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HomeMy WebLinkAboutPermit Mechanical 2002-8-20 ... . I Job# 02-01005-01 I --. "-" ., ",' V~I Page 1 of 2 .". ' TRANS#:01-0010345 DATE:AUG 20 2002 AMT RECD:l $ 100.00 CHANGE:$ 38.25 CASHIER:061 , CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-01005-01 225 Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 3655 Franklin Blvd Eug Assessors Map#: 17033431 Lot: Block: Addition: Tax Lot #: 00701 Subdivision: Owner: Address: C & M Pump Co 36191/2 Franklin Blvd Phone Number: 541-726-5586 Install gas wall furnace City/State/Zip: Eugene, OR 97403-2357 Value: $0 Ulfes yOU to . .oregon laVl req on Utility "nl"l'I\\ol'l.. .._""",t\'leOreg __.fnr\\1 . 'I'''VI rules l:1Uv"'---rhO"e ru\e~ '" v ;'52-001- Contractor 10 Registration\#r. Expiration~D3tIP \ \~\hone Automatic Heat / Eugene Heating 1'l00ti~9~;~.001-0bO\1a?J)~~2~~5)1 tne r~G~' rt-726-7654 \0 p... 0 "......-; \ep,,'- 3675 Franklin Blvd, Eugene, OR 97403 0090. '(ou !flay tedNote:~~e~~ tilication ,.. _ ,,,",0 r:.eO . ....I.hl ,,,0 (;<1"'"'' the Qregu" V' . "44). Office Use nU!fIu"rlor". 1 800-332-2<> CenterlS . . . # Of BUlldmgs: Occupancy Group: Heat Source: Sq. Footage: New Scope Of Work: Mechanical Contractor Type Mechanical Contr Quad Area: # Of Units: Constr. Type: Water Heater: Land Use: Zoning Code: Bedrooms: Range: 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 working day. Rough Gas Rough Mechanical Final Gas Final Mechanical Required InspectiOt~tn\j't: E~PIRc It ,lit: W~CIl I Mechanical ~\ II; PERMI, S\1r>.ll 1\1\S PERMI1 IS MOt -A~er line is installed and capped if not aR~,\~e~1IiQlp~IQliB,'\'3r>.MOOMEO fOR -Prior to cover.. . MEMCEO OR I~'A -When all gas work is complete. COM 180 Or>.\{ PERIOD. -When all mechanical work is complete. /l.tW 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: ';0 . Job# 02.{)1005.{)1 . Page 2 of 2 .' Fee Paid On Receipt# I Mechanical 08/20/2002 10345 08/20/2002 10345 08/20/2002 10345 08/20/2002 10345 08/20/2002 10345 08/20/2002 10345 Value/Quantity Fee Amount One to Four Oullets Minimum Mechanical Permit 8% Administrative Fee - Mechanical Less than 100,000 BTU Mechanical Issuance State Surcharge - Mechanical Total Mechanical 1 $4.00 $29.00 $3,60 $12.00 $10,00 $3.15 $61.75 $61.75 1 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 requested_at the pr<;pr ~e Jfd "a~ the project address is readable from the street. '7UAA'dl>1/ ~~ Signature C <;? - 2f) - 02- Date