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Home My WebLink AboutPermit Mechanical 2004-10-26 ,~ \MG\'-v.- \'i: \W ~\ll I CONTRACTOR INFORMATION I \. \:.'f-.?\\'-\'t.\'-W'-\\ \6\'- ;'\\\J\'" . ~I\ '2>1""1.: \\\\s ~'t.\) t Contractor ~I.) S ?tei~~111sg~\)'t.$x~,~fti'6n Date AUTOMATIC HEAT \\\\\.\C'.1494j2;-, a\'- \'6~~ 10/22/2005 I BUILDING INFoIiMA;'f:I0N:I~l\i ?'t.l'\'~ l\~'{ \V- . Status Issued . o~\o 225 Fifth Street, Springfield, OR . ,\1'0'" 'I ,\\111\'1 "" 541-726-3753 Phone 1'00..... rpf' v \O~\. 541-726-3676 Fax o~ ~>tl '001'0 e ",'0\ r:F:/I' 541-726-3769 Inspection Line ~\. Ole~ 6'0'1 \'\'\ 1~le'" ~IS'> 9'6~' '0'1 ';1$'i\~' \_,,\'0 _c/O l,!>I ...1'0'" .A"'\~" 'jl.V" \... ."". ."',,' n" p '''t!.r:~'' ~!._f :\\J~:'("'~":I"\,,,>:~.''':O\' SITE ADDRESS:~~ l~ :\,CC .~if' cO?' . \'\\'0 \e ~'i\Pfl1lgfield ASSESSOR'S PARC~6~ 9i ~840'\.~0\~\I\I\'1 ~Ol>.l' ~ 01'1 'iO~ 11''3: ef'\el. of' _~'C,I>. PROJECT DESCRIPT~ennC..~~ 't$~.ft'i~~~~plng~'2: C?>>I' ~ \01 \ ,"IS\- ~It'\e r"P;' Owner: OREGON STA1f~'OF ~~RD OF FORESTRY Address: 2600 STATE ST SALEM OR 97310 Contractor Type Mechanical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: VN . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01326 ISSUED: 10/26/2004 APPLIED: 10/26/2004 EXPIRES: 04/26/2005 VALUE: TYPE OF WORK: Heating System TYPE OF USE: Repair Residential Phone 541-726-7654 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Date Calculated Type of Construction Total Value of Project Paee I ofl REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutslDrains: Value Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Appliance Vent Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adjustment Mechanical Total Amount Paid . . CITY OJ:< ~rKll~ut<l~LU Building/Combination Permit PERMIT NO: COM2004-01326 ISSUED: 10/26/2004 APPLIED: 10/26/2004 EXPIRES: 04/26/2005 VALUE: , Fp.p.s P3irl I Amount Paid Date Paid Receipt Number 1200400000000001515 1200400000000001515 1200400000000001515 1200400000000001515 1200400000000001515 1200400000000001515 1200400000000001515 $10.00 $4.50 $3.15 $6.00 $12.00 $4.00 $23.00 10/26/04 10/26/04 10/26/04 10/26/04 10/26/04 10/26/04 10/26/04 $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. I Renuirp.rllnsnp.ctions' Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. 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 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 be used on this project. I fnrther 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. \ ~ h,hlc/()c.I Date Paee 2 ofl 225 Fifth St.reet Springfield, Oregon 97477 541-726-3759 Phone . .~.'fL,!!-C,"ii ~ ~~,,~ ifijj.ty of Springfield Official Receipt .velopment Services Department Public Works Department Job/Journal Number COM2004-01326 COM2004-0 1326 COM2004-01326 COM2004-0 1326 COM2004-0 1326 COM2004-0 1326 COM2004-0 1326 COM2004-0 1327 COM2004-01327 COM2004-0 1327 COM2004-01327 COM2004-01327 COM2004-01327 COM2004-01328 COM2004-01328 COM2004-01328 COM2004-01328 COM2004-0 1328 COM2004-01328 Payments: Type of Payment Cash Change Job/Journal Number COM2004-01326 COM2004-01326 COM2004-01326 COM2004-0 1326 COM2004-01326 COM2004-0 1326 COM2004-01326 COM2004-01327 COM2004-01327 COM2004-0 1327 COM2004-0 1327 COM2004-01327 COM2004-01327 COM2004-01328 COM2004-01328 COM2004-0 1328 COM2004-01328 COM2004-01328 COM2004-0 1328 10/26/2004 RECEIPT #: 1200400000000001515 Date: 10/26/2004 Description + 7% State Surcharge + 10% Administrative Fee Furnace - up to 100.000 btu Appliance Vent Gas Outlets 1-4 Minimum! Adjustment Mechanical .....Mechanical Issuance Fee- + 7% State Surcharge + 10% Administrative Fee Air Handling Unit Up to 10,000 Heat Pump Minimum! Adjustment Mechanical -Mechanical Issuance Fee- + 7% State Surcharge + 10% Administrative Fee Furnace - up to 100,000 btu Appliance Vent Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Item Total: Paid By AUTOMATIC HEAT AUTOMATIC HEAT Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Descrlptiou + 7% State Surcharge + 10% Administrative Fee Furnace - up to 100,000 btu Appliance Vent Gas Outlets 1-4 Minimum!Adjustment Mechanical -Mechanical Issuance Fee- + 7% State Surcharge + 10% Administrative Fee Air Handling Unit Up to 10,000 Heat Pump Minimum! Adjustment Mechanical -Mechanical Issuance Fee- + 7% State Surcharge + 10% Administrative Fee Furnace - up to 100,000 btu Appliance Vent Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Item Total: Page lof2 9:35:58AM Amount Due 3.15 4.50 12.00 6.00 4.00 23,00 10.00 3.15 4.50 8.00 12.00 25,00 10.00 3.15 4.50 12.00 6.00 27.00 10.00 $187.95 Amouut Paid $200.00 ($12.05) $187.95 Amount Due 3.15 4,50 12.00 6,00 4.00 23.00 10.00 3.15 4.50 8.00 12.00 25.00 10.00 3.15 4.50 12.00 6.00 27,00 10.00 $187.95 '-. . . RECEIP4 1200400000000001515 .ate: 10/26/2004 9:35:58AM Payments: Check Number Authorization Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Cash AUTOMATIC HEAT djb In Person $200.00 Change AUTOMATIC HEAT djb In Person ($12.05) Payment Total: $187.95 10/26/2004 Page 2of2