HomeMy WebLinkAboutPermit Mechanical 2000-8-4
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Job# 00-01204-01
Page 1 of 2
TRANS#:01-0002819
DATE:AUG 04 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 059
225 North Fifth Street
Springfield, OR 97477
I
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01204-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 2782 Burlington Ave Spr
Assessors Map#: 17032441
Lot: Block: Addition:
Owner:
Address:
Tax Lot #: 03019
Subdivision:
Reta Gilman
2782 Burlington Ave
Phone Number: 541-746-4874
City/State/Zip: Springfield, OR 97477
Alteration Value: $0
Scope Of Work: Mechanical
Heat Pump
Contractor Type
Mechanical Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Contra~tq'El\lT\UI'l,V,1 C::;'v" ;CLJ\' <;;;'1",1It;~ Y~~-.Jtstration #
, tintlDh~ 91'egon Ulfi\1)
Amerid:e~~~~aRre 0 i~ermes are slj\(feftl
618 ~1~'~_~~~1 ghOAR 952-001-
97 4 77\-QA~ 9 . bta"n copies of the rules by
nnn? "nIl m~\I 0 _
:J__ t (N.~.t~~~,,,tJl,v,\,,,
callingthecen e1'. OHljfiti'tY'i'10tril~liult
numbe~~~~~~~~a:~'''l~'?'M4'.
Zoning Code:
Bedrooms:
Range:
Expiration Date Phone
1 0/31/00 541-954-4686
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
c
~~
';l~ii$''''';''''' ",
To request an inspection call the 24 hour recording at 726-3769, All inspections 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
working day.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
-Area (Sq. Feet)
Main: Accessory:
Rough Gas
Rough Mechanical
Gas Service
Final Gas
Final Mechanical
Required Inspections
I _ _i~~hanical I
- NO I: XPIREIFTHEWORK
- Prior to cover. THIS PERMIT SHALL E MIT IS NOl
-After line is instal~~PlI1!EUEkn~'SiJlf\ddi\'Refcfe~ to~nimum of one appliance. Pressure tel
- When all gas worK IS. MH~~~~ OR IS ABANDONED
- When all mecharti(QIWoT1< is com~~ .
ANY 180 DAY t"'t:' .
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
"
Job# 00-01204-01
Fee
Paid On Receipt#
Mechanical
08/07/2000 2819
08/07/2000 2819
08/07/2000 2819
08/07/2000 2819
08/07/2000 2819
08/07/2000 2819
, I
One to Four Outlets
Minimum Mechanical Permit
Mechanical Administrative Fee
Gas Fireplace
. Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
Grand Total
Page 2 of 2
Value/Quantity
Fee Amount
1
$2.00
$8.50
$.45
$4.50
$10.00
$1.05
$26.50
$26.50
1
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 a~e proper time and that the project address is readable from the stree~. .
/1tJiL#. . .
Signature
./
8-7.~
Date