HomeMy WebLinkAboutPermit Mechanical 2004-4-29
. Ll1:f OJ< ~rRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00502
ISSUED: 04/2912004
APPLIED: 04/29/2004
EXPIRES: 10/29/2004
VALUE:
e
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3530 GAME FARM RD SPACE-2 Springfield TYPE OF WORK: Heating System
ASSESSOR'S PARCEL NO.: 1703154003100
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd: to
J W,reaulres yoU
ATTENTION: Or~lIt'~ffitfer~I'iUtllity
tallow ru\es_ adO?:e~~<>A roles are set tort.!'
~otitic~~~~.w!IOOroIMPR6V9irni~Hr~~V
In OA OD'taII1 ",",~'y_ ~
0090. You may (Note: the telep~e Sidewalk Type:
calling the cen~'egon Utility NotificatIOn DownspoutsIDralns:
number tor thels 1r -800-332-23'\4).
Center
TYPE OF USE:
PROJECT DESCRIPTION: Replace furnace add heat pump
Owner: WILLIAM SKOOG
Address: 3530 GAME FARM RD 29 SPRINGFIELD OR 97477
Contractor Type
Mechanical
I CONTRACTOR INFORMATION I
Contractor License
ASSOCIATED HEATING & AIR CONDITIO 106275
I BUILDING INFORMATION I
# of Units: # of Stories:
Primary Occupancy Group: R-3 Heigh~l lructure
Secondary,Occupancy Group: X ~'l; ~:
Primary Construction !y'p.e ~'t.l.~\\\'t. ~ ~~e e:
Secondary Const.rRG.t1~IU~P~~~ S\\t>-\.: ,\\\S \It.~'.;~pe:
# of Bedrooms: l'~\S \It.\\WI\ \\~()'C.\\ :ot>-~()()~\1rgy Path:
, I' I.1Q\\\1.t: ,,\\ \S ~
~\\,<, -1\r~\I. v _:"0
c,QWI~~~~ Ur>.'l yt."I- I DEVELOPMENT INFORMATION I
SETBACK~~'l .
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Total Value of Project
Paee 1 of2
New
Residential
Phone Number: 541-747-4753
Expiration Date
08/3112004
Phone
541-683-2590
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Furnace - up to 100,000 btu
Heat Pump
Minimum/Adjustment Mechanical
Total Amount Paid
e
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00S02
ISSUED: 04/29/2004
APPLIED: 04/29/2004
EXPIRES: 10/29/2004
VALUE:
~
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$12.00
$12.00
$21.00
4/29/04
4/29/04
4/29/04
4/29/04
4/29/04
4/29/04
2200400000000000443
2200400000000000443
2200400000000000443
2200400000000000443
2200400000000000443
2200400000000000443
$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 Reouired In~nedinn~ I
I Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
By signature, I state and agree, that I have carefully examined tbe 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 during construction.
~12~
Owner or Contractors Signature
---=
'0<;/0'1
Date
;-
Pa!!e 2 of2
225 Fifth Street
Springfiellt, Oregon 97477
541-726-3759 Phone
e
~
WiL,
_ of Springfield Official Receipt
_elopment Services Department
Public Works Department
RECEIPT #:
2200400000000000443
Date: 04/29/2004
lO:23:23AM
Job/Journal Number
COM2004-00502
COM2004-00502
COM2004-00502
COM2004-00502
COM2004-00502
COM2004-00502
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Furnace - up to 100,000 btu
Heat Pump
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Payments:
Type of Payment Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
3.15
4.50
12.00
12.00
21.00
10.00
$62.65
Amonnt Paid
Check
ASSOCIATED HEATING
djb
11521
In Person
Payment Total:
$62,65
$62.65
4/29/2004
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