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HomeMy WebLinkAboutPermit Mechanical 2000-9-15 ! . - ?-~ , - "- . I Job# 00-01393-01 I . -Page 1 of2 TRANS#:01-0003225 DATE:SEP 15 2000 AMT RECD:2 $ 26.50 CHANGE: CASHIER: 059 SPRINGFIELD ~ , CITY OF Sp,RINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-01393-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 617 Hamilton St Spr Assessors Map#: 17033412 Lot: Block: Addition: Tax Lot #: 08100 Subdivision: , ;. L Kristie Sampson Phone Number: 541-726-9273 . _ . "". ,,"-j_ :;I~i;ltu88 . . Address: 617 Hamilton (VVbG-vvV(;"U ! . \lOp&jIYlState/Zlp: "ON ^ll\11n uooalO a4 s p~ Scope Of Work: Mechafl/e'ilP!d~" a,;;'aloN) 'JelUaoaUAIIEN~non 0 ~uOlll!e\al .." 0 ^ew nO}; '060 Line 19 C!!!;RIf'Jm ~!la!dOO U\el~ '.3C-?cC:: \.l~n. u' . ~OO-G96l::!'lfO lIU\lU~~41'~luai) UO!lll:>!~\\ON . \lJO~ les ale salOl a dope salnl MOllo~ Co~trac'fUo69l0 94\ ^Q P~\. . (Y I H=1 ,Registration # Expiration Date '111!+l h . .\]\.P. '1')t"~J("'\ '" I - ./ SuburbaiifPi'oplln~ Lp' 112216 3/6/04 Po Box 206 AlIn Tax Dept, Whippany, NJ 79810-206 Owner: Springfield, OR 97477 Value: $0 Contractor Type Mechanical Contr Phone Office Use Land),Use: "./0 08~ AN\f # Of Buildings: Uf 1t1~(.J ^ v .,~g~~lgrlfH~3jN3\NII\lOO Occupancy Group: l:lO:l 03NOON Bedrooms: ZIl:lOH1\1\1 Heat Source: .LON SI11\Nl:l3d SIiRah'~~~~~~"u:,-, <::1'1-11 Sq. Footage: )ll:jOM3Hl:lI::ll::lldl':l "v..~-,..--_ _ . To request an inspection call the 24 hour recording at 72.!!',3'7;691~1I 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: Required Inspections Mechanical Rough Gas Gas Service -After line is installed and line has been connected to a minimum of one appliance. Pressure te! Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D iArea (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: .~ ,. . . Page 2 of 2 . Job# 00-01393-01 Fee Paid On Receipt# Mechanical 09/15/2000 3225 09/15/2000 3225 09/15/2000 3225 09/15/2000 3225 09/15/2000 3225 Value/Quantity 1 One to Four Outlets Minimum Mechanical Permit Mechanical Administrative Fee Mechanical Issuance State Surcharge For Mechanical Permit 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 ~;~ t~me and that the project address is readable from the street. Signature 'j - . I Date Fee Amount $2,00 $13,00 $.45 $10,00 $1,05 $26.50 $26.50