HomeMy WebLinkAboutPermit Mechanical 2005-9-20
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726,3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 815 RA YNER AVE
ASSESSOR'S PARCEL NO.: 1703331100401
.. LU f OF SrK11'1uFIELD
Building/Combination Permit
PERMIT NO: COM2005-01280
ISSUED: 09/20/2005
APPLIED: 09/20/2005
EXPIRES: 03/20/2006
VALUE:
Springfield TYPE OF WORK: Pellet Stove
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install pellet stove
, Owner:
Address:
BETTY VOKACEK
815 RAYNER AVE
SPRINGFIELD OR 97477
Contractor Type
Mechanical
ATT~MTlnN. nr~nnn ,~\'" r,:t.nllin~~ \lnll tn
follow rules adopted by the Oregq;hb~~iN'umber:
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
----; ".. . . . . r" I - '-
...w......... ....... ..j....., ""..........". .........,................ ,....... _.~- -J
541-746-9442
I CONTR'A@1reRiINFeRMAiriON' 11e telephone
faJllUJJ{ ~J. \~.f.! Jf,..:w-lJ" J.."ty Notification
C I . 1,,,nn ~~') 23--'
en er IS ulcense" 'Expiration Date
162960 01/28/2009
Contractor
JACC ENTERPRISES INC
# of Units:
Primary Occupancy Gronp:
Secondary Occnpancy Gronp:
:. Primary Construction Type
Secondary Construction Type:
. # of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
Phone
541-747-8600
BUILDING INFORMATION 1
R-3
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
nla
VN
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION 1
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
llP.UBLiC-IMPROVEMEl~TS' IF l\1t vS~N01
\' I::' r~'"'''' 'WI'- rtRM\1 I
,1 "0 UNDtR III '-' Sidewalk Type:
J\Ul \\LJKILt 1\\)I\NDONtu I V"
~LJ',\I,\tl~L;tD OR IS D DownspoutslDralns:
~I~~ W\.; DA'I PtRlO '
I Valuation DescriDtion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01280
ISSUED: 09/20/2005
APPLIED: 09/20/2005
EXPIRES: 03/20/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
Fp.p.~ Pail! I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Minimum/Adjustment Mechanical
Pellet StovelInsert
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$15.00
$30.00
9/20/05
9/20/05
9/20/05
9/20/05
9/20/05
2200500000000001295
2200500000000001295
2200500000000001295
2200500000000001295
2200500000000001295
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.
I Rp.nlJirp.l!ln~I"p.~tin""
'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 descrlhed 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 wID remain on the site at all
times during construction.
..~ ~~<Z^--
Owner oV Contractors Signature
fj-zo -0,
Date
Palle 2 of2
, "
ti5 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
, Job/Journal Number
, COM2005-01280
COM2005,O 1280
COM2005,O 1280
COM2005,O 1280
COM2005-0 1280
I
I
1 'Payments:
Type of Payment
, Check
;,
"l'
?
'I
:r
I,
'f
"
"
9/20/2005
.
.P~.~!t:..Q._"~.....' ..-..-..--- .1
WiL'
;
'~ i
..~.. -
RECEIPT #:
JIlty of Springfield Official Receipt
.velopment Services Department
Public Works Department
2200500000000001295
Date: 09/20/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Pellet StovelInsert
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
BETTY VOKECEK
Received By
djb
Page I of1
Item Total:
Check Number Authorization
Batch Numher Number How Received
2288 In Person
Payment Total:
1 :26:32PM
Amount Due
3.15
4.50
30.00
15.00
10,00
$62.65
Amouut Paid
$62.65
$62.65