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HomeMy WebLinkAboutPermit Mechanical 2001-7-24 1. . I Job# 01-00780-01 I . Page 1 of2 TRANS#:01-0006235 DATE:JUL 24 2001 AMT RECD:2 $ 26.50 CHANGE: CASHIER:061 / *' SPRINQFIELD ~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00780-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 3538 Gamefarm Rd Spr Assessors Map#: 17031540 Lot: Block: Addition: Tax Lot #: 02700 Subdivision: Owner: Address: Karen Allred 3538 Game Farm Rd Phone Number: 541-746-5585 City/State/Zip: Springfield, OR 97477 New Value: $0 Scope Of Work: Mechanical Install gas insert Office Use Quad Area: Land Use: NOTICE:# Of Buildings: # Of Units: Zoning Code: Occupanw Group: WORK Constr. Type: Bedrooms: THIS PERrv"He~flSbbrc~IHl: ,r THE Water Heater: Range: AUTHORIZSq.tl100t3ge':lIS PERMIT IS NOT _ - --- -....r COMMENCED UH It; flDfll~UV"C"j , u, , To request an inspection call the 24 hour recording at 726-3769. All inspections re~~sted\~fore 7:00 a.m. will be made the same working day, inspections requested after 7:0INIYnl/Will:tl'e m~Ci'elih'e following working day. Required Inspections Mechanical Rough Mechanical Final Mechanical - Prior to cover. - When all mechanical work is complete. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D [Ar~a (Sq. F" , ;)~ _ MaIO: Accessory: # Of Stories: Current Units: Census Code: Does not apply AT:Ei~TIO;\l:Orsgon 13\\/ requires you to fol!ow rules acio,Jted lJy tile Omgon lidlity Noti'j;cation C3nler. T;10S3 rul<::s ar3 sat forth in OA:=l 852-00'1-001 0 throc'gh OAR 952-001- 0090, You may obtain copies of the rules by calling the center. (Nots: the telephone mHe'iglii((fe~f):Oregon Utility Notification r.p.n'~' js,1-800-332-2344), Proposed Umts: " Total: Fee Paid On Receipt# I Mechanical 07/24/2001 6235 07/24/2001 6235 07/24/2001 6235 07/24/2001 6235 07/24/2001 6235 Value/Quantity Fee Amount One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Duct Heater Gas Fireplace 1 $2.00 $8.50 $.45 (, $.00 $4.50 1 (({!j) ,~ . Job# 01-00780-01 Paid On Receipt# Mechanical 07/24/2001 6235 07/24/2001 6235 , Fee Mechanical Issuance State Surcharge - Mechanical Total Mechanical Grand Total . Page 2 of2 Value/Quantity Fee Amount $10.00 $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 ti~e ffd tha)1he project address is readable from the street. ~~t( 0\ (111&~j Signatur, Q !LI.L4.JiJ...~ d-tYJ / /JIate tJ .