HomeMy WebLinkAboutPermit Mechanical 2003-09-11-i
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Building/Combination Permit
Issued
'itrect, Springfield, OR
.1753 Phone
.t676 Fax
- r69 Inspcction Line
PERMIT NO: COM2003-00892ISSUED: 0911112003APPLIED: 09/1112003EXPIRES: 03/1112004
VALTJE:
iliSS: 2443 38TH ST
i'S I),\RCEL NO.: 1702194209900
'' DIISCRIPTION: Extend gas line to fireplace and range.
\\/ILSON ZANE O & MARY BETH
21-13 N 38TH ST SPRINGFIELD OR 97477
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Alteration Residential
',rr TYpe
I
Contractor
MARSHALLS INC
License
25790
Expiration Date
12t23t2003
Phone
541-747-744s
CONTRACTOR INFORMATION
t
Irtgs:
'e crrl)ilncy Group:
')e crrllurrcy Group:
'..,rslruction TypO
/ionstruction Type:
tirs:
ETBI\CKS
' Sct[rack:
rr c li:
.:ck:
cl llnck:
,lis:
'rovcmcnts:
''cr Available:
Ad,tH,IJiu'
follow rules ad opted bY
Notification Center
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
o/o of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
urr law lequlles !ott lu
the Oregon UtilitY
e rules are set tfhos
Sidewalk Type:
Downspouts/Drains:
SHALL
REQUIRED PARIflNG
Total:
Handicapped:
Compact:
EXPIRE IF THE WORK
NED TOR
ilOIICE:
0090. You maY o
10 through OAR 952-00
r. (Note:the
AR 952-001-00
calling the cente
nurnberforthe Or egon Utilitt
$ Per Sq Ft SquarAFilofr&{J
multiplier or Bid Amount
Total Value of Project
Page I of2
HORIZED
MENCED OR is nsnNoo
PERIOD.
Type of Construction
OAY
Value Date Calculated
o
a\
I,ull,r[r\ L; rN r ur(lY!,q'! r!2N_]
r'
l-
Building/Combination Permit
I ssucd
','cct, Springfield, OR
,5-1 Phone
- 6 l:ax
") Inspection Line
PERMIT NO: COM2003-00892ISSUED: 0911112003APPLIEDz 0911112003EXPIRES: 03/1112004
VALUE:
ees Paid
''I ion
'rl Issrrnnce Fee-
'irrislr:rtive Fee. "rrrcltarge
t-l
', \. r! i rrst lncnt Mechanical
"rrt:rl ,\ntount Paid
Amount Paid
$10.00
$4.s0
$3.15
$4.00
$41.00
$62.65
Date Paid
9mt03
9fiu03
9nu03
9nu03
9fiu03
Receipt Number
1200200000000002r09
1200200000000002109
1200200000000002r09
1200200000000002109
1200200000000002109
Plan Reviews
' :rrr inspection call the24 hour recording at 726-3769, All inspection requested before 7:00 a.m.
'..' lhc same working day, inspections requested after 7:00 a.m. will be made the following work
','lr Cas: After line is installed and required testing and capped if not attached to an appliance.
( l rs: \\/hen all gas work is complete.
', : strte and agree, that I have carefully examined the completed application and do hereby certify that all' '('()n is true and correct, and I further certify that any and all work performed shall be done in accordance with
't: ol'the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
('i 'l',\NCY will be made of any structure without permission of the Community Services Division, Building Safety.
t i i v t lt at only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
grt'c to cnsure that all required inspections are requested at the proper time, that each address is readable from the
' 're pcrmit card is located at the front of the property, and the approved set of plans will remain on the site at all
,.' ,rrsl rrrction.
t/\
c ?-a -a3
Signature Dateon't':tcl
Pase2 of?
m.d
Keourreo InsDectlons I
2l-5 Fifth Strtrt'. ,'ingficl r, 1':".'-:: t )1 ',i7
.'\-7)5-: 'e
eI
.,,()UUti , )
J(rl)/., ()uril:ri r\ tilttbef l )rscrr pt ion Amount Paid
coM2003-00892
coM2003-00892
coM2003-00892
coM2003-00892
coM2003-00892
Gas Outlets 1-4
Minimum/Adj ustment Mechanical
-Mechanical Issuance Fee-
+ 7Yo State Surcharge
+ lUoh Administrative Fee
4.00
41.00
10.00
3. l5
4.50
$62.65Item Total:
Payments:
Type ofPayment Paid By Received By
Check Number
Batch Number Authorization Number How Received Amount Paid
Check REV. ZANE WILSON dlm 4643 In Person
Payment Total:
$62.65
$62.6s
SPrrrirdFiEl la'Citl' of Springfield Official Receipt
f) s'r'l o yr r..r i.nt Services Dep artment
l' r: blic Works Department,
-'i-lrte:
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