HomeMy WebLinkAboutPermit Mechanical 2001-10-1
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Job# 01-0107_2_-01
Page 1 of 2
TRANS# ~ 01,-0006860
DATE:OCT 01 200i
AMT RECD:2 $ 61~75
CHANGE:
CASHIER~061
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-01072-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 5236 Forsythia St Spr
Assessors Map#: 18020421
lot: Block: Addition:
Tax lot #: '02400
Subdivision:
Owner:
Cheryl Meyer
5236 Forsythia Street
Phone Number: 541-988-3316
City/State/Zip: Springfield, OR 97478
New Value: $0
Address:
Scope Of Work: Mechanical
Heat pump with air handler
Contractor Type
Mechanical Contr
Contractor,
Home Comfort Heating
706 Oscar Street, Eugene, OR 97402
Registration #
84164
Expiration Date
6/1/2003
Phone
541-345-2838
Office Use O<0*-
land Use: ~ ~~ ~\.O"\. # Of Build, i,ngs:
,\\);.v S \.~
Zoning Code: Q,.,Y" 1< ~0\ 0<<-- Occupancy Group:
Bedrooms: 'f$~ {-v<<?- <:~ <( Heat Source:
Range: .;:y <(;, .A:X~~ O~v Sq. Footage:
,'~ ...... '\ -,'"
, :'}V. (;~, ~' ~~
To request an inspection call the 24 hour refQr~~~g<ftf~26~'~9.~I?inspections requested before 7:00
, a.m. will be made the same working day, j'q~p'e~tiCi>Rs ~&t\iestga'1~1)7:00 a.m, will be made the~fbllowing
working day, '<-..:<~P ~O~ J'..JY,,() ~y"<($ s ~o~~~'\ ~~
..\:>"" ....{f.>~ ~~ . _,~e ~(\~ t:>'\O_",v
Reql:J,I,red Inspections (,,'<1-' .0~ 0"" IV~ '0-'
C;U ,\Q.,'J ~, 0" 'If- oJ:)'" s,
I ~~chanical I o(o..\'li- _'S'0 ,s0? ~<?- 0(",s0 ~0
-Prior to cover. 0.,0<:$ 0'0'\ g,e" rI'0 ~~ 0~'(;-0 ~O~
- When all mechanical work is complete, O~. ~o~,e ~:S..O ~("O~ '~0? Oe'~ ~\V
, ~\ 0':> 0'\' \)~ o~ ~ ~o
~<V~\'0\,0? V0~~,\)\)~~f\\ ~~o,e~~~ f't,f'bb.~' ,
, ~ &.O~ ~o~ r:z:r::p ~ 0'0 0(,,'~ o~ ;of'b'l:
\0 .~\(1). oJo ~1). 0~~ 0"\,0<:$ r.:JY
~O~O'i?-<?- .J..O~ ",0V,\\,0 'G ,f(3
.~ r-.OjOi...J' ...-!\<0h t"o.(f~ "t"')\ ,,0
O'J ~elg,<; ee.
vAV (;'<)'
Current Units: ~~oposed Units:
Census Code: Does not apply
Quad Area:
# Of Units:
Consti'. Type:
Water Heater:
Rough Mechanical
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main:
# Of Stories:
Accessory:
Total:
('
Fee
Job# 01-01072-01
Paid On Receipt#
Mechanical
10/01/2001 6860
10/01/2001 6860
10/01/2001 6860.
10/01/2001 6860
10/01/2001 6860
10/01/2001 6860.
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
10,000 Cubic Feet or Less
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
Page 2 of 2
Value/Quantity
Fee Amount
1
1
$25.00
$3,60
$12,00
$8.00
$10.00
$3,15
$61.75
$61.75
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/he proper~m~and H~e- ~aUd.::)s readable from the street.
Signature / .
/0-/-0/
Date