HomeMy WebLinkAboutPermit Mechanical 2001-11-19
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Job# 01-01281-01
P~ge t of 2
TRANS#:Ol-0007288
DATE:NOV 19 20m
AMT RECD:2 $ 61,75
CHANGE:
CASHIm:061
City/State/Zip: Springfj@/d, OR 97478
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I\Clt?{0~c",~O ~o ilf-o,.,r:~;ii:.,fO 1 541-747 -7 445
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Office Use"oy I'~- Vj- .;;;.'~ 00 -rl; '0r..:.
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-:;.v<$' ,Heat Source:
Sq. Footage:
SPRINGFIELD
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RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-01281-01
225 North Fifth Street
Springfield, O~ 97477
Office: 726~3759
Inspection Line: 726-3769
Location Of Proposed Site: 3053 . Hayden Bridge Rd Spr
Assessors Map#: 17021932
Lot: ,Block: Addition:
Tax Lot #: 00202
Subdivision:
Owner:
, Joanne Harris
3053 Hayden Bridge Road
Phone Number: 541-746-0062
Address:
Scope Of Work: Mechanical
New
Install gas fireplace insert
Contractor Type
Mechanical Contr
Contractor .
MarshallsHeating
A 110 Olympic Street, Springfield, OR
9.7478'
Quad Area:
# Of Units:
Gonstr. Type:
Water Heater:
Land Use:
Zoning Code:
Bedrooms:
Range:
To req~, est an inspection call the .21, hour ~ecordi~g at 726-3769. All inspections ~eqUe9ted, ~~ 7,:0~
a,m. ~III bemade the same working day, inspections requested after 7:00 a.m, Will be'ma~~uIlOWIn9
working day,. , .' , ,Af -e> ~ '
, :', Required Inspections ' '. J- ~~~f? '
I Mechanical ...{?:.~ ~' ~
Insert -After installation. , . .;y<<l ~~ ~
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#Of Stories: ~ .<:-'~~b<Ptet):
Current Units: ~ CJ~~~ed Units:
Census Code: Does not apply*,"
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?D
-Area (Sq..Feet)
Main:
Accessory:
Total:
Fee
Minimum Mechanical Permit
Paid On Rec~ipt#
Mechanical
11/19/2001 7288
Value/Quantity
Phone
Fee Amount
$36.00
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Job# 01-01281-01
Page 2 of 2 '
Fee
Paid On Receipt#
. Mechanical
11/19/2001 7288
11/19/2001 7288
11/19/2001 7288
11/19/2001 7288
Value/Quantity
Fee Amount
Administrative Fee - Mechanical
Gas Fireplace
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
1
$3.60
$9.00
$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,~. a at1J e proper time ,and t, ha,t the project address is readable from the street.
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