HomeMy WebLinkAboutPermit Mechanical 2004-1-28
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. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-6tmt1
ISSUED: 01/28/2004 (;j;) \ \ q
APPLIED: 01/28/2004
EXPIRES: 07/28/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 5660 DAISY ST 14
ASSESSOR'S PARCEL NO.: 1702334401427
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Add heat pump
Owner: CHRIS SELIN
Address: 5660 DAISY ST #14 SPRINGFIELD OR 97478
Phone Number: 541-746-5758
Contractor Type
Mechanical
I CONTRACTOR INFORMATION.
Contractor License
CHITTIM ENTERPRISES I INC 47396
I BUILDING INFORMATION I
Expiration Date
03/08/2005
Phone
541-461-2101
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
# of Stories: Lot Size:
R-3 Height of Structure 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:
ImpervioQs Surface Area:
;0 \,n' 1 to
I DEVELOPMENT INFORMAT~QJlOt\j\J (eq~;g~n U\\\\W \
.....re.~1~\...a. ~0d tl'1 \t\~ 0 9 ai~ SatE@)1!IRED PARKING
j)\\ \ & adO'P $\9 fU\0 S<<;2..oo
Over~&\9jstifu\e e~~{ .1nO u n O~~ --rPA~:t
# St~e6h",~~(l(qfr:ni\.~O'\otn'l'O .~s 01 \~ta fi!hnwcapped:
Pave~-er~l\ :siiaAi'\';' \ 01o\&\n'009\ , \nce \e\$9~g~ll1lft:
f\ " U f(\&.'1 {",otiS. l.\..\ ~\ncat\O
% Of~~Qovaa~t\Ta ~n\(9{, \,)\\\\\'1 ''<;10
ca\\\09 ''''8 Of~on ~~2..2.344).
hPr \01' \\' . _ '" ~p'Orb""
.1''''''''''' - - _"l'1 '
I PUBLIC IMPROVEMENTS'
Frontyard Setback:
Side 1 Setback:
Side 2 S,etback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available: '
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
N01\CE: XP\RE \f 1HE WORK
1H\S PERM\l SH~~~ \H\S PERM\\ \5 NOT
AU1HOR\Z~O U~~ \~ ~R~NOONEO fOR
\',OMV,,\';I'I:.fO to' 0
I Valuation DewiL\fiarDt~ PER\O .
Notes:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 of 2
,
::
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
Heat Pump
Minimuml Adjustment Mechanical
Total Amount Paid
.
Amount Paid
$10.00
$4.50
$3.15
$12.00
$33.00
$62.65
I FeeL~ahiLI
I Plan Reviews,
Date Paid
1/28/04
1/28/04
1/28/04
1/28/04
1/28/04
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-t&tltr'
ISSUED: 01128/2004 roVvC-t
APPLIED: 01128/2004, .
EXPIRES: 07/28/2004
VALUE:
Receipt Number
1200400000000000126 .
1200400000000000126
1200400000000000126
1200400000000000126
1200400000000000126
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 Reqpired In~llections-1
1 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 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 d is located at the front of the property, and the approved set of plans will remain on the site at all
times during const tion.
Owne
-
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Paee 2 of 2
//f~y
/
Date
,
"
,
225 Fi.{th Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department:,
Public Works Department.
Receipt #: 1200400000000000126
Date: 01/28/2004
I
2:40:14PM ·
Amount Paid
3.15
4.50
12.00
33.00
10.00
$62.65
Job/Journal Number
COM2004-00120
COM2004-00 120
COM2004-00120
COM2004-00 120
COM2004-00120
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Heat Pump .
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Item Total:
Payments:
Type of Payment
Check
. Paid By
JAMES HEATING
Received By
djb
Check Number
Batch Number
Authorization Number
How Received
In Person
Payment Total:
Amount Paid
687
$62.65
$62.65
.
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