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
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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