HomeMy WebLinkAboutPermit Mechanical 2004-01-02Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00009ISSUED: 0110212004
APPLIEDz 0110212004
EXPIRESz 0710212004
VALUE:
SITE ADDRESS: 360 22ND ST
ASSESSOR'SPARCELNO.: 1703361303200
PROJECT DESCRIPTION: Replace gas wall heater
Owner: KIA ARNOLD
Address: 360 22ND ST SPRINGFIELD OR 97477
Contractor Type
Mechanical
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New Residential
PhoneNumber: 541-746-9423
Contractor License
ASSOCIATED HEATING & AIR CONDITIO 106275
Expiration Date
08t3u2004
Phone
541-683-2s90
CONTRACTOR INFORMATION
BUILDIN(
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:ts
law requlres
rubS t
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
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
#3r
REQUIRED PARKING
Total:
Handicapped:
Compact:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
Page I of2
PUBLIC IMPROVEMENTS
Description Type of Construction VaIue Date Calculated
t
Valuation Description I
Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00009ISSUED: 0110212004
APPLIEDz 0110212004
EXPIRESz 0710212004
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ l0oh Administrative Fee
+ 7%o State Surcharge
Appliance Not Listed
Appliance Vent
Minimum/Adj ustment Mechanical
Total Amount Paid
Amount Paid
$10.00
$4.50
$3.1s
$9.00
$6.00
$30.00
$62.65
Date Paid
u2t04
u2t04
t/2t04
uzt04
u2t04
u2t04
Receipt Number
1200400000000000003
1200400000000000003
1200400000000000003
1200400000000000003
1200400000000000003
1200400000000000003
Plan Reviews
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 will 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 during construction.
L4-u/\-
nsnections
Owner or Contractors Signature
Page 2 of 2
Y
F ees raro I
//e/p,t
Date
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
#:1 Date:0 l1:03:2lAM
coM2004-00009
coM2004-00009
coM2004-00009
coM2004-00009
coM2004-00009
coM2004-00009
+ 7Yo State Surcharge
+ ljYo Administrative Fee
Appliance Vent
Appliance Not Listed
Minimum/Adj ustment Mechanical
-Mechanical Issuance Fee-
Item Total:$62.6s
3.15
4.50
6.00
9.00
30.00
10.00
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check ASSOCIATED HEATING djb In Person
Payment Total:
s62.65
-562i-t