HomeMy WebLinkAboutPermit Mechanical 2002-12-16City of Springfield
Mechanical Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 9747 7
541-726-3159 Phone
541-126-367 6Fax
541-7 2 6-3769 Inspection Line
PERMITNO.:
ISSUED:
APPLIED:
EXPIRES:
MEC2002-00127
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SITE ADDRESS: 943 4TH ST Springfield
ASSESSORS PARCEL NO.: 1703352107700 TYPEOF WORK: New
TYPE OF USE: Residential
PROJECT DESCRIPTION: Install Gas Fireplacd
QWNtrUAPPLIEANT: MECHANICAL CONTRACTOR:
POISEL AMY E KEITH LEESMAN 541.995.6157
943 4TH ST 835 N 8TH ST
SpRTNGFTELD ops741.1- HARRISBURG OR 97446
CCB # 72082 Expiration Date: 04104/2003
Descrintion
+ 7%o State Surcharge
+ 8olo Adrrinistrative Fee
-Issuancc Fee.'
Gas Fire place
MinimLrmiAdjustments - Mech
Amount Paid
3.15
3.60
10.00
15.00
30.00
Date Paid
1211612002
1211612002
1211612002
lI"l{iffiffict,
Receint Number
2200200000000000309
2200200000000000309
2200200000000000309
2200200000000000309
2200200000000000309
Cashier
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To Rcqucst an inspection call the 24hotr recording at willbe made
the sarne working day, inspections requested after 7:00 a.m. will be made the
Required Inspections:
1 Rciugh Gas: After line is installed and capped if not attached to an appliance.
2 I;inal Gas: When all gas work is complete.
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certiff that all
information hereon is true and correct, and I further certiff that any and all work performed shall be done in accordance with
the Ordinances ofthe City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I
further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I
frrther agree t0 ensure that all required inspections are requested at the proper time, that each addres is readable from the
stre that the approved set of plans, if applicable, will remain on the site at all times during construction.
Owner or Con
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Date
t/o
Signature