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HomeMy WebLinkAboutPermit Mechanical 2000-06-29r Job# 00-01028-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 SPRTTGFIELD €n 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1919 00022nd St Spr AssessorsMap#: 17032500 Lot: Block: Addition: Job Number: 00-01028-01 Office:726-3759 !nspection Line: 726-3769 Tax Lot#: 00204 Subdivision: ctTY oF sPRtntGFtELq OREGON Owner: Dennis Harlow Address: 2222R Street Scope Of Work: Mechanical heat pumP Phone Number: City/State/Zip: Alteration 541-7464062 Springfield, OR97477 Value: $O Contractor Type MechanicalContr Contractor Home Comfort Heating & Air Condit* Po Box 24205, Eugene, OR 97402 Registration # 84164 , Expiration Date 6t25t01 Phone 541-345-2838 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made working day Required Inspections Mechanical Rough Mechanical - Prior to cover, FinalMechanical -When all mechanical work is complete. the following rosail ? Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? ! Area (Sq. Main: # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Accessory:Total: h${ Job# 00-01028-01 Page 2 ot 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit Mechanical Administrative Fee Less than '100,000 BTU Mechanical lssuance State Surcharge For Mechanical Permit Total Mechanical 06t29t2000 06/29/2000 06129t2000 0612912000 06t2912000 2390 2390 2390 2390 2390 1 $e.00 $.45 $6.00 $10.00 $1.05 $26.50 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 ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time and that the project address is readable from the street. Signature Date s26.50