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HomeMy WebLinkAboutPermit Building 2000-8-16 .. , I Job# 00-01262-01 I - Page 1 of2 TRANSU:01-0002939 DATE:AUG 16 2000 AMT RECD:2 $ 26.50 CHANGE: CASHIER: 059 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-01262-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 1583 Oelrose Ave Spr Assessors Map#: 17032434 Lot: Block: Addition: Tax Lot #: 00109 Subdivision: Owner: Joe Ankeny 1583 Oelrose Ave Phone Number: 541-747-8680 City/State/Zip: Springfield, OR 94778 Value: $0 Address: Contractor Type Mechanical Contr Scope Of Work: Mechanical Alteration New Gas service and fireplace, water heater . .. 'I::/'J/I()/ fOI/OIN~u/e ~.lil",,\;(,,,. IVWir Sado . c" . S~rJJ~nCent:"edbYtheo~; ~. .' Registration # ~m!J~~~il!Jo~OS€' rUles a~on Util121469 P~9~E~t'<5RJ9Vt40J1R e Set fo. .""""'lTInrrth"..:...... Canio~ .'.' 952-11/) '<UII10fHforth' '0""" (NafB: r,..;.' u:ti/'II'>c . C e 'tinO ,",uICflti1.JW . I'l"t"o;o 1.Q":,. nUtilit"N~t... on" "an~,.y~.I1. II/cat,.,. -J")/,_ I., Zoning Code: Bedrooms: Range: Expiration Date 3/27/01 Phone 541-465-4737 Quad Area: '. . # Of Units: Constr. Type: Water Heater: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: Rough Gas Gas Service To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made th:.\'s~me:working day, inspections requested after 7:00 a.m. will be made the following working day. TH/SPER'" All.,.,.. MITSHAI, ~'h R . d I t' . ''''''//'''0 --..-,'-' , equlre nspec Ions C "-c:, UNO "... ,!- 11-IE: OMM'c-N ER 7iHt M 1!:ti" ...... I I I CO CEO S Pc-,.,. ec amca ANV1BOD v OR/SABANO ""VIIIISNCJ' :tlAftP<:;I"" ,. . t II Q,~I'::"'d -I'~ h b t d t . . f I' - er. me,!l1.ms a eu an I mal as een con nee e 0 a mmlmum 0 one app lance. Pressure te: Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D [Ar~a (Sq. Feet) _ Main: Accessory: .. # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: '.. .-" , Job# 00-01262-01 Paid On Receipt# Mechanical 08/16/2000 2939 08/16/2000 2939 08/16/2000 2939 08/16/2000 2939 08/16/2000 2939 08/16/2000 2939 Fee One to Four Outlets Minimum Mechanical Permit Mechanical Administrative Fee Gas Fireplace Mechanical Issuance State Surcharge For Mechanical Permit Total Mechanical Grand Total - Page 2 of2 Value/Quantity Fee Amount 1 $2.00 $8.50 $.45 1 $4.50 $10.00 $1.05 $26.50 $26.50 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 requested at the p~i~e and that the project address is readable from the street. i1~ dl~ Signature 57r~oiJ Date