HomeMy WebLinkAboutPermit Mechanical 2003-8-22
.
Status
Issued
*
. CITY OF ~rKlNGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00755
ISSUED: 08/22/2003
APPLIED: 08/14/2003
EXPIRES: 02/22/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1451 LA WNRIDGE AVE
ASSESSOR'S PARCEL NO.: 1703252207400
Springfield
TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Gas furnace changeout
Owner: WOOD LAURENCE P & CAROL J
Address: 1451 LA WNRIDGE AVE SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
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 ~~W/t Floor:
Type of Heat: ~t. \r i~'s ~~ Floor:
Water: l\. t.'I-!(~ t.~~\S asement:
I\~fi)i\'=~\i ~~~ t.~ i~\~ I( ()~t.~/j arage/Carport
E~.!~Lt.() \l~() r>:o~~() Sq Ft Other:
~\li~~~lolC.t.() ()~~~(\(). Impervious Surface Area:
I DEVELO~1iJj\mii6~TION I
REQUIRED PARKING
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rcaryard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Total:
Handicapped:
Compact:
Description
Type of Construction
~\o
",0'" '\~ 0\~~;'~
I PUBLIC IMPROVEMENTS I ~ ~00~0~~:0 '!>~7?O ~
~~":. .'C\0 '" ~ <IP e'"
~0~0 ~~wa~<fye~:~ 0 ~I,)" ~0
_yO ~00 "",0 ,,'(\ . ,'(' ~o, 0<:-
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~~ ~0"'~ 0<:-\0~~...O"S' vO~\0.;s.0~~0~\~
~ o-tl ~~ 0<:- G ~....fJ ~~<:- ~0\0' ~\'\ ~b.b.,.
'0'" ~~ n.fJ ,,0'0 ~,\':! ~\5 n.'I-
\ '1\\V t\~" 0'1 ~0 ,,0 n.~"
. ....\."\ a. ":J . ((\' _(A~ _.,~~ _rv~
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I ,{\" r\ 't "S' ;s.0 ....
Valuation Deser.io'tlo'n;, ~ ~'o~ ~0~\'"
V' 'S)0 v0~
$ Per Sq Ft Squa~footage
or multiplier or Bid Amount
Value
Date Calculated
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Total Value of Project
Paee I of2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Appliance Vent
Furnace - up to 100,000 btu
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Total Amount Paid
.
. CITY OF SPRINGFIELD"
Building/Combination Permit
PERMIT NO: COM2003-00755
ISSUED: 08/22/2003
APPLIED: 08/14/2003
EXPIRES: 02/22/2004
VALUE:
I Fees Paid I
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$6.00
$12.00
$4.00
$23.00
1200200000000001998
1200200000000001998
1200200000000001998
1200200000000001998
1200200000000001998
1200200000000001998
1200200000000001998
8/22103
8/22103
8/22103
8/22/03
8/22/03
8/22/03
8/22/03
$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 Reouired JnsnedionsJ
I Rough Mechanical: Prior to Cover
2 Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
3 Final Gas: When all gas work is complete.
4 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 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 ofany 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.
/ ~/
aL/t ~._~~/-
Owner or Contractors Sig[71 ()
8' - ,;). ~.3
Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
JobfJournal Number
COM2003-00755
COM2003-00755 '
COM2003-00755
COM2003-00755
COM2003-00755
COM2003-00755
COM2003-00755
Payments:
Type of Payment
Check
,,,,~,,",~F,I.!!'-D.,_
Mi......,.....'.'...,..,....';.....
."",~
~ .-'
,""'.,~,-'-'- .' .:.".- -.
Receipt #: 1200200000000001998
Description
Furnace - up to 100,000 btu
Appliance Vent
Gas Outlets 1-4
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+7% State Surcharge
+ 10% Administrative Fee
Paid By
HOME COMFORT
Received By
djb
l.:heck Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department
Public Works Department
"
Date: 08/22/2003 9:39:52AM '
Amount Paid
Item Total:
12,00
6,00
4,00
23,00
10,00
3,15
4.50
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62,65
$62.65
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