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HomeMy WebLinkAboutPermit Mechanical 2000-7-26 ...... I, . I Job# 00-01159-01 I . Page 1 of 2 TRANS#:01-0002678 DATE:JUL 26 2000 AMT RECD:2 $ 26.50 CHANGE: CASHIER:061 SPRINGFIELD ~~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-01159-01 225 North Fifth Street Springfield, OR 97477 Addition: Office: 726-3759 Inspection Line: 726-3769~, ' Tax Lot#: 06100 Subdivision: Location Of Proposed Site: Assessors Map#: 17032343 Lot: Block: 848 McKenzie Crest Dr Spr Owner: Christine Hathaway 848 McKenzie Crest Dr Phone Number: 541-747-8118 City/StatelZip: Springfield, OR 97477 New Value: $0 Address: Scope Of Work: Mechanical gas piping to new boiler Contractor Type Mechanical Contr Contractor Marshalls Heating 4110 Olympic Street, Springfield, OR 97478 Registration # Expiration Date Phone 541-747-7445 Office Use Land Use: # Of Buildings: Zoning Code: Occupancy Group: Bedrooms: Heat Source: Range: ATTENTION;Slf9660Uimf.9quires you \. I :,t211::).~nnlJtlllt\ iOIlOWrUltltl........... - ' I ra set fon To request an inspection call the 24 hour recording at 726-3769. AI~~tEJal8"d>rnl~~a=.()O, a,m. will be made the same working day, inspections requested after"<YA!A~dl\\m~!,lWHl\rrU~ by working day. 0090. Vou may obta\n CO",,:,,;:, ..........0'119 ~IIJnpthe ......L..... (Note. U,S ''''~'' Required Inspections '1UmbSrfOrUl3ultl\:lUfI ~;;U~/.j~- Mechanical I Center!!: ~.aro-332.2344). I, Quad Area: # Of Units: Constr, Type: Water Heater: Rough Gas Final Gas -When all gas work is complete. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D ,Area (Sq, Feet) I Main: Accessory: NOTICE: - # Of Stories: THeight-lfeet\:HALL EXPIRE IF THE WORK Ml" I 't:r1IVIII U Current Units: JjWrJ~lii~v~.jERTHISPERMITISNO'I Census Code: Does not apply COMMENCED OR IS ABANDONED FOR Total: I ANY 180 DAY PERIOD. ;' " '- . Fee Job# 00-01159-01 Paid On Receipt# Mechanical 07/26/2000 2678 07/26/2000 2678 07/26/2000 2678 07/26/2000 2678 07/26/2000 2678 07/26/2000 2678 One to Four Outlets Minimum Mechanical Permit Mechanical Administrative Fee 3hp -- 100,000 BTU Mechanica' Issuance State Surcharge For Mechanical Permit Total Mechanical Grand Total . Page 2 of2 Value/Quantity Fee Amount I 1 $2,00 $13.00 $.45 $,00 $10,00 $1.05 $26.50 $26.50 By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time and that the project address is readable from the street. sJ!::~ /f~ "7/2-~e) Dat6 /