HomeMy WebLinkAboutPermit Mechanical 2005-04-06Status Issued
225Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-00401ISSUED: 0410612005APPLIEDz 0410612005EXPIRES: 10/0612005
VALUE:
SITEADDRESS: 246738THST
ASSESSOR'S PARCEL NO.: 1702194209800
PROJECT DESCRIPTION: Install gas insert and gas piping
Springfield TYPE OF WORI( Heating System
TYPE OF USE: Addition
Owner:
Address:
Contractor Type
Mechanical
TOM HUNZIKER
2467 38TH ST
SPRINGFIELD OR 97477
Contractor
MARSHALLS INC
License
25790
Expiration Date
12123t200s
Phone Number: 541-
Residential
Phone
541-747-7445
CONTRACTOR INFORMATION
TION
BUILDING INFORMATI(
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
# of Stories:
Height of Structure
Type of Heat:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Secondary Construction Type: , l ol)ted by the
# of Bedrooms: .,'c,nier. Those ru
R-3
t[$on law re
gon util
2 001-0olo th rough
dariing the center.
nunrber for the Ore
Frontyard Setback: Center rs 1 -800-332
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
nla
llI,ffi'#i:?'P*l
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARI(NG
Total:
Handicapped:
Compact:
Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
PUBLIC IMPROYEMENTS
Description Type of Construction
Pase I of2
Value Date Calculated
r&Li-
AIIY l BO DAY PERIO Valuation Description I
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-00401ISSUED: 0410612005APPLIED: 0410612005EXPIRES: 10/0612005
VALUE:
Fee Description
-Mechanical Issuance Fee-
+ lOoh Administrative Fee
+ 7o/o State Surcharge
Gas Fireplace
Gas Outlets l-4
Minimum/Adj ustment Mechanical
Total Amount Paid
Amount Paid
$10.00
$4.s0
$3.15
$1s.00
$4.00
$26.00
$62.6s
Total Value of Project
Date Paid
4t6t05
4t6t0s
4t6t05
4t6t05
4t6t05
4t6t05
Receipt Number
2200500000000000392
2200500000000000392
2200500000000000392
2200500000000000392
2200500000000000392
2200500000000000392
Plan Reviews
To Request an inspection call the 24 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.
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..1*;
Owner or Contractors Signature
Pase2 of2
Date
L/-/_o{
fT
rees raro I
Keourre(l InsDectrons I
225 Fifth Street
Springfield Oregon 97477
541-725-37r; Phone
city of Springlield Official Receipt
_ ;velopment Services Department
Public Works Department
RECEIPT#: 2200500000000000392 Date: 0410612005 11:47:58AM
Job/Journal Number
coM200s-00401
ccM2005-00401
coM200s-00401
coM2005-00401
coM200s-00401
coM2005-00401
Description
+ 1Yo State Surcharge
+ l0o Administrative Fee
Gas Outlets l-4
Gas Fireplace
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Amount Due
3.15
4.50
4.00
15.00
26.00
10.00
Item Total:$62.65
Payments:
Type ofPayment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check MARSHALL INC djb 18541 In Person $62.65
PaymentTotat:
-Sffi
,l
4/612005 Page I of I
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