HomeMy WebLinkAboutPermit Mechanical 2000-11-27SPFINGFIELD
Job# 00-01721-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 23BB 00009th St
AssessorsMap#: 17032612
Lot: Block:
spr
Addition:
Job N umbe r: 00-017 21 -01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot#: 01006
Subdivision:
ctTY oF sPRtilGFtELq OREGON
Owner: Samantha Hale
Address: 23BB gth
Scope Of Work: Mechanical
Contractor Type
Mechanical Contr
541-747-5371
springfield, OR
Value: $O(/'
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Registration #
84164
Expiration Date
6125101
Phone
541-345-2838
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Contractor
Home Comfort Heating & Air Condit.
Po Box 24205, Eugene, OR 97402
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Quad Area:
# Of Units:
Gonstr. Type:
Water Heater:
,(
- a-J
CP'ry
To request an inspection callthe 24hour recording at726-3769. All inspections 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.
- Required lnspections
Mechanical
Rough Mechanical
FinalMechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
- Prior to cover.
-When all mechanicalwork is complete
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Area (Sq.
Main:Accessory:Total:
Job# 00-01721-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit
Mechanical Administrative Fee
Less than 100,000 BTU
Mechanical lssuance
State Surcharge For Mechanical Permit
Tota! Mechanical
11t27t2000
1112712000
1112712000
11t27t2000
11127t2000
3872
3872
3872
3872
3872
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
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
requested at time that is readable from the street.
sig Date
$26.50
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