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HomeMy WebLinkAboutPermit Mechanical 2001-11-19 r / r 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 ,,<~.:'-~ .;:(::\ ~ -;.Val u~e,,~$,O 'v '''V ",'" ., _4'1> ,'~ .0-- ~<;) ,""\ :s'O ""!Y v ,fl;~J,0CS; ~0 ~ r::o'O :s-roC:J (\./0 ,r'\ _~ _ ~,c., _ Q:.. . ~ r\'. ,...... "IF ;K~- oS""' 0' ~""'~. ~ R . t -'t". -\ "# "E" . I< ~t' ~~, ~CJt egIs "'[~ I:~m 'f{)0 ~_~p.lra !?n~pa e I\Clt?{0~c",~O ~o ilf-o,.,r:~;ii:.,fO 1 541-747 -7 445 ~;:' {j-"~' <:>"-'; \.P,1!".~.,..,J5 - " :,:"'" . ~, .&0 ~" 'S' (';;;'<Y \::)~. a;<V , (,:::;' . ~0":) 00 ....:\:3 ':{}1J '...... .o~ t}:)0:> ,.(,,'1' . ",<'} (\. ,...,,<) ,0 ,,0' ....'\Y; _i:1 ' .0.........0~ ~... (5)/ ,('.11>-.... rft' 0.....- ~~' Office Use"oy I'~- Vj- .;;;.'~ 00 -rl; '0r..:. ..........'-&~O\ ~ 4,0 ~~cf::-'tjJ'''' # Of Buildings: '" ~. .~ ~. 0~ '~"'<;)<;)OJ IF'S)0 CJ . Occupancy Group: -:;.v<$' ,Heat Source: Sq. Footage: SPRINGFIELD ~., 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 ~~ ~ ..~&~ ~. t:;.g ~ ~ Q' ~ ~ ~ ~& ~ o R~'-~ tp 4<) ~ ~ O',~ :.\: #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 C'. \. 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. J-k~4/~ '.' Sigmfture . / /I//tyd! Dat~