HomeMy WebLinkAboutPermit Mechanical 2005-09-02Buitdin g/Co mbination Permit
Status: Issued
225 Fifth Street, Springfield OR
541:726-3753 Phone
541-726-3676Fax
541:7 26-37 69 I ns pe ction Line
PERMIT NO: COM2005-01203ISSUED: 0910212005
APPLIEDz 0910212005
E)PIRESz 0310212006
VALUE:
SITE ADDRESS: 202 20TH ST
ASSESSOR'S PARCEL NO.: 1703364201800
PROJECT DESCRIPTION: Gas pipe and propane gas insert
Springlield TYPE OF
TYPE OF USE:
Heating System
Residential
Phone Number: 541-747-2094Owner:
Address:
Contractor Type
Mechanical
DORSY HAI\COCK
202 N 2OTH ST
SPRINGFIELD OR 97477
:iff,liH*,u*Etr,+ftHr:Sl[:Xi,i'iilil1T],"
Expiration Date
03t27t2007
Phone
541-726-5723
)R INFORMATION
Type:
Energy Path:
Sprinkled
Overlay Dist:
# Street Trees
Paved Drive Rqd:
oh 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:
ru\es
,honB
cation
# of Bedrooms:
Frontyrrd Setbaclc
Side l Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
nla
Sidewalk Type:
Downspouts/Drains
REQUIRED PARKING
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplier
Square Footage
orBkI Amount
DEVELOP MENT I NFORMATI(
Description Tvpe of Construction
I of 2
Value Date Calculated
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of
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Valuation Descrintion I
Status: Issued
225 Fifth Street, Springfield, OR
541.,!726-3753 Phone
541-726-3676Fax
541.:7 26-37 69 I nspe ction Line
Buildin g/Combination Permit
PERMIT NO: COM2005-01203ISSUED: 0910212005APPLIEDz 0910212005E)PIRESz 0310212006
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ l0o Administrative Fee
+ 7Vo State Surcharge
Gas Fireplace
LP Gas Tank & Piping
Minimum/Adj ustment Mechanical
Total Amount
Amount Paid
Total Value of Project
Date Paid
9t2los
9t2105
9t2t05
9t2t05
9t2t0s
9t2t05
Receipt Number
1200500000000001292
1200500000000001292
1200500000000001292
1200500000000001292
1200500000000001292
1200500000000001292
$10.00
$4.s0
$3.15
$15.00
$12.00
$18.00
$62.65
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00
a.m. ryill be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certi$ 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 wonk described herein,
and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division'
Building Safety. I further certiff 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
Reouired fnsnections
Owner or Contractors Signature
2of2
Date
5-7a=-
I
rees raro I
225_Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
oity of Springfield Official Receipt
evelopment Services Department
Public Works Department
RECEIPT#: 1200500000000001292 Date: 0910212005 8:54:09AM
Job/Journal Number
coM2005-01203
coM2005-01203
coM2005-01203
coM2005-0r203
coM2005-01203
coM2005-01203
Description
+ 1Yo State Surcharge
+ l0% Adminishative Fee
Gas Fireplace
LP Gas Tank & Piping
-Mechanical Issuance Fee-
Minimum/Adj ustment Mechanical
Amount Due
3.ls
4.50
15.00
12.00
10.00
18.00
Item Total:$62.6s
Payments:
Tlpe of Payment Paid By
uheckNumD€r Aumonzatlon
Received By Batch Number Number How Received Amount Paid
Check AMBASSADOR PIPING INC djb 8777 In Person
Payment Total:
$62.6s
-$6-2J-f
I
'(
9t212005 lofl
ryE