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HomeMy WebLinkAboutPermit Mechanical 2005-2-7 ~WIr~'~l;~Cfi'~JIt;!t ,I -- - ---:'1"~'" -t. "S-J:~~,.r',"''''~=,"~-s''';'':' Status Issued 225 Fifth Street, Springfield, OR , 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00150 ISSUED: 02/07/2005 APPLIED: 02/07/2005 EXPIRES: 08/07/2005 VALUE: SITE ADDRESS: 400 BROADWAY ASSESSOR'S PARCEL NO.: 1703263404700 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: Repair PROJECT DESCRIPTION: Repair gas line damage. NW Natural making repairs to service. Owner: DOUGLAS NELSON Address: 400 BROADWAY ST SPRINGFIELD OR 97477 Contractor Type Contractor # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Setback: Side 1 Setback: Side 2 Setback: , Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction Residential Phone Number: 541- I CONTRACTOR INFORMATION. '*:.ticense Expiration Date Phone R-3 BUILDING INFORMATION I #JblsWi{;~ON: Oregon law requires you t~' . IfIei~ o~~~Jt~ted by the OregOn"~fdl~~ Floor: ~~a.P'enter. Those rules are 5el t..:J.nd Floor: .,...t:\Ao.Qt;9...J)01 -001 0 through OAR 1~tIVT. t. I1l\areP~;V h semen . ~e ~ fllay obtain copies of t e 11.tW:.rage/carport Eruw~~ft center. (Note:.~he tel~. ~'-Other: sN,inWbat lbdtiJlia3)regon Utibw Notif ~nt Load: €,;.~-I.:riE 1..aO>>I;l?_'.>~,\- I DEVELOPMENT INFORMATION. VN REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I NOT'CE: Sidewp~~lrFTHE WORK 1HIS PERMll SHAtno~~~o~~ro~&f5 N01 ~~~~r~~~OU~~~:;BANOONEOtOR ANY 180 DAY PERIOD. I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 __~,~~'"~~~1~~7,,,.. ,.,~",,~, x ~ ~.. Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00150 ISSUED: 02/07/2005 APPLIED: 02/07/2005 EXPIRES: 08/07/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax ,541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Gas Outlets 1-4 Minimum/Adjustment Mechanical Amount Paid Date Paid Receipt Number $10.00 $4.50 $3.15 $4.00 $41.00 2/7/05 2/7/05 2/7/05 2/7/05 2/7/05 1200500000000000161 1200500000000000161 1200500000000000161 1200500000000000161 1200500000000000161 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. LReouired Insoections I 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. ' 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 times during construction. JJ l~ J?1n ~ \ Owner or Contractors Signature Q ~?~ aeJ" Date Pa2e 2 of2 225. Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt elopment Services Department Public Works Department Job/Journal Number COM2005-00150 COM2005-00 150 COM2005-00 150 COM2005-00150 COM2005-00 150 Payments: Type of Payment Cash 2/7/2005 RECEIPT #: 1200500000000000161 Date: 02/07/2005 Description + 7% State Surcharge + 10% Administrative Fee Gas Outlets 1-4 Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Paid By DOUGLAS NELSON Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person Payment Total: Page 1 of 1 9:05:09AM Amount Due 3.15 4.50 4.00 41.00 10.00 $62.65 Amount Paid $62.65 $62.65