HomeMy WebLinkAboutPermit Mechanical 2003-3-19
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. CITY OF SPRING~lELD
Building/Combination Permit
PERMIT NO: COM2003-00190
ISSUED: 03/19/2003
APPLIED: 03/19/2003
EXPIRES: 09/19/2003
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4343 DAISY ST
ASSESSOR'S PARCEL NO.: 1702323406100
Springfield TYPE OF
Heating System
TYPE OF USE:
PROJECT DESCRIPTION: Install gas furnace ans associated piping and ductwork
New
Residential
Owner: GWALTNEY LAUNA RAE & ERIC MATIHEW
Address: 4343 DAISY ST SPRINGFIELD OR 97478
Contractor Type
Mechanical
Owner
I CONTRACIOR INFORMATION.
Contractor License
COMMERCIAL AIR INC 110075
GWALTNEY LAUNA RAE & ERIC MATTHE\
BUILDING INFORMATION.
Expiration Date
12/18/2005
Phone
541-461-4821
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Yrimary Construction Type
Secondary Construction
# of Bedrooms:
# of Stories: Lot Size:
Height of Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
VN Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Impervious Surface Area:
,
I DEVELOPMENT INFORMATION . ~~~~'\
~ '\~~ {-;, ~ REQUIRED PARKING
Overlay Dist: ~~~ ~~~ ~rv~ Total:
# Street Trees \, ~~,~~ ~ r:::,~~~ Handicapped:
Paved Drive ~~\] ~ ,\'\' ~~~ ?~~p~~r '
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SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
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Valuation Description ~ ~~~~>.~' :;;J?;
Description
Type of Construction
$ Per Sq Ft
Square Footaee
Value
Date Calculated
1 of 2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00190
ISSUED: 03/19/2003
APPLIED: 03/19/2003
EXPIRES: 09/19/2003
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
I Fees Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Appliance Vent
Furnace - up to 100,000 btu
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Amount Paid Date Receipt Number
$10.00 3/19/03 1200200000000000854
$4.50 3/19/03 1200200000000000854
$3.15 3/19/03 1200200000000000854
$6.00 3/19/03 1200200000000000854
$12.00 3/19/03 1200200000000000854
$4.00 3/19/03 1200200000000000854
$23.00 3/19/03 1200200000000000854
Total Amount
$62.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work
day.
I Required Inspections I
1 Undertloor Mechanical. Prior to insulation or decking and including required testing.
2 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
3 Rough Mechanical: Prior to Cover
4 Final Mechanical: When all mechanical work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon 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 pertaining to the work described
herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division,
Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be
used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from
the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site
at all times d . con ct'.
:5 -(7 -CJ J"
Date
2 of 2
.9JNGF.JEI'~,__
3/19/2003
I
I
1 :24:28pM
(
.
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield
Development Services Depa.. l...ent
Public Works Department
Official Receipt
Receipt #: 1200200000000000854
Date: 03/19/2003
.
Amount Paid
12.00
6.00
4.00
23.00
10.00
3.15
4.50
Line Item Total: $62.65 .
Line Items:
Job/Journal Number
Description
COM2003-00190
COM2003-00 190
COM2003-00190
COM2003-00190
COM2003-00 190
COM2003-00 190
COM2003-00190
Furnace - up to 100,000 btu
Appliance Vent
Gas Outlets 1-4
Minimwn/ Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment
Paid By
Received By
Check Number Confirm No
How Received
Amount Paid
Payment Total:
62.65
$62.65
Check
COMMERCIAL AIR INC
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In Person
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