HomeMy WebLinkAboutPermit Mechanical 2004-07-27F
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2004-00935ISSUED: 0712712004
APPLIEDT 0712712004
EXPIRESz 0112712005
VALUE:
PROJECT DESCRIPTION: Change out heat pump
Owner: EMMONS DONALD M & MERLENE J
Address: 3228 VALLEY MEADOWS CRT SPRINGFIELD OR 97477
SITE ADDRESS: 3228 VALLEY MEADOWS CT
ASSESSORTS PARCEL NO.: 1702302103800
Springfield TYPE OF WORK: Heating System
TYPE OF USE: Repair Residential
LicenseContractor Type
Mechanical
Contractor
COMFORT FLOW
Expiration Date
06t27t2005
Phone
s4t-726-0100460
)NTRACTOR INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
THE WORK
MIT IS NOT
ED FOR
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:nla
E{l Itsllfol
rutss arc
REQUIRED PARIflNG
Total:
Handicapped:
Compact:
DEVELOPMENT INFORMATION
Description Type of Construction
Total Value of Project
Value Date Calculated
\
PERMIT&{AL{TEXPIRE
!
180
Valuation Description I
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2004-00935ISSUED: 0712712004APPLIED: 0712712004
EXPIRESz 0112712005
VALUE:
tr'ees Paid
Fee Description
-Mechanical Issuance Fee-
+ l0/o Administrative Fee
+ 7%o State Surcharge
Heat Pump
Minimum/Adj ustment Mechanical
Total Amount Paid
Amount Paid
$r0.00
$4.s0
$3.1s
$12.00
$33.00
$62.65
Date Paid
7t27t04
7t27t04
7127104
7t27t04
7t27t04
Receipt Number
1200400000000001 144
1200400000000001 144
1200400000000001144
1200400000000001144
1200400000000001 144
PIan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection 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 work
day.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon 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 Springlield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
D7/ali q
Owner or Contractors Signature Date
Pase2 of2
l(eourreo lnsDectrons
I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
city of Springlield Official Receipt
velopment Services Department
Public Works Department
RECEIPT#: 1200400000000001144 Date: 0712712004 10:50:34AM
Job/Journal Number
coM2004-00935
coM2004-0093s
coM2004-00935
coM2004-00935
coM2004-00935
Description
+ 7Yo St^te Surcharge
+ l0% Administrative Fee
Heat Pump
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Amount Due
3. l5
4.s0
12.00
33.00
10.00
Item Total:$62.6s
Payments:
Type of Payment Paid By
uhecl(Number Authorization
Received By Batch Number Number How Received Amount Paid
Check COMFORT FLOW djb 2666s In Person
Payment Total:
$62.6s
-$62i-f
7t27/2004 Page I of I
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