HomeMy WebLinkAboutPermit Mechanical 2004-05-11o
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-00ss7ISSUED: 0ifltt}004APPLIED: 05/10 t2004EXPIRESz tUtUZ004
VALUE:
SITE ADDRESS: 570 33RD ST
ASSESSOR'S PARCEL NO.: 1702312405000
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New ResidentiatPROJECT DESCRIPTION: Install heat pump and air handter
owner: SMALLEy PETERA.E. & ARwyN L.E.Address: 570 33RD ST SPRINGFIELD OR 97478
Contractor Type
Mechanical
Contractor
CHITTIM ENTERPRISES I INC
License
47396
Expiration Date
03/08/2005
Phone
541-461-210t
# of Units:
Primary Occupancy Group :
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
SHALLffi
UNDER THIS PERMIT IS NOT
OR IS ABANDONED FOR
PERIOD.
$ Per Sq Ft
or multiplier
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
R-3
VN
NOTIGE:
street ImprorementsJ il I s PE R M lT
Storm Sewer a"auauf,i'
i l'1 0 ri I Zt D
ip..i"t Instruction: C0MM ENCED
ANY 1 BO DAY
Square Footage
or Bid Amount
Sidewalk Type:
Downspouts/Drains:
Notes:
Total Value of Project
Pase I of2
DEVELOPMENT
PUBLIC IMPROVEMENTS
Description Type of Construction Value Date Calculated
m
It U ll:l-rll\ (, 11\ i t It1VLq,! 42fll
Valuation Description I
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
ITY
Building/Combination Permit
PERMIT NO: COM2004-00557ISSUED: 0511112004APPLIED: 05/1012004
EXPIRESz lllltl2004
VALUE:
tr'ees Paid
Fee Description
-Mechanical Issuance Fee-
+ l0o Administrative Fee
+ 1o/o State Surcharge
Air Handling Unit Up to 10'000
Heat Pump
Minimum/Adjustment Mechanical
Total Amount Paid
Amount Paid
$10.00
$4.s0
$3.1s
$8.00
$12.00
$25.00
$62.6s
Date Paid
sny04
sny04
5nu04
snu04
sfiU04
5nu04
Receipt Number
1200400000000000710
1200400000000000710
1200400000000000710
1200400000000000710
1200400000000000710
1200400000000000710
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon 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 pertaining to the work described herein, and
that NO OCCUPANCY witl be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times
5\ rr \ o-t
Owner or Contractors Signature
Pase 2 of 2
Date
J
Keourreo InsDecuons
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 phone
nrty of Springlield Official Receipt
-velopment Services Department
Public Works Department
RECEIPT #:1200400000000000710 Date: 0511112004 t0:2Sz44ANr
Job/Journal Number
coM2004-00557
coM2004-00557
coM2004-00557
coM2004-00557
coM2004-00s57
coM2004-005s7
Description
-Mechanical Issuance Fee-
+ 7yo State Surcharge
+ l0% Administrative Fee
Air Handling Unit Up to 10,000
Heat Pump
Minimum/Adjustment Mechanical
Amount Due
10.00
3.1s
4.s0
8.00
12.00
25.00
Payments:
Type of Payment paid By
Check JAMES
COND
HEATING & AOR
Received By
dlm
Item Total:
Batch Number Number How Received
822 In Person
Payment Total:
$62.65
Amount Paid
$62.65
$62.65
snU2004 Page I of I
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