Loading...
HomeMy WebLinkAboutPermit Mechanical 2000-9-5 ;, & . 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