HomeMy WebLinkAboutPermit Mechanical 2010-6-25
City Of Springfield
225 Fifth Sl
Springfield, OR 97477
Phone: 541-726-3753
Emsil: permltcenter@ci.springfield.or.us
Job Address: 6905 THURSTON RD
City/State/ZlP: SPRINGFIELD, OR 97478
SuiieJbldgJapLno.:
Project Name:
Cross Street/directions to job site:
Tax map/parcel no.:
1702352204700
Name: Nicholas Clements
Phone: 760-212-5536
Fax:
Email:
Contact:
Address: PO BOX 412
City/StateJZlP: EUGENE, OR 97440
Phone: 5416832590
Fax: 5416070287
Email:
Metro lie. no.:
City lie. no.:
Upon review and approv<ll by your local Jurisdiction, your penntt will be e-malled or faxed
within one business day, with Instructions on how to schedule your Inspection..
NOTE: This Authorization To Begin Work explrn within 180 dillYs If a Jlennlt ~~ ".!It o.btalned.
The local building department may detennlne thilt an Authorb;atlon To Begin Work Is null and
void If It does not meet applicable land use laws and local ordin.nce5.
tl{).~2{p
Residential Mechanical Authorization To Begin Work
69600-BMC-10-00153
Approval Code: 081375 6/25/2010 11:23 am
State surcharge (12% of permit
total
Technology fee (5% of permit total)
TOTAL PERMIT FEE
$9.48
$3.95
$92.43
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ATTENTION' 0
follow rules ~d;egon law requires you to
~ot;fioation centtr~eth~~~~,~regon UtIlity
~~~t~952-001-001 0 through ~tF;e9~~:O~
. 'au may Obtain copies ofth
calling the center. (Note: the tef: r;:'es by
number for the Oregon Utility N IIC one
Center is 1-800-332'234~. cat/on
^~~
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t') .\,U)
~~
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Inspections Phone: 541-726-3769
This Authorization To Begin Work must be posted al the job site unlil replaced by aPennil
1
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00826
ISSUED: 06/25/2010
APPLIED: 06/25/2010
EXPIRES: 12/25/2010
VALUE:
Status
Issued
225 Fifth Street, Sprin2field, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6905 THURSTON RD
ASSESSOR'S PARCEL NO.: 1702352204700
Sprin2field TYPE OF WORK: Mechanical Only
TYPE OF USE: New
PROJECT DESCRIPTION: Install gas piping for dryer, water heater, range, and furnace.
Residential
Owner:
Address:
CLEMENTS NICHOLAS H
6905 THURSTON RD
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION .
Contractor Type
Mechanical
Contractor License
ASSOCIATED HEATING & AIR CONDITIO 106275
BUILDING INFORMATlON~
Expiration Date
08/311201 0
Phone
541-683-2590
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Gara2e/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION i
REQUIRED PARKING
Frontyard Setba'ck: Overlay Dist:
Side I Setback: # Street Trees Rqd:
~:ae~a~:~I~I.bSE:' ':' 'i,;,,,,,,~::~~~;~:v~~:~e:
Solar SetbldIW;; PERMIT SHAll EXPIRE IF .
COMMENCED OR IS AB~'~;5~~~II111MPROVEMENTS ~I~OW r~/~s~~;:~n~:~~eg~::,r:u~
Street Im~eih\l6t~AY PERIOD NOlIflcSlintMllkirellllThose rules a ser-i':Z.
. In OAR 952-001-Q~ re -UJ
Storm Sewer Available: 0090. ~1fi'.w~t3tlR-YM~9h OAR 9520001_
Special Instruction: Calling the cente In(NcoP/es of the rules by
r. ate: the telephone
number for the Oregon Utility Nolltic:ation
Center 18 1-800-332-2344).
Total:
Handicapped:
~-- Compact:'~.,...~';'"..._
Notes:
I Valuation Description ~
Description
Tvpe of Construction
$ perSq Ft
or m!,l~iplier
Square Foota2e
or Bid Amount
Value
Date Calculated
Pal?:e I of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: C0M2010-00826
ISSUED: 06/25/2010
APPLIED: 06/25/2010
EXPIRES: 12/25/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
6/25/10
6/25/10
6/25/1 0
1201000000000000758
1201000000000000758
1201000000000000758
Total Amount Paid
$92.43
I 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.
~eouire~nsnec~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
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 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 dcscribed herein, and
that NO OCCUPANCY will be made of any structure without permission ofthe Community Services Division, Building Safety.
I furtber certify tbat only contractors and employees wbo are in compliance witb 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, tbat tbe permit card is located at the front ofthe property, and the approved set of plans will remain on tbe site at all
times during construction.
Owner or Contractors Signature
Date
Pa!!e 2 on
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000758
II :39:20AM
Date: 06/25/2010
Job/Journal Number
COM20 I 0-00826
COM20 I 0-00826
COM20 I 0-00826
Payments:
Type of Payment
ONLINE CHGS
cReceintl
Description
15t Appliance
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
ONLINE PERMIT CHGS
,."il
Amount Due
79.00
9.48
3.95
$92.43
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Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
KR
ONLINE ASSOCIAT Online
ED
HEA T1NG
&AIR
CONDITIO
NING
$92.43
Payment Total:
$92.43
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