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HomeMy WebLinkAboutPermit Mechanical 2000-12-13 .. c_ Job# 00-01783-01 . Page 1 of 2 TRANS#:01-0004022 DATE:DEC 13 2000 AMT RECD:2$ 26.50 CHANGE: CASHIER: 061 RESIDENTIAL PERMIT , City Of Springfield Community Services Division Building Safety Job Number: 00-01783-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 ,Inspection Line: 726~3769 location Of Proposed Site: 2099 Bonnie Ln Spr . , Assessors Map#: 17032512 lot: Blo~k: Addition: Tax lot #: 10600 Subdivision: Owner: Address: Gilbert Hoag 2099 Bonnie Lane, Phone Number: 541-741-3789 City/State/Zip: Springfield, OR 97477 New Value: $0 Scope Of Work: Mechanical pellet stove Contractor Type Mechanical Contr Contractor Claxtons 215 E. 38th Ave, Eugene, OR 97405 Registration # Expiration Date Phone 541-484-9583 Office Use land Use: # Of Buildings: Zoning Code: , Occupancy Group: Bedrooms: Heat Source: Range: Sq. Footage: " , , AIT!;NTION'Oregon law reg UI res you to To request an inspection call the 24 hour recording at 726-3769. All inspectio~ns IregUesteHc6Refo~elJ,.::0.oegOn Utility' . h k' d" d f 7 p"o::..1I0lA1 r" t'~ Hllllp _IJ 'JII 'f' ,,", I, a.m. will be made t e same wor 109 ay, inspections requeste a ter :1!J1!J''a.m..wrll'CDe ma e.J.I'ie ollOwlngresetforth k' d " ' , Notification 'emer. I I lose IUlt:>:> '" . wor 109 ay, in OAR 952-001-001 0 through OAR 952-001- R . d I t' , . - '.A_'_ -~~:~~ ^~ +ho rllloc:: h\l equl.re nspeclons(JU~U.lUI.lIIlc;4YV""''''''''v-I''''-,;--'' , . Mechanical I calling the center. (Notue: .II~e tNelet.Pf.hOt~oen numberfortheOragofl tllty 0 Ilca I , , C,:mteris i-eDJ-332.~344). Quad Area: # Of Units: Constr; Type: Water Heater: Freestanding Pelle..t I ~After installation. t,:~.:'t"";"~: ,~-... Construction Types: Occupa'ncy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 ~Area, (Sq. Feet) Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Total: Height (feet): Prol2osed Units:---~- - -_. NOT'CE: . THIS PERMIT SHALL EXPIREIFTHEWOR'i( . AUTHORIZED UNDER THIS PERMIT 'IS NOT ----- " I ~I UI.H1\n'-~lf .~. " ILl 1'-0.: 1\i0oi:1\1\1111 11\11-115-1 I..... Fee' Paid On Receipt#.l\!V 1 RnValuelQuantilty oM. I JJ.l Y ..--r-rin II Mechanical 12/13/2000 4022 Fee Amount Minimum Mechanical Permit $.00 Fee Job# 00-01783-01 Paid On Receipt# Mechanical 12/13/2000 4022 12/13/2000 4022 12/13/2000 4022 12/13/2000 4022 Page 2 of 2 Value/Quantity Fee Amount Administrative Fee - Mechanical Freestanding Pellet Stove Mechanical Issuance State Surcharge - Mechanical Total Mechanical Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper tie and that the project address is readable from the street. A/;,{';- IJ) /\ rJrU- ' , /z-/?- ~ccl Signature .f1 Date 1,350 $.45 $15.00 $10.00 $1.05 $26.50 $26.50