HomeMy WebLinkAboutPermit Mechanical 2003-02-26City of Springfield
Mechanical Permit
Status: Issued
225 Fifth Street
Springfield Oregon 97 477
541-726-3759 Phone
541-726-3676Fax
541-7 26-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
MEC2003-00012
2126t2003
2t26t2003
8t26t2003
SITE ADDRESS:
ASSESSOR'S PARCELNO.:
1230 5THST
170326340s500
Springfield
TYPE OF WORK:
TYPE OF USE:
Addition
Residential
PROJECT DESCRIPTION: Wood Stove Insert
COLLINS VIRGIL RAY & LINDA
1230 N FIFTH ST
SPRINGFIELD OR97477
ME CHANICAL C ONTRACTO&
CCB #
W
TI.{IS PER[4IT SHALL EXPIRE IF THE iI,'OftKAi.llHr:EiZ[D UNiiFH Ti-ilS pEBn,lit-i:r iiC i
r.., i r i l" i l ESdr4ti|qaiDa1eA ij r\ I,t u C ii i lr I U ;i
:: 'i'1.: l-, r,,,. 1'
:ation
Description
+ lloh Administrative Fee
+ 7%o State Surcharge
Minimum/Adiustments - Mech
Wood Stove
Amount Paid
4.50
3.15
15.00
30.00
Date Paid
02t26/2003
02/26/2003
02126/2003
0212612003
Receint Number
1200200000000000748
1200200000000000748
1200200000000000748
1200200000000000748
To Request an inspection call the 24how recording at7264769. All inspections rcquested 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 Inspections:
1 Final Mechanical: When all mechanical work is complete.
2 Pellet Insert: After installation
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certifu 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 Springfield and the laws of the State of Ongon pertaining to the work described herein. I
further certify 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 requested at the proper time, that each address is readable from the
street, and that the approved set ofplans, if applicable, will remain on the site at all times during construction.
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Date
as:K{ttrrtn
212612003
8:51:23AM
CitY of SPringlield
DeveloPment Services DePartment
Public Works DePartment
Official ReceiPt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #z 1200200000000000748
ne Items:
Amount Paid
JoUJoumdNumb€r Dg.rlptior
30.00MEC2003-0OOI2 Wood Stove
15.00MBC20O3-0OO12 Minimur/Adiustnents - Mech
3.15
MEC20O3-OOO12 + 7% Starc Surchnrge
4.50
MEC2003-00012 + 10o/' Administrative Fee
Line Item Total:$52.6s
Payments:
Received By Check Number Confirm No How Received Amount Paid
Type ofPayment Paid By
In Person 52.65
Check LINDA COLLINS lkw 2354
Total:
Date: 0212612003
Page I of I cReceipt.rPt