HomeMy WebLinkAboutPermit Mechanical 2001-6-21
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I Job# 01-00635-01 I
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TRANS#:01-0005902
DATE:JUN 21 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER:061
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00635-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 15 Lorie Ct Spr
Assessors Map#: 17032241
Lot: Block: Addition:
Tax Lot #: 02400
Subdivision:
Owner:
DDn Grousbeck
15 Lorie Ct
Phone Number: 541-895-3247
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
Scope Of Work: Mechanical
Gas furnace
Contractor Type
Mechanical Contr
Contractor
Comfort Flow Heating
1951 Don Street, Springfield, OR 97477
Registration # Expiration Date
460 6/1/2003
Phone
541-726-0100
Office Use
Land Use: # Of Buildings:
Zoning Code: Occupancy Group:
Bedrooms: NO liCE: Heat Source:
Range: THIS p~ Sq. Footage:
I-O^.tl"f-.....
A( '~l '''~' ..., UIlf1LL EXPIRe: ,'" 'T~'-
To request an inspectiDn call the 24 hour recDrding at 726-3769. All inspections reguested beforei7.:00JRK
a.m. :-viII be made the same working day, inspections requested:aft~rvr..:R~~~~~ili'be fTi'aae"th~\~9'19~iQgT
working day. ANY 18 OR IS ABANDONED
. . 0 DA Y PER/I'J/"\ FOR
ReqUired Inspections
Mechanical
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Rough Mechanical
Final Mechanical
- Prior to cover.
-When all mechanical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
iArea (Sq. Feet)
I Main: Accessory:
nl 'lr"'S you to
TIO'''' "'rr.oon IrW roC., ~ ""\
ATTE~l I ..v ~~ , " ~ OreClon lid,1 y
...,' ......d 'J'1'\il.... ... f."o
tollo'.'iluleseuu".. _ rul's"f3 set ior.
. . 'I 10S0 .-
Noti:icati:mCenle,. '. .'ghC"1"l952-001-
. " Of\j-O(l10 hVOc ". by
# Of Stories: 'n OAR v52- Height'(feet):es ot i,10 rules
O You rn3" ,,_,~I "-.'~ \<>phon3
Current Units: 009.. ,P.roposed:Units;J te -. . .
,,'lllf1otlle~-' ,". 'I't NOtltlCo.t10n
Census Code: Does rf6t,ap'ply.r tile Qreeon Uti,! Y3' ')
nulO'UV, ". .~ 1_800-3:;2-2 ~.<, .
I Cen.crl.>
Total:
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Job# 01-00635-01
Paid On Receipt#
Mechanical
06/21/2001 5902
06/21/2001 5902
06/21/2001 5902
06/21/2001 5902
06/21/2001 5902
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Value/Quantity Fee Amount
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Fee
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$26.50
By signature, I state and agree that I have carefully examined the cDmpleted applicatiDn 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 Ore on. I further state that only contractors and employees who are in compliance with
ORS 701.055 III e used on t . project. I further agree to ensure that all required inspections are
requested at thE> oper time a, d hat the project address is readable from the street.
t ~ A/I,..oJO /
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1(;/21 ( ~/
Date
Signature