HomeMy WebLinkAboutPermit Mechanical 2001-01-05SPBINGFIELD
Job# 01-00018-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 5941 Thurston Rd Spr
AssessorsMap#: 17023422
Lot: Block: Addition:
Job Number: 01 -0001 8-01
Office:726-3759
tnspection Line: 726-3769
Tax Lot#: 00204
Subdivision:
crTY oF SPRINGFIELD, OREGOTU
Owner: Mrs Vaughn
Address: 5941 Thurston Rd
Scope Of Work: Mechanical
gas piping, insert and water heater
Phone Number:
Gity/State/Zip:
New
Springfield, OR 97478
Value: $0
Contractor Type
MechanicalContr
Contractor
Claxtons
215E.38th Ave, Eugene, OR 97405
Registration # Expiration Date Phone
s41484-9583
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Rough Mechanical
lnsert
FinalGas
FinalMechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
-Prior to cover.
-After installation.
-When all gas work is complete.
-When all mechanicalwork is complete.
# Of Stories:
Current Units
AUTHOH
Census Code: Does not apply
NOTICE:
THIS PERMIT SHALL EXPIHE IF THE WORK
THISPERMITISNOT
C0la
Accessory:Total:
FOR
Area (Sq. Feet)
Main:
To request an inspection call the 24 hour
a.m. will be made the same working day,
working day.
Job# 01-00018-01 Page 2 o't 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
One to Four Outlets
Minimum Mechanical Permit
Administrative Fee - Mechanical
Gas Fireplace
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
0110512001
0110512001
01105t2001
0110512001
01t05t2001
0110512001
4184
4184
4184
4184
4184
4184
$2.00
$8.50
$.45
$4.50
$10.00
$1.0s
$26.s0
Grand Total
By signature, I state and agree that I
hereby certify that all inform
performed shall be done in
the State of Oregon. I
ORS 701.055 will be
requested at the
Signature
examined the completed application and do
$26.s0
I further certify that any and all work
ces of the City of Springfield and the Laws of
rs and employees who are in compliance with
agree to ensure that all required inspections are
e project address is readable from the street.
and co
s
nis
ance
state that
on this
and
1
1