HomeMy WebLinkAboutPermit Mechanical 2001-10-15
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SPRINQFIELD
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Job# 01-01128-01
Page 1 of 2
TRA~IS~: 01-0006980
. DATE:~~T 15 :001
A(~T REeD - 2 $ 61 75
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CASHIEf\:061
225 North Fifth Street
Springfield, OR 97477
, ...
RESIDENTIAL PERMIT
City Of Springfield
Commumty Services DIvIsion
Building Safety
Job Number 01-01128-01
Office 726-3759
Inspection Line 726-3769
Location Of Proposed Site 1433 Cheek St Spr
Assessors Map# 17032433
Lot Block Addition
Owner
Address
Tax Lot# 00110
SubdivIsion
Jerry Klym
1433 Cheek Street
Phone Number 541-747-4498
City/State/Zip Springfield, OR 97477
New Value $0
Scope Of Work Mechanical
Contractor Type
Mechanical Contr
Quad Area
# Of Umts
Constr Type
Water Heater
Install gas furnace, ac and duct work
Contractor
Andys HTG & AC
220 Ruby Av, Eugene, OR 97404
Registration # Expiration Date
Phone
541-461-1282
Office Use
Land Use
Zomng Code
Bedrooms
Range
# Of BUildings
OccupancYOGr\<:!up
~ \l\l 'W"
Heat ~~urce ,
0\1::.1- I' e' \ \
_....l'';:'- \\.t."''r~q '-',oo~age'
....Il~ _ n\:-I1'"\\\!\
.." ,\-\\01 - ,- ,.-.
To request an inspection call the 24 hour recording at 726-3769 Alllnspe..ct;o~~\~~~,'~!?tE"d before 7 00
a m Will be made the same working day, inspections requested after 7 00 a m\'W~Hie made the follOWing
, ;UI\
working day ", '''''I')\)
"'v'J -.1\=S
., ,
ReqUired Inspections
M~I -
Mechamcal
Construction Types
Occupancy Groups
# Of BUildings
# Of Bedrooms
Handicap Access? D
I" Area (Sq Feet)
I Main Accessory
Rough Gas
Rough Mechamcal
Gas Service
Final Gas
Final Mechamcal
- ~W
- Prior to cover leo.Ulles ~ \.l\III\'/
-After line IS Installed and line has been connected to 'Omlnlmlirt\of one'1fP.Pilance<\.\"pressure te'
-When all gas work IS complete ~-\"\o~ \V~eo'o'/t '~ulaSa\6 ;;2-00\-
- When all mechanical work IS complete P-"\I€ luleS aO~~1 ,,,ose u9" Op-f'< luteS '0'/
\0110'/>1 \10(\ Ce(\ 00,0\"10 ,eS 01 \"a no(\e
~O\lllca n<:,2-00' - ",\al(\ call \"e \elell, callO(\
Op-f'< <> '/ au I~o\e ~Oll 1
1(\ '(au (lIa a(\tel \ \.l\III\'/3M)
0090 \11(\9 \"e c"e 0Ie90(\0..':,':;2-2
ca '-el\OI\ s,-BO
~l' \,0.('\
(\\ffelgh1,(feet)
Proposed Umts
# Of Stories
Current Umts
Census Code Does not apply
Total
,
Job# 01-01128-01
Paid On Recelpt#
Mechamcal
10/15/2001 6980
10/15/2001 6980
10/15/2001 6980
10/15/2001 6980
10/15/2001 6980
10/15/2001 6980
Page 2 of 2
Fee
Value/Quantity
Fee Amount
I
One to Four Outlets
MInimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechamcal
1
$400
$29 00
$360
$1200
$10 00
$315
$61 75
$6175
1
Grand Total
By signature, I state and agree that I have carefully examined the completed appilcatlon 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 /e ~P71 time and that the project address IS readable from the street
/Ii-,~ 0(;7/ ~()/
Date
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