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:
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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