HomeMy WebLinkAboutPermit Mechanical 2004-1-26
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e CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00106
ISSUED: 01126/2004
APPLIED: 01126/2004
. EXPIRES: 07/26/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4675 DAISY ST
ASSESSOR'S PARCEL NO.: 1702324308101
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
Addition
Residential
PROJECT DESCRIPTION:, Add heat pump and coil
Owner: ROBERTSON CHARLES A TE
Address: 4675 DAISY SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor License
ASSOCIATED HEATING & AIR CONDITIO 106275
BUILDING INFORMATION I
Expiration Date
08/31/2004
Phone
541-683-2590
.
,
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
SETBACKS
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd: .
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Type of Construction
I PUBLIC IMPROVEMENTS I
ATTE~dl:wOalk Type:
II N:~~E)Won law requ
follow JtP.~gsB!~P~MI(ilWs: Ires you to
lotification Cen~er Th y the Oregon Utility
J~~~~952-001-00'1 ~ t~~oeU;u~~A~e9~~~6~
"~;Ji...~~~~~y obtarn copies of the ru/&!'I I
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Jmbe~or the, Oregon Utility Notification
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Square Footage' Value ' Date Calculated
or Bid Amount
Street Improvements:
"
Storm Sewer Available:
Special InstrAbacTrlCE:
Notes: l~~SH6~~~~ 3~~LL EXPIRE IF THE WORK
(,(HH~[bJO""D ..' ER THIS PERMIT I~ NOT
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ANY 180 DAY PERIOD. '4f~I~~\1on Descri tion
Description
$ Per Sq Ft
or multiplier
Total Value of Project
Pae:e 1 of 2
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Miscellaneous Mechanical
Amount Paid
$10.00
$4.50
$3.15
$45.00
Total Amount Paid
$62.65
I Plan Reviews I
Date Paid
1/26/04
1/26/04
1/26/04
1/26/04
e CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00106
ISSUED: 01126/2004
APPLIED: 01126/2004
EXPIRES: 07/26/2004
VALUE:
Receipt Number
1200400000000000109
1200400000000000109
1200400000000000109
1200400000000000109
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 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 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.
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Owner or Contractors Signature
Pae:e 2 of 2
Date
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225 Fifth Street ./
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
.
Development Services Department \
Public Works Depa. t...ent
Date: 01126/2004 1:11:39PM
Amount Paid
45.00
10.00
3.15
. 4.50
$62.65
)'
Receipt #: 1200400000000000109
Job/Journal Number
COM2004-00 1 06
COM2004-00 I 06
COM2004-00106
COM2004-00106
Description
Miscellaneous Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Item Total:
.
Payments:
Type of Payment
Check
Paid By
ASSOCIATED REA T '
Received By
lib
Check Number
Batch Number Authorization Number
11181
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65
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