HomeMy WebLinkAboutPermit Mechanical 2002-5-13
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I Job# 02-00562-01 I
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Page 1 of 2
TRANS#:01-000B997
DATE: MAY 13 2002
AMT RECD:2 $ 61.75
CHANGE:
CASHIER:061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00562-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3621
Assessors Map#: 17021942
Lot: Block:
Hayden Bridge Rd Spr
Replace furnace and add AC
Tax Lot #: 05300
Addition: Subdivision:S you t,o
...._..--. IUlI,h'
AI \I~"''' '. r.l b" me U"'!,l~" - ' . h
toI\B!!Q[leJ Numbi~+h9f~ iz'jI,M289;et tort
'/' ,ti~nCentel, ~"~RQ"i2-001-
Notl'Ci~/StateJZip',j10tSpriiigfiel ,OR 97Atla
, OAR i3b~-uU \-", ies ot nil I u,";:' 1
1~1J$!??irou may obtain ~~fe:\(~luj:l:ep$o~e
calling the center,l Utility Notification
numbertor the,01re8g~;_332_2344),
I""'o.ntAr,s ..
Owner:
Doug Wise
3621 Hayden Bridge Rd
Address:
Scope Of Work: Mechanical
Contractor Type
Mechanical Contr
Contractor
Pacific Air Comfort Inc
Po Box 790, Roseburg. OR 97470
Registration #
39237
Expiration Date
3/25/2002"-\ ~
Phone
541-672-9510
Office Use
Land Use: # Of Buildings:
Zoning Code: Occupancy Group:
Bedrooms: Heat Source: 'l'l0\'.\I..
Range: _. c. _ ~WPU\~lfel\'\~ t>.\Q"{
"u,\t-lti~.~~Ptt\\J{11 \S
To request an inspection call the 24 hour recording at 726-3769t~i!?i&.i ~~~ Pmg):J'OO'"
a,m, will be made the same working day, inspections requested il.~' .'till\b$ e~ollowing
working day, COtAtA;~~f\'f ~~p.\OO.
Required Inspectk<<J" ~ ,
Quad Area:
# Of Units:
Constr, Type:
Water Heater:
Mechanical
Rough Mechanical
Final Mechanical
- Prior to cover.
-When all mechanical work is complete,
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
rArea (Sq. Fee(
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
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Job# 02-00562-01
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Page 2 of 2
Value/Quantity Fee Amount
"
.
f"j'
Fee
Paid On Receipt#
I Mechanical
05/13/2002 8997
05/13/2002 8997
05/13/2002 8997
05/13/2002 8997
05/13/2002 8997
1
$33,00
$3,60
$12,00
$10,00
$3,15
$61,75
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
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
OR,S 701,055 wil be us~~n ~,hiS roject. I further agree to ensure that all required inspections are
re~ueste~~0?4.:pct address is readable from the street. ~/fy;./'f;J ~
Sigharu're () , ~te /
$61.75
~ Owgon Construction Contract_oard>> License Details
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Page I of I
OREGON CONSTRUCTION CONTRACTORS BOARD
License Details as of May 14, 2002 6:54 AM
LICENSE NUMBER: 39237
NAME: PACIFIC AIR COMFORT INC
ADDRESS: PO BOX 790 ROSEBURG OR 97470-0000
WORK PHONE NUMBER: 541-672-9510
LICENSE STATUS: Active
EXPIRATION DATE: 3/25/2004
DATE FIRST LICENSED: 3/19/1982
ENTITY TYPE: Corporation
LICENSE CATEGORY: General Contractor/All
EMPLOYER STATUS: NON-EXEMPT
COLONIAL AMERICAN
BOND COMPANY: CASUALTY & SURETY
CO
BOND AMOUNT: $ 15000
BOND EFFECTIVE TO: 3/25/2004
View Bond Historv
MID CENTURY
INSURANCE COMPANY: INSURANCE CO
INSURANCE AMOUNT: $ 1000000
INSURANCE EFFECTIVE 9/19/2002
TO:
View Insurance Historv
View Claims Historv
View X-Reference
Licenses
View SIC Code~
View A~sociated Names
View Buildino Codes Division License Details
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Page Last modified: February 22, 2002
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5114/2002