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HomeMy WebLinkAboutPermit Mechanical 2001-12-06SPRINGFIELD Job# 01-01352-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page Job Number: 01-01 352-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot #: 03400 Subdivision: of2 ltLtLl irtri iJL' nr- J 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 3550 Valentine Ct Spr AssessorsMap#: 17021942 Lot: Block: Addition ctrY oF SPRTNGFIELD, OREGOTU Owner: Stanley Russell Address: 3550 Valentine Ct Scope Of Work: Mechanical Phone Number: City/State/Zip: New 541-747-7220 Springfield, OR97477 Value: $0 lnstall propane fireplace insert and place exterior fuel bottle. Office Use - Land Use: Zoning Code Bedrooms: Range: Quad Area: # Of Units: Constr. Type: Water Heater: # Of Build To request an inspection call the 24 hour recording at726-3769 a.m. will be made the same working day, inspections requested working day. before 7:00 the following Required lns Mechanical - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure ter -After installation. -When all mechanicalwork is complete b'{ Rough Mechanica! Gas Service lnsert FinalMechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main: .ht # Of Stories: Current Units: Census Code:Does not Total: o 01 \e \he \ Accessory: Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical 12106t2001 12t06t2001 12t06t2001 7444 7444 7444 1 ]t t $4.00 $32.00 $3.60 Job# 01-01352-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Gas Fireplace Mechanical lssuance State Surcharge - Mechanical Total Mechanical 12t06t2001 12t0612001 12t0612001 7444 7444 7444 1 $e.00 $10.00 $3.1 s $61.75 Grand Total By signature, hereby certify I state and agree that I have carefully examined the completed application and do 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 beu on this lfurther agree to ensure that all required inspections are the project address is readable from the street. Signatu $61.7s 1>-Z= I I Date