HomeMy WebLinkAboutPermit Mechanical 2000-11-146za-or00-01
SPRINGFIELD
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RESIDENTIAL PERMIT
CitY Of SPringfield
GommunitY Services Division
Building SafetY
Job Number: 00-01 673-01
Office:726'3759
lnspection Line: 726-3769
Tax Lot#: 15900
Subdivision:
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1464 Modoc St
AssessorsMaP#: 17032533
Lot: Block:
Owner: Leonard Madison
Address: 1464 Modoc St
Scope Of Work: Mechanical
Pellet Stove
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Addition:
Phone Number: 541-736-0310
City/State/Zip: Springfield, OR97477
New Value: $1,900
CITY OF OREGON
Quad Area:
# Of Units:
Gonstr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour
a.m. will be made the same working day,
working day
Freestanding Pellet -After installation.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? !
# Of Stories:Height (feet):
Proposed Units:
Area (Sq.
Main:
Fee
Accessory Total:
Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit
Mechanical Administrative Fee
Freestanding Pellet Stove
Mechanical lssuance
11t14t2000
11t14t2000
11t14t2000
1111412000
3788
37BB
3788
3788
$.00
$.45
$15.00
$10.00
1,900
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Job# 00-01673-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
State Surcharge For Mechanical Permit
Total Mechanical
Mechanical
11t14t2000 3788 $1.0s
$26.s0
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
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
Signature Date
$26.50
reque;sted Et the proper time and that the project address is readable from the street.,/t ru.,/r-tt 1rq/."