HomeMy WebLinkAboutPermit Mechanical 2000-9-15
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I Job# 00-01393-01 I
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TRANS#:01-0003225
DATE:SEP 15 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 059
SPRINGFIELD
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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:
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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:
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Page 2 of 2
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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