HomeMy WebLinkAboutPermit Mechanical 2010-6-2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20I0-00704
ISSUED: 06/02/2010
APPLIED: 06/0212010
EXPIRES: 12/02/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 894 POL T A VA ST
ASSESSOR'S PARCEL NO,: 1703342203400
Springfield TYPE OF WORK: Mechanical Only
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TYPE OF USE: Alteration
Residential
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PROJECT DESCRIPTION: Relocate gas meter ..:~.(.
Owner: BRYAN JEFFREY RICHARD
Address: 894 POL T A VA ST
SPRINGFIELD OR 97477
Phone Number: 541-968-2815
,I, CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
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License
Expiration Date Phone
# of Units:
Primary Occupancy Gronp:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
OWNER e' . "
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- "'" IIIIy fl)AR ~fodIt
IIIIMI..::. .... ~e ~ OIfhe ndea .!:
"V8"""" tor the . :ftre tellIftJo..._ "'7
Centet m.'I !1Iy N~
Energy '!2344).
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
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Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
IMPROVEMENTS: '\",',A"',
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AUTHORIZED U HAll EXPIRE IF THtW'dWlype:
COMMSNCEDO~O~~THIS PERMIPI$'~llf'ts/Drains:
ANY..180~DAY PER:~:ANDONED FOR. . '.'
Notes:
I Valuation Description ~
Description
Type of Construction
$ Per Sq Ft
or multiplier ,;
Square Footage
. or Bid Amount
Value
Date Calculated
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Pa2e I of 2
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00704
ISSUED: 06/02/2010
APPLIED: 06/0212010
EXPIRES: 12/0212010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
,541-726-3769 Inspection Line
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Total Value of Project
Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
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Amount Pa,i<!,.~.
_._- .r",.~
",J'Io;:
riaie Paid
6/2/10
6/2/10
6/2/10
Receipt Number
$9.48'~;:i!'
....;...:.....-..:.q.
$3.95 "!
$79.00
......, ..
2201000000000000605
2201000000000000605
2201000000000000605
Total Amount Paid
$92.43
Plan Reviews ~
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
work day. -
Reauired InsDections ~
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.
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By signature, I state and agree, that I have carefully'examinedthe completed applicatiou and do hereby certify that all
information hereon is true and correct, and I furth,e"![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 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
W25~ b ~ /0
~w~r Contractors Signature Date
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Page 2 of 2
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225 Fifth Street
Sp'ringfi~ld, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000605
Date: 06/02/2010
8:18:40AM
Job/Journal Number
COM20] 0-00704
COM20 I 0-00704
COM20 I 0-00704
Payments:
Type of Payment
Check
cReceintl
Description
I st Appliance
+ ] 2% State Surcharge
+ 5% Technology Fee
Paid By
JEFF BRYAN
. Check Number
Received By' . Batch Number
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Page I of I
Item Total:
Authorization
Number How Received
Amount Due
79.00
9.48
3.95
$92.43
Amount Paid
4]45
$92.43
$92.43
In Person
Payment Total:
6/2/20 I 0