HomeMy WebLinkAboutPermit Mechanical 2000-11-3
.~
.;;/-
.
I Job# 00-01627-01 I
SPRINQFIELD
~-
.
Page 1 of 2 .,
TRANS#:01-0003696
DATE:NDV 03 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER:059
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
225 North Fifth Street
Springfield, OR 97477
Location Of Proposed Site: 908 Kelly Blvd Spr
Assessors Map#: 17033411
Lot: Block: Addition:
Owner:
Elizabeth LaMarche
Address:
908 Kelly Blvd
Scope Of Work: Mechanical
Gas Fireplace
Contractor Type
Mechanical Contr
Contractor
Ambassador Piping Inc
Po Box 70737, Eugene. OR 97401
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
Job Number: 00-01627-01
Office: 726-3759
Inspection Line: 726-3769
Tax Lot #: 04400
Subdivision:
Phone Number:
City/State/Zip: Springfield, OR 97477
New Value: $0
~,
'';'
Registr!ftiOI)I#'/j' . 'Expiration Date Phone
VOtit; 'Ie< . ",_
1214E1~..qICation 3/27/0Jle'o c _ 541-465-4737
U09 R95<.(;efITel r. Ol/thf O~" .~. ."
O. y"., 07.n". r,o.~<.. en".,'
'-ql/ingi':"'qYobi '.ulhro/j W'",s <lie ^ VI/iii,
"umber ',eC&I)I",amcoai'!!..hOI!tR I:je/ fOl,
/ortheC"Of,BuilClings:fhe 95<-00
''''~''''' i.. 6~cupW~~lyhGr,oup'(!J/es b'
. 0..... """(/IJ,I. .~jJf1 '
Heat source~OtiticaO?e
Sq. Footage:, Ita.
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 reqU;s'tedJ~ft!lr 7:00 a.m. will be made the following
working day. IIiIS 1.;'1::
R . dt.I' - PE:PIM,:t'
eqUlre nspectlons "~Al.
.., 'V~':> ""1 IF:.
I Mecfianical. .~'eai.lIIVDE:. J(P.I~f: If:
Rough Gas - /ill/v, .'OLI::DOn A'ii/So 7HE:Ltv,
G S . ft I' .. II d d I' h' 80b",. r'f/C>t~' .1':",. fOo., I' P
as ervlce -A er Ine IS Insla e an Ine as een'~~nnec eu..t9~tml",mu!T)S> one app lance. ressure te!
Final Gas -When all gas work is complete. IT/OD. OIVE:Df:OR Nut
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Total:
Height (feet):
Proposed Units:
/""
.
Job# 00-01627-01 I
Paid On Receipt#
Mechanical
11/03/2000 3696
11/03/2000 3696
11/03/2000 3696
11/03/2000 3696
11/03/2000 3696
11/03/2000 3696
.
Fee
Page 2 of 2
Value/Quantity Fee Amount
One to Four Outlets
Minimum Mechanical Permit
Mechanical Administrative Fee
Gas Fireplace
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
1
$2.00
$8.50
$.45
$4.50
$10.00
$1.05
$26.50
$26.50
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 proper time and that the project address is readable from the street.
;vt~s. (1/kJ- J),3-<<J
Signature Date