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HomeMy WebLinkAboutPermit Mechanical 2010-6-29 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00849 ISSUED: 06/29/2010 APPLIED: 06/29/2010 EXPIRES: 1212912010 VALUE: Status Issued ,!YC'I.." _;)\1 ;-lo.H:.". 225 Fifth Street, Springfield, OR 54]-7i6-3753 Phone 54]-726-3676 Fax 54]-726-3769 Inspection Line .~:,; n::; ;;!"{' ',J, , , .'. l?>~. . SITE ADDRESS: 22] W CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: ]70327440]]00 Springfield TYPE OF WORK: Mechanical Only PROJECT DESCRIPTION: Relocate gas meter TYPE OF USE: Alteration Residential Sidewalk Type: ..~,; .,.' " Downspouts/Drains: '~.i~i,:l( 'i~?"""~"",,,:j,,~i.f',~,,;~i';~J . ~,~.'!n' : -\ . ",.. ., . ,'" .<' J' .. ~ . ~ ;:':""'~t~:~1~;i.~~i;Wii.i~~!.~':" ,i;.,,,;, ,':,c" NOTICE: , r:vplRE IF lHE WORl<\ l! ;" TI-ll. MlT Stlf.,L.. t'^ OT {,I: !\U I 'ORIZED DONEn fOR "1,1::: Valuation Descri tion, VlENCEn OR IS ABAN ," .:; :\"':~' ~~I\I 1 Rn nAY PERIOD,"" ' $ Per Sq Ft Square1Fob't\ige or Bl'd Amount Value Date Calculated or multiplier Owner: HARDRE PAUL D Address: 22] W CENTENNIAL BLVD SPRINGFIELD OR 97477 I I CONTRACTOR INF0RMATION ~ Contractor Type Mechanical Contractor OWNER License # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type . Secondary Construction Type: # of Bedrooms: BUIL?ING INFORMATION ~ ;:l~ts_ : n;'t,"" ,{#, of Stories,: . R-3 Height of Structure , Type of, Heat: VB . Water Type: Range Type: , Ene.rgy Path: ulres YOU,to A11'eNTlON: ~tm~5gon UtII\\YI/a :~;je:~ In 'loUrnl~lncop. ,.thetelepMne OO:ilng the t f.Y ~~Witlt .NotilicatiOn number for ~~~344). Ce 0 of Lot Coverage: Frontyard Setback: Side J Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction Pa~e I 00 ,;', H ~'. .',:' Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: ;~: . ,,' :" -.-", CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00849 ISSUED: '06/29/2010 APPLIED: 06/29/2010 EXPIRES: 12/29/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 1< 1{i'~;~ ~:lo '~~L ~,' '~J' i '../' rl,' - ~,TotaIValue of Project I Fees Paid ~ Fee Description + 12% State Surcharge + 5% Technology Fee 1st Appliance. Amount Paid Date Paid Receipt Number $9.48 $3.95 $79.00 6/29/10 6/29/10 :;6/29/10 2201000000000000758 2201000000000000758 2201000000000000758 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. , "i~i~t' : .,/i"i~j:~~ ;'", fo' LReouired Insoections _ . , or;:" {; ~ ;. ; '/'J ~ (: l> Rough Gas: After line is installed and requi'~d' testing and capped if not attached to au appliauce. Fiual Gas: When all gas work is complete. By siguature, 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 described herein, and that NO OCCUPANCY will be made of any structure withont 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 ou this project. I further agree to ensure that all required inspections afe requested at the proper time, that each address is readable from the street, that the permit card is located at the front1of,t,he p'roperty;,'!nd the approved set of plans will remain on the site at all ".m 'mo, mE'" ,.' (' ., &[1 {tre/ ~14vZ7; ~/O Owner or Contractors Signature ~ate . c~ ~~;f ,:~.'\t;;;:::.. f"F~l i ~~ "..'~1:'f.!ft ~~i.:Jl~ ~: '''~J(:~' . , "Jr.,",,", . '.'.".i > '. "'....,,. .'.. Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~:r.J!-Q.!,~... , ;..... ,.' J ., '( --,' '-'-' " ...~.."..; ...,.~_._~.~--,.,:~;.. .-. City of Springfield Official Receipt Development Services Department Public Works Department ,'. " RECEIPT #: 2201000000000000758 Date: 06/29/2010 10:27: lOAM Job/Journal Number COM20 I 0-00849 COM20 I 0-00849 COM20 I 0-00849 Payments: Type of Payment Check cRcceintl Description I sl Appliance + 12% State Surcharge + 5% Technology Fee Paid By PAUL HARDRE Item Total: Check Number Authorization Received By Batch Number Number How Received djb 836 In Person Payment Total: Amount Due 79.00 9.48 3.95 $92.43 Amount Paid $92.43 $92.43 J. ~ pJby,' :5.';;',. . ~~ ~,r~ '"1"';*: '., . I'. i, _...~-~ i~ji'lql . ',4 '\ ..i ." . '~, . 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