HomeMy WebLinkAboutPermit Mechanical 2004-7-20
.
Status
Issued
. CITY vt< ~rK11'luNJ!,LD
Building/Combination Permit
PERMIT NO: COM2004-00897
ISSUED: 07120/2004
APPLIED: 07120/2004
EXPIRES: 01120/2005
VALUE:
.1,
.
,}
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 2150 LAURA ST SPACE 210
ASSESSOR'S PARCEL NO.: 1703271004700
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE:
Alteration
Residential
PROJECT DESCRIPTION: Replace heat pump and air handler,
Owner: MONTGOMERY SHARON ANN
Address: 9351 SW OLD WEST RD POWELL BUTTE OR 97753
I CONTRACTOR INFORMATION I
Contractor License
ASSOCIATED HEATING &\~pt CONDITIO 106275
~:: ". . '\
',r I nu.tlu'f'''; INFORMATION I
..... ~"<\V~
# of Units: ~ ~ ~~# o~'Stories: Lot Size:
Primary Occupancy Group: {S~ ~<.(; ~lfclght of Structure Sq Ft 1st Floor:
Secondary Occupancy Group: ,,<<] '\~S ~'J\:)Type of Heat: Sq Ft 2nd Floor:
Primary Construction Type -x..~ K.~ SO~ Water Type: Sq Ft Basement:
Secondary Construction 'f.ype: ~ S ~<::s {:> ~ Range Type: Sq Ft Garage/Carport
# of Bedrooms: ~~".'<.,~~ x,'J -::s '\)~ ~'\)'J' Energy Path: , 0,$) Sq Ft Other:
~I\:) '2> ~ ~I: ('~'J ~<.(; Sprinkled Building: n/~~ .~~ ~cupant Load:
,,~" ,('\ .," .-.I. .~ ,'~ N
. . .
".~, ~~v~~ V I DEVELOPMENT INFORMA TN~~~ -'O0';()()~,\
,,\:) _~ "\ ~' 0' ~0 Cb<:' ~0'O REQUIRED PARKING
~- ,'I> ~0 ~0'O ~ \oS ~0 (\..
Overlay Dist: O~ 'Q'\'<;) \oS 0 .;s-0 R~O ~o'lotal:
# Street Taee ~i:.~ 0'00,if' fO ~ ,~0 .~v'l> Handicapped:
Paved Dr' . alf,.Q '\'<:' .;s-\O ;.."tl, .;s-0 ~o"',.." Compact:
"",'" ,.p.\' () 0'" ~ ~,
%of~ o>:.er'W"; s::>" .~G o,0'#~~
A<<) ~0 C; ~!J ~,'IY ~ ~'5 ~
~. ,.I. .,,~ <:I() . 0 n\' ,,0 ,,:>":>
. '", - -.
I PUBLIC mi~R~~M~rs:I'0 O\~\~\)-
~'. " '-' ..":'.{::I
'-$' U Rl()' . ~~ \0\ ~0\ Sidewalk Type:
()I:S vit~'Qrj- 00<:'
,. Downspoutsffirains:
~v
Contractor Type
Mechanical
Expiration Date
08/31/2004
Phone
541-683-2590
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
PaeeIof2
.
. CITY VI< :SYK!l'\jl>1<lI!,LD
Building/Combination Permit
PERMIT NO: COM2004-00897
ISSUED: 07/20/2004
APPLIED: 07/20/2004
EXPIRES: 01/20/2005
VALUE:
.
,
,
.
Status
Issued
J
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fpps P3\IU
Fee Description
-Mechanical Issuance Fe....
+ 10% Administrative Fee
+ 7% State Surcharge
Heat Pump
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Numbcr
$10.00
$4.50
$3.15
$12.00
$33.00
7/20/04
7/20/04
7/20/04
7/20104
7/20/04
1200400000000001110
1200400000000001110
1200400000000001110
1200400000000001110
1200400000000001110
Total Amount Paid
$62.65
I Plan Reviews I
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.
I Rpouirf>d Insnf>r.tinn'lj
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signature, 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 donc 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 wilhout 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 inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the silc at all
times during construction.
btfX;{.
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;::::;--
Owner or Contractors Signature
,
Date
7 /ZO J f:!J '-/
I
Pa!!e 2 of2
.
. 225 Fifth Street
. Springfield, Oregon 97477
; 541-726-3759 Phone
d
.
.', Job/Journal Number
, COM2004-00897
COM2004-00897
COM2004-00897
COM2004-00897
COM2004-00897
Payments:
Type of Payment
Check
7120/2004
RECEIPT #:
~
Jiiity of Springfield Official Receipt
"elopment Services Department
Public Works Department
1200400000000001110 '
Date: 07/20/2004
Description
Heat Pump
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
ASSOCIATED HEATING &
NC, INC.
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
jmp II 760 In Person
Payment Total:
Page I of I
1I:24:49AM
Amount Due
12.00
33.00
10.00
3.15
4.50
$62.65
Amount Paid
$62.65
$62.65
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ZZ5 FIITH STREET 0 SPRINGFIELD, OR 97477 0 PH:(54I)726-3753 0 FAX: (541)726-3689
City Job Numbr" CD Nt. 'l-oa~,. 60 B>cn
LOCATION OFFROpOSED WORK; 2. I '50 L c....\AA.."'l
5T
~Z'1O
TAX LOT: ~1 e>~'L\ ~oc4-(l:X:::l
ASSESSO RS MAP'
OWNEP' tL.'1:.w.....uJ IL.........lc""''t PHONE: /4\ - L(~9'
ADDRESS: 2./50 f.~ ~ r d 2/0
CITY: -5(>"-LoV'Go a~ STATE''''I<. ZIP: ~ '1 '7 f
DESCRIPTION OF WORK'
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G.NI ,4, rt.-ktvl. d..t..vL _
NEW:
REMODEL:
ADDITlm'.
DEMOLISH;
OTHER:
VALUE:
CONTRAcrOR'S NAME
GENERAL;
PWMBlN'"
ADDRESS
CONST.
CONTRAcrOR #
EXPIRES PHONE
MECHANICAL'
ELECfRlCAL:
Ass ~ C-< 1A-~O'f
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MECHANICAL PERMIT
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Furnace
ITEM
fJ) Administralivc Fcc
State Surcharge
IJ ~l Total Mechanical Permil Fees
l MlSCELLANEOUS FERMlTS
~ f Demolition
~r~ II State Issuance
I Administrative Fee
State Surcharge
o Total Miscellaneous Fermits
~~
r:-ll\\ At ~.1h, o. 111 IDlh.... 1J... o.
~ ,.ll\t/~~eAll.~11lt1i~at.lt · ~J,!.l!Jlmlt})lllrug.
Exhaust Hood
Fixtures
Residential Bath(s) No.
Sanitary Sewer [T-
Water IT.
, Slorm Sewer fT.
Vent Fan No.
Wood Stove/lnse11/Fireplace Unit
Mechanical Permit
State Issuance
Plumbing Permit
Administrative Fcc
. State Surcharge
Total Flumbing Fees
(
Total Mechanical Permits
Total Plumbing Fermits
Total Miscellaneous Fermits
TOTAL
FEE
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