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Home My WebLink AboutPermit Mechanical 2005-10-27Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-01523ISSUED: 1012712005 APPLIEDz 1012712005 EXPIRESz 0412712006 VALUE: SITEADDRESS: 791 S4TTHST ASSESSOR'SPARCELNO.: 1802051209100 PROJECT DESCRIPTION: Gas piping. Owner: Address:791 S 47TH ST SPRINGFIELD OR 97478 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: Alteration Residential \t \Ato 3rfrt LT\ Contractor Tvpe Mechanical C INC # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Expiration Date 0312712007 Phone 541-726-5723 License 121469 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Tvpe of Construction Page I of2 Value Date Calculated reL PUGHE DELANEY & TAMARA .10 p T'UILDINU II\ t' UryYIA I IUNJ Valuation Description 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: COM2005-01523ISSUED: 10127t2005APPLIEDT t0t27tZ00SEXPIRES: 04t27t2006 VALUE: Fees Pair Total Yalue of Project Date PaidFee Description -Mechanical Issuance Fee- + llYo Administrative Fee + 7o/o State Surcharge Gas Outlets 1-4 Minimum/Adj ustment Mechanical Amount Paid $10.00 $4.s0 $3.1s $4.00 $41.00 10t27t05 10127t05 10127t05 t0t27t0s t0t27t05 Receipt Number 220050000000000r503 2200500000000001503 2200s0000000000r503 2200s00000000001503 220050000000000r503 Total Amount Paid $62.6s To Request an inspection call the24 hour recording at 726-3769. AII inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. wilt be made the following work day. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all inlbrmation 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 wilt 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. or Contractors Signature Pase? of2 Date Os)4- HGFIELD amL, Keourreo tnsDectrons 225Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt ,velopment Services Department Public Works Department RECEIPT #: 2200500000000001503 Date: 1012712005 9:52:55AM Job/Journal Number coM2005-01523 coM2005-01523 coM200s-01523 coM2005-01523 coM2005-01523 Description Gas Outlets l-4 Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- + 7Yo State Surcharge + l0% Administrative Fee Amount Due 4.00 41.00 10.00 3.15 4.50 Item Total:$62.65 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check AMBASSADORPIPING,INC. jmp 89 l0 In Person $62.65 Payment Total: -5A6T ,.i' 101271200s Page I of I aruD