HomeMy WebLinkAboutPermit Mechanical 2001-12-12
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I Job# 01-01368-01 I
NOTICE:
Page 1 of 2
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CITY OF SPRINGFIELD, ORE/JON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
~: SHALL EXPIRE IF THE WORK
o L 'IDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 1 BO DAY PERIOD.
Job Number: 01-01368-01 ,'{d.O\
Office: 726-3759 ,,~\'&
Inspection Line: 726-3769 J:?i;~~~
Tax lot #: 10800 ? '\
Subdivision:
225 North Fifth Street
Springfield, OR 97477
location Of Proposed Site: 1353 C St Spr
Assessors Map#: 17033623
lot: Block: Addition:
Owner:
Gregory Gibb
1353 C Street
Phone Number: 541-747 -6289
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
Scope Of Work: Wood or Pellet Stove
Install freestanding pellet stove,
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769, All inspections 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
working day.
Freestanding Pellet
[
-After installation.
ATTENTION:Oregon iaw requires you to
Required Inspections fUIIUW I uie:s i:1UUJJU:1U uy me uregon utility
Mechanical ~otification Center. Those rules are set forth
in OAR 952.;Q01-001 0 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the t~ephone
numberforthe Oregon Utility Notification
Center is 1-800-332-2344).
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Accessory:
Total:
Fee
Paid On Receipt#
Mechanical
12/11/2001 7483
12/11/2001 7483
12/11/2001 7483
12/11/2001 7483
Value/Quantity
Fee Amount
Minimum Mechanical Permit
Administrative Fee - Mechanical
Freestanding Pellet Stove
Mechanical Issuance
2,900
$15.00
$3,60
$30.00
$10.00
.i. it
Fee
State Surcharge - Mechanical
Total Mechanical
Grand Total
Job# 01-01368-01
Page 2 of 2
Paid On Receipt#. Value/Quantity
Mechanical . J
12/11/2001 7483
By signing this permiUapplication. 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 ~;y02 re;;tl
Signature I
j',<
Fee Amount
$3.15
$61.75
$61.75
l2-lrr hI
, " '
Date
>_:.i
";f. 'II
Job# 01-01368-01
Page 1 of 2
TRANS#:Ol-0007483
DA TE : DEC 11 2001
AMT RECD:2 $ 61.75
CHANGE:
CASHIER:003
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-01368-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 1353 C St Spr
Assessors Map#: 17033623
lot: Block: Addition:
Tax Lot #: 10800
Subdivision:
Owner:
Gregory Gibb
1353 C Street
Phone Number: 541-747-6289
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
Scope Of Work: Wood or Pellet Stove
Install freestanding pellet stove,
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections 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
working day.
Woaa Stov~
Freestanding Pellet
I
- After-iRstallati0A-:-
-After installation,
Required Inspections
Mechanical
\
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Mechanical
12/11/2001 7483
12/11/2001 7483
12/11/2001 7483
12/11/2001 7483
Value/Quantity
Fee Amount
Minimum Mechanical Permit
Administrative Fee - Mechanical
Freestanding Pellet Stove
Mechanical Issuance
2,900
$15,00
$3.60
$30.00
$10.00
'-'"
Fee
Job# 01-01368-01
Paid On Receipt#
Mechanical
12/11/2001 7483
State Surcharge - Mechanical
Total Mechanical
Grand Total
Page 2 of 2
Value/Quantity
Fee Amount
$3.15
$61.75
$61.75
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 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 ;a3 covering may ~e r,.~ired to be removed.
L-J?~;{ 4/C
Signature' ,
IU/I/DI
Date