HomeMy WebLinkAboutPermit Mechanical 2001-03-19Job# 01-00254-01
RESTDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page '1 of 2
SPRINGFIELE,
h,
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2441 0001sth St Spr
AssessorsMap#: 17032433
Lot: Block: Addition
Job Number: O1-00254-01
Office:726-3759
Inspection Line: 726-3769
Tax Lot#: 01800
Subdivision:
crTY oF SPRTNGFIELD, OREGOTV
Owner: Lloyd Simmons
Address: 2441 15lh Street
Scope Of Work: Mechanical
Gas line, W/H & gas insert
Phone Number:
City/State/Zip:
New
541-746-0083
Springfield, OR97477
Value: $O
Contractor Type
Mechanical Contr
Contractor
ABC Stove Service
PO Box 108, Dexter, OR 97431
Registration # Expiration Date Phone
541-937-8618
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour 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.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:Accessory:
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
One to Four Outlets
Minimum Mechanical Permit
Administrative Fee - Mechanical
ApplianceVent (Not Covered in Schedult
Gas Fireplace
Mechanical lssuance
0311912001
0311912001
0311912001
0311912001
0311912001
0311912001
4703
4703
4703
4703
4703
4703
$2.00
$13,00
$.45
$.00
$.00
$10.00
Job# 01-00254-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
State Surcharge - Mechanical
Total Mechanical
Mechanical
0311912001 4703 $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
req at the roper time project address is readable from the street
Date
$26.50
7r-d/