HomeMy WebLinkAboutPermit Mechanical 2004-1-23
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 642 MANSFIELD ST
ASSESSOR'S PARCEL NO.: 1703233411100
Springfield
PROJECT DESCRIPTION: Install gas furnace and ac unit
Owner: CAMERER LIVING TRUST
Address: 642 MANSFIELD ST SPRINGFIELD OR 97477
. CITY OF SPRI1'ljul'lJ!.LU
Building/Combination Permit
PERMIT NO: COM2004-00078
ISSUED: 01/23/2004
APPLIED: 01/20/2004
EXPIRES: 07/23/2004
VALUE:
TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
CHITTIM ENTERPRISES I INC
I BlJILDINy INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
VN
License
47396
Expiration Date
03/08/2005
Phone
541-461-2101
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
SETBACKS
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutsIDrains:
NotesATTENTION'Oregon law reqUIres you l~ WOTICE:
'. . . L .~- ('\.nn"n IIHH'" -'}'" ~"n")T "'H' I C:VDIQe: Ie: THF VV~RK
TOIlOWIUU:foc:".n....,....-.:J ~ ~.~- ~ - .. ,... "",..rr.. _." --
~otificlltion Center. Those rules ar~~1~~tion DescriIAUiWIRIZEO UNDER THIS PERMIT IS NOT
CI OAR 952:-Oj9VP.o~~ thro~gh OAR . I l,ulVllvIENCED OR IS ABANDONED FOR
D .~I'\Qn You mav Obt.B1.ntCuoPleJ:, of thesl#frfsq Ft S'!\'IWf!l@(gIl.YPERIODVIDateCalculated
escl'Iptlon Tvpe ofC~ rucllon telenh"IlU' Ii B'd a ue
calling the center. \"" '''. '" .o~'ftt. 'p er or , Amount
number for the Oregon Utility Notification
I"'_n''''''' 1_!'lr"V'l"l?-?~1l4). T I V I fP'
ota a ue 0 rOJect
Paeelof2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Boiler/Comp Up To 100,000 btu
Furnace - up to 100,000 btu
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Total Amount Paid
.
. CITY OF ~rI<J.l'\jhH1!,LU
Building/Combination Permit
PERMIT NO: COM2004-00078
ISSUED: 01123/2004
APPLIED: 0112012004
EXPIRES: 07/23/2004
VALUE:
, Fpps Paid I
Amount Paid
Date Paid
Receipt Number
1200400000000000099
1200400000000000099
1200400000000000099
1200400000000000099
1200400000000000099
1200400000000000099
1200400000000000099
1200400000000000099
$10.00
$4.50
$3.15
$8.00
$12.00
$12.00
$4.00
$9.00
1/23/04
1/23/04
1/23/04
1/23/04
If23/04
If23/04
If23/04
If23/04
$62.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work
day.
I Rpouirpd Ins,rpctions I
2 Rough Mechanical: Prior to Cover
1 Final Mechanical: When all mechanical work is complete.
3 Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
4 Gas Service: After line is installed and line has been connected to a minimum of one appliance Including required
testing. Presure test done at this point.
5 Final Gas: When all gas work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon 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 pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
(~;;~7);~' ~
-=-i~ -
Owner or Contractors filgnature
_d;)~f04
I
Date
Paee 2 012
225 Fifth'Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00078
COM2004-00078
COM2004-00078
COM2004-00078
COM2004-00078
COM2004-00078
COM2004-00078
COM2004-00078
Payments:
Type of Payment Paid By
Check
J~~~I
Wlj........',.,.".,"',.."..._..~i.,
>,,0,0' "._ \
, ,
,., !
-.....~ ........, ""'~-" "..
Receipt #: 1200400000000000099
.;
.;
City of Springfield Official'Receipt e
,
Development Services Department'
Public Works Department
Date: 01123/2004 1l:40:00AM
Amount Paid
Description
Furnace - up to 100,000 btu
-Mechanical Issuance Fee-
Air Handling Unit Up to 10,000
Boiler/Comp Up To 100,000 btu
Gas Outlets 1-4
Minimum/Adjustment Mechanical
+ 7% State Surcharge
+ 10% Administrative Fee
12.00
10.00
8.00
12.00
4.00
9.00
3.15
4.50
$62.65 .
.
Item Total:
Received By
dim
Check Number
Batch Number
Amount Paid
Authorization Number
How Received
680
In Person
$62.65
JAMES HEATING & AIR
CONDITIONING
Payment Tota.:
$62.65 .
.