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HomeMy WebLinkAboutPermit Mechanical 2001-11-02ctTY oF SPRTNGFTELD, OREcOn SPRINGFIELD Owner: Larry Wilson Address: 2758 3rd Street Scope Of Work: Mechanical Job# 01-01223-01 RESIDENTIAL PERMIT City Of Springfield Gommunity Services Division Building Safety c Page 1 ot 2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2758 00003rd St Spr AssessorsMap#: 17032334 Lot: Block: Addition Job Number: 01-01223-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 00900 \o bdivision -747-7251 , oR97477 Value: $0 # Expiration Date New '*s@{i 5 Contractor Type MechanicalContr Quad Area: # Of Units: Constr. Type: Water Heater: lnstall natural gas fireplace insert Contractor Marshalls Heating 4110 Olympic Street, 97478 Phone 541-747-7445 --" To request an inspection call the 24 hour recording at726-3769. All inspections a.m. will be made the same working day, inspections requested after 7:00 a.m. working day. Required lnspections Mechanical Land Use: Zoning Code: Bedrooms: Range: - Prior to cover. -When all mechanicalwork is complete # Of Buildings: Occupancy Group: rce before 7:00 following !?-- Rough Mechanical Final Mechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? (Sq. Feet) # Of Stories: Current Units: Census Code: Does not apply H, P eight (feet): 'roposed Units: Main:Accessory:Total: Job# 01-01223-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Mechanical lssuance State Surcharge - Mechanical Total Mechanical 1110212001 11102t2001 1110212001 1110212001 1110212001 7166 71 66 71 66 71 66 71 66 $4.00 $41.00 $3.60 $10.00 $3.15 $61.75 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 req at the proper ti and that the project address is readable from the street. Signature Date $61.75 1