HomeMy WebLinkAboutPermit Mechanical 2000-9-29
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Job# 00-01471-01
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Page 1 of 2
TRANS~:01-0003338
DATE:SEP ~9 ~OOO
AMT RECD:1 $ 40.00
CHANGE:$ 13.50
CASHIER: 059
RESIDENTIAL PERMIT
City Of Springfield
Commumty Services DIvIsion
BUilding Safety
Job Number 00-01471-01
225 North Fifth Street
Spnngfleld, OR 97477
Office 726-3759
Inspection Line 726-3769
Location Of Proposed Site 3636 Cherokee Dr Spr
Assessors Map# 18020612
Lot Block Addition
Tax Lot# 01200
SubdivIsion
Owner
Address
Aaron POisson
Phone Number 541-736-1254
3636 Cherokee dr
City/State/Zip
New
Springfield, OR 97478
Value $1,600
Scope Of Work Mechanical
Pellet Insert
Office Use
Land Use # Of BUlldmgs
Zomng Code Occupancy Group
,(\\)\
Bedrooms (\Ul1e'" l'leat\Source
e..... Q..UU1.)
Range "c', 3"' O\egO;,o.~otage
\oa~ J.ne ~oS"'a....J.
,v' . Oleo u,' ~\}Ie,:> c;. 95'2.-\)"
To request an Inspection call the 24 hour recordlng'a:t'i2~\a'76'g\~l\IIIf1sjl~~tIRlil:n~reSY1t:l:b"e'fore 7 00
a m Will be made the same working day, IrlspectIQDl~~g1l3l'teal)liffS'\l\('jO~~~:.Wlfiit\W~\tSIeahe follOWing
working day -.J..O\I\IC'O. 95'l:r;;:/;)'t- 0'O\'<l.\(l CO ~e \\'Ie \e\~\\\C'<l.\\O(l
,,,Op..\:\JC\\I(l\'<l.'1 ^~,\ ~~O .",I\\IJ~O,
Reqlul~ tnsoeEtlfin enup " '>'~"~'
dU ",\1\ ^O'll\ . - " ,\r,,>-'
I Mecn~;'lciU\\'\~.: ,.1" (,-
Preliminary Inspection - Pnor to the Installation of sbiiH'(uel'apPliance which Will be vented through an eXisting chimney
Pellet Insert - After Installation
Quad Area
# Of Umts
Constr Type
Water Heater
Construction Types
Occupancy Groups
# Of BUildings
# Of Bedrooms
Handicap Access? D
iArea (Sq Feet)
I Main Accessory
INOt'>\Z
c 11'"\r\t. 0\
# Of Stories O~\Ct:. Hel9.tlt\(f~el}E-t'>I'J\\"\\5~
Current Umts~ 5 ~t.t'>I'J\\"\ 5;~U&oSel:P5n\~~o 1'0t'>
Census Code "ill,'es nobfflJPiYJ~ \5 p..S/'.~DO
.' rn-lUP ""DOt'>
r~ ~~C~ D
Total COWl (\ \)/'.'/ ~t.t'>\O
IH"'\
Fee
PaId On Recelpt#
Mechamcal
09/29/2000 3338
09/29/2000 3338
09/29/2000 3338
09/29/2000 3338
Value/Quantity
Fee Amount
MInimum Mechanical Permit
Mechanical Administrative Fee
Pellet Insert
Mechanical Issuance
1,600
$ 00
$ 45
$1500
$10 00
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Job# 00-01471-01
Page 2 of 2
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Fee
Paid On Rece.pt#
Mechamcal
09/29/2000 3338
Value/Quantity
Fee Amount
State Surcharge For Mechanical Permit
Total Mechanical
$105
$26 50
$26 50
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
reques at the properJ'?::~:the project address IS readable from the street
UCrv-/~v~ J- Z.Y-- 00
Signature
Date