HomeMy WebLinkAboutPermit Mechanical 2003-12-12
':
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-01246
ISSUED: 12/12/2003
APPLIED: 12/1212003
EXPIRES: 06/12/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1354 I ST
ASSESSOR'S PARCEL NO.: 1703362203000
Springfield TYPE OF WORK: Wood Stove
TYPE OF USE:
New
. Residential
PROJECT DESCRIPTION: Install wood insert
Owner: BILL DESKIN
Address: 1354 I ST SPRINGFIELD OR 97477
Phone Number: 541-915-3429
I CONTRACTOR INFORMATION.
Contractor Type
Mechanical
Contractor
CHRIS B WINSLOW
License
52381
Expiration Date
0111012004
Phone'
541-895-3593
BUILDING INFORMATION.
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
, Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
R-3
SETBACKS
I DEVELOPMENT INFORM'A.ll!l~l~-I.)N:Oregon la~ ~e~~:~~~~~i~i~
f llow rules adopted by tREQUIRED P A , NG
o. Those rules are sel \;:.II \
Oveday Dist: ~otificatlon Center. throTJCU~llOAR 952-00'
# Street Trees Rq~~ OAR 95,2-0Q1-001? o~~~dffN1I?~d::ul'es t
Paved Drive Rqd:0090. You may obtain c C9mP.act:lephOne
. t enter (Note. u.e It: .
% of Lot Coverage: calling t le c 0 ~gon Utility Notification
number~~~~~~iC: ~ _800-332-2344).
I PUBLIC IMPROVEMENTS I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
, Storm Sewer Available:
Special Instruction:
Notes:
i~~lo~~~ ~~~~~ \~~~~~~~{I~~~~
COMMENCED OR-IS ABANDONED FOR ,
hir: 19~ ~!,V PI=RIOO"
I Valuation Description I
Sidewalk Type:
Downspouts/Drains:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01246
ISSUED: 12/12/2003
APPLIED: 12/12/2003
EXPIRES: 06/12/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid'
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Minhimm/Adjustment Mechanical
Wood Stove
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$15.00
$30.00
12/12/03
12/12/03
12/12/03
12/12/03
12/12/03
Receipt Number
1200200000000002594
1200200000000002594
1200200000000002594
1200200000000002594
1200200000000002594
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.
Reuuired InsDections ,
1 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 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.
, a..,..#/ ..
~ or Contractors Signature
/2-IZ -~ S
Date
Pal!e 2 of 2
225 Fifth Srreet
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 1246
COM2003-0 1246
COM2003-01246
COM2003-0 1246
COM2003-0 1246
Payments:
Type of Payment
Check
Receipt #: 1200200000000002594
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Wood Stove
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
YE OLD TOWN SWEEP
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 12/12/2003
9:06:12AM
Amount Paid
Item Total:
3,15
4.50
30.00
15,00
10,00
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65
ZZ5 FIITH STREET. SPRINGFIELD, OR 97477 . PI-I:(541)726-3753 . FAX: (541)726-3689
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Preliminary Inspection is $45.00 (pdor to insert)
Wood Stove/Pellet/Insert Permit is $62.65 (includes Permit, Issuance Fee, State Surcharge &,Admiu(Fee.)
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City Job Number
Job Location /35"<1 ~T/' .5--tree f
)7()"") -=>62- Z
Assessors Map
Owner .13,// /)/2, S 11/7
Address / 3 ~ '-I 1:'
City 5./} /2/11D JilL lei
I I V
Value ~/pellet Stov~~
.2 700 'l!
Contractor l1~rormati()n
Contractor Ye IJ lei 7iJ w/1
Addresf 8/90) j)~u/SS6Y7
City (J,r ..e..f!i;/pd-!
..s (/..; ,t2.e- P
J2c/
Construction Contractors Registration #
5").58/
Tax Lot
o '3C>Oc)
State
D~
Phone 9'/~ - 3L1 z '1
Zip C} 7'1 7 7
(please circle appropriate appliance)
State
Fxpires
f /laJ~r.
( I
By signing this pernlit/application, I agree to call for an inspection(s) as required (726-3769). I state that all
infornlation on this application /pennit is correct and that I was provided with the Wood Stove Safety
inforn1ation for wood burning appliances and preliminary inspection standards as set by the Oregon Department
of Environmental Quality or the Federal Environmental PN ~i' ee-gency and I agree to provide the testing
approval number to the inspector at the time of inspection s~tAmtmfA~~tI!RPm-Er\fqiI'tHB.l~QRK
preliminary inspection, the wall covering may be required 1~ Itl~WmtJNDER THIS PERMIT'S NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIODoate /2/ (Z/ () ~
~~~
:..--- ---.----
S i !maturf' -
b
For Office Use
Date of Application
(2 -( Z - 0 -:>
~
Checked for Delinquencies
.......---
(;hecked for Historical Statuf
Shared Drive(T:)/Buildillg Forms/Wood Stove Pennitl-03,doc