HomeMy WebLinkAboutPermit Mechanical 2010-6-16
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00778
ISSUED: 06/16/2010
APPLIED: 06/16/2010
EXPIRES: 12/16/2010
Y ALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2455 34TH ST
ASSESSOR'S PARCEL NO.: 1702193101112
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Gas piping to range and bar\Jeque
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Owner: KETTWIG ROBERT B & JOVONE B.
Address: 2455 N 34TH ST .
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION ~
Contractor Type
Mechanical
Contractor
AMBASSADOR PIPING INC
License
121469
Expiration Date
03/27/2011
Phone
541-726.5723
BUlL'DING INFI)RMATlON ~
# 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:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
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I DEVELOPMENT INFORMATION ~
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
'''Overlay'Dist:
'# Street Trees Rqd:
Paved Drive Rqd: .
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS ~
NTIO'l' ~i~I',~~)k11\ype:iuires youto
ATTE ";lt~rj.9 !0P Oregon Utility
. ,folloW rules acjji\';:"fIl8~esl&i'ii\i%'a set forth
;. 'Notification Center. - hOAR 952-001-
. in OAR 952-001.0~t~~~h;~~i~S of the rules by
0090. You may 0 (Note: the telephone
calling the center. ilit Notification
. Center is 1.800-332-234
aluation Descri tlOn
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Notes:
NU II\" . E IFTHE W
THIS PERMIT SH~~~ ~~~ PERMIT IS N
AUTHORIZED UN DONED FOR
l!l$,~iib1ioGED ORr~'{\\'r''c~onstruction
ANY 180 DAY PERiGo.
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00778
ISSUED: 06/16/2010
APPLIED: 06/16/2010
EXPIRES: 12/16/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
'Total Value of P~oject
U'ees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Gas Outlets 1-4
Amount Paid
Date Paid
Total Amount Paid
$10.32 ' .
'),1
$4.30;.;,7;) ,
$79.00
. $7.09Lf
$100.62
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6/16/10
6/16/10
6/16/10
6/16/10
Receipt Number
2201000000000000706
2201000000000000706
2201000000000000706
2201000000000000706
I Plan Reviews ~
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 re,ques'ted after 7:00 a.m. will be made the following
work day. .. . .'"
ReQuired Insoections I
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Final Gas: When all gas work is complete.
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By signature, ] state and agree, that] have carefully examined' the completed application and do hereby certify that all
information hereon is true and correct, and ] furth.~Lc~rtity. t~~t 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 descrihed 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
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Owner or Contractors Signature
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..
Date
Paee 2 of 2
225 Fifth Street
Springfield, 'Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000706
Date: 06/16/2010
2:40:29PM
Job/Journal Number
COM20 1 0-00778
COM20 1 0-00778
COM20 1 0-00778
COM20 I 0-00778
Description
1st Appliance
Gas Outlets 1-4
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
CreditCard
Paid By
MA TTHEW CLEMENT
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
79.00
7.00
10.32
4.30
$100.62
Amount Paid
nJm
03595c In Person
Payment Total:
$100.62
$100.62
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6/16/2010