HomeMy WebLinkAboutPermit Building 2003-3-18
'.
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3254 GAME FARM RD
ASSESSOR'S PARCEL NO.: 1703221318900
e;' 9TY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00180
ISSUED: 03/18/2003
APPLIED: 03/18/2003
EXPIRES: 09/18/2003
VALUE:
Springfield TYPE OF
Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install gas fireplace, insert and H2o heater
Owner: SCHUMAN THOMAS RAY
Address: 3254 GAME FARM RD SO SPRINGFIELD OR 97477
Contractor
MARSHALLS INC
SCHUMAN THOMAS RAY
I BUILDING INFORMATION'
Contractor Type
Mechanical
Owner
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
P"rimary Construction Type
Secondary Construction
# of Bedrooms:
VN
SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard S~tback:
Solar Setbacks: ~C\~~
"..\.It p"
. ~'i-?\\\t. '~~\\ \';) \~V '
fO\\C\~\\ 'O\\t>.\..~~ \\\\~ ?~"t.\) f\}~'
. \\\S~~\\) \}"\) la~t>."\)
t>.~~J~l\i~~~~i)\).:
C, -J ,\CO\) \)~
N~t'es:
Description
Type of Construction
1 CONTRACTOR INFORMATION'
License
25790
Expiration Date
12/23/2003
Phone
541-747-7445
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
I DEVELOPMENT INFORMA nON,
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
I. , Iv".v\.;YOiIIClW reqUires you to
h.. . - . _ _ _-1~..........~ h\/tho nr~nnn Utilitv
!pUBLIC IMPROVEME~lil;~il~'r~G~nt~r. Those rules are set for,.:
'n OAH 9r.S~'d""1Ikn"T1 n th-ough OAR 952-001
I . I ewa ype:'. f th ules b'
0090. YOIl may obtain C~pI9S 0 e r -
I' Downspouts/Drams the telephone
callngllll;;u\;ll\.......\,\lv,.....1 ..'
nu,nber for the Oregon Utility Notlill)atlOr.
Ce~teri~ 1-800-332-2344).
I Valuation Descrintion I
$ Per Sq Ft
Square Footage
Value
Date Calculated
I of 2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00180
ISSUED: 03/18/2003
APPLIED: 03/18/2003
EXPIRES: 09/18/2003
VALUE:
Total Value of Project
I Fees Paid'
Fee Description Amount Paid Date Receipt Number
....Mechanicallssuance Fee- $10.00 3/18/03 2200200000000000610
+ 10% Administrative Fee $4.90 3/18/03 2200200000000000610
+ 7% State Surcharge $3.43 3/18/03 2200200000000000610
Gas Fireplace $15.00 3/18/03 2200200000000000610
Gas Outlets 1-4 $4.00 3/18/03 2200200000000000610
Pellet StovelInsert $30.00 3/18/03 2200200000000000610
Total Amount $67.33
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 Insnections I
I Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
3 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.
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 contracton 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 duro g construction.
~(~~
~r~
ontractors Signature
~~>
Date
Owner
2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.,
Line Items:
Job/Journal Number
COM2003-00180
COM2003-00180
COM2003-00180
COM2003-00 180
COM2003-00 180
COM2003-00180
Payments:
TWe of Payment
Check
Paid By
Descriotion
Gas Outlets 1-4
Gas Fireplace
Pellet Stove/Inserl
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
MARSHALLS INC
Receipt #: 2200200000000000610
Date: 03/18/2003
Received By
Check Number Confirm No
djb
Page 1 ofl
3/18/2003.,
I
1:25:57PM
..
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Line Item Total:
.
Amount Paid
4.00
15,00
30,00
10.00
3,43
4.90
$67.33
.
Amount Paid
67.33
$67.33
How Received
In Person
Payment Total:
cReceipt.rpt