HomeMy WebLinkAboutPermit Mechanical 2005-9-27 (2)
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.. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01317
ISSUED: 09/27/2005
APPLIED: 09/27/2005
EXPIRES: 03/27/2006
VALUE:
-.
'Status: Issued
, 225 Fiftb Street, Springfield, OR
, 541-726-3753 Phone
:' 541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3382 GAME FARM RD
ASSESSOR'S PARCEL NO.: 1703221201700
Springfield TYPE OF
Mechanical Only
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Install pellet stove,
- Owner: DANIELS DIANE
Address: 3382 GAME FARM RD
SPRINGFlELD OR 97477
Phone Number: 541-988-0936
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I CON];RA~TOR INFORMATION I
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. Contractor Type Contractor~~oS:. ~ ~,,\\ ,'0 License
:, Mechanical THERMAL,JWSO~'q.....~ 161946
c..'{\~\..\..~ ,\~\-;J,~l~'biLDIN" mruRMATIONI
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# ofUil'fts: -a~'\'\ l?'i:..~'i'i:..\) '\:i \)~ '%> s::>\)' # of Stories: Lot Size:
Primary OCCUpAj;C'6~~. R,'i:..\) ~'i:..~ Height of ,0 Sq Ft 1st Floor:
Secondary Occup ~'(' ~'i:..~ ~ Type of Heat: ,\O\> ,~~$q Ft 2nd Floor:
Yrimary Construct ~~~\) \) Water Type: ,!;,\~ec, f0 0" ",~qf.t Basement:
Secondary Construcli'~~ , Range Type: ~e<S:. ~ec?'O e C,e' ~9lFtparageJCarport
# of Bedrooms: Energy Patb: f0 \1>~ 'is'e 0 ec' ~ ~ ~~')!!.!!cFl Other:
Sprinkled ec?'O ,,'0'\ ,Sol!!)'?" e <Occu-pant Load:
01(" ,nU ....c..e. ......'(\ ~ \~ .....'<:\v ,,<0
....,. -" ~,. ....,,- v ~V' ,(>...
I DEVELOPMEN'f INFORMA'I10N(," ~e ,e O~\\V
I ,~. ~
.;:.'\ ~~ ~\>'~ f0 v"'~'\'\)" ~-i>>~ ~0\.e00"'\ r1'~y REQUIRED PARKING
O,:etfu'.::D~2:(j 1>'\ 0'0 ~e~' r:.0" .<:,"J'l:"'-
# \treeti!ree,~.) (0 e ve~ O~e !O\)()
Pav~<Drivj;l:Rqd: ~'iS'e '{:> '\'
0/0 of 'Ic9~Cov~Fag~~ ^"e\
G" iI"''O~ (;,'l.'-
~.s
Expiration Date
10/29/2006
Phone
541-687-0006
...
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
.-
Total:
Handicapped:
Compact:
IPUBLIC IMPROVEMENTS I
Street
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains
Notes:
I Valuation Descrintion I
Description
Tvpe of Construction
$ PerSq Ft
or multip6er
Square Footage
or Bid Amount
Value
Date Calculated
1 of 2
"
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.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01317
ISSUED: 09/2712005
APPLIED: 09/27/2005
EXPIRES: 03/27/2006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees PaidJ
\>
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Minimum/Adjustment Mechanical
Pellet Stove/Insert
Amount Paid
Date Paid
$10,00
$4,50
$3.15
$15.00
$30.00
9/27/05
9/27/05
9/27/05
9/27/05
9/27/05
Receipt Number
1200500000000001402
1200500000000001402
1200500000000001402
1200500000000001402
1200500000000001402
Total Amount
$62.65
I Plan Reviews I
, To Request an inspection call the 24 hour recording at 726-3769. Ail 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.
Freestanding Pellet Stove: 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 wiD 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 ail requiJ3ed in pections are requested at the proper time, that each address is readable from
the street, that the perm' car is located at e front ofthe property, and the approved set of plans wiD remain on the site
at ~es durin s clio
Xh~ ,~/YJ;, ~cl. 7- 2- 750~
.' Owner or Contractors Signature
Date
2 of 2
225 Fifth Street
~"ringfield, Oregon 97477
J 541-726-3759 Phone
.
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~..:
1iJ.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
JdJ/Joornal Number
COM2005-01317
COM2005-01317
COM2005-01317
COM2005-01317
COM2005-0 \317
Payments:
TWe of Pa)1Oent
Check
,.
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9/27/2005
RECEIPT #:
1200500000000001402
Date: 09/27/2005
Description
Pellet StovelInsert
Minimum/Adjustment Mechanical
-Mechaoicallssuance Fee--
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
DIANE B. DANIELS
Received By
jmp
1 of I
Item Total:
Lheck Number Authorization
Batcb Nmober Number How Received
3748 In Person
Payment Total:
1l:03:06AM
Am...nt Due
30.00
15,00
10.00
3,15
4,50
$62,65
Amount Paid
$62,65
$62,65