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HomeMy WebLinkAboutPermit Mechanical 2001-8-20 " . I Job# 01-00897.01 I . Page 1 of 2 TRANS#:01-0006473 DATE: AUG 20 2001 AMT RECD:2 $ 61.75 CHANGE: CASHIER:061 .---- ~ CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00897-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 223 A St Spr Assessors Map#: 17033532 Lot: Block: Addition: Tax Lot #: 03000 Subdivision: Owner: Springfield Utility Board Address: PO BOX 300 Phone Number: 541-744-3624 .\c',):...~'\ v'" City/State/Zip: SPRINGF.IEt:D~OR 97477 .~,' ~ :\.'- ;\" 0." ,,0 ~e -<'\ ~ ,\ ~0 O<Vl\Il;le: !(,'!$Os '0 '1"" "," ",<1i ,,'0' 0"'" 'S'~ ;:,y. ~. ~\) ~e ,..."~ f,:}\,')\~O ~",...e R"00 ~o~ ..'._ ,',fll ,~o .....'\;~ ~.o ~r>\0 ......v?f. . '''~'~~.'lJ.t).'-J':I'':>,'''' . ~\.\" .....y........ 't<'~ .~O..:.... Contractor -<v Reglstratlon\#,<,'Explratlon~Date / ,v' ,;-....", 1..V' ~v \:,J'c,.' !t-" MarshaUs Heating ',',,'J~\ ',~o~,.,J;;,\j ., 0'0 e~'~ o~ ",,,,'1: \0" 'c7> 0"" 7>'1 <'~ e~ ;::"" 4110 Olympic Street. Springfield, OR d"-' ~ ~ ,;:, <$" <:,13 O~ !Q<:J 97478 \~ 'o'?' -l.o ,,,13 'S'e ,';.... ",(\ .....(). . ^o. . L""'( ",,( '\ Office Use \jv' r'l>~~~?e' (;13\" ~\) New Scope Of Work: Mechanical Replace roof top unit Contractor Type Mechanical Contr Phone 541-747-7445 Rough Mechanical Final Mechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 ,Area (Sq. ;- ~"t) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Total: Fee Job# 01.()0897.()1 Paid On Receipt# Mechanical 08/20/2001 6473 08/20/2001 6473 08/20/2001 6473 08/20/2001 6473 08/20/2001 6473 - Page20f2 Value/Quantity Fee Amount .r .~ Minimum Mechanical Permit Administrative Fee - Mechanical More than 100,000 BTU Mechanical Issuance State Surcharge - Mechanical Total Mechanical 1 $30,00 $3,60 $15,00 $10,00 $3,15 $61.75 $61.75 Grand Total Signature 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 t proper time and that the project address is readable from the street. j flj ~A. PI.)fa----, (// ~ d/rJ/dJ Date