HomeMy WebLinkAboutPermit Mechanical 2009-8-12
CITY OF SPkmt.Jl'H..LD
Building/C~mbination Permit
PERMlT NO: COM2009-01l67
lSSUED: 08/12/2009
APPLIED: 08/12/2009
EXPIRES: 02/1212010
VALUE:
_~;;~U~(':~~J,If;et
"
,
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 382 S 46TH ST
ASSESSOR'S PARCEL NO.: 1702324303700
Springfield TYPE OF WORK: Heating System
PROJECT DESCRIPTION: Gas piping and gas wall furnace
TYPE OF USE: New'
Resideutial
Owner: THA YER THOMAS J
Address: 382 S 46TH ST
, SPRINGFIELD OR 97478
Contractor Type
Mechanical
I CONTRACTOR INFO~~T!9~ ,
, Oregon law I v"'-'e n Utility
Contractor ATTENTION, d'o pted by t\18 Or ~~j!iei1se"
_"Ib<: " e rules p ~,
AMBASSAD.oR)PII:11'I~q-l]1~JI. ThoS ,_n nARI'~'1469-.'-,
NUlll\U......... ._,......,',.,."......,..... ...-...">-;0.....)
in OAR 11~BtJ1WING:INF0R~c4:TION_I)ne
0090. '(OU "'-'enter. (NOle,.':'~ NotificatiOn
calling th<#ror Storie, s:n Utility 44)
\0" tne v,....;:;I '" n'10_?3 .
R-3 number HeIght oflStvucture'
Ce'"':\!;:!;' I'::;' ,
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VB
n/a
Phone Number: 541-636-3329
,
Expiration Date
03/27(201 I
Phone
541-726-5723
Lot Size:
Sq Ft 1St Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft .other:
Occupa,nt Load:
I DEVELOPMENT INFORMATION I
, : REQUIRED PARKING
Overlay Dist; , \\t. 'S'lGIi>'ttal:
# Street Trees Rqd:, Sl\I'-t. \r '\ \\ \S ~ID.~dicapped:
Paved Dr!v~.qd: l>-'-'- 'i:.~ S '?'i:.I'-\S\ t\)~ompact:
% o~l{g1\lfover~~: S\\ Gt.I'- \\\\ G\)~t.'0 ,
"i'r\\S '?:~\1t.'0 \)~Q \S I\\)I\~ ,
I PUBLIC IMPRiiy,i~ENT~S ~1't.I'-\\)V'
, A
v;~'{ '1'O\) V' Sidewalk Type:
Downspouts/Drai,ns:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I V?luation Descriotion ,I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Pa2e I of 2
Value:
Date Calculated
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
I F~es Paid'
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Gas Outlets 1-4
Amount Paid
$10.32
$4.30
$79.00
$7.00
Total Amount Paid
$100.62
I Plan Reviews I
Date Paid
8/12/09
8/12/09
8/12/09
8/12/09
CITY OF SPKH'llTFIELD .
Building/Combination Permit
PERMIT NO: COM2009-01167
ISSVED: 08/12/2009
APPLIED: 08/12/2009 '
EXPIRES: 02/12/2010
VALVE:
Receipt Number
1200900000000000907
1200900000000000907
1200900000000000907
1200900000000000907
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. will;be made the following
work day.
I R~oll!red ~n~,,~~t!,!nsJ
Rough Gas: After line is installed and required testing and capped if not attached to 'an appliance.
, ,
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
,
By signature, I state and agree, that 1 have carefully examincd the completed application and do hereby certify that all
ioformation hereon is true and correct, and 1 further certify that any and all work performed shal(be done in accordance with
the Ordinances. of the City of Springfield and the Laws of the State of Oregoo pertaining to the wo.rk described herein, aod
that NO OCCUPANCY will be made of any structure without permission ofthe Community Services Divisioo, Building Safety,
I further certify that only contractors and employees who are in compliance with ORS 701.005 will'be used 00 this project.
1 further agree to ensure that all rcquired 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 ofthe property, and the approved set of plans will remain on the site at all
times during construction. '
fl1~ /'~
Owner or Contractors Signature
Paee 2 of2
~/2-0CY.
Date
225 E'iftM~reet
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01167
COM2009-01167
COM2009-01167
COM2009-01167
Payments:
Type of Payment
CreditCard
cReceint 1
RECEIPT #:
Description
I st Appliance
Gas Outlets 1-4
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
MATTHEW CLEMENT
City of Springfield Official Receipt
Developmel1t Services Department
,
Pu~lic Works Department
1200900000000000907
Date: 08/12/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
055002b In P,erson
Payme'nt Total:
Page 1 of 1
8:51:44AM
Amount pue
79,00
7,00
4,30
10.32
$100.62
Amount Paid
$100,62
$100.62
8/12/2009