HomeMy WebLinkAboutPermit Mechanical 2004-5-19 (2)
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
..
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00595
ISSUED: 05/19/2004
APPLIED: 05/19/2004
EXPIRES: 11/19/2004
VALUE:
SITE ADDRESS: 1016 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1703264109600
Springfield TYPE OF WORK: Heating System
PROJECT DESCRIPTION: Install heat pump
TYPE OF USE:
Owner: SOGGE IRENE M
Address: 1016 OLYMPIC ST SPRINGFIELD OR 97477
Contractor 1~ftI\Se
UNITED HEATING & AIIi<;:.9bI'H\l1f~l,;;:)A~~\IJ,
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.t<otilicatiOn Cl~(~roug dl \tIS tule& '0'3
"I~O,t>.p. 952'lWe'fIMeJlS~\'{I\e \SISphOnQ
0090. '(ou h m'l&t'dJltpt~ili\'1 No\if~
VN calling t ~~~~"'-"'2..~l'
I\Umbel \q(a ~~
CEil ath:
Sprinkled Building:
Contractor Type
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I CONTRACTOR INFORMATION'
n/a
, v"" "'LOPMENT INFORMATION I
Overlay Dist:
# Street Trees Rqd:
Paved Drive J~
~ ~ll\~A.~(ff:
~O~\C;~~~\i S\\t>.\.\. ~~~\~ ~t\\WI\1\S ~
\ 1"'" r - UNU-f{i. _ _:'lli.H ~fu'
t>.Ul\\Q\\lltO Q\\ Icrl.iliAlWIMYKOVEMENTS I
Street Improvements: CQWlWlf.~~f.~ p\:\\\QIl.
Storm Sewer A vailable: t>.~'{ 1 &0
Special Instruction:
Notes:
Description
New
Residential
Expiration Date
04/04/2006
Phone
541-688-9162
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Total Value of Project
Pa2e I of2
Value
Date Calculated
....1IIIl. '.~.. ..,:.qf!l~ ..,'
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.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00595
ISSUED: 05/19/2004
APPLIED: 05/19/2004
EXPIRES: 1111912004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I F....~, Pfoli4j
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Heat Pump
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4,50
$3.15
$12.00
$33.00
5/19/04
5/19/04
5/19/04
5/19/04
5/19/04
1200400000000000763
1200400000000000763
1200400000000000763
1200400000000000763
1200400000000000763
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 Tn.o~
1 Rough Mechanical: Prior to Cover
2 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 ofany 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 will be 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.
~.
..........---L.t )
.~ .
Owner ~tractors Signature
DC; -ICJ-O ~
Date
Pal!e 2 of2
2~5 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
~
~y of Springfield Official Receipt
"elopment Services Department
Public Works Department
Job/Journal Number
COM2004-00595
COM2004-00595
COM2004-00595
COM2004-00595
COM2004-00595
\..
Payments:
Type of Payment
CreditCard
\;..
\'.
5/19/2004
RECEIPT #:
1200400000000000763
Date: 05/19/2004
Descrlptlou
+ 7% State Surcharge
+ 10% Administrative Fee
Heat Pump
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
UNITED HEATING
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 000387 022316 In Person
Payment Total:
Page 1 of I
11:19:15AM
Amount Due
3.15
4.50
12.00
33.00
10.00
$62.65
Amount Paid
$62.65
$62.65