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Home My WebLink AboutPermit Building 2004-1-20 .' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00079 ISSUED: 01/20/2004 APPLIED: 01/20/2004 EXPIRES: 07/20/2004 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2161 DEBRA DR ASSESSOR'S PARCEL NO.: 1703261101500 Springfield TYPE OF WORK: Wood Stove TYPE OF USE: PROJECT DESCRIPTION: Install wood insert Owner: DOLORES FORD Address: 2161 DEBRA DR SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Mechanical Contractor MARSHALLS INC License 25790 '. BUILDING INFORMATION I " # of Units: # of Stories: Primary Occupancy Group: R-3 Height Q(lit~re Secondary Occupancy Gronp: la'll r\l't'JiI\r~e'&nIiW Primary Construction Type :TIO\'l:IDNlQOf\ \tl~t~e: \~.t\ Secondary Construct\Oil'~: S adopted bY e ~1\!Ill~ ..00' # of Bedrooms: tollO'll r~la caoler. itlos ~~\Pml~.& \: ,,0\itica\IO~-oo~_OO~OU'lfODie8 01 \he fUMe . ~:;:Uma~;ir~~~;li~~:~TION I SETBACKS calling \1"Ie Qf&gQ\l l!! \ ;'344). tof \1"Ie 00-332-" Frontyard Sethack: f\Utllber r,,"'''' Ie: 1-8 Overlay Dist: Side I Setback: . # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: Solar Setbacks: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS' NOTICE: ' THIS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. New Residential Phone Number: 541-747-0981 Expiration Date 12/23/2005 Phone 541-747-7445 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Pal!elof2 Value Date Calculated . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00079 ISSUED: 01/20/2004 APPLIED: 01/20/2004 EXPIRES: 07/20/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , Fees Paid J Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Micimum/Adjustment Mechanical Wood Stove/Insert Amount Paid Date Paid $10.00 $4.50 $3.15 $15.00 $30.00 1120/04 1120/04 1120/04 1120/04 1120/04 Receipt Number 1200400000000000080 1200400000000000080 1200400000000000080 1200400000000000080 1200400000000000080 Total Amount Paid $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. I Reouired fir. SrJl~etions ~ 1IIIIIr.. I Wood Burning Insert: After installation. 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 Divisiou, 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 '~;-~~JM;: # /- 20-(JLj o ner or Contractors Signature Date Pal!e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00079 COM2004-00079 COM2004-00079 COM2004-00079 COM2004-00079 Payments: Type of Payment Check .f ~-.~..'''''''~.''.'~~'' . C l,.,,~'? ~... , Receipt #: 1200400000000000080 .f Description + 7% State Surcharge + 10% Administrative Fee Wood Stove/Inserl Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Check Number Received By . Batch Number Authorization Number Paid By MARSHALLS INe djb City of Sprifigfield Official Receipt Development Services Departmenv Public Works Department Date: 01/20/2004 2:00:38PM Amount Paid Item Total: 3.15 4.50 30.00 15.00 10.00 $62.65 How Received Amount Paid In Person Payment Total: $62.65 $62.65 . .