HomeMy WebLinkAboutPermit Mechanical 2009-7-1
CITY OF SPRINGFIELD
Building/Cbmbination Permit
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PERMIT NO: ciOM2009-00967
ISSUED: 07/01/2009
APPLIED: 07/01/2009
EXPIRES: 01/01/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1125 L ST
ASSESSOR'S PARCEL NO.: 1703264409100
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Springfield TYPE OF WORK: Mechanical Only
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PROJECT DESCRIPTION: Replace existing gas line
TYPE OF USE: Alteration
Commercial
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I V aluation DescriDtion\'~ 1"
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Value
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Owner: CALVARY OPEN BIBLE
Address: . 1116 CENTENNIAL BLVD
SPRINGFIELD OR 97477
I CONTRACTOR INFO~MATION I
Contractor Type
Mechanical
License
121469
Contractor
AMBASsADOR PIPING INC
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
. I BUILDING INFORMATION I
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# ofSI&~res'" le<J.\!ll "0\\ IJtll\Wn
.\ .J:\,.~Cl f'-S ,~~ Ole" et 10lt ,
".'-<"Io,..nelgnt.o -tructureole S .. '0";
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,... lUles ff-ypelof[!ieaf:l \I 01\1'\ 9'" \l'/
lO\\OVl t'IOll CW'afer;J\~jJef)\Jg I t\le {\JleS .
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'llI""" ~'I 0\.> - ".>;)te. .\ t\llcac ..
gO. '10\! llEner~!l'ath: \ l\i\lt'/ "a
00 0\lill9 t\l'l55fi'nkIedcB'UiliIing:)3M).. n/a
Co;;. . _.. tn( tne '-'.~ Qr\O~',j.J"" -
lI'di'EWE;('P'MhlT INFORMATION I
Front yard Setback:
Side I Sethack:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee I of2
Expiration Date
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03/27/2011
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Phone
541-726-5723
Lot Sii,~:
Sq Ft \'st Floor:
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Sq Ft 2,nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
. Total:
. Handicapped:
ii Compact:
Date Calculated
Status
Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Total Amount Paid
Amount Paid
$9.48
$3.95
$79.00
$92.43
Total Value of Project
Fees Pair! J
I Plan Reviews I
Date Paid
7/1109
7/1109
7/1/09
CITY OF SPRINGl'lJ!,LD
Building/C?mbination Permit
PERMIT NO: COM2009-00967
ISSUED: 0,7/01/2009
APPLIED: 0.7 /01/2009
EXPIRES: 0'1/01/2010
VALUE:
Receipt Number
;1
1200900000000000762
1200900000000000762
1200900000000000762
To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. wiHiibe made the following
11
work day. !!
I Renuirer! Insnections I
Rough Gas: After line is installed and required testing and capped if not attached to an ap~liance.
Final Gas: When all gas work is complete.
By signature, I state and agree, that I have carefully examined the completed application anddo hheby 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 w,;lrk described herein, and
that NO OCCUPANCY will be made of any structure without permission ofthe Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS'701.005 wid he used on this project.
I f~rther agree to ensure that all required inspections are requested at the proper time, that each a~dress is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans wiII remain on the site at all
times during constructiOll. "
fV/11/Yh5 ~t1,__~
Owner or Contractors Signatnre
. Pa~e 2 of2
Date
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j-/-O:'fi
I
I!
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225 FIfth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00967
COM2009-00967
COM2009-00967
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
1st Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
MATTHEW CLEMENT.
City of Springfield Official Receipt
Development Services Department
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Pu~lie Works Department
1200900000000000762
Date: 07/01/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How~Received
djb 03505b In person
Payment .Total:
Page I of I
8:31:48AM
Amount Due
79,00
3.95
9.48
$92.43
Amount Paid
$92.43
$92 .43
7/1/2009