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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: __~eAINGi!!IEl&,~, -,." ,. ~ .,. :,1 .:.. .".... -, ':' '.-. ...... .,::..' "i ",' "',,.. ." -' """..,'# 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)\(lV- '.~\w. ~'O\i\ir,e.UO(\ Secondary Construction Typ\l,\ 0 () 'IOU 1l\e.~(I\e'. ~al\agI: .~. # of Bedrooms: ()O~^'\illQ, \"e \"e o,e@~tr~ :' . -_he' \01 ",' \II '$'nnkled Building: n/a aU"'" r.e(l'" I DE~ELOPMENT INFORMATION I Front yard Setback: Side I Setback: Side 2 Sethack: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: Phone Number: 541-744-6916 Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: . Sq Ft Garage/Carport Sq F! Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: , "'~.~' I PU.BLlC I,MPROVEMENTS I ,. ',.c.,,"'. O?-\<- .' ' Ce. "o,?-~iltj,~~~~'~1 . l'\Oi\~' iil\'-'- t"r ~li ,~ . . IS I'E\'IW\li S 1)1'.\'1 iii\S&r;t.itn~rai~s: iii 0\'1121'.1) \l~ . \)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"''' " " 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 ~f!R1N, Q~,I,itij. ,A~ ~. , , ;1IIlIIiiIt........... , ~,"~J' '.; 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