HomeMy WebLinkAboutPermit Mechanical 2000-9-21
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Job# 00-01430-01
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Page 1 of2
TRANS#:01-0003279
DATE:SEP 21 2000
AMT RECD:1 $ 27.00
CHANGE:$ 0.50
CASHIER:061
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01430-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 551 Mallard Ave Spr
Assessors Map#: 17032213
Lot: Block: Addition:
Tax Lot #: 15900
Subdivision:
Owner:
Marshall Humphries
551 Mallard Av
Phone Number: 541-741-7370
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
Scope Of Work: Mechanical
gas furnace
Contractor Type
Mechanical Contr
Contractor
Wilder Heating and Cooling
PO Box 41570, Eugene, OR 97477
Registration # Expiration Date
.Phone
541-741-7370
Office Use
Quad Area: Land Use: # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr. Type: Bedrooms: Heat Source: Ire< you Ie
Water Heater: Range: ", \ cl"! '\.JI\j:\.Sq9FOOt~9:io~ureno-n Utili!'
. '__ ..."'....~."'.arll'\\J ula ~ )
lu,lv" '.u,v_ ---,. Th 'se ruleS are set lon'
To request an inspection call the 24 hour recording at 726-3769. A[Jtil.i$peGtiOn~ren~flbte~tiefo\e(~iQ.o, 952-001.
a.m. will be made the same working day, inspections requested afterl7i;OOla\.~'WiIPt:l~1rIMH~~~~f,O~PYt'i!]gUleS by
working day. 0090. you may ~?~~'{~ote:thetelephone
. . calling the ce _ '. _ _ ..."".. ~I^..f;""tinn
ReqUired Inspect'oniflumOl3flUl '""'-"V>lV" -....,
Mechanical I Cellter;f 1.8(\0-<\32-2344).
- Prior to cover. 1
- When all mechanical work is complete.
Rough Mechanical
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
NOTICE:
# Of Stories: THISlilllightj(feet):LLEXPIRE IFTHEWORK
rt:.IIIVI , .,JII."\
Current Units: RPOrop.osed Units; THIS PERMIT IS NOT
AUT nlLcU UI'JUL-n
Census Code: Does not ap8~MMENCED OR IS ABANDONED FOR
Total: I ANY 180 DAY PERIOD.
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Job# 00-01430-01
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Page 2 of 2
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Fee
Paid On Receipt#
I Mechanical
09/21/2000 3279
09/21/2000 3279
09/21/2000 3279
09/21/2000 3279
09/21/2000 3279
Value/Quantity
Fee Amount
Minimum Mechanical Permit
Mechanical Administrative Fee
Less than 100,000 BTU
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$26.50
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 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 the proper time and that the project address is readable from the street.
~/J/77 'V/IiI_' q -- ~ J.- oC
Signature" - - Date