HomeMy WebLinkAboutPermit Mechanical 2008-7-7
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO' COM2008-0099I
ISSUED 07/07/2008
APPLIED: 07/07/2008
EXPIRES. 01/07/2009
VALUE:
~~
Status
Issued
225 Fifth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
SITE ADDRESS 356 WOODLANE DR
ASSESSOR'S PARCEL NO 1703262103503
SprIngfield TYPE OF WORK MechaDlcalOnly
PROJECT DESCRIPTION New pIpe for gas hue
TYPE OF USE RepaIr
ResIdentIal
Owuer PEDRO FUENTES
Address 356 WOODLANE DR
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION'
Contractor Type
MechaDlcal
Contractor
OWNER
LIcense
BUILDING INFORMATION I
# of UDltS # of StorIes
PrImary Occupaucy Group R-3 HeIght of Structure
Secondary Occupancy Group Type 01 Heat
PrImary ConstructIOn Type VB Water Type
Secondary CoustructlOn Type ATTENrlON' 0 Ran~e Type.
# 01 Bedrooms folloW rules ad re!ilm"~/re~
NotIficatIon C oPI~Il.Nd Rtuld ou to nla
{npAD ~~~ .. enter. --r:~no" ....:"''''9 VI/It/.'{
0090. YO~~P~ION ,
calling the c& !!IJ.'d~rrne,
nUmber for then~r. (Nole theJele;~ es by
C re@llJIt!~Md~j~ one
enter Ia I-fWS~@I2_!!jffJ/fiiqa.tlon
Paved DrIve It'qd,
% of Lot Coverage
Froutyard Setback
SIde I Setback
SIde 2 Setback
Rearyard Setback
Solar Setbacks
I PUBLIC IMPROVEMENTS'
Street Improvements
Storm Sewer AvaIlable
SpecIal InstructIon
Phone Number 541-726-6304
ExpIratIOn Date Phone
Lot SIZe
Sq Ft 1st Floor
Sq Ft 2ud Floor
Sq Ft Basement
Sq Ft GaragelCarport
Sq Ft Other
Occupant Load
REQUIRED PARKING
Total
HandIcapped
Compact
SIdewalk Type
DowuspoutslDrams
NOTICE:
THIS PERMIT SHAll EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
~~~~'~Yo~'~~~I~n~r: rrF.
Notes
DeSCrIptIOn
$ Per Sq Ft
or multIpher
Square Footage
or BId Amount
Tvpe of ConstructIOn
Paee I of2
Value
Date Calculated
CITY OF ~t'Kll~l.-J'lJ<.L1J
Status
Issued
Building/Combination Permit
PERMIT NO: COM2008-00991
ISSUED 07/0712008
APPLIED. 07/07/2008
EXPIRES: 0110712009
VALUE:
225 Fifth Street, SprIngfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769InspectlOu Lme
Total Value 01 Project
Fees PaId ,I
Fee DescrIptlOu
-Mechamcal Issuance Fee-
+ 10% Admm.stratIve Fee
+ 12% State Surcharge
+ 5% Technology Fee
Gas Outlets 1-4
MIDlmum/AdJuslment Mechamcdl
Amount PaId
Date PaId
Receipt Number
$20 00
$500
$600
$250
$500
$45 00
717108
717108
717108
717108
717108
717108
2200800000000001024
2200800000000001024
2200800000000001024
2200800000000001024
2200800000000001024
2200800000000001024
Total Amouut PaId
$83 50
I Plan RevIews ~
To Request an inspectIOn call the 24 hour recordIng at 726-3769 All inspectIOns 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
I Reomred T nsnections 1
Rough Gas After hue IS mstalled aud reqUIred testmg and capped If not attached to an apphauce
Fmal Gas When all gas work IS complete
By sIgnature, I state and agree, that I have carefully eummed the completed apphcatlOn and do hereby certIfy that all
mtormatIOn hereon IS true and correct, and I further certify that any and all work performed shall be done m accordance With
the Ordmances of the CIty of Sprmgfield and the Laws of the State of Oregou pertammg to the work desCrIbed herem, and
that NO OCCUPANCY wIll be made of any structure Without permIssIOn of the CommuDlty ServIces DIVIsIOn, Bulldmg Safety
I lurther certIfy thdt only contrdctors dnd employees who dre 10 comphance WIth ORS 701005 wIll be used on thiS project
I further agree to ensure that all reqUIred mspectlOns 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, aud the approved set of plans wIll remam ou the site at all
times dUI 109 constructIOn
Of'
JJ\ (J I.LO
(2
~iW1k
//7/c? P
Owner or Contractors Signature
Date
Paee 2 of2
22!i FIfth Street
SprIngfield, Oregon 97477
541-726-3759 Phone
~~
a"~5" ~
I
CIty of SprIngfield OfficIal ReceIpt
Development ServIces Department
PublIc Works Department
Job/Journal Number
COM2008-0099!
COM2008-00991
COM2008-0099I
COM2008-0099I
COM2008-0099I
COM2008-00991
Payments
Type of Payment
Check
LReLemtl
RECEIPT #:
2200800000000001024
Date. 07/07/2008
DeSCrIptIOn
Gas Outlets 1-4
Minimum/AdJustment Mechanical
~Mechanlcallssuance Fee-
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
PEDRO FUENTES
Item Total
Check Number Authorization
Received By Batch Number Number How Received
dJb
2884
In Person
Payment Total
Page I of]
8 27 56AM
Amount Due
500
4500
2000
250
600
500
$83 50
Amount Paid
$83 50
$83 50
71712008