HomeMy WebLinkAboutPermit Mechanical 2002-09-09Job# 02-01072-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 ot 2
Job Numbe r= 02-0107 2-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00400
Subdivision:
SPRINGFIELD
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225 Fifth Street
Springfield, OR97477
Location Of Proposed Site: 255 00038th St Spr
AssessorsMap#: 17023142
Lot: Block: Addition:
clTY oF sPRtNcFtELD, OREGON
Owner: Cynthia Coachman
Address: 255 38th Street
Scope Of Work: Mechanical
lnstall range hood and vent
Phone Number:
City/State/Zip:
Alteration
541-744-2521
Springfield, OR 97478
Value: $0
Contractor Type
GeneralContr
Contractor
David Brundage
PO Box 425, Walterville, OR 97489
Registration #ration Date
102755
Phone
541-746-4503
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# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
htJ'
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 lnspections
Mechanical
Rough Mechanical
Fina! Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:
- Prior to cover.
-When all mechanicalwork is complete.
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Accessory Total
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O\.
Job# 02-01072-01 Page 2 ot 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Hood and Exhaust
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
Mechanical
09t09t2002
09t09t2002
09t0912002
09t09t2002
09t09t2002
10550
10550
10550
10550
10550
1 $9.00
$36.00
$3.60
$10.00
$3.1 5
$61.75
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
o 701.055 will be used on this proj ect. I further agree to ensure that all required inspections are
the project address is readable from the street.at the proper time and
$61.75
'.- d-L-
Date