HomeMy WebLinkAboutPermit Building 2000-3-21
\...' ".'
Job# 00-00436-011
.f "v
Page 1 of 2
TRANS#:Ol-0000996
DATE:MAR 21 2000
AMT RECD:1 $ 50.00
CHANGE:$ 7.00
CASHIER:059
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00436-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
I
Inspection Line: 726-3769
Location Of Proposed Site: 2575 CASTLE Dr Spr
Assessors Map#: 17032333
Lot: Block: Addition:
Tax Lot #: 05000
Subdivision:
Owner: NICK SIECINCKI Phone Num'ber: 541-726-5458
Address: 2575 CASTLE DR ,. f~\j;~:~~:~~M&b5prm~f5~h~fjd;:g~a~hTib, OR'97477
Scope Of Work: Miscellaneous l\!otlflcatr<Mt€n.al!il:18r. Those rules are~PfOrth$O .
~n OAR 952~001-001 0 through OAR 952-001,-
NEW GAS APPLIANCES w~&~~l~~~b~rl~~~~~~~~rse;:~~~ by
nom2~r~~~th~ Ore(]on Utility Notification
t.t?ntsr rs "1-Rnn-~~?-2344)
Land Use: "- --," # Of Buildings:
Zoning Code':" 'H ; ',. Occupancy Group:
Bedrooms: Heat Source:
Range: Sq. Footage:
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
To request an inspection call the 24 hourrecolQ1qg,..~b716-3769. All inspections requested before 7:00
a.m. willbe made the same working day, inspe~\iOM\fi6E1~ested after 7:00 a.m. will be made the following
working day. THI~~IiE_RMIT~HAbl~XPIR~IFTH~WORK
^~Ef~FIJI~~lHi;; t=t:Hivi'll It; NUT
le()MM~rKbi~ ISABANDONEO FOR
Final Plumbing - When. all plumbingf\J)6rn8fsta~M~~~Og,
Mechanical
Rough Gas
Rough Mechanical
Gas Service
Final Gas
Final Mechanical
"Prior to cover.
-After line is installed and line has been connected to a minimum of one appliance. Pressure te~
- When all gas work is complete.
- When all mechanical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
, Total:
. Job# 00-00436-01 Page 2 of 2
v Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
Minimum Plumbing Permit Fee 03/21/2000 996 $.00
State Surcharge For Plumbing Permit 03/21/2000 996 $1.05
Miscellaneous Plumbing 03/21/2000 996 15 $15.00
Plumbing Administrative Fee 03/21/2000 996 $.45
Total Plumbing $16.50
Mechanical
One to Four Outlets 03/21/2000 996 1 $2.00
Minimum Mechanical Permit 03/21/2000 996 $2.50
Mechanical Administrative Fee 03/21/2000 996 $.45
Less than 100,000 BTU 03/21/2000 996 1 $6.00
ApplianceVent (Not Covered in SchedulE 03/21/2000 996 1 $4.50
Mechariicallssuance 03/21/2000 996 $10.00
State'Surcharge For Mechanical Permit 03/21/2000 996 $1.05
Total Mechanical $26.50
Grand Total $43.00
By signature, I state and agree thatl 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, that the project address is readable from the street, that the permit card
is located at the fro f the property, arnd e approved set of plans will remain on the site at all times'
during constru 10..... , '. ' 2 ( 00
' .", "5-
~ ~
, ,
Date