HomeMy WebLinkAboutPermit Building 2003-12-2
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LITY VI<. :Sl'KINlIl<l~LU
BAing/Combination Permit
PERMIT NO: COM2003-01200
ISSUED: 12/02/2003
APPLIED: 12102/2003
EXPIRES: 06/0212004
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1307 QUlNAL T ST
ASSESSOR'S PARCEL NO.: 1703264115700
Springfield TYPE OF
Single Family Residence
TYPEOFUSE:
New
Residential
PROJECT DESCRIPTION: Gas W/H, FP insert & gas lines
Contractor Type
Mechanical
Contractor
MARSHALLS INC
ATTENTION:Oregon law requires Y0U to
TOIIOW rUles aoopteo oy me ureQon utility
\/otilication Center. Those rules are S2t for
m OAR 952-001-0010 throuph OAR !l52-0r
0090. You may obtam caples o11he n'IE:<;
I CONTRACfOR INF.ORl\:lA HeN "lter. (Nato: the telcrhone
number for the Omgon UliIity Notification
Licenser i~ 1Expiration-Dat~ Phone
25790 12/23/2003 541-747-7445
Owner: SMITH DEANN & RONALD
Address: 1307 QUlNAL T SPRINGFIELD OR 97477
BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 151 Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
SETBACKS
I DEVELOPMENT INFORMATION'
CR: REQUIRED PARKING
. W011 &:
Overlay DlstTHIS PERMIT SHAll EXPIRE IFiTh\Ii:WORK
# Street T.ree~ ORIZED UNDER THIS PEP!i\Md'SaliliHI:
Paved DrIve ~W~MENCEO OR IS ABANOOI'i'C\Tllijf\l:
% of Lot Cov~~,e1 80 DAY PERIOD.
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
IPUBLlC IMPROVEMENTS I
Street
Sidewalk Type:
Downspouts/Drains
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Desc ription
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
1 _r '"
,
Status:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Appliance Vent
Gas Fireplace
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Total Amount
.
LITY V1< 1Sl'Kll'll> nt<.;LU
BAing/Combination Permit
PERMIT NO: COM2003-01200
ISSUED: 12/02/2003
APPLIED: 12/02/2003
EXPIRES: 06/02/2004
VALUE:
I Fees Paid ,
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$6.00
$15.00
$4.00
$20.00
12/2/03
1212103
12/2/03
12/2/03
1212/03
1212/03
12/2/03
1200200000000002528
1200200000000002528
1200200000000002528
1200200000000002528
1200200000000002528
1200200000000002528
1200200000000002528
$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.
wiu be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
Reauired Insoections ,
1 Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
2 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.
3 Rough Mechanical: Prior to Cover
4 Final Gas: When all gas work is complete.
5 Final Mechanical: When all mechanical work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do hereby cerlii)' 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 certii)' that only contractors and employees who are in compliance with ORS 701.005 will be
used on this project.
1 further agree to ensure that all required inspections are requested at the proper time, that each address is readable from
~3(i JiiS~" 7'~:::~"".' ,m,"", 00' ", .,;;:'\ ";J ~V" 'M ""
Owner or Contractors Signature Date ~
,., ~" '"I
.1
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
C0M2003-0 1200
COM2003~0 1200
COM2003~0 1200
COM2003-0 1200
COM2003-01200
COM2003-01200
COM2003-0 1200
.ments:
Type of Payment
CreditCard
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Receipt #: 1200200000000002528
Description
Appliance Vent
Gas Outlets 1-4
Minimum! Adjusnnent Mechanical
Gas Fireplace
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
dim
Check Number
Batch Number Authorization Number
Paid By
MARSHALL'S INC
000236 065924
. City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 12/0212003
3:13:56PM
Amount Paid
Item Total:
6.00
4.00
20.00
15.00
10.00
3.15
4.50
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65