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HomeMy WebLinkAboutPermit Mechanical 2001-1-30 (2) '.. /' # " ..r.. . I Job# 01-00084-01 I .... '. .., Page 1 of 2 TRANS#:01-0004341 DA TE : ,J AN 30 2001 AMT RECD:2 $ 26.50 CHANGE: CASHIER:059 '" ...- .* CITY OF SPRINGFIELD~ OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00084-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 . Inspection Line: 726-3769 location Of Proposed Site: 4633 Daisy St Spr Assessors Map#: 17023243 lot: Block: Addition: Tax lot #: 07801 Subdivision: Owner: Address: Pam Harrison Phone Number: 541-747-5113 City/State/Zip: Springfield, OR 97478 Value: $0 4633 Daisy Street Scope Of Work: Mechanical Woodstove Needs Preliminary inspection to determine if chimney is useful for fire or lining for wood stove Alteration Preliminary Inspection Wood Stove Office Use Quad Area: land Use: # Of Buildings: # Of Units: Zoning Code: Occupancy Group: Constr. Type: Bedrooms: , .~ Heat Source: Water Heater: Range: f~~:",:c~'..': . .,- Sq. Footage: l\I"'j"" ....~~. .. . . . :tV I,Jr\l"":. _ :~lt ~... ..'.... . To request an inspection call the 24 hour recording atr72~376~!IAII...Ir.~pe~tlons re.quested before 7:00 a.m. ~ill be made the same working day, inSpeCtions.1~s~~e'd:~f!~!i?&~qJ~;r:n...wil!,9J;m~de the following workIng day. c' II' Ou mal' ")bt . "lfOLiqt 0" ~'. .) I'.' ct '"1\''' ., ,. :::II" , . I '"'1 l - . · 61:;1 nr. .. ... , I ')'11)' , 'WI;;) -.,.., , R.n..... I' . t":..t;~y '..IQ. ,,^ ".-1.. eqUlreul nsp~C?,t9nsf:""'" \''J'(;[,. 'j :'. d.... {!J/:J3 U I Mechanical '-'1 J~r,)., I, ,,;:.'.;;. r~/dpnCl/-~' -Prior to the installation of solid fuel appliance whiCh~i)i'bg)~Write,O.::\hrough an existing chimney. -After installation. I Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D -Area (Sq. Feet) Main: Accessory: NonCE' # Of ~WNesJAM;T Height (feet): currE1~iTl!Jiji~~ZF'D SHALL EXp;!$r.op..osed Units: C CA. Ir,. D~' ItA''''' -" t: If' r~r:- ensus/.",~~~C ,oes not:app'I~Sp _ '7c WORk IIA... t::.Df),..,.. 'E.AnAIT ...., 780DAY -"'\IABAND lVI, /SNor Total: PERICD. ONEDFOR Fee Paid On Receipt# Mechanical 01/30/2001 4341 01/30/2001 4341 01/30/2001 4341 01/30/2001 4341 Value/Quantity I Fee Amount Minimum Mechanical Permit Administrative Fee - Mechanical Wood stove Mechanical Issuance 1,000 $.00 $.45 $15.00 $10.00 ~; ,/ . Job# 01-00084-01 Paid On Receipt# Mechanical 01/30/2001 4341 . Page 2 of 2 Value/Quantity Fee Amount Fee State Surcharge - Mechanical Total Mechanical Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are . r/.uest~t the prope~ t~e and th~~he project address is readable from the street. ~ nu/AJ.- .ym//M~ 1- 3D-Of Signature / . Date $1.05 $26.50 $26.50