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Home My WebLink AboutPermit Mechanical 2001-01-25Job# 01 -00004-01 COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 ISPRINGFIELD 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 725 00042nd St Spr AssessorsMap#: 18020521 Lot: Block: Addition: Job Number: 01-00004-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 08300 Subdivision: oITY OF SPRINGFIELD, OREGON Owner: Head Start Address: 221 B Street Scope Of Work: Mechanical appliance vent Phone Number: City/State/Zip: New 541-334-7267 Springfield, OR97477 Value: $2,500 Gontractor Type MechanicalContr Contractor Keith Clemmer Construction po box 51274, Eugene, OR 97405 Registration # 86924 Expiration Date 41312002 Phone 541431-0192 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at726-3769. All inspections 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 working day. Framing Final Building Rough Mechanical Final Mechanical Gonstruction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? (Sq. Feet) Height (feet): Proposed Units: Required Inspections Buildin - Prior to cover. -When all required inspections have been approved and the building is complete Mechanicai I -Prior to cover. -When all mechanicalwork is complete. # Of Stories: Current Units: Census Code: Does not apply Main:Accessory:Total: Job# 01 -00004-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building Buildinq 01t2512001 0112512001 0112512001 4312 4312 4312 2,500 $38.50 $2.70 $1.16 $42.36 Minimum Mechanical Permit Administrative Fee - Mechanical ApplianceVent (Not Covered in Schedulr Mechanical lssuance State Surcharge - Mechanical Tota! Mechanical Mechanical 01103t2001 01103t2001 01t03t2001 0110312001 01t03t2001 41 56 41 56 41 56 41 56 4156 1 $10.50 $.45 $4.50 $10.00 $1.0s $26.50 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 Signature $68.86 requested at the proper time and that the project address is readable from the street. l6rfr'Ul,,*-l- zr- o\ Date Job# 01-00004-01 COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Pagel of2 SPRINGFIELD 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 725 00042nd St Spr AssessorsMap#: 18020521 Lot: Block: Addition Job Number: 01-00004-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 08300 Subdivision: ctTY oF SPRINGFIELD, OREGO^ Owner: Head Start Address: 2218 Street Scope Of Work: Mechanical appliance vent Phone Number: City/State/Zip: New 541-334-7267 Springfield, OR97477 Value: $O Contractor Type Mechanical Contr Contractor Keith Clemmer Construction po box 51274, Eugene, OR 97405 Registration # 86924 Expiration Date 413t2002 Phone 541-431-0192 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording a1726-3769. All inspections 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 working day. Required lnspections Mechanical MENCED OR IS ABANDONED FOR lSODAYPEBIOD.Rough Mechanical FinalMechanica! Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main: - Prior to cover. -When all mechanicalwork is complete # Of Stories: Current Units: Census Code:Does not apply Height (feet): Proposed Units: rhoAH952-001- rs of the rules by rha telephoneAccessoryTotal: tt I n \ Job# 01-00004-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Minimum Mechanical Permit Administrative Fee - Mechanical ApplianceVent (Not Covered in Schedult Mechanical lssuance State Surcharge - Mechanical Total Mechanical Mechanical 01t03t2001 01t03t2001 0110312001 01t03t2001 01t03t2001 4156 4156 41 56 41 56 41 56 $10.50 $.45 $4.50 $10.00 $1.05 $26.50 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 req uested at the proper time and that the project address is readable from the street Signature Date $26.50 /-as^ol 1