HomeMy WebLinkAboutPermit Mechanical 2010-6-30
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00859
ISSUED: 06/30/2010
APPLIED: 06/30/2010
EXPIRES: 12/30/2010
VALVE:
Status
Issued
225 Fifth Street, Springfield, OR
541- 726-3 753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 2409 16TH ST }'.~1' "..'\~pringfi~ld TYPE OF WORK: M.R.flIetHFill~ . '" _ 0
ASSESSOR'S PARCEL NO,: 1703243401900 "::L. "":.:" . ~OJ\\~
,..-...-- .., .,"" TYPE OF USE: New Residential
PROJECT DESCRIPTION: Replacing approxim~tely 30 feet of gas line
Owner: BELLAMY MARK L & ELLA K
Address: 2409 16TH ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION ~
Contractor Type
Mechanical
Contractor
OWNER
',. . License
Expiration Datt:hone
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'BUILDING INFORMATlON~
# 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: " .
Slfrlnkle,fB\Jildinf
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Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION ~
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
PUBLIC I
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved Drive R.9d: . 8'mpact:
% of LetT~~~LQt'!: Oregon law requires you.
follow rurls 'adopted by the Oregon Utility
otification Center. Those rules are set forth
rou
tain copies of the rules by
calling the center. (tSKl@wilil< 'f)ll\\l~one
number for the Oregon Utility Nol1ficatlon
',:' Center is 1_8oij'8ms~IPrains:
Street Improvements:
Storm Sewer Available:
Special Instruction:
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Notes:
NOTICE:
Description
Twrc: p!:Qnnl PIR!: I
/\UTHORIZED UNDER THI~I'W' ., ~
COMMENCED OR IS ABAN~f;% escrtptlOn I
,LINY 180 DAY PERIOD,
Type of Construction
$ Per si{ft . '::. . Square Footage
or mu~(ip.(ierl~h: !'.l~l,tl'oiLBid Amount
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Value
Date Calculated
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00859
ISSUED: 06/3012010
ApPLIED: 06/30/2010
EXPIRES: 12/30/2010
VALUE:
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
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Total Value of Project
Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
]st Appliance
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$9.48:".j'" :~
$3.95'1J6'{:t' :,;':;i. 'j)1""
$79.00 ...
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$92.43' ,
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6/30/] 0
320]00000000000035]
320]00000000000035]
320]00000000000035]
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 requested after 7:00 a.m. will be made the following
work day.
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Reduired InsDections I
Rough Mechanical: Prior to Cover .
Final Mechanical: When all mechanical work is complete.
By signature, J state and agree, that J have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and J furtbercertify that any.anil all work performed shall be done in accordance with
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the Ordinances of the City of Springfield and the Caws of the State of Oregon pertaining to the work described herein, and
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that NO OCCUPANCY will be made of anystructur~.withoutipermission of the Commnnity Services Division, Building Safety.
I further certify that only contractors and employeesiwho 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 Signa'~
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Date
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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 #:
3201000000000000351
Date: 06/30/2010
10:42:30AM
Job/Journal Number
COM20 I 0-00859
COM2010-00859
COM20 I 0-00859
Payments:
Type of Payment
CreditCard
cReceintl
Description
I st Appliance
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
MARK BELLAMY
Item Total:
Check Number Authorization
R<eceived By Batch Number Number How Received
njm 09776g In Person
Payment Total:
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Page I of I
Amount Due
79.00
9.48
3.95
$92.43
Amount Paid
$92.43
$92,43
6/30/20 I 0