HomeMy WebLinkAboutPermit Mechanical 2001-6-27
.
''0
I Job# 01-00660-01 I
.
Page 1012
TRANS#:01-0005999
DATE:JUN 27 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00660-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 2150 Laura St Spr
Assessors Map#: 17032710
Lot: Block: Addition:
Tax Lot #: 04400
Subdivision:
Owner:
Laverne Henshen
Phone Number: 541-747-8779
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
2150 Laura St Sp 1
Scope Of Work: Mechanical
Install heat pump
Contractor Type
Mechanical Contr
Contractor
Home Comlort Heating
706 Oscar Street, Eugene, OR 97402
Registration # Expiration Date
84164 6/1/2003
Phone
541-345-2838
Office Use
Quad Area: Land Use: ,# m'Buildinlfs:ires you \0
ATTENTION:",,, ~', '. . ...." ",'"nnn Utility
# Of Units: Zoning Code: follow rules adqccupancy Group.: et forth
-. ......~ rilles ale S
Constr. Type: Bedrooms: Notification CenHeat Source: OAR 952-001-
W H R 001S"~1F~ Ih-""nn
ater eater: ange: in OAR 952- q. .ootage: f the rules by
_............ ,..r\lllP.SO
OO!:lU. TUU "'~, -~". {~Iot". thetelepnone
To request an inspection call the 24 hour recording at 726-3769. All inGpecti.oncs'reijGested b,efcir~l,Oglitication
a.m. will be made the same working day, inspections requested after !lig,O.'a:mf1wili'li'rriiade' t~~:f9~~~ng
working day. Center IS 1-800-i:li:l>< I
Required Inspections
Mechanical
Rough Mechanical
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
- Prior to cover.
-When all mechanical work is complete. "Y'\Cc. -rLlE WORK
NO I~' EXPIRE If I rl
1\-11S PERMll S\-If\L~R 1\-11S PERM\\ \S NOl
f\U1HORIlEO UNO f\"W-lOONEO fOR
ENCEO OR IS
COMM.., ~n\(\I).
N'f ~80~elghWeet):
f\ Proposed Units:
# Of Stories:
Current Units:
Census Code: Does not apply
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 01 the City of Springfield and the Laws of
the State 01 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 tim and tha project.ad~ess is readable Irom the street.
/%~~A ~ __n.
, 6' _ n__
~ ~--
Signature'
.
.~
Job# 01-00660-01
Fee
Paid On Receipt#
I Mechanical
06/27/2001 5999
06/27/2001 5999
06/27/2001 5999
06/27/2001 5999
06/27/2001 5999
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
.
Page 2 012
Value/Quantity
1
Fee Amount
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$26,50
4-,?,)-c7/
Date