HomeMy WebLinkAboutPermit Mechanical 2002-3-6
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Job# 02-00254-01
Page 1 of 2
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TRANS#:Ol-0008234
DATE: !'lAF: 06 2002
AMI RECD:2 $ 61.75
CHANGE:
CASHIER:003
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00254-01
225 Fifth Street
Springfield, OR 97477
,
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 4985. Forsythia St Spr
Assessors Map#: 18020422
lot: Block: Addition:
Tax lot #: 02900
Subdivision:
Owner:
Address:
Ron Monroe
Phone Number: 541-726-3874
4985 Forsythia Street
Scope Of Work: Mechanical
New
City/State/Zip: Springfield, OR 97478
Value: $0
NOTICE:
THIS PERMIT SHALL EXPIRE IFTHEWORK
. AUI.t1QRI7"ED.UNPER THIS PERM. IT IS NOT
Reglstre~<tv1rVfEN ~ffi~~?~ A?!A~DONEO~B'j!f
38001 ANY180 rr,iJ1b%1iIOD. 541-343-1681
New heat pump system
Contractor Type
Electrical Contr
Mechanical Contr
Contractor
Oregon Electric Service
PO Box 2237, Eugene, OR 97402-0070
Home Comfort Heating & Air Conditioning 84164
Po Box 24205, Eugene, OR 97402
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
..,'- - '.:'c yOU to
ATTE~.!e/2-5j03"'-~":~'-:('\ ,..,-.'- ::/5~~.~~45~28B'8'
f...IL-.;rq,,:!PS~{IOPTeGoyth0l::J.~b>"" .., ''*h
\J"I., '-~', ..J" . . Th e "'Jlec:; are set j -,I l
~.';jtificatlon Centel.. OS.", :.. r. j-, nr.:.0J!n.!-
in OAR 952-0Ul"UU IV LlIlVI.~\.:l" v:,':' ..- d "
0090. You may obtain copIes ot t.~e ru.e~ by
Il'ng t'#"Of.'B' 'u' 'l'I'd.il>.,'g~s'_9: tr..,etelephone
call ~.\C_c ,n. 'f'"
b {r.\'" ..a':..~J'DG" Iltil11V Notl ICatlon
'1um er ,~C.cUtJClIIG.y roup.,. 4)
;'">.r ."),')...,. r ,
Ctl.' ~+-t' s" -Lf.l!" ;.., "i~".234 .
nea ource:'.
Sq. Footage:
. To request an inspection call the 24 hour recording at 726-3769, 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
working day.
Final Mechanical
Required Inspections
I Mechanical
- When all mechanical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
. Height (feet):
Proposed Units:
Total:
~
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Job# 02-00254-01
Page 2 of 2
.:. Fee
Minimum Mechanical Permit
8% Administrative Fee- Mechanical
3hp - - 100,000 BTU
10,000 Cubic Feet or Less
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Paid On Receipt#
Mechanical "
03/06/2002 8234
03/06/2002 8234
03/06/2002 8234
03/06/2002 8234
03/06/2002 8234
03/06/2002 8234
Value/Quantity
Fee Amount
Grand Total
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 ~t the prop.~-aA<'j7hat the projstctaddress~ readable from the street.
/%~~ /~I ~--_.... 3-~-o~
Sigrf.i(.{fe ('.frO - 0 . Date
$25.00
$3,60
$12.00
$8,00
$10,00
$3.15
$61.75
$61.75
225 FIFTH STREET , ;;:
. SPRINGFIELD, OREGON 9747.j
INSP~CTIO~RE. ........ ~;:72'~i~
OFFICE'726~315'<; ;;11/
... .:j 't,,}:. ". ,,~(":'~t~1
1( weA'f. I~.N.. ().F IN. ,~T~. ....~>>.1;.J.J)N
-n-=&S' I;"" ('l;<;' "';'0
~ Multi-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
1 gOz. 0 c...; z Z 0 L 9cn.:J Items Cost Sum
bmitted has the following
l' followmg protect as su " I d use
JO~ESCRIPTION z~~mg and does not require specIfiC an1000 sq.ft.
LLJ(...U2. <tj..P Rooroval LD (L Each ,
Zoning ''2-j sq. ft or portIon
Permits are non-transferable and expire '~~ ... 0 (;ICII;;Ol - $ 19,00
if work is not started witiRtrso days ~ E,lrhM.ol.nufd Home or
of issuance or if work is Stl~~&tgnature Modular Dwelling
ISO days. Service or Feeder $ 50.00
\f~"
;,:::';
E, Misce l,ln~ol!s', ~ervic~lf~~der not
-Eaclfinstallation; "'.
. PlinlP:or 'irrigatIon. .. .
SIgn/Outline Lighting'
.' Limited Energy/Res ,
: Limite~ Energy/Comm
$45,00
MinimuniElecfriCPermitInspection Fee is $45.00 + SUI'charges
:.:,- u:,"::'" ; ":.~_ ';_ :,~'. '. -~::/'::.';'';_'::;::(: :,:" '. .- .;::: .', : .- '.-'-
4, SUBTOTAL OF ABOVE
7% State Surcharge
8 % Administrative Fee
TOTAL
<.45 $.'C>
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-51,05