HomeMy WebLinkAboutPermit Mechanical 2002-05-28Page 1 of2
SPRTNGFIELD
Job#o2-00622-01
spr
Addition:
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IHAIJET:
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225 Fifth Street
Springfield, OR97477
Location Of Proposed Site: 431 S 00037th St
AssessorsMaP#: 17023143
Lot: Block:
Owner: Daniel Perkins
Address: 431 S 37th Street
Scope Of Work: Mechanical
lnstall gas service and gas fireplace
Job Numbe r: 02-00622-01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot #: 01303
Subdivision:
RESIDENTIAL PERMIT
City Of SPringfield
GommunitY Services Division
Building SafetY
I
Contractor TYPe
Mechanical Contr
Contractor
Daniel Perkins
431 S 37th Street, SPringfield, OR
Phone Number: 541-726-2440
City/State/Zip: Springfield,OR97478
New Value: $0
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6-:,
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Buildings:
Occupancy GrouP:
Heat Source: Forced Air Gas
Sq. Footage:
nce.
minimum of one appliance. Pressure tes
C
ot
Phone
541-726-2440
Quad Area:
# Of Units:
Constr. TYPe:
Water Heater:
Office
Land Use:
Zoning Gode:
Bedrooms:
Range:
\
Gas
To request an insPection callthe 24 hour recording al 726-37 69. All insPections
a.m. will be made the same
working day.
working day, insPecttons requested after 7:00 a.m. will
Required lnsPections
Rough Gas
Rough Mechanical
Gas Service
FinalGas
Final Mechanical
Gonstruction TYPes:
OccupancY GrouPs:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
-Area (Sq
Main:
-After line is installed and
-Pnor to cover.
-After line is installed and line
-When all gas work is comPlete.
-When all mechanicalwork is co
# Of Stories:
Current Units:
Census Code: Does not apPlY
Height (feet):
Proposed Units:
ctrY oF SPRINGFIELD, OREGON
Accessory Total:
i\u'
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Job# 02-00622-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
One to Four Outlets
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
Gas Fireplace
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
05t28t2002
05t28t2002
05t28t2002
05t28t2002
05t28t2002
05t28t2002
9258
9258
9258
9258
9258
9258
1 $4.00
$32.00
$3.60
$e.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
ihe State of Oregon. I further state that only contractors and employees who are in compliance with
ORS 701.055 wiil 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.
F l"6
$61.75
r ^-n*l
Signature Date
1
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