HomeMy WebLinkAboutPermit Mechanical 2005-9-7
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01220
ISSUED: 09/07/2005
APPLIED: 09/07/2005
EXPIRES: 03/07/2006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1425 HAYDEN BRIDGE RD
ASSESSOR'S PARCEL NO.: 1703252200702
Springfield TYPE OF
Heating System
PROJECT DESCRIPTION: Install gas fireplace and piping
TYPE OF USE: New
Residential
Owner:
Address:
ROBERT WARREN \N {eD.U\{es 'J~\\~~\}
1425 HAYDEN BRIDGJJ(.YJh{egon \a: tne o{egon t 'O{\n
SPRINGFIEL~~~~t~dopted ~~c;e {\~\e~ ~{~ ~~2-00'\-
\O\~~.. (. n cenwl'.\ hI.Qug\\ ""'.~-""r> rU\eS uy
~ot\'\Ca~52_00'\.O~1l0~Y'J1~TION ,
\n Op..B. u f{\a'J 0 J ~~ote'. nt:' o\\,\ca\\O
C~~~8r \ne cente{. on \j\\\\\\) N A) License
MARsfl\A~&rlN.6e ore~n{')_332-23A' 25790
nUll''''. 1'::1 \ -
centc BUILDING INFORMATION'
Contractor Type
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy
P'rimary Construction Type
Secondary Construction
# of Bedrooms:
R-3
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled
VN
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Phone Number: 541-729-3410
Expiration Date
12/23/2005
Phone
541-747-7445
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
,,' . .~,nr: \1= I\-\E \NOR~
IPUBLIc'IMPl!O,:YIi;MENis~'~\:~~\S'?ERM\1 \~ NU \
\'" . \' '-u U\W~' . \nr\i\'~Q fOR
,-\\,f\ \-\OR Ll- OR \S t:\BSitlewalk Type:
I E\'~CED
CONI\\!\ (, QI\'{ PERIOD. Downspouts/Drains
hN'< '\ Bv
Street
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Description I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
1 of 2
Value
Date Calculated
Status:
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01220
ISSUED: 09/07/2005
APPLIED: 09/0712005
EXPIRES: 03/07/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid'
. Fee Description
-Mechanical Issuance Fee--
+ 10% Administrative Fee
+ 7% State Surcharge
Gas Fireplace
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$15.00
$4.00
$26.00
9/7/05
9/7/05
9/7/05
9/7/05
9/7/05
9/7/05
Receipt Number
1200500000000001313
1200500000000001313
1200500000000001313
1200500000000001313
1200500000000001313
1200500000000001313
Total Amount
$62.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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
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 property, and the approved set of plans will remain on the site
at all times during construction.
,g~. ~~ r--- /-0 ":J"
Owner or Contractors Signature
Date
2 of 2
2~5 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
"ity of Springfield Official Receipt
,evelopment Services Department
Public Works Department
Job/Journal Number
COM2005-01220
COM2005-01220
COM2005-01220
COM2005-0 1220
COM2005-0 1220
COM2005-01220
Payments:
Type of Payment
Check
Ii
, ~ j
Of
9/7/2005
RECEIPT #:
1200500000000001313
Date: 09/07/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Gas Outlets 1-4
Gas Fireplace
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
MARSHALLS INe
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 18815 In Person
Payment Total:
I of 1
2:10:37PM
Amount Due
3.15
4.50
4.00
15.00
26.00
10.00
$62.65
Amount Paid
$62.65
$62.65