HomeMy WebLinkAboutPermit Mechanical 2000-12-18SPRINGFIELD
Job# 00-01807-01
RESIDENTIAL PERMIT
City Of Springfield
Gommunity Services Division
Building Safety
Page 1 of2
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 3450 Virginia St Spr
AssessorsMap#: 17023134
Lot: Block: Addition:
Job Number: 00-01 807-01
Office:726-3759
!nspection Line: 726-3769
Tax Lot#: 01504
Subdivision:
k
crrY oF SPRINGFiELD, OREGOTV
Owner: Ken Poling
Address: 3450 Virgina Street
Scope Of Work: Mechanical
NEw GAs piping
for bbq, water heater, insert, dryer
Phone Number:
City/State/Zip:
Alteration
541-726-7787
Springfield, OR
Value: $0
Contractor Type
Mechanical Contr
Contractor
Ambassador Piping lnc
Po Box 70737, Eugene, OR 97401
Registration #
121469
Expiration Date
3127t2001
Phone
541-465-4737
Quad Area:
# Of Units:
Constr. 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 recording at726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day.
Required lnspections
Mechanica!
Rough Gas
Rough Mechanical
Gas Service
Final Gas
FinalMechanical
Construction Types:
Occupancy Groups:
- Prior to cover.
-After line is installed and line has been connected to a minimum of one appliance. Pressure ter
-When all gas work is complete.
-When all mechanicalwork is complete.
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:Accessory Total:
Job# 00-01807-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
One to Four Outlets
Minimum Mechanical Permit
Administrative Fee - Mechanical
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
Mechanical
12t18t2000
1211812000
1211812000
1211812000
12t18t2000
4069
4069
4069
4069
4069
I $2.00
$13.00
$.45
$10.00
$1.05
$26.50
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
at and that project address is readable from the street.
Signature Date
$26.50
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