The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2003-9-17 . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00916 ISSUED: 09/17/2003 APPLIED: 09/17/2003 EXPIRES: 03/17/2004 VALUE: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2450 GROVEDALE DR ASSESSOR'S PARCEL NO.: 1703233309500 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: PROJECT DESCRIPTION: Install gas line to cooktop and bbq Owner: GRACE DENNIS C & KATHLEEN S Address: 2450 GROVEDALE DR SPRINGFIELD OR 97477 I CONTRACTu,," u"'un.MATION" Contractor Type Mechanical Contractor AMBASSADOR PIPING INC License 121469 I BUILDING INFORMATION I # of Buildings: # of Stories: Primary Occupancy Group: R-3 Height of Struc~t~G?o.'& Secondary Occupancy Group: TY~"-m~a.f 1 :\ \'0 ~GI Primary Construction Type \fJl', ~~'te't ~?o.WI\ ?o. Secondary Construction Type: l\01 ?'t.?o.WI\1 'O~~ ,\)~t.\) \,0 # of Bedrooms: 1\\\'0 G?o.\lt.\) \} ~~ : ~\}':.~~~\-_~Ct.~, ~..\\\Q\)' \J~~ '\'O~ i:it~ELOPMENT INFORMATION. SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: New Residential Expiration Date 03127/2005 Phone 541-726-5723 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: . c"nu\.v Paved Drive Rqd: VI feQUlfe.Compact: oregon \a 0 egoO U'(,IIlY % of Lot C~y["ge:,ON" ted b)l tM r ar~ set Ion tnllOVl fuleS~~~~~r,l\1oSe f~~e~lI.p. 952-00, I PUBLIC IMPROVEME'N:fSI11-001 ~ \I~~pi~S 01 \\1e r~~"n-e. \I\~' . - a)l obtaIn -Ihe \ele? , 0090. '(ou m nSi~~walltType: NO\iliCa\lOn . \\1e ce '" 'no Utl\lW callIng 10f \\1e Dowfisl!outslDrahis,). mber . . 1-8UO-"""-- nU center IS Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Total Value of Project Pa!!e 1 of2 Value Date Calculated . . CITY VI' ~rKll'\it..I'IELD Building/Combination Permit PERMIT NO: COM2003-009I6 ISSUED: 09/17/2003 APPLIED: 09/17/2003 EXPIRES: 03/17/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line I F~~~ Pairl I Fee Description -Mechanical Issuance Fee- -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Gas Outlets 1-4 Minimum/Adjustment Mechanical Amount Paid Date Paid Receipt Number $10.00 $10.00 $4.50 $3.15 $4.00 $31.00 9/17/03 9/17/03 9/17/03 9/17/03 9/17/03 9/17/03 1200200000000002153 1200200000000002153 1200200000000002153 1200200000000002153 1200200000000002153 1200200000000002153 Total Amount Paid $62.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work day. I Renuired Tn~ne"tinns I 1 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. By signature, I state and agree, that I have carefully examined tbe completed application and do hereby certify that all information hereon is true and correct, and I furtber 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 pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 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 street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. . /~~sd~ 0, ~ Owner or Contractors Signature > Date Pal!e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Iit~~.""""a,~.,~"=,......,,,.,...,.. -', . , ' ~ , "'''.." ' " , ; . '. ; _, .. """'~.'..,.~ I '.~ ,~,.,,,._. " " Job/Journal Number COM2003-00916 COM2003-00916 COM2003-00916 COM2003-00916 COM2003-00916 COM2003-00916 Payments: Type of Payment Check Receipt #: 1200200000000002153 City of Springfield Official Receipt Development Services Department Public Works Department Date: 09/17/2003 . 1:24:12PM Amount Paid Description + 7% State Surcharge + 10% Administrative Fee Gas Outlets 1-4 MinimwnlAdjustment Mechanical -Mechanical Issuance Fee- -Mechanical Issuance Fee- 3,15 4.50 4,00 31.00 10.00 10.00 $62.65 Item Total: Paid By AMBASSADOR PIPING Received By djb (;heck Number Batch Number Authorization Number Amount Paid . How Received In Person Payment Total: $62,65 $62.65 JJ~ ll{\ ~tp ~: o ~po ~(p,06. \b.OD ~ -0\.00- &o.n W\.al . ~l? b\ah. ~q Ar..~ ~ \;i lo6 . -\o-\oJ- . ~ J-~I. ~S \.OW- ~oo$cl CX\ ~ _~OO\' ~ ~e~~ ~ ~ Db Qoo"ili 1'l\~[Jdj~' q.lg{)3