HomeMy WebLinkAboutPermit Mechanical 2002-04-22SPRINGFIELD
Job# 02-00474-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
Job Numbe r: 02-0047 4-Q1
Office: 726-3759
lnspection Line: 726-3769
Tax Lot#: 00900
Subdivision:
ITIUL
225 Fifth Street
Springfleld, OR97477
Location Of Proposed Site: 353 00018th St Spr
AssessorsMap#: 17033624
Lot: Block: Addition
crTY oF SPR7NGFIELD, OREGON
Owner: GUY DENT
Address: 353'18TH ST
Scope Of Work: Mechanical
Phone Number:
City/State/Zip:
New
INSTALLING GAS LINE FOR WATER HEATER AND RANGE
541 -736-8626
SPRINGFIELD, OR 97477
Value: $0
Contractor Type
Mechanical Contr
Contractor
GUY DENT
353 18TH ST, SPRINGFIELD, OR97477
Re g istratio n # ; t ;f,Ep;,a1fdri'DdtCd' u;'1 u''pi't b$H li,-,.iliili:f
ili,#""-S:1li'Ef'?,edtrioh
, rr OAR ?52-C01 "00 1 0 through O.lI e5?--0-0J.
.
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
il090. You may oDtaln coples ur rrrqro.:
""i"iring tne ienter' (Note:lhetel?P!:l:.
n umUdr toAn eolnndtfi lity-N otitlcalron
Ce oec up'a f Sf G?a76++1'
Heat Source:
Sq. Footage:
To request an inspection cal
a.m. will be made the same'
working day.
ll the 24 hour recording at726-37 69. All inspeeti0nsYdquested before 7:00 _ _. .- r,A^,
working day, inspectiohs requested after ?,64;.;:;iuiErie$d-thEYbi8fiil{t-"E: rrr^nr/
,f
Required Inspections
Mechanica!
-After line is installed and capped if not attach
ANY 180 DAY PERIOD
ed to an appliance.
i ., l-\,,ilElJ I vr I
Rough Gas
Rough Mechanical
Gas Service
FinalGas
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq. Feet)
Main:
-Prior to cover.
-After line is installed and line has been connected to a minimum of one appliance. Pressure tes
-When all gas work is complete.
-When all mechanicalwork is complete.
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Accessory:Total
Job# 02-00474-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Mechanical
One to Four Outlets
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
ApplianceVent (Not Covered in Schedule
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
04t22t2002
04t22t2002
04t22t2002
04t22t2042
04t22t2002
04t2212002
8696
8696
8696
8696
8696
8696
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
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
requested at the proper time and that the project address is readable from the street.
Signature
$61.75
L1->>-oz-
Date
1