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HomeMy WebLinkAboutPermit Mechanical 2002-05-06225 Fifth Street Springfietd, OR g2477 Location Of proposed Site: AssessorsMap#: 17033600 Lot:Block: Owner:City Of SpringfieldAddress: Z2S Fifthstreet Scope Of Work: Mechanical Replace 5 ton heat pump PUBLIC PERMIT city Of Springfietd Community Services Division Buitding Satety 201 S O00.t8th St Spr Addition: Page 1 of 2 Job Number: 02-00517-01 Office: 726_3759 lnspection Line: 726_376g Tax Lot #: OO5O0 SPRINGFTELED Contractor Type MechanicalContr !:rglr Mechanicat rtnat Mechanical Handicap Access? Area (Sq Automatic Heat / Euor sgl3..;;,' ffi ,J ;iflil:J,T y_'., " _ Subdivision: Phone Number: 54 \9 s s$\$ $0 s 149452 # Expiration Date 10t22/2005 requested before 7:00a.m. willbe made the following D},, Contractor - Prior to cover -When all C phone 541-726_7654 Quad Area: # Of Units: Constr.Type:(VN) Wood FrameWaterHeater: To request an inspection call the 24 houra.m. willbe made the same working day,working day, # Of Buitdings: Occupancy Group: Heat source: Asmb w/o stage 3 Sq. Footage: :v ocI I:.::'::t'"n rvpes(VN) wooo FrametJccupancy GrouDs: # Of d;;;;evups:Asmb Mo stase 300_ Generat # Of Bedrooms: # Of Stories:Storage Current Units: Census Gode: Does not Business Height (feet): proposed Units: apply crrY oF SPRINGFTELD, OREGON Main: Totat: -loU* OZ-00517-01 - Office Use Land Use: PageZ of 2 Fee Paid On Receipt# ValuelQuantity Fee Amount Mechanica! Minimum Mechanical Permit 8% Administrative Fee - Mechanical 3hp-- 100,000BTU Mechanical lssuance State Surcharge - Mechanical Total Mechanical 05106t2002 05t06t2002 05t06t2002 05t06t2002 05t06t2002 8852 8852 8852 8852 8852 1 $33.00 $3.60 $12.00 $10.00 $3.1 5 $61.75 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 ti and that the project address is readable from the street. Signature $61.75 -o> Date Job{ 02-00!11{1 l