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Home My WebLink AboutPermit Mechanical 2003-3-25 "-' '. . Status: Issued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-3769 Inspection Line - . City of Springfield Mechanical Permit ~ t PERMIT NO.: MEC2003-00019 ISSUED: 3/25/2003 APPLIED: 3/25/2003 EXPIRES: 9/25/2003 SITE ADDRESS: 2592 MANOR DR ASSESSOR'S PARCEL NO.: 1703233301600 Springfield TYPE OF WORK: TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Extend gas line for appliance MECHANICAL CONTRACTOR: 541-463-1441 ~~CE'F'C A~~~~~~ INC . ~\.'tCl!: ~ ~()i?O ~\)~~~~WI~:' ~~D<t~~ I ~D ~xpiration Date: 03/25/2004 ~"'- Q\I-<Y' n \~I.- Amount Pai~\\O"~\"r_D (J" ~ Paid Receiot Number ,,<- ~'t.\~\)<' ?'t." - + 10% Administrative Fee 4.50 c,OWl \\')Q D~'l 03/25/2003 1200200000000000882 + 7% State Surcharge 3.V5 03/25/2003 1200200000000000882 -Issuance Fee- 10.00 03/25/2003 !.~9.0200000000000882 Appliance Vent 6. 03/25/2003 ~e5 .1200200000000000882 Gas Outlets 1-4 4.00 03/25/20,QJj~eo.\)\eC)OlioQ~QQ000000000882 Minimum/Adjustments - Mech 35.00. ~f~t;/~~~?\~e ~;c. 3-~!.:2~~f)~e,Q.00000000882 . . .' ,i. )\..... f.\'~":,,, ,.,,\€,.p;: ~\""'... ~..\t~':)"", . To Request an mspectlon call the 24 hour recordmg at J26'-3769~oAlllhspeCl1ons~quested'liefore 7:00 am WIll be made the same working day, inspections requested after 1:b~alii't~'WiIJ\]je\1hadelm~\\.jfoii6wihg;~ofRi~g:day. \0\\.....1;\\\0\\. C"\r\,\..\Jv.,..$'\c \"'_.,'(\e"~_It\\\c'o.- ~oO.p.?- 9':l~ ",3-'1 oV~e~' l..~u~0\\~\\'J ~Ao.l' \~ 09$.'<0 \~ece:0~e<60 r:/!>~?:?:. 1 h G ft I. .. 11 d d () d '.f'\\~~ .. '\~h d ..9.\) I. Roug as: A er me IS msta e an cappe llnot'attac e ,to an app lance. ~Vv ~,,,. 2 Final Gas: When all gas work is complete. ~u: Ce 3 Rough Mechanical: Prior to Cover 4 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 certi/)' that any and all worlc 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. I further certify 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, that each address is readable from the street, and that the a~~~Y_edSet.ofPlans,~~j!:;.wifl remain on the site at all times during jtruction. /I'i/~ -- /_.~~ .?ll~/O? O~or s.ontfact~.Sigmitiire Date ( L....-- I of I OWNER! APPLICANT: ZIV SIMHI 2592 MANOR DR SPRINGFIELD OR 97477 Descriotion ReQuired Insoections: 541-672-9510 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone .e Items: Job/Journal Number MEC2003-000 19 MEC2003-000 19 MEC2003-000 19 MEC2003-00019 MEC2003-00019 MEC2003-000 19 ........ayments: 7 Type of Payment CreditCard '" Paid By SIMHI ZIV Description Appliance Vent Gas Outlets 1-4 Receipt #: 1200200000000000882 Date: 03/25/2003 Minimum/Adjustments - Mech -Issuance Fe..... + 7% State Surcharge + 10% Administrative Fee Received By Check Number Confirm No djb 000026 024646 Page loft 3/25/2003 1:33:0IPM City of Springfield Development Services Department Public Works Department Official Receipt Amount Paid 6.00 4.00 35.00 10.00 3.15 4.50 Line Item Total: $62.65 How Received Amount Paid In Person 62.65 $62.65 Pa~ment Total: cReceipt.rpt