HomeMy WebLinkAboutPermit Mechanical 2004-01-26Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00105ISSUED: 0112612004
APPLIEDz 0112612004
EXPIRESz 0712612004
VALUE:
SITE ADDRESS: 157 lzTIJ ST SPACE 73
ASSESSOR'S PARCEL NO.: 1703354100201
PROJECT DESCRIPTION: Replace electric furnace
Springfield TYPE OF WORK: Heating System
TYPE OF USE: Repair Residential
Owner:
Address:
BLACKMORE BONNE J & LESTER W
157 N I2TH ST #73 SPRINGFIELD OR 97477
Contractor Type
Mechanical
Contractor License
ASSOCIATED HEATING & AIR CONDITIO 106275
Expiration Date
08t3u2004
Phone
541-683-2590
)NTRACTOR INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
NTION:Oregon lavv requlres you rG
r*neadmficd&toltp Oregon Util ity
rtifi Ce les are set for
OAR oAB 952-OO
r90 ies of the rules !
cal
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh ofLot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
ol
ffiugenter. (Note: the telephone
for the Oregon Utility Notification
Sidewalk Type:
NOTICE:Downspouts/Drains
THIS PERMIT S HALL EXPIRE IF TH E WORKAUTHORIZED U NDER THIS PEBM IT IS NOICOMMENCEDOB IS ABANOON ED FOR
REQUIRED PARJ(NG
Total:
Handicapped:
Compact:
L
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
Pase I of2
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
rutn
g
Description Type of Construction Value Date Calculated
t ullJt-rll\(, rN11uKlvr,q Ilglu
Valuation Description I
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00105ISSUED: 0112612004APPLIEDz 0112612004EXPIRES: 0712612004
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ l0o/o Administrative Fee
+ 7%o State Surcharge
Furnace - up to 100,000 btu
Minimum/Adj ustment Mechanical
Total Amount Paid
Amount Paid
$10.00
$4.50
$3.1s
$12.00
$33.00
$62.6s
Date Paid
u26t04
u26t04
u26t04
u26t04
u26t04
Receipt Number
r200400000000000108
1200400000000000108
1200400000000000108
1200400000000000108
1200400000000000108
To Request an inspection call the 24 hour recording at 726-3769. AII 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.
I Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
Reou
\
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 701.005 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.
c/-{A [//t-4.'^-a4r\/07
Owner or Contractors tifonature
,l
)C
Paze2 of2
rees raro
d^*ltt,.---'
olt"
225 Fifth Street 4!
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
08 Date:
coM2004-00105
coM2004-00105
coM2004-0010s
coM2004-00105
coM2004-00105
Furnace - up to 100,000 btu
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7%o State Surcharge
+ lU%o Administrative Fee
12.00
33.00
10.00
3.15
4.s0
Item Total:$62.65
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check ASSOCIATED HEATING llh lllSl In Person
Payment Total:
s62.6s
$62.6s )