HomeMy WebLinkAboutPermit Mechanical 2004-12-15BPRU{CFISI.D
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3616 Fax
541 -7 26-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2004-01522ISSUED: 1211512004APPLIEDz 1211412004EXPIRES: 06/1512005
VALUE:
SITE ADDRESS: 449 9TH ST
ASSESSOR'S PARCEL NO.: 1703351308000
PROJECT DESCRIPTION: Gas furnace
Springlield TYPE OF WORK: Heating System
TYPE OF USE: Repair Residential
PhoneNumber: 541-746-0463
License
Owner:
Address:
KENNETH EILERS
449 N 9TH SPRINGFIELD OR 97477
Contractor Type
Mechanical
Contractor
COMFORT FLOW
Expiration Date
06t27t200s .
Phone
541-726-0100
# 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:
Special Instruction:
Notes:
Structure
r Type:
Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
o/o of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:nla
$ Per Sq Ft
or multiplier
1$
Square Footage
or Bid Amount
PARKING
DEVELOPMENT INFORMATION
Description Type of Construction
Total Value of Project
Value Date Calculated
!
Valuation Description I
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-01522ISSUED: 1211512004APPLIED: 1211412004
EXPIRES: 06/1512005
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ llYo Administrative Fee
+ 77o State Surcharge
Appliance Vent
Furnace - up to 100,000 btu
Minimum/Adj ustment Mechanical
Total Amount Paid
$10.00
$4.50
$3.15
$6.00
$12.00
$27.00
t2n5t04
r2lt5l04
t2n5t04
tzlt5l04
t2lt5l04
12n5t04
Receipt Number
1200400000000001748
120040000000000r748
1200400000000001748
1200400000000001748
1200400000000001748
1200400000000001748
Amount Paid
$62.6s
Date Paid
Plan Reviews
To Request an inspection call the 24 hour recording at 726-3769, All inspection 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 work
day.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Reou
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 Springfield 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.
Owner or Contractors Signature
Paee 2 of 2
Date
_r ees raro
SPnrilGrtaro trity of Springfield Official Receipt
jvelopment Services DePartment
Public Works Department
225 Fifth Street
Springfietd, Oregon 97 477
541-726-3759 Phone
RECEIPT#: 1200400000000001748 Date: 1211512004 1:24:l5PM
Job/Journal Number
coM2004-0 r s22
coM2004-01522
coM2004-01522
coM2004-0t522
coM2004-0t522
coM2004-0t522
Description
+ 70% State Surcharge
+ l0%o Administrative Fee
Furnace - up to 100,000 btu
Appliance Vent
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Amount Due
3. l5
4.s0
12.00
6.00
27.00
10.00
Item Total:$62.65
Payments:
Type of Payment Paid By
Check Number
Received By Batch Number
Authorization
Number How Received Amount Paid
Check COMFORT FLOW djb 28065 In Person
Payment Total:
$62.65
-56r-6-T
t2/t5t2004 Page I of I