HomeMy WebLinkAboutPermit Mechanical 2001-8-24
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I Job# 01-01039-01 I
Page 10f 2
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RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
TRANS#:Ol-0006786
DATE;SEP 24 2001.
AMT RECD:l $ 62.00
CHANGE;$ 0.25
CASHIER:061
Job Number: 01-01039-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 6616 ESt Spr
Assessors Map#: 17023414
Lot: Block: Addition:
Tax Lot #: 03813
Subdivision:
Owner:
Address:
Dan England
6616 E Street
Phone Number: 541-747-6313
City/State/Zip: Springfield, OR 97478
New Value: $0
Scope Of Work: Wood or Pellet Stove
pellet stove
Contractor Type
Mechanical Contr
Contractor .
Registration # Expiration Date
Phone
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Orleys Craftstove Center O~~ 541-485-0533
1875 W. 6th Ave, Eugene, OR 97402 It:. \\"\~ ~ "",
_.nt=. I~ .f': \\\'u
. ,r:~. ~.,..r I. . ~\ '\ i"
OffIce ~~"": i..;" ~\ 'o\"\\)..\..\.. \\"\\'0 ?~~t':~ rO~
Land Use: ',\-\\'0 ?~~W\ D \j~'O~~ \)..\~B(Jildings:
Zoning Code: . D\\"\O?\1.€ O~ \10 \)..'0 Occupancy Group:
Bedrooms: ~ ~~t=-~c,t'O <"';j\O'O' Heat Source:
Range: CO:\\ \)~'{?c. . Sq, Footage:
", "(IV
P-\~ .
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 foliowing
working day.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?D
-Area (Sq. Feet)
Main:
# Of Stories:
Current Units:
Census Code: Does not apply
R . d I t' - . In! \ to
eqUlre nspec Ions enU\\""~ J '\""
\a\N r "1 n \Jtl h,
Mechani~at ,....,t\\\i'loregodn"'., ~J'e orego set tortn
...-r \:::.\~ . . - :\e \J Y \ s are O~
~ \ I ru\es ado? 1nose rU e p,.R 952-0 -
to\\o\J\/ . n center. tnroUgn 0 e rU\eS '0'/
Not\t\cat\O /") OO~ .OO~ 0 on\es ot tn "'one
p..'r. 95~- 'ota\n C \"" te\eP",
\n 0 'lou rf\a'J 0 r (,Note: ~~e Not\t\catlon
0090.. tne cente, on Utl\IW
ca\\lng ~ne oreg ''1-:12-2344).
'oer tor I , -I 800-~~
nurf\ cen\lHeiglit (feet):
Proposed Units:
Pellet Insert
I
-After installation.
Accessory:
Total:
Fee
Paid On Receipt#
Mechanical
09/24/2001 6786
Value/Quantity
Fee Amount
Minimum Mechanical Permit
$15.00
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Job# 01-01039-01
At
Page 2 of 2
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Fee
Paid On Receipt#
Mechanical
09/24/2001 6786
09/24/2001 6786
09/24/2001 6786
09/24/2001 6786
Value/Quantity
Fee Amount
Administrative Fee - Mechanical
Pellet Insert
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
By signing this permit/application, I agree to call for an inspection(s) as required (726-3769). I state
that all information on this application is correct. I further state that the appliance I am installing
meets smoke emission standards as set by the Oregon Department of Environmental Quality or the
Federal Environmental Protection Agency and I agree to provide the testing approval number to the
inspector at the time of inspection. I also understand that if I am requesting a preliminary inspection,
t~overing may be required to be removed. 0
--,- h/\A ~ D 1-<). S/lf"~~ C?- ~4 -C) (
Sig'rrcfture () Date
2,500
$3.60
$30.00
$10.00
$3.15
$61.75
$61.75
WOOD STOVEIINSERT INSPECTION APPLICATION
. CI1Y OF SPRING.r WLD
COM1vfUNITY SERVICES DMSION - BUILDING SAFETY
r
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759.
INSPECTION LINE: 726-:-3769
Job Location: loG I (() [~~.
Ass<ssorsMap#:nb~7>Y 14 -;e;?, ~ '
Owner: \1)/4 "') ~ T')eA....)\S~ r,,) (~I A. 00
ST'
Address: <..0 (0 I <0 ~ / ---
J:'dA Lu~,r.-
Phone#:
7'-ll-h313_
Zip: q /., '-'IIS(
.~ '
City: ~ p r::- L P
Value of Wood Stov~t Stov~
.../
State: 0V2- E-
d-- 'S 0 () .cc
(please circle appropriate appliance)
non of insert)
es Permit, Issuance Fee, State Surcharge & Admin Fee).
Type of Inspection Requested:
Contractor:
Address:
Phone#:
City:
State:
Zip:
Construction Contractors Regimation#:' 'J ~ 5? (j ~ Expires:
By signing this permit/application, I agree to call for an inspection(s) as required (726-3769). I state that
all infonnation on this application/permit is correct and that I was provided with the Wood Stove Safety
information for wood burning appliances and preliminary inspection standards. I further state that the
appliance I am installing meets smoke emission standards as set by the Oregon Department of
Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing
approval number to the inspector at the time of inspection. I also understand that if I am requesting a
~rninary inspection, the wall covering may be ~ed to be removed.
(_1~y (k ') . E:^I~~/J?~ ~ y q - ;:1'-\ - 0 I
Signature <5 Date
FOR OFFICE USE
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REQUIRED INSPECTION(S): WOODSTOVE/PELLET/INSERT PRELIMINARY'
Date of Application: D <7 Z ~ 6 ~ Job #: 0(;--0 (67) '1 ~ or
,
Checked for Delinquencies:
--'.
Checked for Historical Status: -----
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DZ<*f1.rI'10
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f--i ." -li:8- r--':J 0
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VALIDATION: