HomeMy WebLinkAboutPermit Mechanical 2000-11-27
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I Job# 00-01723-01 I
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RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
TRANS#:01-0003873
DATE:NDV 27 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 059
CITY OF SPRINGFIELD, OREGON
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Job Number: 00-01723-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Ins,pection Line: 726-3769
Wood Stove
Tax Lot #: 02000
Additio~~ , Subdivision:
vVI{.Y"i':
P..hone,Niilmber: 541-726-9441
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-1CI~/State/Zlp: Eugene, OR 97403
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,/)1 f'I.te~~!i9n"r~p ~.(( Value: $860
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Uu/, ".'fjA. ~..<'l-~ 7,~"",
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~fy/Q 46'-4~ ~$~ '7t~/Ih
Office Use ~ ' ~OIW'-~/i-/8 Ol;>.r-
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Quad Area: ,LanCl,Use: # 0tBuildiligs:
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# Of Units: , I Zoning Code: Occupancy Group:
'1 ~, . ,",.... "'"
Constr. Type: JL,Bedrooins,: . Heat Source:
, 1)9. 'R' '(,,; "'lff) ~..... S F
Water Heater: ~ '0 aBge: "'U/' '~)/~; , ""'" q. ootage:
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'To req~est an inspection call the ,t~hB<<~~~9S1ai~~fl.7&:~3:7~6~9~(.' ~~~~SP,~9tions ~equested before 7:0~
a.m. ~III be made the same working dayf,ID;>peC!~9.ns~r~9.ueJlJ.e~'~~erc7c;,9P~8'!m. will be made the following
working day. ",,::\-, ';-'1""0 \'l ,.... Or. '/),'0 :)1'", ,Utlll.... #
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Location Of Proposed Site: 1715
Assessors Map#: 17033443
Lot: Block:
Concord Ave Spr
Owner:
Steve Ramseur
Address:
1715 Concord Ave
Scope Of Work: Mechanical
Woodstove
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Mechanical
11/27/2000 3873
11/27/2000 3873
11/27/2000 3873
11/27/2000 3873
Value/Quantity
I '
Fee Amount
Minimum Mechanical Permit
Mechanical Administrative Fee
Woodstove
Mechanical Issuance
860
$.00
$.45
$15.00
$10.00
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4,/r
Fee
State Surcharge For Mechanical Permit
Total Mechanical
Grand Total
Job# 00-01723-01
Paid On Receipt#
Mechanical
11/27/2000 3873
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Page 2 of 2
Value/Quantity Fee Amount
$1.05
$26.50
$26.50
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
requested at the proper time and that the project address is readable from the street.
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Signature
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Date