HomeMy WebLinkAboutPermit Building 2001-09-21Job# 01-00398-02
RESIDENTIAL PERMIT
City Of Springfield
Gommunity Services Division
Building Safety
Page 1 of 2
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1919 00022nd St 37 Spr
AssessorsMap#: 17032500
Lot:37 Block: Addition
Job Number: 01-00398-02
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00204
Subdivision: Maia
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Owner: Robert Kelley
Address: 191922nd, Space 37
Scope Of Work: Manufactured Home on Private Lot
This is a copy with a new Sequence Number
Phone Number:
City/State/Zip:
New
541 -746-8sB0
Springfield, OR97477
Value: $O
Contractor Type
MechanicalContr
Contractor
Absolute Comfort MHC
PO Box 861, Turner, OR 97392
Registration #
084104
Expiration Date
6t1t02
Phone
503-743-3901
Quad Area:
# Of Units:
Constr. Type: (VN) Wood Frame
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group: Dwelling
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour 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 Mechanical
FinalMechanical
Construction Types(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
- Prior to cover.
-When all mechanical work is complete.
Accessory Structure
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: New Mfg Home
Main:Accessory:Total:
Job# 01 -00398-02 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit
Administrative Fee - Mechanical
3hp - - 100,000 BTU
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
09121t2001
09t21t2001
09t21t2001
09t21t2001
0912112001
6768
6768
6768
6768
6768
1
$33.00
$3.60
$12.00
$10.00
$3.1s
$61.75
Grand Tota!
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 Springfield 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 701.055 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 propery, and the
approved set of plans will remain on the site at alltimes during construction.
Date
$61.75
Signature