HomeMy WebLinkAboutPermit Mechanical 2010-2-16
CITY<' OF SPRINGFIELD
Building/CQmbination Permit
PERMIT NO: COM2010-00210
ISSUED: 02/16/2010
APPLIED: 02/16/2010
EXPIRES: 08/16/2010
VALUE: $ 1,500.00
~...< ('..,
SF.!AINGF,IEI.O,
-('" ,~...,... "
. T
.'[
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1792 42ND ST
ASSESSOR'S PARCEL NO.: 1702300001912
Springfield TYPE OF WORK: Mechanical Only
PROJECT DESCRIPTION: Replace gas line
TYPE OF USE: Repair
Commercial
Sidewalk Type: , , '
".:"j....:..<
, DownspoJt~/D:~f~ov.'/-
~\\'.f \f 1" \S tl01
"01\Ct~~\i S"f>-\.\.$\\\S ?tV.~gfO\\, ,,'
"(\-\\S ?~n).,t'" \)~\lt: ~l',~~UO~, '" ,"
;.(0\1""'" D\l~\S, .'
I Valuation De~, N,~li.~ ?~?\OD,
.. d'\, . ,1JI.'
$ Per Sq Ft p..~qn~,~e Footage "
or mnltiplier or Bid Amount Value Date Calcnlated
Owner: MARY E KELLEY TRUST
Address: 36575 CAMP CREEK RD
SPRINGFIELD OR 97478
I CONTRACTOR !NFORMA TlON ,
Contractor Type
Mechanical
License
147111
Contractor
J LOGUE GAS WORKS INC
BUILDING INFORMATION.
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Constrnction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
, ,Height of Strnctnre
, ~/l'IaIN~tllresyou.t~
ATTEtmON: Ore d\5C. fhtpOregon Utility
follOW rules adop .,.tw!sif)1lles are set forth
Notification cent~\Y\'IftDtl9lbOAR 952-001-
In OAR 952-001 ~ 'qjdp:.ell1i1Ml\lgrules by n/a
^n<lI\ YOU ma'{ 0 ~,. ,,'"' ....".t~tell"one
calling 5i~W:'llI1Illl"F6~
"umber Is 1~Ul.~}'1!.. t
Center
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd::,''''
% of Lot Coverage:,
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLICIMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Speci.llnstruction:
Notes: '
Description
Tvpe of Construction
!'aee I of2
Expiration Date
03/06/2011
Phone
54 I -345-7599
Lot Size:
Sq Ft 1St Floor:
Sq Ft 2nd Floor:
Sq Ft B,asement:
Sq Ft Garage/Carpod
Sq Ft Other:
Occnpant Load:
REQUIRED PARKING
Total:
, Handicapped:
, CQ,mpact:
\
~ "
-1 l'
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00210
ISSUED: 02/1612010
APPLIED: 02/16/2010
EXPIRES: 08/16/2010
VALUE: $ 1,500.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone '
541-726-3676 Fax
541- 726-3 769 I nspection Line
'.
, ; --,i~.
Bid Amount
Use Bid Amount
$1.00
1,500.00
$1,500.00
$1,500.00
02/16/20 I 0
Total Value of Project
Fe~s Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Mechanical-Value '
Amount Paid
Date Paid
Receipt Number
$6.96
$2.90
$58.00
2/16/10
2/16/10
2/16/10
,
1201000000000000140
1201000000000000140
1201000000000000140
Total Amount Paid
$67.86
I Plan Reviews I
To Request an inspection call the 24 hour rec'ording 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
work day.
I, R~,o~]ired T?~necti1'ns I
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 [ have carefully examined the completed application and do hereby certify tbat all
information hereon is true and correct, and [ 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 withont permission ofthe Community Services Division, Building Safety.
[ further certify that only contractors and employees who are in compliance with ORS 701.005 wili'be used on this project.
I further agree to ensure,that all required inspections are requested at the proper time, that each a~dress is readable from the
street, that the pcrmit 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.
r!lJ~ I --
Ot?' COtfo'fignaturc
~-Ib ~/D
"_.-." ':' ,..,.
Date
, "-J'
Paee 2 of 2
225 rlfth St;eet
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM20 I 0-0021 0
COM20 I 0-0021 0
COM20 I 0-0021 0
Payments:
Type of Payment
Check ,
cReceintl
RECEIPT #:
Description
Mechanical- Value
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
J LOGUE GAS WORKS INC
City of Springfield Official Receipt
Development Services Department
Public Works Department
1201000000000000140
Date: 02/16/2010
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
4286
In Person
Payment Total:
.:!
",
"
Page I of I
11:36:16AM
Amount Due
58,00'
6,96
2,90
$67.86
Amount Paid:
$67,86
$67.86
2/16/2010