HomeMy WebLinkAboutPermit Mechanical 2002-10-17Status: Issued
225 Fifth Street SpringfieH, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37 69 Inspection Line
CITY OF SPRIN FIELD
Building/C ombination Permit
PERMIT NO: COM2002-01226ISSUED: 1011712002
APPLIEDz 1011712002
E)GIRESz 0411712003
VALUE:
SITE ADDRESS: 157 lzTIJ ST SPACE 47
ASSESSOR'S PARCEL NO.: 1703354100201
PROJECT DESCRIPTION:
Owner: JOHNSON BESSIE A
Address: 4851 MAIN ST APT 205 SPRINGFIELD OR 97478
Springfield TYPE OF WORK Heating System
TYPE OF USE: New
Owner: SpRING LANE MOBILE VILLAGE
Address: l57lzTH ST #85 SPRINGFIELD OR 97477 ATTENI l0t\l:Uregon iaw regutres you tc
Owner: BOyDE BEHNKE
follow rules adopted bythe Oregon Utitity
Notification Center. Those rules are set foril'Address: t57lzTH sr SPACE#47 SPRINGFELD oR 9flOAR952-001-0010th rough oAB 952-001
,center. (Note: the telephone
the Oregon Utility Notification
Contractor Type
Mechanical
Owner
Contractor
HOME COMFORT HEATING & AIR
JOHNSON BESSIE A
Phone Number: 541-726-9853
Phone Number: 541-726-9853
Expiration Date Phone
06t25t2003 541-345-283884r64
Contractor
EVELOPMENT
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Avaitable:
Special Instruction:
# ofStories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
oh of Lot Coverage:
tffilr3fr&E:dtdt'Ituy
uoj 0I N00 Nve6$bHeen$dd{ l 0 3
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Jl luldxl]'lvHS llt/''Juld slHl
REar,frtil0ifirrNc
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains
Notes:
I of 2
Status: Issued
225 Fifth Stree[ SpringfieH, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37 69 Inspection Line
CITY
Buildin g/C ombination Permit
PERMIT NO: COM2002-01226ISSUED: 1011712002
APPLIEDT 1011712002E)PIRES: 0411712003
VALT]E:
Valuation Description
Description Type of Construction $ Per Sq Ft Square Footage
Total Value of Project
Value Date Calculated
Fee Description
+ 7%o State Surcharge
+ 87o Administrative Fee
-Mechanical Issuance Fee-
tr'urnace - up to 100.000 btu
Minimum/Ad i ustment Mechanical
Amount Paid Date Receipt Number
2200200000000000077
2200200000000000077
2200200000000000077
2200200000000000077
2200200000000000077
$3.1s
$3.60
$r0.00
$r2.00
$21.00
10n7t2002
10n7t2002
10n7t2002
10fi7t2002
101t7t2002
Received By
ddk'
ddk
ddk
ddk
ddk
Total Amount $49.7s
Total Fees Paid Prior ta 9l3ii.102
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
wiII be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
Fees Paid
Plan Reviews
Required Inspections
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any structure without permissbn of the Community Services Division,
BuiHing Safety. I further certi$ 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.
Owner or Contractors Signature
."/rntt/", ." 7. -2of2
Date ./(i -/ F-a Z-
I
225 FIF|H STREET . SPRINGFIELD, OR 97477 o PH:(541)726-3753 o FAX: (541)726-3689
CityJobnu^O"rW{s
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LOCATION OF PROPOSED WORK:f ar'/1 €'e t #c
ASSESSORS MAP:t7 b3fr +l
ADDRESS:
CITY:
DESCRITTION OF WORIC
NEW:
-
REMODEL:_
TAX LOT:
PHONE:72(o -qs53
ztP: f,l a {17
DEMOLISH: OTHER-VALUE:
I a?h 4
r1a I
NAME ADDRESS PHONE
ARCHITECT:
CONTRACTOR'S NAME ADDRESS
CONST.
CONTRACTOR #EXIIRES PHONE
GENERAL:
35
ELECTRICAL:
l\#
FT4
$+
0
B
w
hd4
6'{i
*'{q
il't{
kr
@*
&
Furnace
Exhaust Hood
Vent Fan No.
Wood Stove/lnsert/tireplace Unit
Mechanical Permit
State Issuance
Administrative Fee
State Surcharge
Total Mechanical Permit Fees
State Issuance
Administrative Fee
State Surcharge
Total Miscellaneous Permits
MM
Fixtures
Residential Bath(s) No.
Sanitary Sewer FI.
Water FI.
Storm Sewer FI.
Plumbing Permit
Administrative Fee
State Surchalge
Total Plumbing Fees
Total Mechanical Permits
Total Plumbing Permits
Total Miscellaneous Permits
TOTAL
TEE
Demolition
h6eehaffifea-E' P'[tmb,l*g' W...{[sqdEaneous
2t)I
3r*1, 6f?
INSPECTION REQUEST '726-3769
OFFICE: 726-3159
.;.,225 FtFTtl STREET
Z,:' SO**OaIELD, OREGON 97477
I. LOCATION INSl-h TAILATI
L
DESCRIPTION
EL IUCAL PERMIT APPLICATION
Jorr Number C.O fn ?NL'd>e,b
.. 3. COMPLETE FEE SCTIEDULE BELOW
City
z$t-
tlrvelling unit.
Itenrs Cost Sum
$ r 06.00oI 500
or portion
thereof
Each Mauufd Horne or
Ivlodular Du'elling
Sen,ice or Feeder $ s0.00
" $50.00
$69.00
$1oo.oo _
Permitsarenon-transferablean0e.$iie q,noa\o(€
if rvork is not started rvithin I80 dpygurrzect "'-
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor rse
1',Expiration Date -o
Su;lcnising Electriciun
B. Scrliccs or Feedcrs
AIf,fiNTItJN r[fits,9{],h?v;, : (1 s r { c':;
n'c . folh$[ulFoiddopt€d b-y=th-e oregor
Notification Center. Those rules ar
n O00trgS3{01sS010 th:'ouoh il-)A s 63.00
$ 75.0000g0lYopsua{nbtetr copies ct t
6Al I SngnhE 6€Shrp$l r;tCI : ih r; t +-$ 125 .00 _
n{frI{ ge-WnSpttff Orerye n Ll t i i i1v Ni
-_- src:.00
s375.00
s 50.00
Feeders
or Relocation
Oryners Name
P
OWNER ALLATION
The installation is being made on
property I orvn lvhich is not intended
for sale, lease or rent.
l€ Be h,r ke ''
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts see
"8" abot'e
E. I\'Iiscellnneous (Sen'icc/fceder. not inclutled)
-Each installation
Pump or irrigation
Linrited Energr'/Res
Li nrited Energry'Cornnr
4. SUBTOTALOFABOVE
7%o Stltc Surchurgc
8 7n Admini.stratit'c Fce
\51 tLYh s|+{1
Bralrch Circuits
UOfTgtf,teration
or Extension Pcr panel
iiirs.nE-nmgr$Hi!! EXeTRE lF THE *0ff0, 43_ -
nuifdniitri' il tl o r n T H I s P E R rvtff4$Nl
C 0 ffi#l'tt*uioa r l6iA&aNilQlrffi .[08
ANflBfSrfeeRtOO. $ 3 oo
$50.00
$50.00
$25.00
$+s,00
C
I\Iininrunr Electric Pernrit Ins;tcction Fce is S-15.00 * Surchar.gcs43-
Oryncrs Signature
TOTAL 5t.1S
Ncw'or
Inclutled:
aoc
_ $ 19.00 -