HomeMy WebLinkAboutPermit Mechanical 2009-12-29
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01844
ISSUED: 12/29/2009
APPLIED: 12/29/2009
EXPIRES: 06/29/2010
VALUE:
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Status
Issued
225 Fifth Street, Springfield, OR
. 541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5647 HIGH BANKS RD
ASSESSOR'S PARCEL NO.: 1702280001600
Springfield TYPE OF WORK: Pellet Stove
PROJECT DESCRIPTION: Freestanding pellet stove
TYPE OF USE: New
Residential
Owner: GILBERT CODY E & ALYSIA T
Address: 5647 HIGHBANKS RD
SPRINGFIELD OR 97478
Contractor Type
Mechanical
I CONTR~eTOR INFORMATION I
License
Contractor
OWNER
, I. BUlLDI~~!NpBk~TlONI
Q,Ofl ,,,, e OleU- e\ \Oll,.
# of Units: ~Ot\.. Ole \eO 'o1b~la'!lSi~1l~:,2-00\'
Primary Occupancy Group: p..~ ~ e.O~~,. 'fl\~~~O~~~{IIri '0"1
Secondary Occupancy Grou&o\\?"'ce.\iOflCe~..oO\~\~ :R\iiYi~~\~,,~e
Primary Construction Type t\0\\{~~ 9'59-00 o'o'J)\(lV- '.~\w. ~'O\i\ir,e.UO(\
Secondary Construction Typ\l,\ 0 () 'IOU 1l\e.~(I\e'. ~al\agI: .~.
# of Bedrooms: ()O~^'\illQ, \"e \"e o,e@~tr~ :' .
-_he' \01 ",' \II '$'nnkled Building: n/a
aU"'" r.e(l'"
I DE~ELOPMENT INFORMATION I
Front yard Setback:
Side I Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
Phone Number: 541-744-6916
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
. Sq Ft Garage/Carport
Sq F! Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
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I PU.BLlC I,MPROVEMENTS I ,. ',.c.,,"'. O?-\<- .' '
Ce. "o,?-~iltj,~~~~'~1 .
l'\Oi\~' iil\'-'- t"r ~li ,~ . .
IS I'E\'IW\li S 1)1'.\'1 iii\S&r;t.itn~rai~s:
iii 0\'1121'.1) \l~ . \)I\~I)O~ .'
I\\lil-\ I) 0\'1 IS ,... ,,'
COW\W\E~CEI\'/ 1'1'.\'1101).
. 1l~'/ ~B(} I)
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I V.aluation Descriotion I
Descrilltioll
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Paee I 01'2
Value
Date Calculated
Status
Issued
. '1"'''
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CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01844
ISSUED: 12/29/2009
APPLIED: 12/29/2009
EXPIRES: 06/29/2010
VALUE:
225 Fifth Stree', Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Valne of Project
Fe~s P~id I
Fee Description
+ 12% State Snrcharge
+ 5% Technology Fee
1st Appliance
Amonnt Paid
Date Paid
Receipt Nnmber
$9.48
$3.95
$79.00
12/29/09
12/29/09
12/29/09
2200900000000001440
2200900000000001440
2200900000000001440
-
Total Amonnt Paid
$92.43
I Plan Reviews I
,;1' t ',-
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 Relluired Ins"ectio"s I
Freestanding Pellet Stove: After installation.
By signatnre, 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 fnrther certify that any and all work performed shall be done in accordance with
'he Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work descrihed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Commnnity 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 frum the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the xi'e at all
times during construction.
Illo?i- ]
Owner or Contractors Signature
Izf2-qJ()Q
I
Date
Pa2e 2 of 2
225 Fifth Street
. ..
" .
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009.0 1844
COM2009.0 1844
COM2009-0 1844
Payments:
Type of Payment
Cred itCard
cReceinll
RECEIPT #:
Description
I st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
CODY GILBERT
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,A~ ~. , ,
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City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001440
Date: 12/29/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
038829 In Person
Payment Total:
,
Page I of I
2:07:20PM
Amount Due
79,00
3,95
9.48
$92.43
Amount Paid
$92.43
$92.43
12/29/2009