HomeMy WebLinkAboutPermit Mechanical 2001-8-9
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I Job# 01-00856.01 I
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SPRINQFIELD
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00856-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759 ~
Inspection Line: 726-3769
Tax Lot #: 05700
Subdivision:
Location Of Proposed Site: 5315 Leota St Spr
Assessors Map#: 17023331
Lot: Block: Addition:
Owner:
J.J. MacNickels
5315 Leota
Phone Number: 541-726-1179
Address:
Scope Of Work: Mechanical
City/State/Zip:
New
Sjpringfield, OR 97478
Value: $0
Contractor Type
Mechanical Contr
l\IOTICE:
THIS PERMIT SHALL EXPIRE IF THE \""01( Office Use
QUIl.(rAr~a:IZED UNDER THIS PERMIT Ifllai1Ci Use:
# %Y,~!~1tNCED OR IS ABANDONED FOZoning Code:
Co~~tr1~PI~il.Y PERIOD, Bedrooms:
WaterYHeater: Range:
Contractor
American Gas Appliance Service Inc
618 Hamilton St, Springfield, OR
97477-3611
Registration #
77621
Expiration Date
10/31/02
Phone
541-954-4686
AnENTlor-<:Q,zgon law requires you to
4....11....... ....I,.,,,, .-:a...~.........torl h" tho nronnn IltilihJ
~~otification Center. Those rules are set forth
in OAR 952-00,-nr"!1Ii'r,:>uoh OAR 952-001-
# Of BUlltllngs:
0090. You may OOIC1"Il;VI-'I,,~ of the rules by
II' h 'Occupancy Group: h
ca 109 t e Ct;llllCI. \1'fV.~. ul..;; ,.....ap one
number for t1!!e.!!~J>,,oJ~r""!::ity Notification
Centc.l;iq, F~Qta9l!;!-2344).
To request an inspection call the 24 hour recording at 726-3769. All inspections 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
working day,
Required Inspections
Mechanical
Rough Gas
Rough Mechanical
Final Gas
Final Mechanical
- Prior to cover.
-When all gas work is compfete.
-When all mechanical work is complete,
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
iArea (Sq, Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
D
3: -'<
-'< t:) ""
DD
;:0 -i;Z:
J'T1 rr1 (lJ
C"')..#
("") OD..
D ..co
CJ) r'.,) G1 ........
::I: ,.
rT1::C .. '66
;:0 ::I> D' c)
.. z: ~ t".J Ci'
C) G'J. C) GJ
t.....QT1 -.J a ....0
j-L u tJ1 j-L t'.,)
Total:
...
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Fee
One to Four Outlets
Minimum Mechanical Permit
Administrative Fee - Mechanical
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
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Job# 01.00856.01
Paid On Receipt#
Mechanical
08/09/2001 6392
08/09/2001 6392
08/09/2001 6392
08/09/2001 6392
08/09/2001 6392
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Value/Quantity Fee Amount
1
$4.00
$41.00
$3.60
$10.00
$3.15
$61,75
$61,75
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 of the City of Springfield and the Laws of
the State of 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 att~~oper time and that the project address is readable from the street
J.a~ ff/P'
Signature
f(-l-6J!
Date