HomeMy WebLinkAboutPermit Mechanical 2003-2-18
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-00088
ISSUED: 02/18/2003
APPLIED: 02/18/2003
EXPIRES: 08/18/2003
VALUE:
.,
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3827 WINSLOW AVE
ASSESSOR'S PARCEL NO.: 1702194102000
Springfield TYPE OF
Heating System
PROJECT DESCRIPTION: Install gas furnace
TYPE OF USE: New
Residential
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Square Footaee
Owner: ROSS S & CAROL J PHIBBS REVOC LIVIN
Address: 3827 WINSLOW SPRINGFIELD OR 97477
I CONTRACfOR INFORMATION.
Contractor Type
Mechanical
Owner
Contractor
MARSHALLS INC
ROSS S & CAROL J PHIBBS REVOC LIVIN
BUILDING INFORMATION'
License
25790
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Vrimary Construction Type
Secondary Construction
# of Bedrooms:
# of Stories:
Height of
Type of Heat: ,\0
Water Type: 5~P~ ,~{\.~ ~
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IPUBLIC IMPROVEMENTS.
SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
$ Per Sq Ft
1 of 2
Expiration Date
12/23/2003
Phone
541-747-7445
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2003-00088
ISSUED: 02/18/2003
APPLIED: 02/18/2003
EXPIRES: 08/18/2003
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
I Fees Paid I
Fee Description Amount Paid Date Receipt Number
-Mechanical Issuance Fee- $10.00 2/18/03 1200200000000000712
+ 10% Administrative Fee $4.50 2/18/03 1200200000000000712
+ 7% State Surcharge $3.15 2/18/03 1200200000000000712
Air Handling Unit Up to 10,000 $8.00 2/18/03 1200200000000000712
Appliance Vent $6.00 2/18/03 1200200000000000712
Furnace - up to 100,000 btu $12.00 2/18/03 1200200000000000712
Gas Outlets 1-4 $4.00 2/18/03 1200200000000000712
Minimum! Adjustment Mechanical $15.00 2/18/03 1200200000000000712
Total Amount $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 ReQuired Insnections I
1 Rough Mechanical: Prior to Cover
2 Final Mechanical: When all mechanical work is complete.
3 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
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 ail 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 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 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,1ur_ingf}_ 0 s~uction.
if . - :;2.-(X'-o3
Owner of::Xac&/s S~nature Date
2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
COM2003-00088
COM2003-00088
COM2003-00088
COM2003-00088
COM2003-00088
COM2003-00088
COM2003-00088
COM2003-00088
Payments:
Type of Payment
Check
Paid By
MARSHALLS
Description
Furnace - up to 100,000 btu
Air Handling Unit Up to 10,000
Appliance Vent
Gas Outlets 1-4
Receipt #: 1200200000000000712
Date: 02/1812003
Minimum! Adjustment Mechanical
~Mechanical Issuance Fee~
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
Check Number Confirm No
djb
Page 1 of 1
2/1811003
11:31:42AM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Amount Paid
12.00
8.00
6.00
4.00
15.00
10.00
3.15
4.50
Line Item Total:
$62.65
How Received
Amount Paid
In Person
62.65
$62.65
Payment Total:
cReceipl.rpt