HomeMy WebLinkAboutPermit Mechanical 2000-10-31
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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""
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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
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equlre nspec Ions ""t\t:-.. 0"
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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.
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Signature"" -'
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