HomeMy WebLinkAboutPermit Mechanical 2001-2-28
...- ,"\
..
I Job# 01-00181-01 I
.
Page 1 ofkRANS#: 01-0004578
DATE:FEB 28 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER:003
SPRINGPIELD
~
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00181-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3887 Pinyon St Spr
Assessors Map#: 18020614
Lot: Block: Addition:
Tax Lot #: 10100
Subdivision:
Owner:
Lila Lancaster
Phone Number: 541-501-1562
City/State/Zip: Springfield, OR 97478
New Value: $0
Address: 3887 Pinyon Street
Scope Of Work: Mechanical
Install Gas FP and gas line
Contractor Type
Mechanical Contr
Contractor
Marshalls Healing
4110 Olympic Street, Springfield, OR
97478
Registration # Expiration Date
Phone
541-747-7445
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections 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
working day.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
rArea (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Mechanical
02/28/2001 4578
02/28/2001 4578
02/28/2001 4578
02/28/2001 4578
02/28/2001 4578
Value/Quantity
Fee Amount
One to Four Outlets
Minimum Mechanical Permit
Administrative Fee - Mechanical
Gas Fireplace
Mechanical Issuance
$2.00
$13.00
$.45
$.00
$10.00
.. ;,\
Fee
State Surcharge - Mechanical
Total Mechanical
Grand Total
.
Job# 01-00181-01
Paid On Receipt#
Mechanical
02/28/2001 4578
.
Page 2 of 2
Value/Quantity Fee Amount
$1.05
$26.50
$26.50
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time and that the project address is readable from the street.
~
Sign~ture
4//~
)
~761
Date