Loading...
HomeMy WebLinkAboutPermit Mechanical 2002-6-16 ~j I Job# 02-00723-01 I . ~ .. -. Page 1 of 2 ~~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00723-01 225 Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 4961 Assessors Map#: 18020422 Lot: Block: Forsythia Dr Spr Installing a 2 ton heat pump & coil Tax Lot #: 03200 Addition:"'! fi.:I~, 1~"SubdiilisI6ii':'''4~lIes you, 10 1:_11_... _..I..~ ~.04........t"'........" tht:\r'\ronnn Iltlhhl Ph~~~iN'ti~b~r:ln'S41T74;"'1122)S are set forth !'l nMl (l~?.001-001.0 through OAR 952,001- CltY/State/Zlp:"y ,SprJngfield"ORf97,47,~les by liv~U. TUU diu. lJl.,;lQn. "'''''I-'I~U OJ .' U New calling thO center. (valife:1he$0.lephone numbllr for the Oregon Utility Notification Center i131-P~(" M~_?344). Owner: Dave Rausch Address: 4961 Forsythia Scope Of Work: Mechanical Contractor Type Mechanical Contr Contractor Home Comfort Healing & Air Conditio PO Box 24205, EUgene, OR 97402 Registration # 84164 Expiration Date 6/25/2003 Phone 541-345,2838 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use ' Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. All inspections 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 workin9 day. NOTICE: XPIRE IF THE WORK . :rUle: PFRMIT SHALL E - -'''T 1<' .."T ReqUIred Inspectlartll-' ' IZED UNUtM I n1iJ H, ,.... ..', - ' , I Mechanical ~~~~~NCED OR IS ABANDONED FOR . Prior to cover. , DAY PERIOD. - When all mechanical work is completep.lllY 180 Rough Mechanical Final Mechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D ["Area (Sq. Feet), I Main: , . Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: :D :3: -l -":::l ::a :D:D :::0 --l :z: ................,... c-:;I.. =l==I= ("") t::::Ic.......a.. D uC::O CD I'.JZj--J. :J: 1 1--1 ("").{;Io) t-'-O rr1 ::c ~ 0 ;0 ::D 0-. 0 uz.....f"-..)""O aG"). 00"- ......rn-.JOF"...:J ......... U1N~ . . 'f Job# 02-00723-01 . Page 2 of2 Fee Paid On Receipt# Value/Quantity Mechanical I 06/17/2002 9624 06/17/2002 9624 06/17/2002 9624 1 06/17/2002 9624 06/17/2002 9624 Fee Amount Minimum Mechanical Permit 8% Administrative Fee - Mechanical Less than 100,000 BTU Mechanical Issuance State Surcharge - Mechanical Total Mechanical $33,00 $3,60 $12,00 $10,00 $3,15 $61.75 $61.75 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 project. I further agree to ensure that all required inspections are request?1~~7~~:::S.iS~blefrom thestreel. so.k.; 0 & -/~ -C) L- Date