HomeMy WebLinkAboutPermit Mechanical 2001-7-3
,.
.
I Job# 01-00675-01 I
.
Page 1 of 2
TRANS#:Ol-0006050
DATE:JUL 03 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00675-01
225 North Fifth Street
Springfield,OR.97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1163 Custom Way Spr
Assessors Map#: 17032634
Lot: Block: Addition:
Tax Lot #: 07500
Subdivision:
Owner:
Betty Hockley
1163 Custom Way
Phone Number:
Address:
Scope Of Work: Mechanical
City/State/Zip: Springfield. OR 97477
New Value: $0
Install gas fireplace insert
Contractor Type
Mechanical Contr
Contractor
Midgleys
1678 W 7th Ave, Eugene, OR 97402
Registration # Expiration Date
Phone
541-343-1131
'(",.,_.. ".
\," l~'(, ',,~ :-.i.~A''-'_ , ." _
~. . ", " , I,." I :.~~...., .~~~
.... ,""''''.... ~ . # Of B 'Id' " ". .
~"*!,~,:.~;.-,.~.;.~ \. ..:' 'j,', ,', -';; _ ul,_lng.~:.~~
f~~.~k':,;;r<. c',). :Oce.~'p~ncy"G[oujJT::m.;
f~ - ^, '. '. . " ,'.. '-. ". .,'"
.t.~'-,II'\" .~'-""H S .' ( ..*v
. ." "0 , '," '0,-, ., eat.. ource'.. ...
. f'.... .' .'. .' 7" ~. ....
.. ~ ,', .:i"_'\.:: - " f'," .. ,;. .' ~ . ~. ~\. ~f1'(\,
.-v...' '. S "F t "''''-''
, ' '. ....-~.: ' q. 00 age;. '; '~ ;.' "",
-...-:....;....-..- ,-.'(,.... ---.......- . .; ,~... ~~
~."~,.'.+ ..~,'.:~,.., ~.. '.. ~.' ",- t..'... :,_ '_,~ ..~".\~
To request an inspection call the 24 hour recording at 726-3769. AII.in.'spections requested before7:0Q. ..:.
a,m. will be made the same working day, inspections requested after 7:00a,m, will be 'made the following'~v
working day. . - "
Office Use
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Land Use:
Zoning Code:
Bedrooms:
Range:
Required Inspections
Mechanical
Rough Gas
Rough Mechanical
Final Gas
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
-Area (Sq. Feet)
Main:
- Prior to cover.
-When all gas work is complete. il",C; :;7.c:~.
-When all mechanical work is complet~'1 \ f--"-='
, I i (. I.l;~ .;\I/lT SHALL E
AlJT!-:On!ZED UNDER :PIRE IF THE WORK
COIVW:::W":D OR IS HIS PERMIT IS NOT
, Vl, ABANDO
NN 1 An rVI Y PFR10l) , NED FOR
Height (feet):
Proposed Units:
# Of Stories:
Current Units:
Census Code: Does not apply
Accessory:
Total:
..
.
Fee
Job# 01-00675-01
Paid On Receipt#
Mechanical
07/03/2001 6050
07/03/2001 6050
07/03/2001 6050
07/03/2001 6050
07/03/2001 6050
07/03/2001 6050
.
Page 2 of 2
Value/Quantity Fee Amount
I
~/
One to Four Outlets
Minimum Mechanical Permit
Administrative Fee - Mechanical
Gas Fireplace
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 used on this project. I further agree to ensure that all required inspections are
reque~~~ that the project address is readable from the street. 7/J /0 I
, .
Signature Date .
1
$2.00
$8,50
$.45
$4.50
$10.00
$1,05
$26.50
$26.50
1