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HomeMy WebLinkAboutPermit Mechanical 2001-10-9 ..,'. 10 . Job# 01-01111-01 . Page 1 of2 TRANS#:01-0006943 DATE:OCT 09 2001 AMT RECD:2 $ 61.75 CHANGE: CASHIER:061 SPRINGFIELD ~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-01111-01 225 North Fifth Street Splingfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 2411 Dumas Dr Spr Assessors Map#: 17032344 Lot: Block: Addition: Tax Lot #: 00109 Subdivision: Owner: Joann Keefauver Phone Number: 541-726-0B7B City/State/Zip: Springfield, OR 97477 New Value: $0 Address: 2411 Dumas DI Scope Of Work: Mechanical Replace gas furnace " .("'.f:..,'" Quad Area: # Of Units: Constr, Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: ~ ~'.- "- E 't' D"tXV ~C\ph xplra 10.!;''i. a ~ ~ ~ '" one 8/31/~Q02v o<:.Q.'i.'~ ,\551-683-2590 \\ '(:.. "S" :(..<;) ,>. ,,~,v"'" -<:'(.' ("J""'.... . ,,' .", '. ...0. \ .,<"i ... .,.. v.\~)r ~YO' .- ~J"'\ r-\) ('\'~ \....' .....\..';..... ~,,\ ~ .\., ~"" ~ ,.~,#Of Buildings: \ .'\~,') r :'.... .... .J.;:. . .\\' ~ 0"" G ',~ ",' " ccupancy roup: I ....... \,' ("',...' -'..... o,~, Heat Source: -.. ,', Sq, Footage: Contractor Type Mechanical Contr Contractor Registration # Associated Heating & Air Conditioning Inc 106275 Po Box 412, Eugene, OR 97440 To lequest an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same wO/king day, inspections requested after 7:00 a.m. will be made the following working day. Required Inspections Mechanical Rough Mechanical Final Mechanical - Priol to cover. -When all mechanical wO/k is complete. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D [Ar~a (Sq. Feet) _ MaIO: Accessory: -.- n ,\1..,.' ,(,J~' " \'.J" .' , # Of Stories:, "",,;.. Height(feet); , Current Units: '. ' Propos~d Units: Census Code: Does not a~ply " " .",." (.- Total:-~1 ...:,. \ lL . Job# 01-01111-01 . Page 2 012 Fee Paid On Receipt# r-- Mechanical 10/09/2001 6943 10/09/2001 6943 10/09/2001 6943 10/09/2001 6943 10/09/2001 6943 Value/Quantity Fee Amount One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Mechanical Issuance State Surcharge - Mechanical Total Mechanical Grand Total 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 pro.ect. I further agree to ensure that all required inspections are requeste at the p,r~ and lha he project address is readable from the stleet. . a -'" \ Jo~ q~(!)J . "II - . , Date 1 $4.00 $41.00 $3.60 $10.00 $3.15 $61.75 $61,75