HomeMy WebLinkAboutPermit Mechanical 2004-8-11
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Status
Issued
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2004-00995
ISSUED: 08/11/2004
APPLIED: 08/11/2004
EXPIRES: 02/11/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6964 BLUEBELLE WAY
ASSESSOR'S PARCEL NO.: 1702353304601
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install ac
Owner: CHARPENTIER MICHELLE
Address: 6964 BLUEBELLE WAY SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION.
OU \0 .
Contractor u\teS ~ \,)\\\\~ LIcense
MARSHALLS INC _nt\ \a.'l'I t~~te~on _,.", \ot~790
~\O",.. ~ "''"' ~IH':.. - 'l:i. ~ . - "r
~~ tu\eS 3! ~et. tOug \ne tU
# of Units: \O\\~ lOt' cat' ..00'\0 ~}\S~Rf\!(!SP\ ~e?no,:e n
Primary Occupancy Group: ~O-U'\\C~rz...o()'\ o'O\B@igf?r;.~.~tf.b~g~<<\ca\\O
Secondary Occupancy Group: \t' O~ ""aU 1t\a.'f n\~yp.~f,-nt\\\'t'4 A~.
Primary Construction Type 009\JV!(' \~ Ce ~@~9f~~cc-'2.':)A
Secondary Construction Type: r:;).W(\~ ~ \ot \'(\e ,il\D~llfype: .
# of Bedrooms:' t\ut"'08 ce(\\et ~nergy Path:
Sprinkled Building:
Contractor Type
Mechanical
Expiration Date
12/23/2005
Phone
541-747-7445
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION.
Front yard Setback: I
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
- · t\('\""
I PUBLIC IMPROVEMENTS I "j..~\'i\t. \~ ~~ 'CO ~O\
\\t)~\C~~~\,\ S\\~t~~~~\\) ~O'i\
,\\\\S ~t:~\1.t5.) \j~~~\1\1/Drains:
~\j,\\\~t.~Ct.\) ~t.~\a\).
CaW; '\ CO() \)~'{
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Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 of 2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-00995
ISSUED: 08/11/2004
APPLIED: 08/11/2004
EXPIRES: 02/11/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
l Fees Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$8.00
$37.00
8/11/04
8/11/04
8/11/04
8/11/04
8/11/04
2200400000000001036
. 2200400000000001036
2200400000000001036
2200400000000001036
2200400000000001036
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 Reouired Insoections I
Rough Mechanical: Prior to Cover
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 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 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
~;6U~DU~ f5-/!~O'-l
~~ or Contrac~~g~atu~e Date
Paee 2 of2
225 Fifth Street
~, .
Sprmgfield, Oregon 97477
541-726-3759 Phone
~,fP' of Springfield. Official Receipt
c"i'elopment ServIces Department
Public Works Department
RECEIPT #:
2200400000000001036
Date: 08/11/2004
2:23:42PM
Job/Journal Number
COM2004-00995
COM2004-00995
COM2004-00995
COM2004-00995
COM2004-00995
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Air Handling Unit Up to 10,000
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Payments:
Type of Payment
Check
Paid By
MARSHALS INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 18132 In Person
Payment Total:
Amount Due
3.15
4.50
8.00
37.00
10.00
$62.65
Amount Paid
$62.65
$62.65
8/11/2004
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