I
ONLINE Thermal Online
Resources
Payment Total:
lO:40:45AM
Amount Due
79.00
3.95
9.48
$92.43
Amount Paid
$92.43
$92.43
12/1 0/2009