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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 ^ . lil' TYPE OF USE: Alteration Residential '."I" "J. 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 , .~.~,.. ~ License Expiration Date Phone # of Units: Primary Occupancy Gronp: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: OWNER e' . " ~.,.- ON ~~~ - "'" 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 :1 .'. 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"', :;, ", .,.,,,;~.:.).,. 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 _~,,_.," .."..i....-, . . -~-,. .--..'---. '~~41~, 1':";"~:~'~ ",I,', Pa2e I of 2 r. 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 ..A' . ~. , i ~' Total Value of Project Fees Paid ~ Fee Description + 12% State Surcharge + 5% Technology Fee 1st Appliance .-,'.j".:.; .f.... 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. . '.~G~: ._ c,~ _,4 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 ,.'."'. " ", (,;{!;.;.. Page 2 of 2 ",+Y1'1 ...~ '..... ~ ~ l' \ t ,j i L 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 . djb ~~};l :. ,. yo, , :, ~ ~1#~\ ,,~;,:ii!~)_, '~~;\?1' . <Jj;~i,~oi ~:'I:-;~'J~~1 'i'vb.'-' " .jJj. '.'; .., ;1 . ," ~ <.';" '~i . .:Pi"~ t;~;~ .~i 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