HomeMy WebLinkAboutPermit Mechanical 2009-2-12
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00206
ISSUED: 02/1212009
APPLIED: 02/1212009
EXPIRES: 08/12/2009
VALUE:
'.
SITE ADDRESS: 919 G ST'
ASSESSOR'S PARCEL NO.: 1703351208100
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Gas piping- 4 outlets
Owner: JUDD SHELVIA J
Address: PO BOX 495
SPRINGFIELD OR 97477
in I~I-, ~-' C. -:'J_:lr'l'1_nn1 n thrnl rnh n8'j:l Qt:i'J-001 ~
0,1: mNTRACTORJNF()~T10l"!""les by
. calling the center. (Note: the telephone
Contractor number for the Oregon Util~icens'e;atioiExpiration Date
AMBASSADOR PIPING INGnter is 1-800-3321:Z:146~. 03/27/2009
BUILDING INFORMATION I
, .
Contractor Type
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Constructiou Type:
# of Bedrooms:
Frontyard Setback:'
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of ConstructIou
1\', -'.!''-'r'N: Oregon law requires you to
fc:" ':i . . .'",' adopted by the Oregon Utility
1\.. -,~......,~"_ '" ('"""lnl" Thr'\coCl 1"1 doC' ~I'C coot fnrth
# of Stories:
R-3 Height of Structure
Type of Heat:
Water Type:
NOTlCE:Range TYPte:
THIS PERN~f:~IfJ;~t~tif!i'AP.J: IF THE V'd,QRK
/lIITlinRI7~8 IIMn~R TI-lle: 'D~R~nIT Ie: ~lnT
l; U IliDEVE.I!;(i)PMENIT'fIfl)Hl:0.RMl\:U0!l1KI
AN'll tiU UAY PtKIUU.
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Residential
Phone
541-726-5723
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
I Valuation Descriotion ~
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee I of2
Value
Date Calculated
Status
Iss it ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00206
ISSUED: 02/12/2009
APPLIED: 02/12/2009
EXPIRES: 08/12/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541"726'3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Pair! I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
.2/12/09 .
2/12/09
2/12/09
2200900000000000168
2200900000000000168
2200900000000000168
,
Total Amount Paid
$92.43
I Plan Reviews I
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 Reouirer! Insnections ,
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
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance witb
the Ordinances of the City of Springfield and tbe 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
. ~\~:.~cons~uct~~~-L ^' ~ I~ ~ ,--.,{)
'" . j 1) ~Oj LV J-J.-Lu.uJ,.." rl r;J, L/-I
Owner or Contractors Siguature
Date
Page 2 of2
225 Fifth Street
Spring6eld~ Oregon 97477
541-n6-3759 Phone
Job/Journal Number
COM2009-00206
COM2009-00206
COM2009-00206
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
1st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
DEBORA CLEMENT,
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000168
Date: 02/12/2009
, Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cjc
00582b In Person
Payment Total:
Page I of I
IO:08:45AM
Amount Due
79,00
3,95
9,48
$92.43
Amount Paid
$92,43
$92.43
2112/2009