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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