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Home My WebLink AboutPermit Mechanical 2006-7-17 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00894 ISSUED: 07/17/2006 APPLIED: 07/17/2006 EXPIRES: 01/17/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3443 OREGON AVE ASSESSOR'S PARCEL NO.: 1702313400302 Springfield TYPE OF WORK: Mechanical Only Owner: Address: TYPE OF USE: Addition PROJECT DESCRIPTION: Install gas line for range and dryer 'feS \joll \0 ~ r r,11 \a'-N fe~~~n9n \J\\\\W,,\ , "'o\J l' Iv ~ - SeT IllI .~. ~,,-:,~, ,,\esC3Je Prh-n'nPNumber: .' , l' ose fu 0 95'2.=lJv"'- -\'3f, (I D Op.:f\ 'eN . , "J:\ ~0\ \. 001 0 tDfo~9 1 tDe fll\eS " ,,' r':Jul- '._ rnO\es 0 '.cnnne ,", - ,\", ~'_" roo.'/. Qu'...." ("'01e', \.111:: lU'-,~, at\On C(!)lyrRA'CT,Q&cINiFtQRM' \lfD.l'1\: Ot\IIC Cail"':;:J tne V:;:J 3'2.- 44). 'oef 10f '\ 9J:)0-3 Contractor nUro centef \5 -License Expiration Date AMERICAN GAS APPLIANCE SE"RVICE IN 77621 10/31/2006 Residential NANCY BELL 3443 OREGON ST SPRINGFIELD OR 97477 541-521-4240 Contractor Type Mechanical Phone 541-954-4686 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION' REQUIRED PARKING t: \N.OR" ", Overlay Dist:.. '. p\Rt \t '\~ot~:NO\ # Street Tr~~~RMI'F' W\\\ S\-\t\\...\... tf\--l\S PtRNiia~:aicapped: Paved Driv<\~gy:?t.R t.D UNDt.R'\ . ~DONt.gom1Pact: % of Lot cor..U\l'g~R\1 D OR \S t\Bt\N COW\W\~~~t.r-." pt.R\OD, .~ \ '~. 1 I I U - I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2006-00894 ISSUED: 07/17/2006 APPLIED: 07/17/2006 EXPIRES: 01117/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 8% State Surcharge Gas Outlets 1-4 Minimum/Adjustment Mechanical Amount Paid Date Paid $10.00 $4.50 $3.60 $4.00 $41.00 7/17/06 7/17/06 7/17/06 7/17/06 7/17/06 Receipt Number 1200600000000001076 1200600000000001076 1200600000000001076 1200600000000001076 1200600000000001076 Total Amount Paid $63.10 I 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 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 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. 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 located at the front of the property, and the approved set of plans will remain on the site at all times during construction. !/f#///LJ 7-(7-t)&, Owner or Contractors Signature Date Pae:e 2 of 2 225 Fifth Street j Springfield, Oregon 97477 541-726-3759 Phone C:Lo of Springfield Official Receipt 1 ~Iopment Services Department Public Works Department Job/Journal Number COM2006-00894 COM2006-00894 COM2006-00894 COM2006-00894 COM2006-00894 Payments: Type of Payment Check cReceint I RECEIPT #: 1200600000000001076 Date: 07/17/2006 Description + 8% State Surcharge + 10% Administrative Fee Gas Outlets 1-4 Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Paid By AMERICAN GAS APPLIANCE Item Total: Check Number Authorization Received By Batch Number Number How Received djb 5625 In Person Payment Total: Page 1 of 1 1:45:30PM Amount Due 3.60 4,50 4,00 41.00 10,00 $63.10 Amount Paid $63,10 $63.10 7/17/2006