HomeMy WebLinkAboutPermit Mechanical 2001-7-24
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Job# 01-00778-01 .
Page 1 of 2
TRANS#:Ol-0006231
DATE:jUL 24 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 061
RESIDENTIAL PERMIT
City'Of Springfield
Community Services Division
Building Safety
Job Number: 01-00778-01
225 North Fifth Street
Springfield, OR 97477
'Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 2750 Villa Way Spr
Assessors Map#: 17032333
Lot: Block: Addition:
Tax Lot#: 00203
Subdivision:
Owner:
Address:
Tom Montgomery
2750Villa Way
Phone Number: 541-747-5255
City/State/Zip: Springfield, OR 97477
New Value: $0
Scope Of Work: Mechanical
Install propane fp'in'sert
Contractor Type
Mechanical Contr
Contractor
Marshalls, Heating
4110 Olympic Street, Springfield, OR
97478
.' Office Use , B30 ^ -.qC Ot! ~ ^~'{j
Quad Area: Land Use: CO\ ~eh~1}i1ai~~~~
# Of Units: Zoning Code: 3NOmN~N S\ ~~cypancY'G\r~~p:
Constr. Type: Bedrooms: 'dO:! a d S\\.U.. 'd3~Qt 'Source:
Water Heater: 'Range: 1.0N S\ 1.\\N'd3 :1',.\\d~3 "'\S-4~fFoot,age:
M :3\11. J\ ,- .
To request an inspection call the 24 hour recording at 726-3~ 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
working day,
Registration #. Expiration Date
Phone
541-747-7445
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main:
Required Inspections
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. ec amca ..\. sd:~:".I""" \.l,.\f1\J
P' t - "",<;,c-OO'3 . , jO' laQ
- nor 0 cover. . t\1VCZc,-v'"'''' oe.10 aL\~ f UI\\-eO
-When all mechanical work is complete. \}\\oN ,,\\\\\fi tlOt~ "jaWao aL\\ 6 ~ '0600
U~~~~da\a\ aL\\~~~~~ U\-e\Qo ,,-e~;;6 'd"O U\
{..O. sa\nl aL\\ }O s 6nOJI,.\\ 0 \;00'" ~~'J uon-eonnON
... ~00"'Z96 'd"~a~nl aso\.\l' l~~p-e sa\I\J MO\\O}
l.\\.IO} \as ~~~ajO al.\\ {..Q pa~~O""NO\lN311"
{..\\\\\H~i~91:M.e'et)~.-e\ u06
0\ t'J9roposed Units:
# Of Stories:
Current Units:
Census Code: Does not apply
Rough Mechanical
Final Mechanical
Accessory:
Total:
.,
Job# 01-00778-01
Paid On ..Receipt#
Mechanical
07/24/2001 6231
07/24/2001 . 6231
07/24/20016231
07/24/2001 6231
07/24/2001 6231
Page 2 of 2
'-"
. Fee
Value/Quantity
Fee Amount
I
Minimum Mechanical ~ermit
Administrative Fee - Mechanical
Gas Fireplace .'
Mechanical Issuance
State Surcharge - Mechanic(ll
Total Mechanical
1
$10,50
$.45
$4.50
$10.00
$1,05
$26.50
$26.50
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
r~;Z:;;;::'d ;;:;;;iect address is re.ada~le from the street <; bl/ 101
Signatufe U -- Dati,
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