HomeMy WebLinkAboutPermit Mechanical 2000-9-5
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Job# 00-01349-01
Page 1 of 2
TRANS#:01-0003123
DATE:SEF' 05 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 061
225 North Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01349-01
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 210 W Centennial Blvd Spr
Assessors Map#: 17032744
lot: Block: Addition:
Owner:
Address:
Tax lot #: 06300
Subdivision:
Mark Mcgee
210 W Centennial Blvd
Phone Number: 541-747-0999
City/State/Zip: Springfield, OR 97477
New Value: $0
Scope Of Work: Mechanical
install furnace and ac
NOTICE:
To request an ,inspection call the 24 hour recording at 726-3769, All i~~~5mN1~~B~~b~~fc,I~5r~~oHEWORK
a.m. will be made the same working day, inspections requested after ~Offa100~Hl[lllelD<tia'a8melfulft5Wi~~TIS NOT
working day. COMMENCED OR IS ABANDONED FOR
Required InspectionsAiJY ~00 DA'( rCnIOD.
Mechanical
Contractor Type
Mechanical Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Rough Gas
Rough Mechanical
Gas Service
Final Gas
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq, Feet)
Main:
Contractor Registration # Expiration Date
Phoenix Mechanical
210 W Centennial Blvd, Springfield, OR
97477,
Phone
541-747-4970
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
- 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. TTENTIO'...' q e' lOt.,
W II . I . I AI I 1,,:uregcl av- ~ ",.1 ..:. -
- hen a mechanlca work IS comp ete. followrulesadoptedbytheOregonUtiih.
Notification Center. Those rules are set for
in OAR 952-001-001 0 through OAR 952-00'
D090.You may obtain copies of the rules t
calling the center. (Note: the telephone
# Of Stories: num~~t~Qf.~on Utility Notificatior,
C t U 't P inM[lS ~ -Rnn-~~?-2344).
urren m s: r O'S'ea-units:
Census Code: Doe~ not apply,
Accessory:
Total:
..
Fee
Job# 00-01349-01
Paid On Receipt#
Mechanical
09/06/2000 3123
09/06/2000 3123
09/06/2000 3123
09/06/2000 .3123
09/06/2000 3123
Page 2 of 2
Value/Quantity
Fee Amount
Minimum Mechanical Permit
Mechanical Administrative Fee
Less than 100,000 BTU
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
Grand Total
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 proi/Ar ~ 11~ :nd that the project address is readable from the street.
lfUP~ f -t- )-fJri)
Signature - ~ Date
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$26.50