HomeMy WebLinkAboutPermit Mechanical 2001-5-21
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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/
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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