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HomeMy WebLinkAboutPermit Mechanical 2000-10-31 ~, ~. .-- I , o>~ I Job# 00-01612-01 I Page 1 of2 TRANS#:01-0003660 DATE:OCT 31 2000 AMT RECD:2 $ 26.50 CHANGE: CASHIER: 059 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-01612-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 2618 Manor Dr Spr Assessors Map#: 17032333 Lot: Block: Addition: Tax Lot #: 01700 Subdivision: Owner: Mary Lou Clark 2618 Manor Drive Phone Number: 541-741-4921 City/State/Zip: Springfield, OR 97477 New Value: $2,988 Address: Scope Of Work: Mechanical Pellet Stove Insert Contractor Type Mechanical Contr Contractor Registration # Expiration Date Phone Quad Area: # Of Units: Constr. Type: Water Heater: Midgleys . .. 541-343-1131 1678 W 7th Ave, Eugene, OR 97402 v ,.~ ';0(: Q" .<. ,\)I~~ "'',.:;0<.' . . .,..... ~C"\O "c.y r"\.b.:T"" .j<,,\'- \\e-"'- ".- \)1"\\'- I Office,l:Jse - :,'P.I ,,\~~O." < ,,\ \1" .,' . W": ~\Of< V" _()()~ ': cOll,e.. . ,2,I,,1l Land U!\l!Cl~\C'3 9'6'Z.-()()~ o\N~\f< ~O\" \~<,~,qf'Buildings: Zoning c.gde~ ~O\) {\\:~e~\el. ~O(' 1)1.\\\\ Occupancy Group: Bedrooms!'09 a.\\\~9\~ \\"eO((l~_ Heat Source: Range: C ....'01:11 ,0 _v.o' Sq, Footage: n\\'1' , ("'0" 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 working day. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 ,Area (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply R 'd I t' ..nP.v.. equlre nspec Ions ""t\t:-.. 0" . W~\ c~ Mechanical,. ,.tt., '!...\.. 'E.'l-.rr,. - 'E.I'oWl~ Iv ~O\'-~WI~S\'\I>' 'E.1'o\\,\\'Orr ~'E.DrOI'o \\'\\'0 rr€ rl.'E.D 'J~D r>-'Or>-~DO i\\'\Or" DOI'o\'O ~OWlWl'E.~C~,< ?'E.I'o\OD, r>-~'< ~\\\) DI>' Height (feet): Proposed Units: Pellet Insert ' I -After installation. Total: Fee Paid On Receipt# Mechanical 10/31/2000 3660 Value/Quantity Fee Amount Minimum Mechanical Permit $.00 . ? Job# 00-01612-01 Fee Paid On Receipt# Mechanical 10/31/2000 3660 10/31/2000 3660 10/31/2000 3660 10/31/2000 3660 Mechanical Administrative Fee Pellet Insert Mechanical Issuance State Surcharge For Mechanical Permit Total Mechanical Grand Total . Page 2 of 2 Value/Quantity Fee Amount I 2,988 $.45 $15.00 $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 ~ pro~time and that the pr~ct address is readable from the street. r0"~~A'S /ff ~L~ Signature"" -' 1:!9f}H~