HomeMy WebLinkAboutPermit Mechanical 2005-12-7
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CITY OF SPRINGFIELD'
Building/Combination Permit
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Status: Issued
',i 225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: cOM2005-01701
,ISSUED: 12/07/2005
APPLIED:' 12/07/2005
EXPIRES: 06/07/2006
VALUE:
'. SITE ADDREsS: . 2717 MAlA LP
. ASSESSOR'S PARCEL NO.: 1703251406700
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Springfield TYPE OF Heating System
TYPE OF USE: New Residential
:: PROJECT DESCRIPTION: Gas piping, gas fireplace stove
Owner: BElTY WIEMERS REVOCABLE LIVING TRUS
Address: 2717 MAlA LOOP '.
SPRINGFIELD OR 97477
Phone Number: 541-736-1994
I CONTRACTOR INFORMATION I
,
, Contractor Type
Mechanical
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Contractor !A~m~s yaE:X;}iration Date Phone
AMBASSADOR PIPINM~TION; Orego.~_I~nt4l)~eaon Utilit)03/27/2007 541-726-5723
L Iro1B'fUNb:'- 'l~~dtiMirf~eN es are se; 10\ ~ ~
NOlI\ll,ClllU" ~ -001 0 thrOUg~ OAR 952~00
in aNlf~6r~~~ obtain copies ot the rU\V~J.1YSize:
OOOOe~tl61'ay t r (Note: the te\ephot~q Ft 1st Floor:
~i>lfb~lte<al[' ;. gon Utility NotltlcaS?{Ft 2nd Floor:
n~nm1tYi)'the. ~e800_332-2344). Sq Ft Basement:
RaiIge ~p~r IS - . Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled n/a Occupant Load:
~i
o!
'.:.' # of Units:
" Primary Occupancy Group:
, Secondary Occupancy
:f. Yrhnary Construction Type
, Secondary Construction
# of Bedrooms:
R-3
VN
I DEVELOPMENT INFORMATION.
Front yard Setback:
Side 1 Setback:
" Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handi~apped:
. Compact:
Notes:
IPUBLIC IMPROVElflP lftJeWORK
tte ~~E'f anS;
1H\S PERM\l StWUER1\i\$ftRM\l '5 NOt
f1.U1HOR\IEO U )'R~'t~ fOR
COMMENCED 0
AN~ 180 DAY PER\OO.
~
~ Street
. Storm Sewer Available:
t. Special Instruction:
, I Valuation Description I
Description
Type of Construction
$PerSqFt
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
1 of 2
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CITY OF SPRING~lELI):.~
Buildi.nglCombination Permit:
PERMIT NO: COM2005-01701
ISSUED: 12/07/2005
APPLIED: 12/07/2005
EXPIRES: 06/07/2006
VALUE:
Status: Issued
. 225 Fifth Street, Springfield, OR
. 541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees PaidJ
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
" + 7% State Surcharge
i 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
12/7/05
12/7/05
12/7/05
12/7/05
12/7/05
12/7/05
Receipt Number
1200500000000001785
1200500000000001785
1200500000000001785
1200500000000001785
1200500000000001785
1200500000000001785
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Total Amount
$62.65
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.
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Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
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 wiD remain on the site
at all times du~i~/onstruction.
~!/;ti?u;; (k/W~ /2~?~c?s-
Owner or Contractors Signature
Date
~
2 of 2
~f5 Fi{th Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-01701
COM2005-01701
GOM2005-01701
CQM2005-01701
COM2005-0 170 1
COM2005-0 170 1
P~yments:
TrPe of Payment
. . C~eck
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12/7/2005
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RECEIPT #:
1200500000000001785
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Gas Outlets 1-4
Gas Fireplace
Minimum! Adjustment Mechanical
~Mechanical Issuance Fee-
"ity of Springfield Official Receipt .
.Jevelopment Services Department
Public Works Department
Date: 12/07/2005
Item Total:
l.:heck Number Auttlorization
Batch Number. Number How Received
9024 In Person
Payment Total:
Paid By . Received By
AMBASSADOR PIPING INe djb
1 of I
8:48:34AM
Amount Due
3.15
4.50
4.00
15.00
26.00
10.00
$62.65
Amount Paid
$62.65
$62.65
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