HomeMy WebLinkAboutPermit Mechanical 2001-2-14 (3) Job#01-00129-01 Page 1 of 2
SPRINGFIELD TRC1
ANS#:01-0004448
9111111L CITY OF SPRINGFIELD, OREGON DATE:FEB 14 2001
,��yy AMT RECD:2 $ 53.00
Ti17� 2 $ 26.50
RESIDENTIAL PERMIT CHANGE:
CASHIER:059
City Of Springfield
Community Services Division Job Number: 01-00129-01
Building Safety
225 North Fifth Street Office: 726-3759
Springfield, OR 97477 Inspection Line: 726-3769
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Location Of Proposed Site: 6769 Bluebell Ct Spr SCANNED
Assessors Map#: 17023444 Tax Lot#: 00806
Lot: Block: Addition: Subdivision:
Owner: Mike and Michelle Campbell Phone Number: - -
Address: 6769 Bluebell Ct City/State/Zip: Springfield, OR 97478
Scope Of Work: Mechanical Alteration ' '+1, v, Value: $0
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Contractor Type Contractor Registration#6 CExpiratidli Sate0/ ^ Phone
Mechanical Contr Comfort Flow Heating Co 460 ��r "' `'6/27/2001 t �j� 541-726-0100
1951 Don St Ste D, Springfield, OR '
97477-1993
Office Use
Quad Area: Land Use: #Of Buildings:
#Of Units: Zoning Code: - Occupancy Group:
Constr.Type: Bedrooms: Heat Source:
Water Heater: Range: 1T'SHALL Exp/RFSq. Footage:
urJUER THI'r orn.
quest._
To request an inspection call the 24 hour recording at 726-3769.:'All inspect ions'requestedi`before 7:00
a.m. will be made the same working day, inspections requested after 7:00aim?will:be`made.ttie following
working day. r'ER100. r"
Required Inspections
Mechanical
Final Mechanical -When all mechanical work is complete.
Construction Types:
Occupancy Groups:
#Of Buildings: #Of Stories: Height(feet):
#Of Bedrooms: Current Units: Proposed Units:
Handicap Access? Census Code:Does not apply
Area (Sq. Feet)
Main: Accessory: Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit 02/14/2001 4448 $9.00
• ` • Job#01-00129-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Administrative Fee-Mechanical 02/14/2001 4448 $.45
3hp-- 100,000 BTU 02/14/2001 4448 1 $6.00
Mechanical Issuance 02/14/2001 4448 $10.00
State Surcharge-Mechanical 02/14/2001 4448 $1.05
Total Mechanical $26.50
Grand Total $26.50
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 time and that the project address is readable from the street.
Signature Date
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