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Home My WebLink AboutPermit Mechanical 2005-01-19Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00069ISSUED: 0111912005APPLIED: 01/1912005EXPIRES: 0711912005 VALUE: SITEADDRESS: 435 S38THST ASSESSOR'S PARCEL NO.: 1702314401622 PROJECT DESCRIPTION: Gas insert Springlield TYPE OF WORI( Heating System TYPE OF USE: New Phone Number: 541-746-1479 Expiration Date 10t20t2005 Residential Phone 541-343-1131 0wner: Address: M M COOK TRUST 435 S 38TH ST SPRINGFIELD OR 97478 Contractor Type Mechanical Contractor License DIVERSITY ENVIRONMENTAL SERVICES 119364 CONTRACTOR INFORMATION V BUILDING INFORMATI( # 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: R-3 VN lo\\ow inO t\ 1 $ Per Sq Ft or multiplier # ofStories: Height of Oonter Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: the Square Footage or Bid Amount Load: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS Description Type of Construction Page 1 of2 Value Date Calculated h t0R Building/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: COM2005-00069ISSUED: 0111912005APPLIED: 01/1912005 EXPIRESz 0711912005 VALUE: Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 77o State Surcharge Gas Fireplace Gas Outlets 1-4 Minimum/Adj ustment Mechanical Total Amount Paid Amount Paid $r0.00 $4.50 $3.15 $1s.00 $4.00 $26.00 $62.65 Total Value of Project Date Paid ytgtos utgt05 Utgt05 utgt05 ut9t05 utgl05 Receipt Number 1200500000000000071 1200s0000000000007r 1200500000000000071 1200500000000000071 1200s00000000000071 1200500000000000071 Fees Paid 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. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Reouired Insnect 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. Owner or Contractors Signature Pase2 of2 Date - 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Oflicial Receipt ,,elopment Services Department Public Works Department RECEIPT #: 1200500000000000071 Date: 0111912005 1l:00:58AM Job/Journal Number coM2005-00069 coM2005-00069 coM2005-00069 coM2005-00069 coM2005-00069 coM2005-00069 Description + 7o/o State Surcharge + l0% Administrative Fee Gas Outlets l-4 Gas Fireplace Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3. l5 4.50 4.00 15.00 26.00 10.00 Item Total:$62.6s Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check MIDGLEYS djb 9045 In Person Payment Total: $62.6s -sffir vt9l200s Page I of I trFlledS..o