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HomeMy WebLinkAboutPermit Mechanical 2001-5-21 . . 4- .~ I Job# 01-00518-01 I Page 1 of2 TRANS~:01-0005458 DATE:MAY 21 2001 AMT RECD:2 $ 26.50 CHANGE: CASHIER: 061 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00518-01 225 North Fifth Street Springfield, OR 97477 Addition: Office: 726-3759 Inspection Line: 726-3~. . Tax Lot#: 01200 ~ Subdivision: Location Of Proposed Site: 2812 Assessors Map#: 17032332 Lot: Block: Manor Dr Spr Owner: Carol Fairbourn Phone Number: 541-746-3712 Address: 2812 Manor Dr City/State/Zip: New Springfield, OR 97477 Value: $0 Scope Of Work: Mechanical install gas appliances Office Use Land Use: # Of Buildings: Zoning Code: Occupancy Group: Bedrooms: Heat Source:equires you to R }"- "E:NT'O"I'S"<F"nn ,"w I Water Heater: ange: . ',~ :... _. ,I~<' ~'''~,;TA~O~~,~b Oregon Utility. . . . r. I':::~.~;:.~;~n ~pn(er Those rulas are ~t:n lUll" To request an inSpection call the 24 hour recording at 726-3769. All InsperJlRD~ (~qp-~m~8 !?!!toJ~tM.OR 952-001- a.m. will be made the same working day, inspections requested after'7:00\a:m?will'be maae,the.1following, rules by y may 001""1 vv>, w -. .. working day. 0090. ou t (Note' the telephone calling the cen er. . .,. t' R "d I' . ... ~____n I Hint" Notllca Ion equlre nspectlons nUlIIU'" .v' ...- - - 344) . I Center is 1-800-332-2 . Mechamcal Quad Area: # Of Units: Constr. Type: Rough Gas Rough Mechanical Final Gas Final Mechanical - Prior to cover. -When all gas work is complete. - When all mechanical work is complete. NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D ,Area (Sq. Fee~) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# Mechanical OS/21/2001 5458 OS/21/2001 5458 OS/21/2001 5458 Value/Quantity Fee Amount One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical 1 $2.00 $13.00 $.45 r/ . . '" Job# 01-00518-01 Fee Paid On Receipt# Mechanical OS/21/2001 5458 OS/21/2001 5458 Page 2 of2 Value/Quantity Fee Amount Mechanical Issuance State Surcharge - Mechanical Total Mechanical Grand Total 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 rther state that only contractors and employees who are in compliance with ORS 701.055 will e us d on this project. I further agree to ensure that all required inspections are ~~~~ per 'me ~~~e :::ress is readable from the street. 5 ~ ~ I ~:2(f)} Signaturec' \ Date $10.00 $1.05 $26.50 $26.50