HomeMy WebLinkAboutPermit Building 2010-6-24
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 819 CENTENNIAL BLVD
ASSESSOR'S PARCEL NO.: 1703264313700
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00817
ISSUED: 06/24/2010
APPLIED: 06/24/2010
EXPIRES: 12/24/2010
VALUE:
Springfield TYPE OF WORK: Heating System
PROJECT DESCRIPTION: Install direct vent room heater
Owner: SMITH MICHAEL E
Address: 923 COUNTRY CLUB RD STE 150
EUGENE OR 97401
TYPE OF USE: New
Residential
Phone Number: 541-517-0877
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
OWNER
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
# of Stories:
Height ?f Structure
Type of Heat:
Water Type:
. Range Type:
Energy Path:
Sprinkled Building:
VB
License
Expiration Date Phone
ola
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
.' I DEV}Ir;OPMENT INFORMATION I
. \aVlle~U\Ie&OrU\i\\\'I
Frontyard Setback: O~~ OIe90~ '0':1 \"e Ole~e set ~Iay Dist:
Side 1 Setb~e.~, S adO~\e "I:"OSe tu\e~jl.p. 9S2~1rret Trees Rqd:
Side 2 Setb~ t\J ~ cen\et. O\NOU9" \"e tu\P;\~ Drive Rqd:
Rearyard ~tl\if~:2.oo\.oO\ ~n CO~ies r/. \e\ep"~!"Lot Coverage:
Solar SetbayJfOf>.i\ 'fOU tlIe.':/ o'o~~ t~o\e: ~~ ~o\~~\~"" .."
ca\\\~~l tot ,,,e \I \_&00-332- PUBLIC IMPROVEMENTS
t\Ulll cemel '
Street Improvements: Sidewalk Type:
Storm Sewer Available:
Special Instruction:
Notes:
nl.~il , : ~,f.;d 1 'J
I valu~i;~~'~e~~ription ~
., .
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Page I of2
REQUIRED PARKING
Total:
Handicapped:
Compact:
DownspoutslDrains:
NOTICE" ," '.'::'>;::.";d;;i"~'!;;;i,:';;';iJ:e:'".
THIS PERMIT SHAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
CO,MMENCED I ;;}:!,,:,
ANY 180 DAY PERIOD...'-"'" ':.','
Value
Date Calculated
; ,/
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00817
ISSUED: 06/24/2010
APPLIED: 06/24/2010
EXPIRES: 12/24/2010
VALUE:
.i;
Status
Iss u ed
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54] -726-3676 Fax
54]-726-3769 Inspection Line
; ~:;;:
, ~, 1 .' ,: 1 :
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--:t?tiil Y~lue of Project
li!8'1't;,.',;" ': ;
I 'Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
]st Appliance
Amount Paid
Date Paid
$9.48
$3.95
$79.00
6/24/] 0
6/24/] 0
6/24/] 0
Receipt Number
220]000000000000737
220]000000000000737
2201000000000000737
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.
Rough Mechanical: Prior to Cover
1l,'_' ,'" _ .
LReauired-Insnections ,
. \f \'.;;
H~~:1t :.I.d
,j~~:''''' . ' ,
Final Mechanical: When all mechanical work is complete.
By signature, 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:properry,:il'nd the approved set of plans will remain on the site at all
"m:;~:..""; ~ .,'. ;
Owner or con~ors Signature
G-2L(--lo
Date
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Paee 2 of 2
225' Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
22010QQ000000000737
Date: 06/24/2010
9:18:33AM
Job/Journal Number
COM20 I 0-00817
COM20 I 0-00817
COM2010-00817
Payments:
Type of Payment
Check
cReccintl
Description
1 st Appliance
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
MICHAEL SMITH
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
79.00
9.48
3.95
$92.43
Amount Paid
djb
In Person
Payment Total:
$92.43
$92.43
7632
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Page 1 of I
6/24/2010