HomeMy WebLinkAboutPermit Mechanical 2001-05-04|5PFINGFIELD
Job# 01-00462-01
RESIDENTIAL PERMIT
City Of Springfield
Gommunity Services Division
Building Safety
Page 1 of 2
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2819 Villa Way Spr
AssessorsMap#: 17032332
Lot: Block: Addition:
Job Number: 01-00462-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 02200
Subdivision:
ctTY oF SPRINGFfiELq OREGOTV
Owner: Graig Windmer
Address: 2819 Villa Way
Scope Of Work: Mechanical
Phone Number:
City/State/Zip:
New
541-744-2807
Springfield, OR97477
Value: $0
Contractor Type
MechanicalContr
Contractor
American Gas Appliance Service lnc
618 Hamilton St, Springfield, OR
97477-3611
Registration #
77621
Expiration Date
10131t02
Phone
541 -954-4686
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection callthe 24hour recording a1726-3769. 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 Gas
Gas Service
FinalGas
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
-After line is installed and line has been connected to a minimum of one appliance. Pressure ter
-When all gas work is complete.
EXP\flE \F IHEWORK
TH\S PER
# Of Stories:
Current Units:
Census Code: Does not apply
i 1IHALL
P
M\T \SNOT
Main:Accessory:Tota!
ABANDONED
FOR
Job# 01-00462-01 Page 2 of 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
05t04t2001
0510412001
05104t2001
0510412001
05t04t2001
05t04t2001
5174
5174
5174
5174
5174
5174
1
2
$2.00
$4.00
$.45
$9.00
$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
I further agree to ensure that all required inspections are
project address is readable from the street.
Signature I Date
$26.50
.fhr
oRS 701.055 be
requested at