HomeMy WebLinkAboutPermit Mechanical 2000-06-20Job# 00-00975-01
RESIDENTIAL PERMIT
Caty Of Springfield
Community Services Division
Building Safety
Page 1 of 2
SPRINGFIELD
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 454 00021st St Spr
Assessors Map#: 17033613
Lot: Block: Addition:
Job Number: 00-00975-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 07400
Subdivision:
crTY oF SPRTNGFIELD, OREGON
Owner: Ruby and Jack Gorter
Address: 454 21st St
Scope Of Work: Mechanical
Phone Number:
City/State/Zip:
New
541-7464299
Springfield, OR
Value: $0
This is a copy with a new Application Number
Contractor Type
MechanicalContr
Contractor
Crystal Clean Air lnc
Po Box 24408, Eugene, OR 97402
Registration #
96878
Expiration Date
211712001
Phone
541-484-2286
Quad Area:
# Of Units:
Constr. Type:
Water Haater:
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 Z:dtl6ffil@Ebe made the following
working dav' THTspERIMTTSHALLEXpTRETFTHEWoHK
Required lnspections
Mechanica! I COiliN4ENCED OR lS ABANDONED FOR
Rough Mechanical -Prior to cover.
Final Mechanical -When all mechanicalwork is complete.
Construction Types
Occupancy Groups
# Of Buildings:
# Of Bedrooms:
Handicap Access?
# Of Stories: Height (feet):
Current Units: Proposed Units
Census Code: Does not apply
Main
(Sq. Feet)
Accessory:Total:
Job# 00-00975-01 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
Total Mechanica!
0612012000
06t20t2000
06t20t2000
06t20t2000
0612012000
2245
2245
2245
2245
2245
$9.00
$.45
$6.00
$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
1