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Home My WebLink AboutPermit Miscellaneous 2011-7-8 ~ o City Job Number ..~ b . 1;~ Jo Local1on: ~ Assessor's Map: ~ ..~ ~~ ~ r-. ~ I tP'I\. Owner: W\ t=Y\j c;",c1\ ~ AddresS:t.j~ a 5caJ..e... -<( City: ~,("~+\'e\d 1\(( 5 "~i ~ ~ ~ ~ Contractor: If~ lj!0 ~ ~ ra ~ ~ ~ ~ rtI1J. Signature: ~ o ~ iPj,?~f .:.~~~.. GITy;.o'E.:Spm,NGFIELn' OREGbN~,~'~'",~:,~~, :~"",:J{' ,. ~-';'. -... ~_'-"-""%.' ",<,,! ....-!"~..>.ijOJ"'-\,.{O\.j\.^.'''''~~_ ~~"~~-,": .o;,&,p. t "",il*'1h~~.":1.""'~4~~-: .'>; "'._. ><;~"'"'" _ _~",^',~.4'-~. ,"~..:'-:l""'r':. ~_.-..~'- w ~-,._ ~ "". 225 FIITH STREET. SPRINGFIElD, OR 97477. PH:(541)726-3753 . FAX: (541)726-3689 5/I-OI70b r..{ f::, l. (...v\:$ c..A- ~e '70 z.:> LJ'-fL..( ~12... Tax Lot: C> 0 7( J 1\v, Phri:/1 'J:,'1l.Jr 2.8 '3 3 e'>1Z.. Zip: 4 ., l..f ., 8 State: Preliminary Inspection for wood burning inserts is $66.04 (prior to insert). Wood Stove/Pellet/Insert Permit is $87.04 (includes applicable fees and sUrcharges). Contractor Information C~t1o Wlf\SIOW D, 6A. L{ -e O\J.. '1<IuJ~ Address: B\,,?oS ~\A<;5oIl ~f), . City: C y-e.c; """""II State: ~R... Construction Contractor's Registration #: .5 2.3 [3 I 6WAf Phone: (5"")8'15- 3sq3 Zip: C\ 742<" Expires: / J /0 It 2- , , 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 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. -~~ Date: 7/ ~II( t { .;.; Ii""" XPIRE \F1IiE WORK '\1IS PERMIT SIif\.~~~Ii\S PERMIT \S NOT .\ ITHORIZEO UNO . _ . "1'\1'\"'" R ~OMMENCED I'~ Checked for Historical Slilfu.f:f\.Y PERIOD. . \I~ I ,~-- Shared Drive(T:)lBuilding Forms/Wood Stove Permit 7..{l8.doc: CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01706 IVR Number: 811123368001 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/08/2011 ISSUED: APPLIED: 07/08/2011 07/08/2011 225 Fifth 51 Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us EXPIRES: VALUE: 01/03/2012 $0.00 SITE ADDRESS: 462 CASCADE DR, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702344400713 SCOPE: Wood Stove I Insert WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Wood Insert Phone Number: OWNER: ADDRESS: ENGLAND JAMES 0 & HOLLY 0 462 CASCADE DR SPRINGFIELD OR 97478 Contractor Type Mechanical Contractor Contractor Name CHRIS B WINSLOW CONTRACTOR INFORMATION i Lie Type CCB BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Units: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lie No 52381 Lie Exp 01/10/2012 Phone 541-942-3452 Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Site Information i Engineered Fill: Fill Volume:- "Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils ReP9"IRe~Ili:d;)regon law requires youto Pi, ,t:: ." --' b th Oregon Utility Joiiow rules adopted Y e les are set forth Notification Center. ThhOSe rUh OAR 952-001- . OAR 952-001-0010 t roug In obtain copies of the rules by 0090ii~0~:e~~nter. (Note t\18 te!e~l1~ cal 9 f the Oregon Utility Nol.i:r<::a.IOrtl number or 234'- Center is 1-800-332- p- .:.._....i..'. NOTICE: IRE If THE WORK THIS PERMIT S~~~~ ~~S PERMlT IS NOT. AUTHORIZED URIS ABANDONED FOR :' COMMENCED 0 ANY 180 DAY PERIOD. Springfield Building Permit 7/8/2011 8:4S:50AM Page 1 of 3 SP~N:::iJ ~\tb ~.OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01706 IVR Number: 811123368001 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726.3769 Fax: 541-726-3676 perrnitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/08/2011 ISSUED: APPLIED: 07/08/2011 07/08/2011 EXPIRES: VALUE: 01/03/2012 $0.00 SITE ADDRESS: 462 CASCADE DR, Springfield, OR 97478 ASSES OR'S PARCEL NO: 1702344400713 SCOPE: Wood Stove I Insert WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Wood Insert Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION' Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Description Type of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID ~ Description Amount Paid Technology fee (5% of permit total) $3.95 F~rst ApE~~'2ce F~e ~- --=-~~~~=~-~--~-'-$79.00 State of Oregon Surcharge (120~~ of applicable fees) $9.48 Total Amount Paid $92.43 Date Paid 07/08/2011 07/08/2011 -.------ -- ._----. ---- - - -. 07/08/2011 ReciDt # 2011001924 2011001924 . ..-.-..--.,...".,.......,.--".., 2011001924 Springfield Building Permit 7/8/2011 8:45:50AM Page 2 of 3 SP~~\N~-.. FIE. .~..~ ~~ ~~REGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01706 IVR Number: 811123368001 www.ci.springfield_or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@cJ.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/08/2011 ISSUED: APPLIED: 07/08/2011 07/08/2011 EXPIRES: VALUE: 01/03/2012 $0.00 SITE ADDRESS: 462 CASCADE DR, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702344400713 SCOPE: Wood Stove f Insert WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Wood Insert Plan Review ~ DeDartment Application Acceptance Received Due Date 07/08/2011 07/08/2011 Result Over the Counter ComDleted 07/08/2011 Reviewer David Bowlsby Mechanical Review 07/08/2011 Comments: Over the counter permit flniti_aIReview>" _";,',." .' "j07/98/201'1 V~;cg~~ebt~: < o~i_~u~t.e(p~;m'it":.\': 07/0812011 07/08/2011 Not 07/08/201.1 ;.'07/08/2011 c .';,~' ~.,';tl'rr,."";",&.~"": tA;C, ",. F ",.Over ttie.CoUnter-, - :"'~.- ;:;~ " "^>~^ INSPECTIONS REQUIRED ~ David Bowlsby "~: ~David Bow[s"by', ~'"" _ ~-j;.\"" ~...' ,- ~':.::5" ^ ""'-""', :3..,.'".". , .i-:4f.-r/0.-.-.-.:':':'.':';i.7>" ,] :>. .".~"~ -- Inspections 2140 Pellet, Gas, Fireplace or Wood Stove 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 shaff be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or 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. Wood Stove: After Installation. 7!5J//r , Date Springfield Building Permit 7/8/2011 8:45:50AM Page 3 of 3 . . .' TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 FiflhSt Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01706 462 CASCADE DR permitcenter@ci.springfield,or,us RECEIPT NO: 2011001924 [[)ESCRIP..tIONil&~T"" ','~_ First Appliance Fee State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) RECORD NO: 811-SPR2011-01706 DATE: 07/08/2011 :"<:;S/;N:;;.1~/':Z\d',);:q~:,,, .~i !'l" ~~.~;; "kIACCQUNf~c:ODE?," z', .',AMO~UNffDUE 224-00000-425604 79.00 821-00000-215004 9.48 100-00000-425605 3.95 TOTAL DUE: 92.43 ",~_"+"J0AMOUN'FPAllici~;z $92.43 . ..:;;; T5;;j''<<~ bI?AYMEt:lfTYPE.,> Check 21982 . PAY,OR _ ,-:^CASf"ER:-6BOII(,~yj~ ,-,COMIVIENTS , . _ ye old town sweep '-v""".! TOTAL PAID: $92.43