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
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225 Fifth Street, Springfield, OR
54]-7i6-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
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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:
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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
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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 ~
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,{#, 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
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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:
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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
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~,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
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$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 _
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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
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Owner or Contractors Signature ~ate
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Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
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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
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