HomeMy WebLinkAboutPermit Mechanical 2003-7-2
.
Status
Issued
*
. Lit r OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00577
ISSUED: 07/02/2003
APPLIED: 07/02/2003
EXPIRES: 01/02/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1387 KELLOGG RD
ASSESSOR'S PARCEL NO.: 1703342203900
Springfield
TYPE OF WORK: Heating System
TYPE OF USE:
Repair
Residential
PROJECT DESCRIPTION: Replace heat and air handler
Owner: WILSON RICHARD L & JUDITH K
Address: 1387 KELLOGG RD SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Owner
Contractor
DEAN M SCHULTZ
WILSON RICHARD L & JUDITH K
BUILDING INFORMATION'
License
133733
Expiration Date
02123/2005
Phone
541-767-0626
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
R-3
SETBACKS
I DEVELOPMENT INFORMATION I
Frontyard Sethack:
Side I Sethack:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBIlIC IMPROVEMENTS I
~eS 1 \j'i.\\\" <.i.
eo..-v\ 0\' :1.\0:\
Storm Sewer Available: \'3-">l'lt eot?,(f, te ",0 ?_<:J:) ,
Special Instruction: ~e~O~ "Q'l ~ "W'" ",,0C1)':' - ~0S"Q,
N:O eO e~ Or ~\.\ e
~\O'\ . 009"< -{,'(\os "r>'(\ ~ :1.'(\0 ~O~. ~
A~"\ ~e"'0' ,,\et. ('\'(\to \€",O :l.e\0~~\r.'3-\\O
~ ' ,,>0\ t\) GC\ J::.<;J\. (j0<) ..~e ~\O\\
,o\\O\v.;i.\O~l:"\l<;J\ 0'Q\0-\~ ~o\e\j'i."\\'l ~f>.f>.,\.
~6'\\ X- 9l ~'3-'l ~\et. "O~ ~?:'l-
. Or --to" C (j0 ate'!) f,).'O
\~ RJI:J. fJ. 'S' \\,0 \,~\j
d:J ~\\"'. ~,ot t\'"
c ~"Qe Ge~\e
~-v
Street Improvements:
Sidewalk Type:
Notes:
Downspouts/Drains: ~O~'#.
\~~ \f '\~ \~ ~O'
~()1.\tf:. ~\'t ~~~~~$\~ \'~~ \0\\
'\~\~ ~~\t~\) U~~ \~ ~~~
(>.U"\ ~~'t\C'i.\) 't~O~
t,~ \Ya\\ ~
Paee I of2
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
~ Fpp~ Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Heal Pump
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$8.00
$12.00
$25.00
7/2/03
m/03
7/2/03
7/2/03
7/2/03
7/2103
Total Amount Paid
$62.65
I Plan Reviews I
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00577
ISSUED: 07/02/2003
APPLIED: 07/02/2003
EXPIRES: 01102/2004
VALUE:
Value
Date Calculated
Receipt Number
1200200000000001701
1200200000000001701
1200200000000001701
1200200000000001701
1200200000000001701
1200200000000001701
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work
day.
l.~POlJirpd l11~\l\I\iUrW
I Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
By signalure, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon 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 pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required' spections are requested at the proper time, that each address is readoble from the
stree~:i~he permit card is loca ed at t I front of the property, and the approved set of plans will remain on the site at all
"~y;;;"'"% 7 - z - 03
Owner or Contractors Signature) Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00577
COM2003-00577
COM2003-00577
COM2003-00577
COM2003-00577
COM2003-00577
Payments:
Type of Payment
. Check
.
r..
'LJ..'~~.
Wi:.i-.1
Receipt #: 1200200000000001701
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Air Handling Unit Up to 10,000
Heat Pump
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
DEAN HEATING AND AIR
Check Number
Received By. Batch Number Authorization Number
djb
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 07/02/2003 1:22:46PM
Amount Paid
3.15
4.50
8.00
12.00
25.00
10.00
$62.65
Item Total:
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65