HomeMy WebLinkAboutPermit Mechanical 2002-09-18l-
Job# 02-01125-01
RESIDENTIAL PERMIT
Caty Of Springfield
Community Services Division
Building Safety
Page 1
SPRINGFIELD
225 Fifth Street
Springfield, OR97477
Location Of Proposed Site: 582 00028th St Spr
AssessorsMap#: 17033614
Lot: Block: Addition:
Job Number: 02-01 125-01
Office: 726-3759
!nspection Line: 726-3769
Tax Lot#: 02500
Subdivision:
ctTY oF SPRINGFTELD, OREGON
Owner: Elisa Cravvford
Address: 287 D Street
Scope Of Work: Mechanical
Phone Number:
Gity/State/Zip:
Repair
541-682-2094
Creswell, OR 97426
Value: $0
Change out gas to gas in all 4 units
Gontractor Type
MechanicalContr
Contractor
Beymer Heating and Sheet Metal
300 River Rd, Eugene, OR 97404
Registration #
04483
Expiration Date
11114t2002
Phone
541 -688-5004
\att{'9e\too:
.00\Office Use
Land Use:b.j
o
\h
Quad Area:
# Of Units:
Gonstr. Type:
Water Heater:Range:
To request an inspection call the 24 hour recording at
a.m. will be made the same working day, inspections
working day.
Rough Gas
Rough Mechanical
FinalGas
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:
up:
before 7:00
be made the following
C
Required lnspections
Mechanical
-After line is installed and capped if not attached to an appliance.
-Prior to cover.
-When allgas work is complete.w
Mfum*:y#of!
Gurenltftfi6Q u^' ' Proposed Units:
Census Udde: Does not apply
Accessory:Total:
Zoning Code:
Bedrooms:
1E\
\h
Job# 02-01125-01 Page2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical lssuance
State Surcharge - Mechanical
Tota! Mechanical
09t18t2002
09t18t2002
09118t2002
09118t2002
09118t2002
1 0656
1 0656
1 0656
1 0656
1 0656
4
$.00
$3.84
$48.00
$10.00
$3.36
$6s.20
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.
$65.20
u---7-tg-oz
Signature Date