HomeMy WebLinkAboutPermit Mechanical 2003-1-23
r"~" ,
~.. ..
.
.
City of Springfield
Mechanical Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: MEC2003-00002
ISSUED: 1/23/2003
APPLIED: 1/23/2003
EXPIRES: 7/23/2003
SITE ADDRESS: 6948 GLACIER DR
ASSESSOR'S PARCEL NO.: 1802022203900
Springfield
TYPE OF WORK: New
TYPE OF USE: Residential
PROJECT DESCRIPTION: Install gas stove and chimney vent
I\TTCI\ITu.'r.t.' \~...___._
OWNER! APPLICANT:
KASLER MARC W & CARMEN A
6948 GLACIER DR
SPRINGFIELD OR 97478
fO!'?w ~ules adoPte~~<;A~&:?NTRACTOR:
Notlflcallon Center. TMISStlE('{sare set forth 541.343-1131
In OAR 952-o01-001016'7t8.NY.~T~Vi~~~Vjij'fUE
0090. You may obtair~f,,~q,rr~~ (~9is by
calling the center. (~IM: t~R.3~ephgffilfatiOn Date: 10/20/2003
......_L..__.l:__...._, .-.
- - -. ,_. un" -'Qtfv" VUlllY I"VlIIll;cUlon
Amount Paid Center is 1-80cD!t:.:P:'~4). Reeeiot Number
4.50 01/23/2003 1200200000000000591
3,15 01/23/2003 1200200000000000591
10,00 01/23/2003 1200200000000000591
6.00 01/23/2003 1200200000000000591
15.00 01/23/2003 1200200000000000591
4,00 01/23/2003 1200200000000000591
20,00 01/23/2003 1200200000000000591
Descriotion
+ 10% Administrative Fee
+ 7% State Surcharge
-Issuance Fee-
Appliance Vent
Gas Fireplace
Gas Outlets 1-4
Minimum/Adiustments, Mech
To Request an inspection call the 24 hour recording at 726-3769. All inspec~ted before 7:00 am. will be made
the same working day, inspections requested after 7:00 am. will be made\'h~I(l{1~\vorking day.
, \. ~'t.\'\'"'':.~n~\ _.,
\\:,1:.. ~\\t'\." \\\';) I:: \) ,"",..
Reouired Insnections: ,,0"' \,'(:.~\A\" \J~'ijt.~ '\ ~~'ijQ~r;
\\\\~ Q~\tt.'ij 'ij~ \~ to.'O
to.\J'\~ ~'(:.~C'(:.~ ~'(:.~\Q'ij.
By Signature, I state and agree, that I ha$eq.~~amined the completed application and do hereby certify that all
information hereon is true and correct, and I furiilWcertify 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. I
further certify 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 at the proper time, that each address is readable from the
':;;: "':\::IM' if ""lirobl.. will ,~", '" "" 'i~:: ~:: "'ri" '=In<',,
Owner or Contractors 'sfgnature Date f
I of 1
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
MEC2003-00002
MEC2003-00002
MEC2003-00002
MEC2003-00002
MEC2003-00002
MEC2003-00002
MEC2003,00002
Payments:
TWe of Payment
Check
Paid By
MIDGLEYS
Description
Appliance Vent
Gas Outlets 1-4
Gas Fireplace
Receipt #: 1200200000000000591
Date: 01/23/2003
Minimum/Adjustments, Mech
-Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
Check Number Confirm No
djb
Page I of I
1/23/2003 III:!,
10:16:04AM .
..
City of Springfield
DeveIopment Services Department
Public Works Department
Official Receipt
Line Item Total:
.
Amount Paid
6.00
4,00
15.00
20.00
10.00
3,15
4.50
$62.65 .
Amount Paid
62.65
$62.65
How Received
In Person
Pavment Total:
cReceipt.rpt