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HomeMy WebLinkAboutPermit Mechanical 2001-03-27SPRINGFTELD Job# 01-00292-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2819 VILLA Way Spr AssessorsMap#: 17032332 Lot: Block: Addition: Job Number: 01 -00292-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 02200 Subdivision: ctTY oF SPRTNGFIELD, OREGOTV Owner: Craig Widmer Address: 2819 Villa Way Scope Of Work: Mechanical Phone Number: City/State/Zip: New 541-744-2807 Springfiled, OR97477 Value: $O lnstalling gas line, 2 inserts & water heater 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 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. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Feet) Main:Accessory: # Of Stories: Height (feet): Current Units: Proposed Units: Census Code:Does not apply Total: Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical ApplianceVent (Not Covered in Schedult Gas Fireplace Mechanical lssuance State Surcharge - Mechanical Total Mechanical 03t27t2001 0312712001 0312712001 03t27t2001 0312712001 03t27t2001 03t27t2001 4775 4775 4775 4775 4775 4775 4775 1 2 $2.00 $.00 $.47 $4.50 $e.00 $10.00 $1.09 $27.06 Grand Total $27.06 1 Job# 01-00292-01 Page 2 of 2 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 allwork 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 ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are at the proper time that the project address is readable from the street. g - 2t-ol Date