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HomeMy WebLinkAboutPermit Mechanical 2001-4-13 \ . I Job# 01-00367 -01 I . Page 1 of2 TRANS#:01-0004935 DATE:APR 13 2001 AMT RECD:2 $ 26.50 CHANGE: CASHIER: 004 .' ~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00367-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 5335 MAIN St Spr Assessors Map#: 17023331 Lot: Block: Addition: Tax Lot #: 06100 Subdivision: 4! Owner: Philip Saunders 5335 Main St.. Space 5 Phone Number: 541-988-9131 City/State/Zip: Springfield, OR 97478 Alteration Value: $0 Address: Scope Of Work: Mechanical Install heat pump system. Contractor Type Mechanical Contr Contractor Home Comfort Heating & Air Condit' Po Box 24205, Eugene, OR 97402 Registration # 84164 Expiration Date 6/25/2001 Phone 541-345-2838 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769, All inspections 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 working day, Required Inspections Mechanical I Rough Mechanical Final Mechanical - Prior to cover. - When all mechanical work is complete, Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 rArea (Sq. Fl d) - Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: o. ,/ . Fee . Minimum Mechanical Permit Administrative Fee - Mechanical 3hp - - 100,000 BTU Mechanical Issuance State Surcharge - Mechanical Total Mechanical Grand Total . Job# 01-00367-01 Page 2 of2 Paid On Receipt# Value/Quantity Mechanical I 04/13/2001 0004935 04/13/2001 0004935 04/13/2001 0004935 1 04/13/2001 0004935 04/13/2001 0004935 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. // ~/. ) Sig'flature - - - .0 ./ Fee Amount $9,00 $.45 $6,00 $10,00 $1,05 $26,50 $26,50 (j-/3-C)/ Date