HomeMy WebLinkAboutPermit Mechanical 2002-8-13
"
I ~.',~,
'-
....
-. .
I Job# 02-00975-01 I
. Page 1 of2 V'
TRANS#:01-0010272
DA TE : AUG 13 2002
AMT RECD:2 $ 61.75
CHANGE:
CASHIER:003
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00975.01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 983 Kintzley Ave Spr
Assessors Map#: 18020624
Lot: Block: Addition:
Tax Lot #: 06000
Subdivision:
Owner:
Todd Koen
983 Kintzley Ave
Phone Number: 541-988-3850
City/State/Zip: Springfield, OR 97478
Alteration Value: $0
Address:
Scope Of Work: Mechanical
Install heat pump
Contractor Type
Mechanical Contr
Contractor
Comfort Flow Heating Co
1951 Don Street. Springfield, OR 97477
Reg istration #
00460
Expiration Date
6/27/2003
Phone
541-726-0100
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
r-Area (Sq. Feet:
I Main: Accessory:
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. requires you to
On law '\'ty
. ._,.,-","UN:ureg .~_ ('\rAnon Utll
. ReqUired Inspections ,,,. - dOpll:lU "'] ... - se110l<"
Mechanical jfOllOW r.ules ~nter.lhose rules are 952-001-
-When all mechanical work is complete. Noti1iCa~~~~01_0010thrO~ghOit~e rules by
in ~RyOU may obtain cOf~~~~ telephO~e
00 cailing the center. t~~ Utility NotificatIOn
number for the'O;~~00_332-2344).
Centens
Height (feet):
Proposed Units:
# Of Stories:
Current Units:
Census Code: Does not apply
Final Mechanical
Fee
Total: NOl'CE~ U^LL EXPIRE IF THE WORK
'THlt D!:RMIT ~~~~t'l ~ ~.r. r::r.W':. Ie NnT
Paid On Rec&IPT#i~~.I~~~Y1'!A~a,t!g~OONOOia~ount
Mechanical 'JV"'''~OA.Y PERIOD.
08/13/2002 102i71" , $33.00
Minimum Mechanical Permit
-."-'.
.
Fee
8% Administrative Fee - Mechanical
3hp - - 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
Job# 02-00975-01
Paid On Receipt#
I Mechanical
08/13/2002 10277
08/13/2002 10277
08/13/2002 10277
08/13/2002 10277
.
Page 2 of2
Value/Quantity Fee Amount
1
$3.60
$12.00
$10.00
$3.15
$61.75
$61.75
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
reqi ,ted at the proper ti~d that the project address is readable from the street.
'IIM~ _ :.f~-A' q~B /( S/o2-
Sigrture
v
- ~
Date