HomeMy WebLinkAboutPermit Mechanical 2000-9-5
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TRANS#:Ol-0003120
DATE:SEP 05 2000
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 061
I Job# 00-01347-01 I
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01347-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 615 Hayden Bridge PI Spr
Assessors Map#: 17032621
Lot: Block: Addition:
Tax Lot #: 01201
Subdivision:
Owner:
Peter Berezniak
Phone Number: 541-747-9480
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
615 Hayden Bridge Ln
Scope Of Work: Mechanical
install gas insert and water healer
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call1he 24 hour recording al726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspeclions requested after 7:00 a,m, will be made the following
working day, NOTICE:
-~
Rough Gas
Gas Service
Final Gas
R . d I t' ru'C'~Lnl\.U"T'''' ..... -,.-.--.--- -- -
equlre nspec Ions . -- ...... -".. ''''_-'H' II U... II IIIL;. nun"
Mechanical 'jUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
-After line is installed and line has been co~/)~~tjl.sbt!?i,ElIl9i!!irl1~Ti of one appliance. Pressure te!
- When all gas work is complete. .
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
Fee
# Of Stories: ATT'flili'dhl~;Q~rf1~or, ia,^, iequirer '/OL' '0
C t U 'ts follo\>Uwesa.{ig ed.tlytheOregonUtililv
urren m : NotifiClfir6W~'i't'l'e !Wi'oserulesaresetfor.
Census Code: Does nO~(!l1ijjlA'R952-001-0010throughOAR952.00i
10090. You may obtain copies of the rules b~
Total: calling the center. (Note: thetelephone
ntlRlbt.i "'YI'j.t'~4 UIIQ....WI ~~t~;ji.. ~.;. ~'II'~~ .~H4 III
Receip~enterh:l3ttOOlb6a~44). Fee Amount
1
Paid On
I'
Mechanical
09/06/2000 3120
09/06/2000 3120
09/06/2000 3120
09/06/2000 3120
1
One to Four Outlets
Minimum Mechanical Permit
Mechanical Administrative Fee
Gas Fireplace
1
$2.00
$8.50
$.45
$4.50
."
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..
,
Fee
.
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
Grand Total
Job# 00-01347-01
Paid On Receipt#
Mechanical
09/06/2000 3120
09/06/2000 3120
.
Page 2 of2
Value/Quantity
Fee Amount
$10.00
$1.05
$26.50
$26.50
By signature, I stale and agree that I have carefully examined lhe completed application and do
hereby certify thai all information herein is lrue and correcl, and I further certify that any and all work
performed shall be done in accordance with lhe Ordinances of the City of Springfield and the Laws of
lhe Slate 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 lhat all required inspections are
reques~ at th~per time and lhal e project address is readable from the slreet.
V;t;, b
Signature
ct/6/od
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Date