HomeMy WebLinkAboutPermit Mechanical 2004-10-14
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CITY tJ1< ;srKll~GFIELD
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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Building/Combination Permit
PERMIT NO: COM2004-01274
ISSUED: 10/14/2004
APPLIED: 10/14/2004
EXPIRES: 04/14/2005
VALUE:
Status
Issued
SITE ADDRESS: . 1448 MAIN ST APT I
ASSESSOR'S PARCEL NO.: 1703363202900
Springfieid TYPE OF WORK: Mechanical Only
TYPE OF USE:
Repair
Commercial
PROJECT DESCRIPTION: gas line replacement
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501 N 1ST ST CREs~~~.~12d~~~ l0~<;;I>-\\ :~~\e<; ~'l
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COJlt~. ~~ u ~I>'l ~,f'.\e\' ~f~ \J n,'l;'l-'?J~ License
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# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Expiration Date
02118/2005
Phone
541-744-7991
Owner:
Address:
Contractor Type
Plumbing
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
nla
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION , ~~~:"~
<- \~ '\ . gmRED PARKING
'X\~" ~ n
Overlay Dist: ~\.. '\:.~ S "?'\:.'?\ . till"
# Street Trees Rqd:C:. ;\ S~I>' x.~ '\~~ ~\)~'fi andicapped:
Paved DriV~~"'.t~'\:.~*\ \) \)v.\) S ",'01>' Compact:
% of Lot Cov#age:~~\lt: \) ~~ ~ 'i)\)'
",\)~~~'\:.V.C,:t>.i "?'\:.~~
I PUBLIC IMPROVE~'fs'i' 1 -
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspoutsmrains:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Sqnare Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 of2
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CITY OF Srn.ll~GFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-01274
ISSUED: 10/14/2004
APPLIED: 10/1412004
EXPIRES: 04/14/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I F~~s Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$4.00
$41.00
10/14/04
10/14/04
10/14/04
10/14/04
10/14/04
Receipt Number
2200400000000001291
2200400000000001291
2200400000000001291
2200400000000001291
2200400000000001291
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.
I Reouir~d Insn~ction\l
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Final Gas: When all gas 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 ofany 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 further agree to ensure tbat all required inspections are requested at the proper time, that each address Is readable from the
street, that the permit car Is located at the front of the property, and the approved set of plans will remain on the site at all
times onstru 0
~ n /()//ylr? i
Owner or Contractors Signature
Date
Page 2 of2
225 Fin.... Street
.,'
Springfield, Oregon 97477
541-726-3759 Phone
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aity of Springfield Official Receipt
Wbevelopment Services Department
Public Works Department
Job/Journal Number
COM2004-01274
COM2004-0 1274
COM2004-01274
COM2004-01274
COM2004-0 1274
Payments:
Type of Payment
CreditCard
10/14/2004
RECEIPT #:
2200400000000001291
Date: 10/14/2004
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Gas Outlets 1-4
Minimuml Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
DAVID NICHOLS
Item Total:
Check Number Authorization
Received By Batcb Nnmber Nnmber How Received
djb 021394 In Person
Payment Total:
Page 1 of I
2:26:53PM
Amount Due
3.IS
4.S0
4.00
41.00
10.00
$62.65
Amount Paid
$62.65
$62.65