HomeMy WebLinkAboutPermit Mechanical 2003-4-9
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NOTICE' r:t f S " f" Id
THIS PERMIT SHALL EXPIRE IF THE WOR1\1 yO" prmg Ie "
AUTHORIZED UNDER THIS PERMIT IS NcMechamcal Permit
::"!.IDr.~~ nn It' ^D^Mnml~n mQ
ANY 180 DAY PERIOD. PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
MEC2003-00021
4/9/2003
4/9/2003
10/912003
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1259 ISLAND CT
ASSESSOR'S PARCEL NO.: 1703342200217
Springfield
TYPE OF WORK:
TYPE OF USE:
Alteration
Residential
PROJECT DESCRIPTION:
Replace gas furnace
OWNER/APPLICANT:
SHAW DOUGLAS HAROLD & SU
1259 ISLAND CT
SPRlNGFIELD OR 97477
)\1ECHANICAL CONTRACTOR:
ASSOCIATED HEATING & AIR CONDI 541-683-2590
PO BOX412
EUGENE OR 97440
CCB # 106275 Expiration Date: 08/3112004
Descriotion Amollnt Paid Date Paid Receiot Number
+ 10% Administrative Fee 4.50 04/09/2003 1200200000000000984
+ 7% State Surchar~e 3.15 04/09/2003 1200200000000000984
-Issuance Fee- 10.00 04/09/2003 1200200000000000984
Furnace - up to 100.000 btu 12.00 04/09/2003 1200200000000000984
Minimum/Adiustments - Mech 33.00 04/0912003 1200200000000000984
To Request an inspection call the 24 hour recording at 726-3769'TtMrinw.ffitB~Je{mested before 7:00 a.m. will
be made the same working day, inspections requested after 7:09~'1ffi\. rot~Niao~?Sd~~\~U~*JbVijlt/Wg day.
l>4UUln,,,,auu.. ""G'..'. I flU~tt rU'6::5 tlr.:. 401W. ..(l1
Reauired InsDections: in OAR 952-001-0010 through OAR 952-001
. .. . 0090. You may Qbtaln copies of the rules b)
1 Rough Gas: After line IS Inst~ lied and capped tf not attac~lmQlIh~Ilt\W~Note: the telephone
2 Final Gas: When all gas work is complete. nUlnber for the Oregon Utility Notification
3 Rough Mechanical: Prior to Cover Center Is 1-800-332-2344).
4 Final Mechanical: When alll11cehanical work is complete.
By Signature, I state and agree, that I 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 orllle City of Springfield and the laws of the State of Oregon pertaining to the
work described herein. I further certi ry 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 requested at the
proper time, that each address is readable from the street, and that the approved set of plans, if applicable, will
;:Z~~:;::s;~~n. ~~5
v'Owner or Contractors S;"gnature Date
Pa~e I of I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
MEC2003-00021
MEC2003-00021
MEC2003-00021
MEC2003-00021
MEC2003-00021
Payments:
Type of Payment
Check
Paid By
Receipt #: 1200200000000000984
Date: 04/09/2003
Description
-Issuance Fee-
Furnace - up to 100,000 btu
Minimum/Adjustments - Mech
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
Check Number Confirm No
ASSOCIATED HEATING
Jmp
Page I of I
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4/9/2003
1:54:53PM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Line Item Total:
.
Amount Paid
10.00
12.00
33.00
3.15
4.50
$62.65
Amount Paid .
62.65
$62.65
How Received
In Person
Payment Total:
cReceiptrpt