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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