HomeMy WebLinkAboutPermit Mechanical 2005-7-22
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Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
~
,
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00958
ISSUED: 07/22/2005
APPLIED: 07/22/2005
EXPIRES: 01122/2006
VALUE:
SITE ADDRESS: 850 MARILYN CT
ASSESSOR'S PARCEL NO.: 1703342101705
Springfield TYPE OF
Mechanical Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: InstaU Gas Furnace & AC
Owner:
Address:
PRESSMAN ERNEST I & GRETA M
850 MARILYN CT
SPRINGFIELD OR 97477
Phone Number: 541-747-1228
Contractor Type
Mechanical
Contractor
PACIFIC AIR COMFORT INC
\I!~TICE:
TI-II<:: D~R~,1IT <::I-Ihll ~'x'DIR~ II' TI-IJ: I^ln""
^"TUnl1'7U, ''''DER THIS PEHMIT IS NOl
I CONTRACTOR INFORMATION:, ' I
- - "..m _, IS ABI'\NOOI~EO FOR
ANY 18Ei~~ris~ERICExpiration Date Phone
39237 03/25/2006 541-672-9510
# of Units:
Primary Occupancy Group:
Secondary Occupancy
P'rimary Construction Type
Secondary Construction
# of Bedrooms:
.
I BUILDING INFORMATION'
, _,IbHowing project as submitted has the following
# of Stories: ,-.'. ',00 does 'f'c\{'5iIl!~!' specific land use
Height of Sq Ft Ist Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft GaragelCarport
Energy Path: Sq Ft Other:
Sprinkled nla Occupant Load:
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: Total:
# Street ~rees r,TTENTION: Oregon law requ!;l!l9~i9@JW!d:
~aved DrIve ~qdl,\:, rule" adopted by the Or~.Y.'m~~lty
Yo of Lot COY~,~~~t'ation Center. Those rules are set forth
in CAR ~352.001.001 0 through OAR 952-001-
IPUBLIC IMPROVEMENTs I may ootaln cu~,c" ,,, ."e rult:::; uy
__....~ .,Ie center. (Note: the telephone
number for tr~i<!C:'!I1I!<.-ilIYp~;y Notification
Centeo\)~~m~~).
Street
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descrintion I
, Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
1 of 2
.
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00958
ISSUED: 07/22/2005
APPLIED: 07/22/2005
EXPIRES: 01122/2006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
~ Fl'l's P~id ,
- Fee Description
-Mechanical Issuance Fee--
+ 10% Administrative Fee
+ 7% State Surcharge
BoilerlComp Up To 100,000 btu
Furnace - up to 100,000 btu
MinlmumlAdjnstment Mechanical
Amount Paid Date Paid Receipt Number
$10.00 7/22/05 1200500000000001061
$4.50 7/22/05 1200500000000001061
$3.15 7122/05 1200500000000001061
$12.00 7/22/05 1200500000000001061
$12.00 7/22/05 1200500000000001061
$21.00 7/22/05 1200500000000001061
Total Amount
$62.65
I Plan Reviews I
To Request aD impectioD 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.
Rfyr~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical 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 bt accordance
with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertabting to the work described herebt,
and that NO OCCUPANCY wiD 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 nsed
on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from
t eel, that the enol! card is located at the front of the property, and the approved set of plans wiD remain on the site
du' c ns ructlon.
(-2-~
Ow~er or Contractors Signature
Date
2 of 2
SPRINGFIELD
225 FIITH ~I""LI . SPRING FlEW, OR 97477. PH:(541)726-3753 . FAX: (541)726-3689
~ CityJobNumber CDmwos -COqst
o LOCATIONOFPROPOSEDWORK: B=YJ ~~'I~If\r~ ~ L.Q. q14-1~
ASSESORS MAP: TAX LOT:
O.
~\ OWNER:6Vl'\e~-b ~~Y\1I;\t/\
~\ ADDRESS: j>fi).r'4~A4-/
rrI11 CITY: srn "Df1P *1 ' ,
~l DESCRIPTION OF WORK:
'II ~l NEW:
'~l.
, 0 CONTRAcrOR'S NAME
GENERAL:
PHONE:
r-rt.-f-/-\~
I
_.'
"
tJp
ZIP: Cl1l.f11
STATE:
-,
'11\tb./l ~~ 1 AI0
. ,
REMODEL: X ADDlTON: DEMOLISH:
(
OTHER:
VALUE:
.
ADDRESS
CONST.
CONTRAcrOR #
EXPIRES
PHONE
~ PLUMBING: ' .
r MECHANICAL:~'hr-,Ai)....r~; ~ 4ltibbtl\'a.inS,+< >pf-UI'1'1Lf11 1t2f'l2-~'" ';1u;1~
ELECfRlCAL:
MECHANICAL PERMIT
PLUMBING PERMIT
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f-},
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ITEM PEE
Furnace V' ~. 0 f)
Exhaust Hood
Vent Fan No.
Wood Stove/lnsert/Fireplace Unit
ITEM
PEE
Fixtures
Residential Bath(s) No.
Sanitary Sewer IT.
Water IT.
Storm Sewer IT.
Mechanical Permit Subtotal
"Minimum of $45.00 V
State Surcharge 7%
Administrative Fee 10%
Plumbing Permit Subtotal
"Minimum of $45.00
State Surcharge 7%
"
Issuance Fee
Administrativc Fee 10%
TOTAL MECHANICAL
TOTAL PLUMBING
M~th_~:CIDJl ·
Phlamlbiitw~ ·
MiSJc:e:Mla.tltle(Q)lfUS;
.
Shared Drive(T:)/Building FonnslPennit Worksheet 3-04.doc
225 Fifth Street
Sp.ringfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00958
COM2005-00958
COM2005-00958
COM2005-00958
COM2005-00958
COM2005-00958
Payments:
Type of Payment
Check
"
'j
7/22/2005
.
.1!~._'!..F:l,IlLD,"__ "" _ " .'.
Wr '"
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, -,-
JiJ.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
RECEIPT #:
1200500000000001061
Date: 07/22/2005
Description
Furnace - up to 100,000 btu
Boiler/Comp Up To 100,000 btu
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By Received By
PACIFIC AIR COMFORT, INC ddk
I of I
Item Total:
LnccKNUD10er AutnonzatlOD
Batch Number Number How Received
10848 In Person
Payment Total:
11:10:10AM
Amount Due
12.00
12.00
21.00
10.00
3.15
4.50
$62.65
Amount Paid
$62.65
$62.65