HomeMy WebLinkAboutPermit Miscellaneous 2000-11-28
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I Job# 00-01730-01 I
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RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
TRANS#:01-0003884
DATE:NDV 28 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 061
SPRINGFIELD
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CITY OF SPRINGFIELD, OREGON
Job Number: 00-01730-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
, Inspection Line: 726-3769
Location Of Proposed Site: 740 Filbert Ln Spr
Assessors Map#: 18020522
Lot: Block: Addition:
Tax Lot #: 00700
Subdivision:
Owner:
Address:
Shirley Cantrell
740 Filbert Lane
Phone Number: 541-747-1385
City/State/Zip: Springfield, OR 97478
New Value: $1,200
Scope Of Work: Wood or Pellet Stove
Pellet Stove
Contractor Type
General Contr
Contractor
Claxtons
215 E, 38th Ave, Eugene, OR 97405
Registration # Expiration Date
Phone
541-484-9583
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
f\~~7~0r,'~.
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All in~~~c;i~~~~~quesiecibeiO'!E?:]:'60THcl"JORi<
a.m. will be made the same working day, inspections requested after 7:00.a.mcwill:be made:theifolloWing;-'\SNOT
k' d I-\U j IIUl"j,:'_LJ V.'I;~'--" .. ._.. -
wor Ing ay. C~: ," ''''',' ,~'=~ 0"" IS ;'''J~I\)OON'::D FOR
\.J "11...lC.I\...........W 11. ru.J
Required Inspections Ni.Y 'il:lU UAY I"ci'i.JiJ.
Mechanical I
I
-After installation.
Freestanding Pellet
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
rArea (Sq. Feet)
Main: Accessory:
^.JTEN....,.,r'\'.r.~........f'" ",'," - ":-:",\Iov.("
f"\ I. v ._ _'. '. --' . J ....
. , ' "1'" "r 'oor Uti' \,
. folloVJ 1l'\3' 'l(,O'J\';U )" .1 < U - :,".
# Of Stories: N ..,' ,Height (feet): ;lust-Iules :olf:O 581 :;,.
OlhIC.....lIVI,....V.1h-,.. . .~.
Current Units: in OAM ~!:.qp.9~!!c!il!:Jnits:-OlighOAtl0o2-0v ,.
Census Code: Does not,!p'pJyyou may obt8in capi3s of the rul3S by
callilly ,r'd-:"neJf. ,'~llt..;:.~~31:J1;;?ho'la
Total: I nUlllbdrior ih~ (!l J:JOfl U'llltl' Notification
__.......0';.- "t ".,~. .....':I_)rl14).
Fee
Paid On Receipt#
'Mechanical
11/28/2000 3884
Value/Quantity
Fee Amount
Minimum Mechanical Permit
$.00
"
...
.
Fee
Job# 00-01730-01
Paid On Receipt#
Mechanical
11/28/2000 3884
11/28/2000 3884
11/28/2000 3884
11/28/2000 3884
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Page 2 of2
Value/Quantity Fee Amount
Mechanical Administrative Fee
Freestanding Pellet Stove
Mechanical Issuance
Siate Surcharge For Mechanical Permit
Total Mechanical
Grand Total
By signing this permiVapplication, I agree to call for an inspection(s) as required (726-3769). I state
that all information on this application is correct. I further state that the appliance I am installing
meets smoke emission standards as set by the Oregon Department of Environmental Quality or the
Federal Environmental Protection Agency and I agree to provide the testing approval number to the
inspector at the time of inspection. I also understand that if I am requesting a preliminary inspection,
the wall covering may be required to be removed.
~tlAA ~~\V'\- lIJ~r10()
Signature Date
1,200
$.45
$15.00
$10.00
$1.05
$26.50
$26.50
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SPRINGFIELD
WOOD STOVElINSERT INSPECTION APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION - BUILDING SAFETY
225 Fifth Street
Springfield, Oregon 97477
Co.. Vlf?
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owner:.6"~~\r~ ,uu/\1\rrLL
Address: 7(,J) +1{~P~\r+ I./J I/lP
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City: ~v; VI c-,\\ p.l ,.d State: C'l'T<-
I <...t,
Value of Wood StovJ;lIet Stov~ert: -c~/21J,-
Job Location: '7 Ln -;;: ( .J.o P;v, ~
Assessors Map #:
225 FIFTH STREET
SPRINGFIELD. OR 97477
(541) 726-3753
FAX (541) 726-3689
Office: 726-3759
INSPECTION LINE: 726-3769
Tax Lot#:
00700
Phone#: ll7 - J'3cfC
Zip: q 7(P 1d'
(please circle appropriate appliance)
Preliminary Inspection is $15.00 (prior to installation of insert)
Wood Stove/Pellet/Insert Permit is $15.00 + 1. 05state surcharge + $.45 Administrative Fee + $10.00
Issuance.
Type of Inspection Requested:
Contractor: Cl Q.viu\.l\\~~'
Address: Q/~ r 3~ /-We.
City: (l ,,0 t? 1-" P
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(G"LAAV1 ~
State: rY\2.-
Construction Contractors Registration#:
?7?:Jk
f>t'. \A) 'Ice
Phone#: Iv!:!' -:q~g,?
r .
_Zir _q 1'lO:;'
EXPires:---E.,!J.K.) OJ
By signing this permit/application, I agree to call for an inspection(s) as required (726-3769). I state that
all information on this application/permit is correct and that I was provided with the Wood Stove Safety
information for wood burning appliances and preliminary inspection standards. I further state that the
appliance I am installing meets smoke emission standards as set by the Oregon Department of
Environmental Quality or the Federal Environmental Protection Agency and I agree to provide the testing
approval 'lumber to the inspector at the time of inspection. I also understand that if I am requesting a
prel~ary inspection, th~lI 7v~^y be required to be removed. I) L'A'-JO..::>
\ .'.\111_0_,\.1 ~\...Y/ ~ /;J\J
Signature V Date
FOR OFFICE USE
REQUIRED INSPECTION(S): WOODSTOVFJPELLETIINSERT
Date of Application:
//-2lr-c,,=>
2/5_0
Total Amount Collected: b
Receipt #:
'3 H' 'I
Job #: 00 - D 17 sO - 0 (
PRELIMINARY
Checked for Delinquencies:
Checked for Historical Status:
Issued By:
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