HomeMy WebLinkAboutPermit Mechanical 2003-7-31
Status
Issued
,., CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: .COM2003-00688
ISSUED: 07/31/2003
APPLIED: 07/31/2003
EXPIRES: 01/31/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspection Line
SITE ADDRESS: 3823 WINSLOW AVE
ASSESSOR'S PARCEL NO.: 1702194101900
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install AC
Owner: JORGENSON TAMI
Address: 3823 WINSLOW AVE SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
COMFORT FLOW
VN
License Expiration Date Phone
460 -"O~\~t'J 06/27/2005 541-726-0100
BUILDING INFORMATJ~'\~Ot\ \)"~\~~
Ot\ \o-l;;o<6 9.'(6 Se J:jO"
# of St~f4~'(0~ 6 '0'1 ~ '(u\9S ~f'. 9'5'2,~~ ~ize:
J!~~NO ~lI{t\ose 1t).~'{\ 0 \'{\0 '(~ 1st Floor:
~'f:i~ ~e'{' :\O~'(O ~esO\ e\eQWi~~~nd Floor:
'O\\~a~~<< )f>~ J~O ~t\ Co9 . \'(\0 \! O,\'~t Basement:
~o\''Ka~~ ~e: ~ O'O\~ ~o\~\~\\'i ~AA~~q Ft Garage/Carport
. ~~b{l.:nh~ C0t\\6'{ .0~Ot\ fJJ?-"?-~ Sq Ft Other:
,t\ o9I~). . ~ \'{\0 \'{\0 Qt fOf$Y'5 Impervious Surface Area:
o 'Jl'\~ ,..,n~ A," (1 '\'
I DEVELo..R~T(lJ~~;:CRMATION I
REQUIRED PARKING
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
~tJ,,~
\~t. ~tJ\
-'/1~ \t If'- \S
I PUBLIC IMPROVEME~rS ~ S~~\..\.. 't.~~\S ~'t.~~~ ttJ~
~\)~~t."~ I(.\) \J~~~~~9
\~\)\~tJ,,\t CJt.\) 'l)~W9uts/Drains:
~ ~~t.~ ~ ~~
CtJ \~\) \)
~~'{
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
. Date Calculated
Total Value of Project
Pa\?:e 1 of 2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-00688
ISSUED: 07/31/2003
APPLIED: 07/31/2003
EXPIRES: 01/31/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Appliance Not Listed
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
Receipt Number
$10.00
$4.50
$3.15
$8.00
$9.00
$28.00
7/31/03
7/31/03
7/31/03
7/31/03
7/31/03
7/31/03
2200200000000001330
2200200000000001330
2200200000000001330
2200200000000001330
2200200000000001330
2200200000000001330
Total Amount Paid
$62.65
Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Reouired Insoections I
1. Rough Mechanical: Prior to Cover
2 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 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'l,"ocated at the front of the property, and the approved set of plans will remain on the site at all
times during construction: : .
. ..-' ; ...;:;11 ~_ I
-...-----r:~?~ /:/tlVh J >j D"3
Owner(or Contractors Signature Date.
Pae:e 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00688
COM2003-00688
COM2003-00688
COM2003-00688
COM2003-00688
COM2003-00688
Payments:
Type of Payment
Check
Reccipt#:2200200000000001330
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Air Handling Unit Up to 10,000
Appliance Not Listed
-Mechanical Issuance Fee-
Minimum! Adjustment Mechanical
Paid By
COMFORT FLOW
Received By
djb
Check Number
Batch Number Authorization Number
City of Springfield Official Receipt
Development Services Department.
Public Works Department.
Date: 07/31/2003
3:11:24PM .
Amount Paid
Item Total:
3.15
4.50
8.00
9.00
10.00
28.00
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65