HomeMy WebLinkAboutPermit Mechanical 2001-2-15
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I Job# 01-00136-01 I
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Page 1 of2
TRANS#:Ol-0004459
DATE:FEB 15 2001
ANT REeD:2 $ 26.5D .
CHANGE:
CASHIER: 061
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00136-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 695 Edgemont Way Spr
Assessors Map#: 17033413
Lot: Block: Addition:
Tax Lot #: 06800
Subdivision:
Owner:
Don Vanderpool
1257 Hamilton Street
Phone Number: 541-747-7079
CitylStatelZip: Springfield, OR 97477
New Value: $0
Address:
Scope Of Work: Mechanical
install gas stove
Contractor Type
Mechanical Contr
Contractor
Midgleys
1678 W 7th Ave, Eugene, OR 97402
Registration # Expiration Date
Phone
541-343-1131
Office Use
Quad Area: Land Use: ' # Of Buildings:
# Of Units: 1 Zoning Code: Occupancy Group: Dwelling
Constr. Type: (VN) Wood Frame Bedrooms: ~.._,~"."_^,,,Heat,Sou!ce:":::-~~ '~:>
W t H t R ATT ,', ,~, S F ta Ul''''
a er ea er: ange: .....Il,...:;:~~I;li. .....1.....\1\_'... .~. .(~o_.ge:)n .1:olY,_
o ",'.-t:f:~"lid(,~;...,(h.I"ftl\';;:it:.:"UI;]t- ..l1~;W..JLj."'I."
To request an inspection call the 24 hour recording at 726-37~9: 1~~in~P.~RtiRQ~l[~!1~1'1,,1~d.l.bef6re'7:00Uu'l.
a,m, will be made the same working day, inspections requestedcafter 7:00 a~m. will be,made thefoUowing by
, ' 0090 You:Tnl")L'L~'"" ,.' ",,,
working day, . .' - , ' '1 ('I,'pl'una
calli\lg'(h,,-:dl1\~i. \.\0l".,:' - ~~. ': '
R . d I ti ' - . ,co' ,'''"!''..~tlon
eqUlre nspeC?J?n!!dl'''' ..,~.-,...,.~,. ....,_, '+I).
Mechanical ICZi1lvn:,;, 1............... ....v_ ....-
Rough Mechanical
Final Mechanical
- Prior to cover.
-When all mechanical work is complete.
Construction Types:(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
,Area (Sq. F ..1)
I Main: Accessory:
Accesso~J Structure,
.. "'..---
# Of Stories: THIS P~,l~~~(.~~~tEXPIRE IFTHE WORK
Current Units: AI JTH08r~~B~~u'-l:~!fHIS PERMIT IS NOT
Census Code: New SF C~~~~7IIdCED OR IS ABANDONED FOR
Total: !ANY180DAYPERIOD.
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Fee
Minimum Mechanical Permit
Administrative Fee - Mechanical
Gas Fireplace
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
Job# 01-00136-01
Paid On Receipt#
Mechanical
02/15/2001 4459
02/15/2001 4459
02/15/2001 4459
02/15/2001 4459
02/15/2001 4459
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Page 2 of2
ValuelQuantity
I
Fee Amount
1
$10,50
$.45
$4,50
$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
re::?t! g~~im:;;e:t the project address is readable from the street.
Signature ?
.;2//5/0/
Date