HomeMy WebLinkAboutPermit Mechanical 2003-2-10
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Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
City' of.. Springfield
Mecha:Aical Permit
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PERMIT NO.: MEC2003-00007
ISSUED: 2/10/2003
APPLIED: 2110/2003
EXPIRES: 8/10/2003
SITE ADDRESS: 833 5TH ST
ASSESSOR'S PARCEL NO.: 1703352108100
Springfield
tYPE OF WORK:
TYPE OF USE:
PROJECT DESCRIPTION: Install gas freestanding fireplace and H20 heater
MECHANICAL CONWCTOR:
541~747-1787 MARSH~~~J\\t. 'N~O\
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,\,\\S ?t"~tU~\)]2 ~~{\~U~Plfation Date: 12/23/2003
n \QP.\t.. O? \
Amount Paid ~a~~t~~~~~ Receiot Number
4.50 . ~W-{ ,\COt) 02/10/2003 1200200000000000678
3.15 02/10/2003 1200200000000000678
10.00 02/10/2003 1200200000000000678
12.00 02/1 0/2003 1200200000000000678
15.00 02/10/2003 120020000o.~OOO00678
4.00 02/1 0/2003 1'~02'08'O'gQOO~0'ob678
14.00 02/1O/2003{egOfl \a\j\Ji~o,g20&O06Q~lt0.00618
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To Request an.mspectI~n call ~he 24 hour recordmg at 726-3~7~N \~\l~ln~~~~\qli).s"\~~~~,~d)~fOJ.~J;.tl~'am. wIll be made
the same working day, mspectIons requested after 7:00 am~~tl'1)JtW*l&Et~~dg1111Q~n~'\m@'Mrl~illi~one
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ReQuired Insnections: \n gO '(ou ~ cen\e{. ~ n \)\\\\\\} AA~
00 ',\\n9 \ne ne Otego ~'3'3?/1..'3 '
1 Rough Mechanical: Prior to Cover C~f{\bet\ot\et\S ,\~BOO
2 Final Mechanical: When all mechanical work is co~plete. cen
OWNER! APPLICANT:
DOUGLAS BUTLER
833 5TH ST
SPRINGFIELD OR 97477
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Descriotion
+ 10% Administrative Fee
+ 7% State Surcharge
-Issuance Fee-
Appliance Vent
Gas Fireplace
Gas Outlets 1-4
Minimum! Adiustments - Mech
New
Residential
541-747-7445
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 wolk perfonned shall be done in accordance with
the Ordinances ofthe City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I
further certify 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, that each address is readable from the'
stree~ at that ~ approved set of p lan~ if app licable, will remain on the site at all times duri ng construction.
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Owner fr eon~ Signature . Date
1 of 1
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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.e Items:
Job/Journal Number
MEC2003-00007
MEC2003-00007
MEC2003-00007
MEC2003-00007
MEC2003-00007
MEC2003-00007
MEC2003-00007
Payments:
Type of Payment
Check
Paid By
Description
Appliance Vent
Gas Outlets 1-4
Gas Fireplace
Receipt #: 1200200000000000678
Date: 02110/2003
Minimum/Adjustments - Mech
-Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
MARS HALLS INC
Received By
Check Number Confirm No
djb
Page 1 of 1
2/10/2003
11:53:55AM
City of Springfield
Development Services Depa. Lment
Public Works Department
Official Receipt
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Amount Paid
12.00
4.00
15.00
14.00
10.00
3.15
4.50
Line Item Total:
$62.65
How Received
Amount Paid
In Person
62.65
$62.65
Payment Total:
cReceipt.rpt