HomeMy WebLinkAboutPermit Mechanical 2003-10-24
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Status
Issued
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01084
ISSUED: 10/24/2003
APPLIED: 10/24/2003
EXPIRES: 04/24/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4708 MAIN ST
ASSESSOR'S PARCEL NO.: 1702324200105
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE:
Alteration
Commercial
PROJECT DESCRIPTION: Replace rooftop unit
Owner: MCKENZIE DAIRY QUEEN
Address: 4740 MAIN ST SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
SERVICE SPECIALISTS
License
140770
Expiration Date
02108/2004
Phone
541-736-3940
BUILDiNG INFORMATION I
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Wa~ Type: Sq Ft Basement:
~~ype: St! Ft Garage/Carport
.~ Path: ~!::t Other:
~'.c.'\: n... 0 .:-';')
,~ _.>>'" <t.\S'~r:/f:> ~!-9..\IJ'!~us Surface Area:
~l!~~PMENT INFORMA TlON '~'~0~J~0 "'~<''V:0'" '
"~,,,<:-! ~'" ~ 00 0"''If.j:" 0"~~HIREDPARKING
,#~~ ~~~O~~~
Frontyard Setback: q.' ~~ ~ Overlay Dist: 0<:- 'Q~ 0" ?f c/' ~0 ~<!tal:
Side 1 Setback: ~<(,. #- ~~ ~ f? ~~. # Street Trees Rqd'o..0Q) 0~ ~oq ~o-s, 0'" 0~ ~cHandicapped:
Side 2 Setback: ~~ K,<<:: '!f> ~ "5 n4f Paved Drive Rqd:~, )"o~~ /:- t;:, ~ o~'< 0~'~ ",€~pact:
~~ r;.:,'X ~ ~<<;~, <~ '/>v ~0 " ~v o::.:::;~ !],-
Rearyard Setback: ~ ~ x-"5 ~ ~"f- % of Lot Col'-@!'lI~~ 0~ ~ is' ~ ~ .....<'::>'1:
Solar Setbacks: '" S _~ <0<::; A<<) ....:s' ~(j COot;:," cP 0'" If R'"
r \,~',,, _,,' ."".0 _>-' _~ ~ _.0 _(:< ,
'-'~' I PUBLIC IMPRQ\JF;~~TS"~0 c.~0 :'''' ,,"
"'-0' '~~ f?,
, " ",t;:,' ~~ ~~"idewalk Type:
"r;sJ;;}~0C
~ C. ~~ Downspoutsffirains:
~
B
VN
SETBACKS
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Palle 1 of2
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. CITY OF ~rlUI~uFl~L1J .
Building/Combination Permit
PERMIT NO: COM2003-01084
ISSUED: 10/24/2003
APPLIED: 10/24/2003
EXPIRES: 04/24/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fr.r.s P3irl I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Furnace - up to 100,000 btu
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$12.00
$33.00
10/24/03
10/24/03
10/24/03
10/24/03
10/24/03
Receipt Number
1200200000000002368 '
1200200000000002368
1200200000000002368
1200200000000002368
1200200000000002368
Total Amount Paid
$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.
L.Reouired Insor.etions I
1 Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
By signature, 1 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 he 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
times during construction.
I'~~~~-
11~?1'J J.q~
Date
Owner or Contractors Signature
Paee 2 on
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 1084
COM2003-0 1 084
COM2003-0 1 084
COM2003-0 1 084
COM2003-0 1084
Payments:
Type of Payment
Check
~
~~"'-;----, .--'
,:
Receipt #: 1200200000000002368
Description
-Mechanical Issuance Fee-
Minimum! Adjustment Mechanical
Furnace - up to 100,000 btu
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
jmp
(;heck Number
Batch Number Authorization Number
Paid By
SERVICE SPECiALISTS
1759
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 10/24/2003 2:46:48PM
Amount Paid
10,00
33,00
12,00
3,15
4,50
$62.65
Item Total:
How Received
in Person
Payment Total:
Amount Paid
$62,65
$62.65
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