HomeMy WebLinkAboutPermit Mechanical 2003-1-9
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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City of Springfield
Mechanical Permit
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PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
MEC2003-00001
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1/9/200W-:
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1/9/W" /
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711J720'03
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SITE ADDRESS: 2812 MANOR DR
ASSESSOR'S PARCEL NO.: 1703233201200
PROJECT DESCRIPTION:
OWNER/APPLICANT:
CAROL FAIRBOURN
670 HAMILTON ST
SPRINGFIELD OR 97477
Desc rintiol!
+ 10% Administrative Fee
+ 7% State Surcharge
-Issuance Fee-
Appliance Vent
Gas Outlets 1-4
Minimum! Adjustments - Mech
Springfield
TYPE OF WORK:
TYPE OF USE:
New
Residential
Install gas piping and appliances
MECHA)'/!CAL CONTRACTOR:
CA~~~MN
~\?;~~1~~'~'r~'97477
.u\e~O 6'O'I\~~lli!>~....~~c;j ~~~1fation Date:
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Amounl'Paide"'~ _'e~' .,,<<,~Oll;tte. 'P!'i<f\e9. _o..\\O{\ Receint Number
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\41~.ac0-\\O~'l-J::J()'" "f:)\0.\{\~-/H'lO~9 :g\O\~. 1200200000000000523
~~<iJ.~ ~~S ~0-'1 0 ~e~.%~\\G 1200200000000000523
ill (lQ)~ -{ou c:fa~ ~et:filW~ 1200200000000000523
li~<l~~\)' '~\~e \~00 .9'1%9/2003 1200200000000000523
4.00 c~\\"f:)e~ 'O~ 1<\\0\ '''' '\ 01/09/2003 1200200000000000523
29.00 f\u(<i Ce 01/09/2003 1200200000000000523
To Request an inspection call the 24 hour recording at 726-3769. All inspections requeste;:ore 7:00 a.m. will be made
the same working day, inspections requested after 7:00 a.m. will be made the follQ.~~ day.
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Reouired InsDections: O,\\Crc:. ~ ~\',~IJ 1\',\CZl ~t.\) ~v
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By Signature, I state and agree, that I have care~W~~ ~tlll!"completed application and do hereby certifY that all
infonnation hereon is true and correct, and I further c~~ any and all woIk performed shall be done in accordance with
the Ordinances o~~ City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I
further certifY th t only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I
further agree to e ure\that al[;:equired inspections are requested at the proper time, that each address is readable from the
C~'J:~ili ';;';:~~' will rem.;,oo tl< "'''7:q:':;3
Owner rtO?iract~ Si,gnature Date:
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