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HomeMy WebLinkAboutPermit Mechanical 2002-09-30t Page 1 of2SPBIIUOFIELD €n 225Fifth Street Springfield, OR97477 Location Of Proposed Site: 2589 00035th Pl Spr AssessorsMap#: 17021942 Lot: Block: Addition RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-01 172-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 04900 Subdivision: Job#72-01 clTY oF SPRINGFIELD, OREoON Owner: Pauland Lisa Bedortha Address: 2589 35th Place Scope Of Work: Mechanical Phone Number: Gity/State/Zip: New 541-741-2810 Springfield, OR97477 Value: $0 Gas fireplace insert Contractor Type MechanicalContr Contractor Midgleys 1678 W 7th Ave, Eugene, OR 97402 Registration # 19364 Expiration Date 1 Phone 541-343-1131 Quad Area: # Of Units: Gonstr. TyPe: Water Heater: 1 (VN) Wood Frame Office Use Land Use: Zoning Bedrooms: Dwelling To request an insPection call the 24 hour recording at a.m. will be made the same working daY. Range: working day, inspections requested after nspections requested before 7:00 7:00 a.m. will be made the following Aili Rough Mechanical FinalMechanical Construction Types(VN) Wood Frame OccupancY GrouPs: Dwelling # Of Buildings: # Of Bedrooms: HandicaP Access? Area (Sq. Required lnsPections Mechanical -Prior to cover. -When all mechanicalwork is complete # Of Stories; Height (feet): Current Units: ProPosed Units:1 Census Gode: Does not aPPIY Main:Accessory:Total: 'e\"n<OO,ot",rl Job#02-01172-01 Page 2 ot 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit 8% Administrative Fee - Mechanical Gas Fireplace Mechanical lssuance State Surcharge - Mechanical Total Mechanical 09t30t2002 09t30t2002 09t30t2002 09t3012002 09t30t2002 10762 10762 10762 10762 10762 $36.00 $3.60 $e.00 $10.00 $3.15 $61.75 1 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 and that the project address is readable from the street.requested at the proper S ignature $61.75 qeil- Date