HomeMy WebLinkAboutPermit Mechanical 2005-12-21Status Issued
225Fifth Street, Springfield, OR
541-726-3753 Phone
547-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-01686ISSUED: 1212112005
APPLIED z 1210512005EXPIRES: 06/21/2006
VALUE:
INFORMA
SITEADDRESS: 6042PEBBLECT
ASSESSOR'SPARCELNO.: 1802033400171
PROJECT DESCRIPTION: Install heat pump
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
PhoneNumber: 541-554-1799
Expiration Date
0813U2006
Residential
Phone
541-683-2s90
C)wner:
Address:
MATT SUTTEN
6042 PEBBLE CT
SPRINGFIELD OR 97478
*
Contractor Type
Mechanical
#of
Primary
Secondary
Primary
Secondary Type:
# of Bedrooms:
. Frontyard Setback:
Slde I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
License
TING & AIR CONDITIO 106275
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
VN
Range Type:
Energy Path:
Sprinkled Building:nla
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
o/o of Lot Coverage:
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARJilNG
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
' Description Type of Construction
Page 1 of2
Value Date Calculated
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Valuation Description I
Status Issued
111 \ifth Streer, Springfi erd, oR541-726-3753 phone
541-726-3676Rax
541-7 26-3769 Inspection Lin e
B uildin g/ C o mb in atio n permi t
Amount Paid
$10.00
$4.s0
s3.1s
$12.00
$33.00
Total Value of project
Date Paid
t2t2u05
t2tzu05
t2tzu05
l2t2u0s
t2t2u05
coM2005-0I685
12t21t2005
12105t200s
06t2u2006
Receipt Number
2200s00000000001728
2200500000000001728
220050000000000r728
2200500000000001728
2200s00000000001728
PERMIT NO;
TSSUED:
APPLIED:
EXPIRES:
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ l0%o Administrative Fee
+7%oStile Surcharge
Ileat Pump
Minimum/Adjustment Mechanical
Total Amount Paid
To Request an inspection call the24
will be made the same working day,
day.
$62.6s
hour recording at 726-3769. AII inspection requested before 7:00 a.m.
inspections requested after 7:00 a.m. will be made the following work
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Plan
Reouired Insnecf
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 of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be 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 projeet.
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.
/6,,^
Owner or Contractors Signature
B*-L
Pase2 of2
Date
lz-zl -c:f
%
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
:ity of Springfield Official Receipt
Jevelopment Services Department
Public Works Department
RECEIPT #: 2200s00000000001728 Date: 1212112005 1:43:15PM
Job/Journal Number
coM2005-01686
coM2005-0r686
coM2005-01686
coM2005-01686
coM2005-01686
Description
+ 7oh State Surcharge
+ l0% Administrative Fee
Heat Pump
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Amount Due
3.15
4.50
12.00
33.00
10.00
Item Total:$62.65
Payments:
Type ofPayment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
(r.
)(
Ir
:("
tf
Check ASSOCIATED HEATING &
A/C,INC.
jmp 14018 In Person
Payment Total:
$62.6s
$62.6s
t
t2/2y2005 Page I of I