HomeMy WebLinkAboutPermit Mechanical 2003-10-6
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01008
ISSUED: 10/06/2003
APPLIED: 10/03/2003
EXPIRES: 04/06/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 507 VALLEY VIEW AVE.
ASSESSOR'S PARCEL NO.: 1803022101100
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install propane furnace
Owner: DAVID BEL YEA
Address: 507 VALLEY VIEW AVE SPRINGFIELD OR 97477
Phone Number: 541-521-3332
SETBACKS
I CONTRACTOR INFORMATION I
C t t L. E . ~O~ D t Ph
on rac or lcense ~u~ 4 n a e one
CHITTIM ENTERPRISES IINC 47396 ~(\U,\'(etp...(\ \!K\~)zf,.005 541-461-2101
~ ' '(e~- roe" ^"
BUILDING INFORMAT ~eO ~'(e &'l.JVV
.O'(~'tI 0'0 '\1 '(U,\eS ~ CJ ~eS \
# of Stot.in\O~' oo~\e "{.'(\o~/~ ~~'(\ 0 ~ ~g~~
H~'~~'r~~~~e't. o~'(o i\eSO'~i\Ii>Ys~~r:
T ~\~'M" C0 ~~()o~ ~~ co~ e".\'(\~{l\~~M(rFloor:
W ?~~~~:&~..oO ~ o'O\0l ~o'V, u~\\\'$~ ~~~asement:
R~2~~ ~ ~'lJ. e~\e'('e~O~ ~,?>?,.11ff <t GaragelCarport
Enefg~~t~O \'(\0 C ~0 0'< ~<o(;)()~ Sq Ft Other:
o c~\~~ '( \0'< ~ ~ \<?J ~ Impervious Surface Area:
..",0 !.~\e '
I DEVELOPMENt'iNFOR.MATION I
R-3
Contractor Type
Mechanical
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
~\)~~
\T \\\~ \~ ~O\
. ~'iO'~'t. _,n~"\\ \ffi
I PUBLIC IMPROV~Jl'iTS~S\\t--\..\..:\\\\~ \'C~~\) '(
\\\) \S ?'t.\\~~\) \)~~~~~pe:
\\'\\ \)\\\L- n ~\, f\f\. .
\\\)\'P 'i.~CJt..'v. ~1{.\,~"t>outs/DralDs:
CJ\)\'1\~ CO\) \)~
~~'{
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pa2e 1 of2
Status
Issued
CITY OF SPRINGFIELD "
Building/Combination Permit
PERMIT NO: COM2003-01008
ISSUED: 10/06/2003
APPLIED: 10/03/2003
EXPIRES: 04/06/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I 'lFees Paid'
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Appliance Vent
Furnace - up to 100,000 btu
LP Gas Tank & Piping
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$6.00
$12.00
$12.00
$15.00
10/6/03
10/6/03
10/6/03
10/6/03
10/6/03
10/6/03
10/6/03
1200200000000002277
1200200000000002277
1200200000000002277
1200200000000002277
1200200000000002277
1200200000000002277
1200200000000002277
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 InsDections I
1 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
2 Rough Mechanical: Prior to Cover
3 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 ofthe property, and the approved set of plans will remain on the site at all
\ time: . 0 UClIO)
~. _ (fA ld LY (03
Owner or Contra~ Signature Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 1 008
COM2003-0 1 008
COM2003-0 1 008
COM2003-0 1 008
COM2003-0 1 008
COM2003-0 1 008
COM2003-0 1 008
Payments:
Type of Payment
Check
'""
Receipt #: 1200200000000002277
Description
Furnace - up to 100,000 btu
Appliance Vent
LP Gas Tank & Piping
Minimum! Adjustment Mechanical
~Mechanical Issuance Fee~
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
JAMES HEATING
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department'
Public Works Department'
Date: 10/06/2003 2:50:25PM
Amount Paid
Item Total:
12.00
6.00
12.00
15.00
10.00
3.15
4.50
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65