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Home My WebLink AboutPermit Mechanical 2004-12-02Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax S4l-7 26-37 69 Inspection Line PERMIT NO: COM2004-0147 6ISSUED: 1210212004 APPLIEDT 1210212004 EXPIRESz 0610212005 VALUE: SITE ADDRESS: 1850 YOLANDA AVE ASSESSOR'S PARCELNO.: 1703243400303 PROJECT DESCRIPTION: L.P GAS LINE & GAS INSERT Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential Owner: Address: ULAM JOHN C & TILLIE E 1850 YOLANDAAYE SPRINGFIELD OR 97477 14tp .9l6to Contractor Type Mechanical Contractor AMBASSADOR PIPING INC License 121469 Expiration Date 03t27t200s Phone 541-726-5723 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: sPecia, jil'+tttm uN : o res on taw requires You to Notes:lollow rules adoPted by the Oregon UtilitY Notificati rules are set forth 0090 calli multiplier # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Vo ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla IOTIGE: HIS PERMIT SHALL EXPIRE IF THE WORK Sidewalk Type: Downspouts/Drains: REQUIRED PARI(NG Total: Handicapped: Compact: Date CalculatedPer Sq Ft Square Footage or Bid Amount value ANY 1B(] DAY PER|OD DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS DescriptioBu m on Center. Those Total Value of Project rEl l,ul_l-ulr\ rJ rN r( t,KtvrA, u!2Nl FIELD Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-01476ISSUED: 1210212004 APPLIEDz 1210212004 EXPIRESz 0610212005 VALUE: Fee Description -Mechanical Issuance Fee- + l0Yo Administrative Fee + 7%o State Surcharge Gas Fireplace Gas Outlets l-4 Minimum/Adj ustment Mechanical Total Amount Paid Amount Paid $10.00 $4.s0 $3.15 $1s.00 $4.00 $26.00 $62.65 Date Paid t2t2t04 12t2t04 r2t2t04 t212t04 t2t2t04 t2t2t04 Receipt Number 1200400000000001686 1200400000000001686 1200400000000001686 1200400000000001686 120040000000000r686 120040000000000r686 To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. witl be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon 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 Springtield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction.a- \.'T Owner or Contractors Signature Pase2 of? Date Bees Prrd I Keouired lnsDecttons I 225 Fifth Street Springlield, Oregon 97477 541-726-3759 Phone -<ity of Springfield Official Receipt ",evelopment Services Department Public Works Department RECEIPT #: 1200400000000001686 Date: 1210212004 2:35:52PM Job/Journal Number coM2004-01476 coM2004-01476 coM2004-01476 coM2004-01476 coM2004-01476 coM2004-01476 Description Gas Outlets 1-4 Gas Fireplace Minimum/Adjustment Mechanical -Mechanical Issuance Fee- + 7o/o State Surcharge + l0% Administrative Fee Amount Due 4.00 15.00 26.00 10.00 3.15 4.50 Item Total:$62.65 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check AMBASSADOR PIPING DLM 8209 In Person $62.65 Payment totat: -56ffi t2/212004 Page I of I