HomeMy WebLinkAboutPermit Mechanical 2005-12-21
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CITY OF SPRINGFIELD
"Status: Issued
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.: 225 Fifth Street, Springfield, OR
- 541-726-3753 Phone
~ 541-726-3676 Fax
541-726-37691nspection Line
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Building/Combination Permit
PERMIT NO: COM2005-01762
ISSUED: 12/21/2005
APPLIED: 12/21/2005
EXPIRES: 06/21/2006
VALUE:
SITE ADDRESS: 658 MALLARD AVE
ASSESSOR'S PARCEL NO.: 1703221314400
Springfield TYPE OF
Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install heat pump and air handler
:: Owner:
Address:
TIM JABLONSKI
658 MALLARD AVE
SPRINGFIELD OR 97477
Phone Number: 541-747-6842
# of Un its:
Primary Occupancy Group:
Secondary Occupancy
Yrimary Construction Type
Secondary Construction
", # of Bedrooms:
I CONTRACTOR INFORMATION'
Contractor Licensees Y'Ex\)iration Date
MNB ELECTRIC INC iENilON' Oregon \11i2.t91~egon Uti\l1i'1I1912006
COMFORT FLOW M, d'" ",I,,!'. ~dopte~b\~9~ ,\es are set \:O~i2712007
I Bii;~-v.uu.. :I~r OiiMAT~roNlh OP,~e"';:;e~ 'bY
, OAR \lO<'''V- . in COpl"S 01 tone
In ~~~ stoties:'Y obta (Note: the te\ep\11!,~ize:
Oq'f;~~~;,ofl\e cen~~'egon Uti\\ty Not\hCSq Ft 1st Floor:
"ilp.I1\!1!,~eat:'le" 1.800.332.2344), Sq Ft 2nd Floor:
Water ~e:ter IS Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled nla Occupant Load:
Phone
541.726-8601
541-726-0100
"
\ Contractor Type
~i Electrical
. Mechanical
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VN
I DEVELOPMENT INFORMATION'
" Front yard Setback:
,i Side 1 Sethack:
,', Side 2 Setback:
'I. Rearyard Setback:
, Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
IPUBLIC IMPROVEMENTS I
Street
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Dra~ ~O~\<.
t~" ~\~~ W :t ,IS ~01
~~~ ~~i~~~ ~~'t~ 1~~~~~~~ fO~
~U1~O~\ a> Q~ \$ to;
CO~\I.~~~~~ ~()O.
f>.~'f \~Q
Notes:
I of 3
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Description
Type of Construction
.'
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Minimum/Adjustment Electrical
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Heat Pump
Minimum/Adjustment Mechanical
)J
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Total Amount
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01762
ISSUED: 12/21/2005
APPLIED: 12/21/2005
EXPIRES: 06/21/2006
VALUE:
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
F....s P.llid ,
Amount Paid
Date Paid
Receipt Number
2200500000000001725
2200500000000001725
2200500000000001725
2200500000000001725
1200500000000001872
1200500000000001872
1200500000000001872
1200500000000001872
1200500000000001872
1200500000000001872
$4.50
$3.15
$43.00
$2,00
$10.00
$4.50
$3.15
$8.00
$12.00
$25.00
12/21105
12121105
12121/05
12/21105
12130/05
12/30/05
12/30105
12/30/05
12/30/05
12/30/05
$115.30
I Plan Reviews I
To Request an inspection can 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. win be made the following
. work day.
~ RMJ~rl lno,~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
p' Final Electric: When all electrical work Is complete.
2 of 3
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CITY OF SPRINGFIELD
Building/Combination Permit:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2005-01762
ISSUED: 12/21/2005
APPLIED: 12/21/2005
EXPIRES: 06/21/2006
VALUE:
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 wiD 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.
1 further agree to ensure that all required inspections are requested at the proper time, tbat each address Is readable frum
the stre~:~~it card is located at the front of the property, and the approved set of plans wiD remain on the site
at all ti j~h/r 1<- /3c? )cJS-
- '-- ~
Owner or Contractors Signature Date
.
3 of 3
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ii5 Fifth Street
springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-01762
COM2005-01762
COM2005-0 1762
COM2005-0 1762
COM2005-0 1762
COM2005.0 1762
Payments:
Type of Payment
CJ!eck
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12/30/2005
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ety of Springfield Official Receipt
evelopment Services Department
Public Works Department
RECEIPT #:
1200500000000001872
Date: 12/30/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Heat Pump
Air Handling Unit Up to 10,000
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
COMFORT FLOW HEATING
Received By
djb
I of 1
Item Total:
LoecK Numoer AutDonzallOD
Batch Number Number How Received
32354 In Person
Payment Total:
9:52:52AM
Amount Due
3,15
4,50
12.00
8,00
25,00
10,00
$62.65
Amount Paid
$62,65
$62.65