HomeMy WebLinkAboutPermit Mechanical 2009-12-29
Building/Combination Permit
PERMIT NO: COM2009-01781
ISSUED: 12/29/2009
APPLIED: 12/14/2009
EXPIRES: 06/29/2010
VALUE:
Status
Issued
225 Fifth S'rect. Springfield. OR
541-726-3753 Phone
541-726-3676 Fax
541-726,3769 Inspection Line
CITY OF ~n~m\"l'l~LD
SITE ADDRESS: 810 65TH PL
ASSESSOR'S PARCEL NO.: 1702341300302
Springfield TYPE OF WORK: Pellet Stove
PROJECT DESCRIPTION: Pellet insert
TYPE OF USE: New
Residential
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I. V~luatf6'I,,,'iclescriDtion I
Owner: PLOWMAN PERRY
Address: 810 65TH I'L
SPRINGFIELD OR 97478
I C?NTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
AMBASSADOR PIPING INC
License
121469
# of Units:
Primary Occupancy Group:
Secondary Occupancy Gronp:
Primary Construction Type
Secondary Constrnetion Type:
# of Bedrooms:
. I B,UILDING INFORMATION I
# of Storieb\l8ll~;'
R-3 ~~\fJDOO~ot\\\
~O"': Ole~~'Il'/ ~~wales~\OO~.
,. ado~ (\':';' Ql;e11 p..? 95." b"
to\l~ \e&cen\el.:~O\'~'O~ \1\8 lU\eS 'J
"'O\if\ca\~~.oo~-O~foI~Il.~~ \e\e~~~n
\11 Op..? OU (l\e.~ 0 ~JlI'i(WI~~"~~Q)>,\\ n/a
nn90. 'l ..... cell\__~,,(\ ~ . ""i"'.
~;:':~WE'ttI;;o..~~f'jNFORMATION I,
nU".... J! \ "
Front yard Setback:
Side] Setback:
Sidc 2 Sctback:
Rearyard Setback:
Solar Setbacks:
,Overlay Dist:
# Street Trees Rqd:
Paved !>rive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Des<:riPtion
Tvpc of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee ] of 2
Phone Number: 541-746-7319
Expiration Date
03/27/20] ]
Phone
541-726-5723
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQU]RED PARKING
Total:
Handicapped:
Compact:
, Value
Date Cakulated
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01781
ISSUED: 12/29/2009
APPLIED: 12/14/2009
EXPIRES: 06/29/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541,726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fee,S Paid'
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
12129/09
12129109
12/29109
2200900000000001441
2200900000000001441
2200900000000001441
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.
I Reauit'cd Insnections ,
, I
Pellet Inseo.t: After installation
By signa'ure, 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 accordance with
the Ordinances 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 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. .
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Owner or Contractors Signature Date
Paee 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541:.726-3759 Phone
Job/Journal Number
COM2009,0 1781
COM2009-0 1781
COM2009.0 1781
Payments:
Type of Payment
Cred itCard
cRcceintl
RECEIPT #:
Description
I st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
raid By
DEBORAH CLEMENT
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City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001441
Date: 12/29/2009
Item Total:
Check Number Authorization
Received By Batch Number -Number How Received
djb
02575c In Person
Payment Total:
Pa,ge I of I
2:28:03PM
Amount Due
79,00
3,95
9.48
$92.43
Amount Paid
$92.43
$92.43
12/29/2009