HomeMy WebLinkAboutPermit Mechanical 2002-12-03City of Springfield
Mechanical Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97 47 7
541-726-3759 Phone
541-726-3676Fax
541-726-3769 Inspection Line
PERMITNO.:
ISSUED:
APPLIED:
EXPIRES:
MEC2002-00121
12t3t2002
12t3t2002
6t3t2003
1206 3OTHST
1702303401300
Springfield
TYPE OF WORK:
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install gas service and gas fireplace
QW:
FREDERICKSON GEORGE L & B ]
1206 N 3OTH ST
SPRINGFIELD OR 97478
MECHANICAL CONTRACTOR:
KEITH LEESMAN 541-995-6157
835 N BTH ST
HARRISBURG OR 97446
CCB # 72082 Expiration Date: 04104/2003
Descrintion
+ 70 State Surcharge
+ 8% Administrative Fee
-Issuance Fee-
Gas Fireplace
Gas Outlets l-4
Minimum/Adjustments - Mech
Amount Paid
3.15
)'cu. d
-r o\] .*
o€
Date Paid
r210312002
1210312002
t210312002
1210312002
12t0312002
t2103/2002
Cashier
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Receint Number
1200200000000000327
1200200000000000327
1200200000000000327
1200200000000000327
1200200000000000327
1200200000000000327
To Request an inspection call the 24 hour recording at726-3769. All inqpections re 7:00 a.m. willbe made
the same working day, inspections requested after 7:00 a.m. will be made the follo
Required Inspections:
1 Gas Service: After line is installed and line
this point.
ofone appliance. Presure ter
2 Rough Mechanical
3 Final Mechanical:
By Signature,I state and application and do hereby certit/ that all
ffirmation hereon is true and correct, and I further certiff that any and all wor{< 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. I
further certify 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, that each addres is readable from the
street, and that the , if applicable, will remain on the site at all times during construction.
or SiErature
1of1
Date
tJ-3 -o^
SITE ADDRESS:
ASSESSORS PARCEL NO.: