HomeMy WebLinkAboutPermit Mechanical 2004-1-12
.
Status
Issued
*:
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00034
ISSUED: 01112/2004
APPLIED: 01109/2004
EXPIRES: 07/12/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1441 LA WNRIDGE AVE
ASSESSOR'S PARCEL NO.: 1703252207100
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install electric furnace and heat pump
Owner: MATTHEW BOLTZ
Address: 1441 LA WNRIDGE AVE SPRINGFIELD OR 97478
,Phone Number: 541-729-5541
I CONTRACTOR INFORMATION.
Contractor Type
Mechanical
Contractor
HOME COMFORT HEATING & AIR
License
84164
Expiration Date
06/25/2007
Phone
541-345-2838
BUILDING INFORMATION I
VN
# of Stories: Lot Size:
Height of Structure . S'Lfl\~~ l3iPllr:
Type of Heal<~: ty-\'I?t \iiqliil d~~"9r:
Wate~n.t.\, . \1 S\\r>.\.\. S \'~qWt ~Mment:
Rangef~~:\'t.~\'JIt.O \.I~Ot.~ 1\\\ ~O(~qijlt!;8'r'olge/Carport
Energy ~~tl\~O~II O~ IS r>.~1\ Sq Ft Other:
"O\'JI\'JIt.~Ct.O nI:I'IOO. Impervious Surface Area:
" -f' "b'l n..
I DEVELOPMENF'iNFdRMATION I
REQUIRED PARKING
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Conm.~~ to
tequlrel> Y rt"
% of Lot Coverage: l'l,oregon 100\11 oregon UtI \'.
AiTEl'liIO. ted '0'/ \tl61 are Bet ter\.
.. ........ BdOP _ _~" nlleS _~" 1\0'
I PUBLIC IMPROVE~tsii!l(l ce~~1 ~ \hrO~g~ ~;;~;~u\'8S \.
, , OAf\ 9!l2.,ooaV~~V1? e \eleptlO~e
G090. 'toU meD6\\\\~~~ lNo\e. \~lY \,&O\\lIcatIOO
, callIng \tl \tle ore~~~..Z344).
U9l'oerlor '" 1..~('\('\-3.;o
n r'':''.....t,...,' .
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
Pallelof2
.
.
CITY OF SrKll'luJ<u,LU
Status
Issued
Building/Combination Permit
PERMIT NO: COM2004-00034
ISSUED: 01112/2004
APPLIED: 0110912004
EXPIRES: 07/1212004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I FI'I" P~ill .
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Furnace - up to 100,000 btu
Heat Pump
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$12.00
$12.00
$21.00
1/12/04
1/12104
1/12/04
1/12/04
1/12104
1/12104
1200400000000000039
1200400000000000039
1200400000000000039
1200400000000000039
1200400000000000039
1200400000000000039
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 R'Wlltrl'd In,oedlon,.
II II If II
1 Rough Mechanical: Prior to Cover
2 Final Mechanical: Wben 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 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 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 site at all
times during construction.
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Date
Paee 2 of2
225 Fifth Street ,;."
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00034
COM2004-00034
COM2004-00034
COM2004-00034
COM2004-00034
COM2004-00034
Payments:
Type of Payment
Check
"~"""'c'"""
WI': '~__':"'.=c"'__'~ .1.
-'c.c~ '
. WIllI' j
~ . ~.- . .",.". --" .","_.-, ..
Receipt #: 1200400000000000039
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Furnace - up to 100,000 btu
Heat Pump
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
HOME COMFORT
Received By
djb
Check Number
Batch Number Authorization Number
CiTy of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 01/12/2004 IO:06:20AM
Amount Paid
3,15
4,50
12,00
12,00
21.00
10,00
$62.65-
"
Item Total:
How Received
In Person
Payment Total:
.
Amount Paid
$62,65
$62.65-
.