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Home My WebLink AboutPermit Mechanical 2005-4-25 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2005-00482 ISSUED: 04/25/2005 APPLIED: 0412512005 EXPIRES: 10/25/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1163 QUINALT ST ASSESSOR'S PARCEL NO.: 1703264106900 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration PROJECT DESCRIPTION: Install gas fireplace insert and gas water heater Residential Owner: WILLOUGHBY SHERRY L Address: 1163 QUINALT ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION. Contractor Type Mechanical Contractor AMBASSADOR PIPING INC License 121469 Expiration Date 03/27/2007 Phone 541-726~5723 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Sethack: Side 1 Sethack: Side 2 Sethack: Rearyard Set hack: Solar Sethacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk Type: Storm Sewer Available: DownspoutslDralns: Special Iffl~~rION: Oregon law requires you to follow rules adopted by the Oregon Utility Notes:Notification Center. Those rules are set forth -.- --- --1 ^^"^"I...__.....hr\^oat:;.'J.nn1. '~090: y~~~ ~;y o-bt~incopies of thfl~~'ifi.~tion DescriotioiJ'It .~~~:,'" T SHALL U(PtRE IF THE WOI;:< calling the center. (Note: the tel T . I\LJ I r1UHtLI:U Ui~L,tH THIS PeRMIT IS NUT number ~r the Oregon Utility Not'~fp\Ws~ Ft Square Footage'ED OR IS .\ P.Ai~DONED cm< Description YDe ofConstructioJl'344) .. ';'v"...,~ " Value Date Calculated C mt::fls,.ou -w~ - or multiplIer or Bh~,'\"1ouuJtJAY PERIOD. Pa2e 1 of2 . lir. . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2005-00482 ISSUED: 04/25/2005 APPLIED: 04/25/2005 EXPIRES: 10/2512005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541~726-3676 Fax 541-726-37691nspection Line Total Value of Project Fp.p.s PfclidJ Fee Description -Mechanical Issuance Fe.... + 10% Administrative Fee + 7% State Surcharge Appliance Vent Gas Fireplace Gas Outlets 1-4 Minimum/Adjustment Mechanical Amount Paid Date Paid Receipt Number $10.00 $4.50 $3.15 $6.00 $15.00 $4.00 $20.00 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 2200500000000000490 2200500000000000490 2200500000000000490 2200500000000000490 2200500000000000490 2200500000000000490 2200500000000000490 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./luirp.d ~ Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do herehy 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 he 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. r\ ~~Ji~ - - - .... - ~\~~', \ ~ Dat~ ,...,<;, Owner or Contractors Signature Paee 2 of2 +J ~ ~4 ~ rtJ ~: H, o ~: '" ~ ~, ~: ~ ~: 1 . S?II'll~W<O:!?Ie:LItl> r . ~~~ " 'OITY10F'SPRINGFIELD "OREGON' ,,: .1, . , 1 /,,& \>l:]}' 22:; rHTH STKITr . SI'KINCnEW, OK lJ74 77. rH:(:;41 )726-:,7:;:, . lAX: (:;41)72(,-:,('89 City Job Number [)-aJ#L \ I (p~ Q~ Ylr}' df:: LOCATION OF rROrOSED WOKK: ASSI:SORS MAr: TAX LOT: ~JrV"' i ll. Ji \ \C:--:-J"'hu mONI:: 5L,~ -t=fj 0 ~ '-II a'") ~ ',....~ ^.r-' \ ADDRr^~S: \ ",""\ \L.YLl." ....v.::IC-> CITY: ~\l \c-f . ~TATI:: ~ zlr: Cfr-Ill OWNI:K: DESCKII'1'I0N or WORK: NI:W: Rr.MOmL: ADDITON: DI:MOLlSH: OTHI:R: V ALUI:: . CONTRAcrOK'S NAMI: ADDRI:SS CON~T, CONTRACI'OK # l:xrlRES rHONI: GI:NI:RAL: rLUMBING: MJ:CIIANICAL:aJlD Q,\,,,,\P/' St"T~ ELI:CrRICAL: 3PlP1 I~Lo 'Sl~ \~ 14y.Ci MECHANICAL PERMIT PLUMBING PERMIT ITEM FEE ITEM FEE t;;4f tJ~ r:.}.J4JtT I Venl ran No, ~ IJ/jll Wood Stove/Insert/Fireplace Unit FUnlace fixtures Residenlial Hath(s) No, Sanitary Sewer IT. Water fL Storm Sewer rr. I:xhausl Hood Mechanical I'ermit Subtotal "Minimum of $45.00 State Surcharge 7% Administrative ree 10% I'lumbing rcrmit Subtolal **Minimum of $45.00 State Surcharge 7% Issuance fce Adminislrative Fcc 10% TOTAL MECHANICAL TOTAL I'LUMHlNG Me,ehanieall · - ~ - ... - -. . - ~. .. - -' -" P ]1 1!.. ., ~funlaJtn~ · Mrseellaneous, __ , __..._ """ ~ .,0_ ,_ _., _ ~ _ ~_ .;1 .:J _ .. ..' Shared Drive(T:)/Building Fonnsli'cnnil Worksheel ).04.doc 225 Fiftn Street ., Springfield, Oregon 97477 541-726-3759 Phone . .~ 1Ir.1 _ity of Springfield Official Receipt ~evelopment Services Department Public Works Department Job/Journal Number eOM2005-00482 eOM2005-00482 eOM2005-00482 eOM2005-00482 eOM2005-00482 eOM2005~00482 eOM2005-00482 Payments: Type of Payment Check , .. 4/25/2005 RECEIPT #: 2200500000000000490 Date: 04/25/2005 Description Appliance Vent Gas Outlets 1-4 Gas Fireplace -Mechanical Issuance Fee- Minimum/Adjustment Mechanical + 7% State Surcharge + 10% Administrative Fee Paid By AMBASSADOR PIPING lNe Item Total: Check Number Authorization Received By Batch Number Number How Received dim 8520 In Person Payment Total: Page I of I 2:31:08PM Amount Due 6.00 4.00 15.00 10.00 20.00 3.15 4.50 $62.65 Amount Paid $62.65 $62.65