HomeMy WebLinkAboutPermit Mechanical 2002-12-10
, .~
City of Springfield
Mechanical Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: MEC2002-00125
ISSUED: 12/10/2002
APPLIED: 12/10/2002
EXPIRES: 6/1012003
SITE ADDRESS: 4370 SMITH WAY Springfield
ASSESSOR'S PARCEL NO.: 1702322401300 ATTEi\lTION:On.r:WPE-OF WORK:
follow rules adopted bV':'1E.. '
Notification Center. T1iKJ!:E,9f:USE:
PROJECT DESCRIPTION: Pellet Stove Install~tiQh\R952-001-0010throlgr-. ,<
0090. You may obtain caple;
New
Residential
..-__ __ JI_t_._ ___.A._.. ft\Y_.\_.
OWNER/APPLICANT:
BIEGHLER ALFRED C & SHARRlJ
4370 SMITH WAY
SPRINGFIELD OR 97478
""""II"11M "11_ __~I"'_.~ \" ..._.._ .
nur.~~~IC;;~~CONTRACTOR:
Center-if i-Fie,!'.".
CCB # Expiration Date:
Desc riotion
Amount Paid
Date Paid
Receiot Number
Cashier
+ 7% State Surcharge 3,15.2 1200200000000000371 ddk
+ 8% Administrative Fee 3,60 T I. faiT SH J7QO~00000000000371 ddk
-Issuance Fee- 10,00 7 ~J iiB@o~~@lWd60ob!E7WORK ddk
Minimum/Adjustments - Mech 15,00 Al.kn~WED UNO~el>4~~mPJ31S NOT ddk
Pellet Stove/Insert 30,00 CO'M~~iWgED ORl~~A~~~~~FliR ddk
. t\IIH 1.911 UAY t:'tHIUU '
To Request an inspection call the 24 hour recording at 726-37b9. 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 worldng day.
Reauired Insnections:
1 Freestanding Pellet Stove: After installation.
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
infonnation hereon is true and correct, and I further certify that any and all worK performed shall be done in accordance with
the Ordinances ofthe City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I
further certify 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 proper time, that each address is readable from the
street, and that the approved set of plans, if applicable, will remain on the site at all times during construction.
,)j)/l/J/U J/ ~r ~~
O~r- or Contractors Siinature tJ
Date
/ :J- / () - () ;;Z
1 of 1