HomeMy WebLinkAboutPermit Mechanical 2000-09-13SPRINGF!ELD
Job# 00-01390-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
TRANS$:01-0001113
DATE:SEP 13 TOOO
AHT RE[D:2 $ 2&.50
CHANEE:
IASHIER:061
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1458 Yolanda Ave Spr
AssessorsMap#: 17032433
Lot: Block: Addition:
Job Number: 00-01 390-01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot #: 02900
Subdivision:
ctTY oF SPRTNGFIELD, OREGO^'
Owner: Wayne Hann
Address: 1458 Yolanda Ave
Scope Of Work: Mechanical
gas piping and insert installation
Phone Number:
City/State/Zip:
New
541-747-7077
Springfield, OR97477
Value: $O
Contractor Type
Mechanical Contr
Contractor
Ambassador Piping lnc
Po Box 70737, Eugene, OR 97401
Registration #
121469
Expiration Date
312712001
Phone
541465-4737
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 inr
a.m. will be made the same working day, inspections requested after 7
working day.
Required lnspections
Mechanical
Rough Gas
FinalGas -When all gas work is complete.
spections requested before 7:00
:00 a.rfirl@[EEaOe the following
THIS PERMIT SHALLEXPIilE IFTHEWORK
,\,nro Tulc pFFlt\IlT ls NoTW
CO*N,i*CED OR IS ABANDONED FOB
ANY IsODAYPERIOD.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? [
# Of Stories:
Current Units:
Census Gode: Does not apply
Area (Sq. Feet)
Main:
eanter ic t
Accessory:Total
nUt 344)
Job# 00-01 390-01 Page 2 ot 2
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 Mechanical
Mechanical
09113t2000
09113t2000
09/1 3/2000
09/1 3/2000
09/1 3/2000
09/1 3/2000
3213
3213
3213
3213
3213
3213
1
1
$2.00
$8.s0
$.45
$4.50
$10.00
$1.05
$26.s0
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
Signature Date
$26.50
requested at the proper time and that the project address is readable from the street.rtffi,s&*-)=-l-/5^@.