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HomeMy WebLinkAboutPermit Mechanical 2004-6-10 '<t Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00682 ISSUED: 06/10/2004 APPLIED: 06/10/2004 EXPIRES: 12/10/2004 VALUE: SITE ADDRESS: 949FAIRWAYPL ASSESSOR'S PARCEL NO.: 1703342200838 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Install gas piping under slab Owner: STOVALL M SCOTT & JONI M Address: 949 FAIRWAY PL SPRINGFIELD OR 97477 ......, \....' Contractor Type. Mechanical I CONTRACTOR INFORMATION" Contractor DEAN M SCHULTZ Phone 541.767-0626 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ,. Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ',.' Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description License 133733 Expiration Date 02123/2005 I BUILDING INFORMATION I # of Stories: R-3 Height of Structure Type of Heat: VN Water Type: Range Type: NOTICE: EnerIlY.r"U1;.,.. \F-JHE WORK THIS PER~I: ~~~~~tmp~i~\T IS Ncrta ~~~W,I;.n'E~kt.JI:iThf.ilNNOO~~N I ANY 1BO DAY PERIOD. Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 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: I PUBLIC IMPROVEMENTS I Sidewalk T18e: O on law r~ulres you ATTENTION: rag e ~~qg~lijrains: follow rules adoPta~h~s~hrules are set forth Notification Cen~10 through OAR 952-001- In OAR 952-001-Obtaln copies of the rules by .",...n Vnllmav0 . .._~__~ - ~--~U\.t:I. \11"" ..........1"". I calK"!! U '0 "".._n . . 'f tion Valmftionup.sepntfbn n Utility Nob lea Center IS 1 0-332-2344). $ Per Sq Ft 'Square Footage Value or multiplier or Bid Amount Type of Construction \~ Date Calculated Total Value of Project Pa2e 1 of2 . . CITY OF ~rKlNhI<lJ!,LD Building/Combination Permit PERMIT NO: COM2004-00682 ISSUED: 06/10/2004 APPLIED: 06/10/2004 EXPIRES: 12/10/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L.Fee~ PaW Fee Description -Mechanicallssuance Fee- + 10% Administrative Fee + 7% State Surcharge Gas Outlets 1-4 Minimum/Adjustment Mechanical Minimum/Adjustment Mechanical Amount Paid Date Paid $10.00 $4.50 $3.15 $4.00 $10.00 $31.00 6/1 0/04 6/1 0/04 6/1 0/04 6/10/04 6/10/04 6/10/04 Receipt Number 1200400000000000880 1200400000000000880 1200400000000000880 1200400000000000880 1200400000000000880 1200400000000000880 Total Amount Paid $62.65 I Plan Reviews I To Request an inspection calI the 24 hour recording at 726-3769. AII 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 folIowing work day. I Reouiretl ue~tion~ I Underslab Gas: After line is installed and required testing and capped if not attached to an appliance. By signature, I state and agree, that 1 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. c~ /(1 - 02- Owner or Contractors Signature Date Page 2 of2 225 Fifth Street Sp"ri,ngQeld, Oregon 97477 541-726-3759 Phone . 8..P~'RJN~~~' _",._.~ " Wit, ; n.. ' .-'...... " .....ty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200400000000000880 Date: 06/10/2004 11:00:03AM '-. '., . Job/Journal Number . COM2004"00682 COM2004"00682 COM2004"00682 COM2004"00682 COM2004"00682 COM2004"00682 Description + 7% State Surcharge + 10% Administrative Fee Gas Outlets I A Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Minimum! Adjustment Mechanical Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 3.15 4.50 4.00 31.00 10.00 10,00 $62.65 Amount Paid Check SCOTT STOVALL djb 3764 In Person Payment Total: $62.65 $62.65 ,. ~ '. ........ , ~': 6/10/2004 Page I of I