HomeMy WebLinkAboutPermit Mechanical 2003-11-4
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Status
Issued
*
. CITY OF SrKll'\jlJt<u,LU
Building/Combination Permit
PERMIT NO: COM2003-01116
ISSUED: 11/04/2003
APPLIED: 11/04/2003
EXPIRES: 05/04/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,
SITE ADDRESS: 2196 LOCH DR
ASSESSOR'S PARCEL NO.: 1703251202700
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install gas insert and piping
Owner: LEONARD ARNEY
Address: 2196 LOCH DR SPRINGFIELD OR 97477
Phone Number: 541-747-8641
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I CONTRACTOR INFORMATION I
LiC~~~~ Expiration Date
_ \<z~\J \S ~ 12123/2003
I BUILDING INF@~~TllON'~~ fr.'\)'<-
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c,\:i llHe'type:
\'-~ nergy Path:
Phone
541-747-7445
Contractor Type
Mechanical,
Contractor
MARSHALLS INC
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# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
,\0
I, DEVELOPMENT INFORMATlON".,'\"0'i.{i\\'1 <:-
\'i?JJ..- aQ,O(\ ,,0\\00 REQUIRED PARKING
~ 0\ \0 ~..Cl
Overlay Dist: 0(\\'<> >i$'a ~a" '<> ~ '?J':i ~0" \ Total:
# Street Trees:R4d: '0'\ 0 \<J 01" ~0 \<J (\0 Handicapped:
PavedD_n~~ttqii?~X'OS 0<JQ,X' 0\" ~a(PO :i.\o"'Compact:
~\\,~o\0\' >i$'\ ,',a" \0 ,~\c'<>
:\%(;,f utleoverage:' \) " 'c,o'V ,>i$'0 ~O\\
I>' ~\o-tl \~o(\ V;Cl<vv~\i\(\,~O\~~'i.{i\~ '?JI>.I>.I'
\0 ......'?): ...t').. ,0 _" '\,: -.v ....!?~
I PUBmc;.'i\\ri>RoYiMENTs,.a%~()~'?J.J~
\" f\,\l' f\," \.\'- "
ClCl'" ~\\(\~ \0\ (/\~ Sidewalk Type:
C'<> ~0\ (" c<"
(\<J~
Downspoutsmrains:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pal1elof2
.
'-
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01116
ISSUED: 11/04/2003
APPLIED: 11104/2003
EXPIRES: 05/04/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspeclion Line
I F"". Paid I
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Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Gas Fireplace
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$15.00
$4.00
$26,00
1lI4/03
1lI4/03
1lI4/03
1lI4/03
1lI4/03
1lI4/03
1200200000000002422
1200200000000002422
1200200000000002422
1200200000000002422
1200200000000002422
, 1200200000000002422
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 Relluired Tn.nectinn.'
1 Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete,
3 Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
4 Final Gas: When all gas work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do herehy certify that all
information hereon is true and correct, and I further certify that any and all work performed shall he 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 Commnnity Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed 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
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Owner or Contractors Signature
/1_ r.-j-o"b
Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-01116
COM2003-01116
COM2003-01116
COM2003.01116
COM2003-01116
COM2003-01116
Payments:
Type of Payment
Check
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Wit-,-~."'~~,.BLO""_,"-' ~",'" "..'.,.
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c... ,M_, ,,.~._._- ,...;
Receipt #: 1200200000000002422
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Gas Outlets 1-4
Gas Fireplace
-Mechanical Issuance Fee-
Minimum/Adjustment Mechanical
Paid By
MARS HALLS INe
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Departll!ent
Public Works Department
.
Date: 11/04/2003 3:15:34PM
Amount Paid
Item Total:
3,15
4,50
4,00
15,00
10,00
26,00
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62,65
$62.65
.
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