HomeMy WebLinkAboutPermit Mechanical 2001-9-10
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Job# 01-00974-01
Page 1 of 2
TRANS#:Ol-0006644
DATE:SEF' 10 2001
AMT RECD:2 $ 61.75
CHANGE:
CASHIER: 061
225 North Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00974-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 6955 Glacier Dr Spr
Assessors Map#: 18020223
Lot: Block: Addition:
Owner:
Tax Lot #: 04800
Subdivision:
Ellis Runk
6955 Glacier Dr
Phone Number: 541-746-5429
City/State/Zip: Springfield, OR 97478
New Value: $0
Address:
Scope Of Work: Mechanical
Heat pump
Contractor Type
Mechanical Contr
Contractor
Andys HTG & AC
220 Ruby Av, Eugene, OR 97404
Registration # Expiration Date Phone
541-461-1282
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Office Use 0:\ \C~:. t":~?\\'IE. 11': " ~\Q'
~ "1-1/1-'-'-1:' ,-"..,1"\.,"
Land Use: "S '?E\'IM\\ ., \1~\'9f Buil~ig9.~
Zoning Code: \ \-II OW2E.O \l\'lOE.\'I ~~C:HpanCy Group:
Bedrooms: /I-\l\1-I _ ~o:v 0\'1 IS /I-?Heat Source:
Range: COWll-<',::~~:'J pc?\09 Sq, Footage:
bN'i '10" -'
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.
Quad Area:
# Of Units:
Constr, Type:
Water Heater:
Rough Mechanical
Final Mechanical
Required Inspections
Mechanical
- Prior to cover.
- When all mechanical work is complete,
P.I ,t:i\; nON:Oragon law requires you to
follow rules acioj)ted by the Oregon Utility
I\'oti'iication Center. ThoS3 rulas are set forth
in OAR 952-001-0010 through OAR 952-001-
0090, You may obtain copies of the rules by
# Of Stories: calli.lg the CenHeightJ(feetj? telephone
number for the a."nnn II"':'" "n\'lf'lcat'lon
Current Units:' , Proposed 'Units:
(:an(::,r IS l-buU-a;;s2-~;;l44).
Census Code: Does not apply
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq, Feet)
I Main: Accessory:
Total:
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Job# 01-00974-01
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Page 2 of2
Value/Quantity Fee Amount
"
"
,
Fee
Paid On Receipt#
Mechanical
09/10/2001 6644
09/10/2001 6644
09/10/2001 6644
09/10/2001 6644
09/10/2001 6644
1
$33,00
$3,60
$12,00
$10,00
$3,15
$61.75
$61,75
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
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 at the proper time and that the project address is readable from the street.
~~~ S6?rrO/Cl('
Sig~ure Date