Loading...
HomeMy WebLinkAboutPermit Mechanical 2001-9-17 '. Job# 01-01008-01 Page 1 of 2 TRANS#:01-0006?15 DATE:SEP 17 2001 AMT RECD:2 $ 123.50 CHANGE: CASHIER:003 ~ RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-01008-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 721 City View Blvd Spr Assessors Map#: 17033414 Lot: Block: Addition: Tax Lot #: 04700 Subdivision: Owner: Address: Shirley Chase 721 City View Blvd Phone Number: 541-726-7422 City/State/Zip: Springfield, OR 97477 New Value: $0 Scope Of Work: Mechanical replacing gas furnace Contractor Type Mechanical Contr Contractor Registration # Expiration Date Comfort Flow 1951 Don Street, Springfield, OR 97477 Phone 541-726-0100 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Required Inspections Mechanical \ Rough Mechanical - Prior to cover. , . , Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D [Ar~a (Sq. r ->.t) _ Main: Accessory: # Of Stories: Current Units: Census Code: Does not appiy Height (feet): Proposed Units: Total: Fee Paid On Receipt# Mechanical 09/17/2001 6715 Value/Quantity Fee Amount Minimum Mechanical Permit $33.00 . Fee Job# 01-01008-01 Paid On Receipt# Mechanical 09/17/2001 6715 09/17/2001 6715 09/17/2001 6715 09/1712001 6715 Page 2 of2 Value/Quantity Fee Amount Administrative Fee - Mechanical Less than 100,000 BTU Mechanical Issuance State Surcharge - Mechanical 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/()l;ed on this project. I further agree to ensure that all required inspections are req11rk:\ pr~,;~t~ t;[ct_~ddress is readable from the street. 9//7/ ()) Signature Date 1 $3.60 $12.00 $10.00 $3.15 $61.75 $61.75