HomeMy WebLinkAboutPermit Mechanical 2001-04-02SPRINGFIELD
Job# 01-00313-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 400 00021st St Spr
Assessors Map#: 17033613
Lot: Block: Addition
Job Number: 01-0031 3-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot #: 7600
Subdivision:
ctTY oF SPRilVGFfiELq OREGON
Owner: Robert Eugene Batchelor
Address: 400 21st Street
Scope Of Work: Mechanical
Phone Number:
City/State/Zip:
New
541-747-5318
Springfield, OR97477
Value: $O
lnstalling gas line for water heater and gas range
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
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.
Required Inspections
Mechanical
Rough Gas
Rough Mechanical
Gas Service
FinalGas
FinalMechanica!
Construction Types:
Occupancy Groups
# Of Buitdings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
Main:Accessory:Total:
- Prior to cover.
-After line is installed and line has been connected to a minimum of one appliance. Pressure ter
-When all gas work is complete.
-When all mechanicalwork is complete.
# Of Stories: Height (feet):
Current Units: Proposed Units
Census Code:Does not apply
Fee Paid On Receipt# Value/Quantity Fee Amount
One to Four Outlets
Minimum Mechanical Permit
Mechanical
0410212001
0410212001
1 $2.00
$13.00
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Job# 01-00313-01 Page 2 ot 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Administrative Fee - Mechanical
ApplianceVent (Not Covered in Schedult
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
04t02t2001
04t0212001
0410212001
04t0212001
$.45
$.00
$10.00
$1.05
$26.s0
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 the proper time and that the project address is readable from the street.
Signature Date
$26.50
4/z1ot
ffi Job:01-00313-01
Address:400 21st St
Owner: Robert Eugene Batchelor
Fees
Mechanical
Vents
ApplianceVent (Not Covered in Schedule)
Gas PiPing SYstem
One to Four Outlets
Minimum Mechanical Permit Fee
Minimum Mechanical Permit
Mechanical lssuance Fee
Mechanical lssuance
SubTotal
MechanicalAdmin
Administrative Fee - Mechanical
SubTotal
Mechanical Surcharge
State Surcharge - Mechanical
SubTotal
FEE DETAILS
Value/QuantitY
1.00
Received: 412101
Unit: BLDG:FLR:
Amount Due Amount Paid
2.00
13.00
10.00
25.00 0.00
0.45
0.45 0.00
0.00
1.05
1.05
Totalfor Mechanical 26.50 0.00
Grand Tota!:26.50 0.00
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