Loading...
HomeMy WebLinkAboutPermit Mechanical 2000-10-25SPRINGFIELD Job# 00-01586-01 RESIDENTIAL PERMTT City Of Springfield Community Services Division Buitding Safety Page 1 of 2 #olm,Wuull33 IHANGE I IASHIER:059 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 693 Woodcrest Dr Spr AssessorsMap#: 17033413 Lot: Block: Addition: Job Number: 00-01 586-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 02100 Subdivision: ctTY oF SPR1NGFfiEL4 OREGON Owner: Tony Drexler Address: 693 Woodcrest Dr Scope Of Work: Mechanical New gas service and 2 appliances Phone Number: City/State/Zip: New 541-747-9376 Springfield, OR97477 Value: $O Contractor Type MechanicalContr Contractor American Gas Appliance Service lnc 618 Hamilton St, Springfield, OR 97477-3611 Registration # 77621 Expiration Date 10/31/00 Phone 541-954-4686 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings:"s\soRi Group: Source: Footage: To request an inspection call the 24 hour recording a1726-3769. All in 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. Rough Gas Gas Service FinalGas Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? ! Area (Sq. Feet) Main: -After line is installed and line has been connected to a minimum of one appliance. Pressure te: -When all gas work is complete. # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Accessory:Total: Job# 00-01587-01 Page2 otZ Fee Paid On Receipt# Value/Quantity Fee Amount One to Four Outlets Minimum Mechanical Permit Mechanical Administrative Fee Gas Fireplace Mechanical lssuance State Surcharge For Mechanical Permit Total Mechanicat Mechanical 10t25t2000 10t25t2000 1012512000 10t25t2000 1012512000 1012512000 3599 3599 3599 3599 3599 3s99 1 $2.00 $8.50 $.45 $4.50 $10.00 $1.05 $26.50 1 Grand Total $26.s0 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 vyill be used on this project. I further agree to ensure that all required inspections are requested altffe proper time and that the project address is readable from the street.tut/-,,4 tu z-f*) Signature Date