HomeMy WebLinkAboutPermit Mechanical 2003-12-15
.
. U 1 i' OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01255
ISSUED: 12/15/2003
APPLIED: 12/15/2003
EXPIRES: 06/15/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2000 HENDERSON AVE
ASSESSOR'S PARCE~ NO.: 1803032000190
Eugene
TYPE OF WORK: Mechanical Only
TYPE OF USE:
New
Commercial
PROJECT DESCRIPTION: Install gas line and heater
Owner: FARWEST STEEL CORPORATION
Address: PO BOX 889 EUGENE OR 97440
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
TWIN RIVERS PLUMBING INC
License
17695
Expiration Date
03/11/2005
Phone
541-688-1444
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
SETBACKS
I. DEVELOPMENLINIlO$'lATION I
....
~01\Cf:. Ii S\-\i'.\.\. f.'t-?IR~~~~' \1' IS ~Oi.
\-\IS ?E.RWI \)E.\\ ir~er/ay' VO\\
i \,\O\\I1.E.U \l~ S i'.'CIf.,!1iilQ,1j\ ees Rqd:
i'.\l~...E.~CE.\)'O\\ I 0" Paved Drive Rqd:
CO ,,,,,, '\'{ ?E.\\I u.
f>.~'{ 1aQ U" % of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS I ' ""'quIres you to
~'Or""qon \a~~ I v Utility
ATTEl'lTIU ' Sidewalk,Type:>rCQon
follow IJIs:; adOplt;~,:I,;' "' 'I:~~ are S€)t 1011
,,' "on C811J!ownspoutslDr~lDs:-, 35';1-00'
\lollllcall 1 '010 tnrouCjll.,/,\ll-1 \
;n OAR 9::i~-01.l -. I't~in COl'):z~ 01 the rll 25
0090. You mL\y 0._ NO;'): thetels~hO~e
Callino ,,-2 ~3r",-r. ( Ut'llity NotificatIon
OJ ., _ ~,"""nnn
"..:...-:~~~... IV_ ~. P.. 1 "n()~~12~~~1t.:-"+I'
I Valuation Descriotion I' -~"- '" -,
Notes:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 of2
.
. Ll1 1: OF SPRIrlil>-NJ<..LD '
Building/Combination Permit
PERMIT NO: COM2003-01255
ISSUED: 12/15/2003
APPLIED: 12/15/2003
EXPIRES: 06/15/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
1 Fp.p.s~
Fee Description
-Mechanical Issuance Fee--
+ 10% Administrative Fee
+ 7% State Surcharge
Furnace - Unit Heater
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$12.00
$4.00
$29.00
12/15/03
12/15/03
12/15/03
12/15/03
12/15/03
12/15/03
2200200000000001875
2200200000000001875
2200200000000001875
2200200000000001875
2200200000000001875
2200200000000001875
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 I nsneetions I
1 Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
2 Rough Mechanical: Prior to Cover
3 Final Gas: When all gas work is complete.
4 Final Mechanical: When all mechanical work is complete.
By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon 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 pertaining to the work described herein, and
that NO OCCUPANCY will he 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.
~t~
/7-1/s- joy
Date I (
Owner or Contractors Signature
Pa2e 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
-.~."q,.~".1!H!. .,,' '
la:l'.."'.."..'....
."A!;: .
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City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 12/15/2003 1:52:51PM
Amount Paid
3.15
4.50
12.00
4.00
29.00
10.00
$62.65
Receipt #: 2200200000000001875
Job/Journal Number
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Furnace - Unit Heater
Gas Outlets 1-4
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
COM2003-01255
COM2003-0 1255
COM2003-0 1255
COM2003-01255
COM2003-01255
COM2003-01255
Item Toial:
Payments:
Type of Payment
Check
Paid By
TWIN RIVERS PLUMBING
Received By
djb
(;heck Number
Batch Number Authorization Number
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65
.
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