HomeMy WebLinkAboutPermit Mechanical 2000-05-05SPRINGFIELD
Job# 00-00655-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
TRANS*:01-0001546
DAIE:I,IAY 05 2000
At'lT RECD:Z $ 26.50
CHANGE:
DASHIER:059
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 157 00012th St Spr
Assessors Map#: 17033541
Lot: Block: Addition:
Job Number: 00-00655-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00201
Subdivision:
clTY oF SPRINGFIELD, OREGOI'
Owner: Bessy Odell
Address: 157 12th Street #80
Scope Of Work: Mechanical
Phone Number:
City/State/Zip:
New
541 -746-3055
Springfield, OR97477
Value: $O
ContractorType Contractor
Manuf Home lnstall Marshalls Heating
4110 Olympic Street, Springfield, OR
97478
Registration # Expiration Date Phone
541-747-7445
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range
# Of Buildings:
Occupancy Grou
Heat Source:
p:
asi.ut$
\o1'
To request an inspection call the 24 hour
a.m. will be made the same working day,
working day
Rough Gas
FinalMechanica!
requested before 7:00
a.m. will be made the following
Construction Typesr
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:
Required lnspections
Mechanical
-When all mechanicalwork is complete.
# Of Sto
Current
Census Cod
\t
1os
Accessory:Total:5N
Units:
ool
\nl 6re a1(
'11
Job# 00-00655-01 Page 2 ot 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Mechanical Permit
Mechanical Administrative Fee
Less than 100,000 BTU
Mechanical lssuance
State Surcharge For Mechanical Permit
Total Mechanical
Mechanical
05/0s/2000
05/05/2000
05/05/2000
05/05/2000
05/05/2000
1546
1 546
1 546
1546
1 546
1
$9.00
$.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.
$26.50
._fla?2,Mzhr%,
Signature
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