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HomeMy WebLinkAboutPermit Mechanical 2003-12-18 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-01266 ISSUED: 12/18/2003 APPLIED: 12/18/2003 EXPIRES: 06/18/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4371 FORSYTHIA ST ASSESSOR'S PARCEL NO.: 1802052100800 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install heat pump and associated ductwork Owner: ALBERT GOLETZ Address: 4371 FORSYTHIA DR SPRINGFIELD OR 97477 Phone Number: 541-741-3630 "l I CONTRACTOR INFORMATION I Contractor Type Mechanical Contractor EUGENE HEATING & COOLING License 149452 Expiration Date 10/22/2005 Phone 541-726-7654 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: . Sq Ft Garage/Carport Energy Path:t':n';,~,\':;C:!'~'C(8q0i1ISqJFf.~Otiier:S yO;.! LO k~!avv . Jl:...:; S!c;n,J12U t.J\Iiiip'ei~ous:Su~f~t~t~rea: I J .. .. R-3 ~ r: ,., :,: "~; _ __''""','> ~ .....,. _:- \ ~',".c,r>~ ."'JI \ '-'["\ '~_'(' l~_.... \ SETBACKS I DEVELOPMENT'Il~rEORMNf.ION-'I',i'; t ,;-~,U7h lM: :;~,~~ .~)() 009(;, '/~" :'., :'/ "'-::",::~ "'Y 1j2~' ~~R:B~U!~P PARKING . 1f'"':>!::"I.nn ''';.., '"'l.'-=,,('\ ,'" ,f""'~' :',- ',',-",:,\ .,-f......~:'\'!"\ ~'.:l Overlay Dlst: v.AI '8< ., ".','~ r;~. '\' ,.':..,' .Tot~!,:' ?':~ # rnl':"'V"l-~'.3r;'" t; .........,:),. "(.:\'"'1"'\::'1' 1-.. "\' " '""',,. .....'"t',."'eoo<. Street Trees Rqd,:.... l~, 1,' =. \ ,. "".J~, ","",') 'Handicappea: Paved Drive Rqd: '" ~,-"'V .:" 1..,:;n~-s~"?'). 23t6inpact: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: NOTICE: TiJlo o~~~~ij"'-="'_ AUTH,OR' Th"~MEm15rr;ORK COMMENCED OR IS ABANDOLNnE'VO"I NO~idewalk Type: ANY 180 DAY PE FOR RIOD. Downspouts/Drains: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: Notes: "'1 I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated ... ,.,\' Total Value of Project Paee 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-01266 ISSUED: 12/18/2003 APPLIED: 12/18/2003 EXPIRES: 06/18/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line L Fees Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Heat Pump Minimum/Adjustment Mechanical Amount Paid Date Paid $10.00 $4.50 $3.15 $12.00 $33.00 12/18/03 12/18/03 12/18/03 12/18/03 12/18/03 Receipt Number 2200200000000001899 2200200000000001899 2200200000000001899 2200200000000001899 2200200000000001899 Total Amount Paid $62.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work day. L Reouired Insoections I 1 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon 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 pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 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, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all ?12~Z'tr;i it~IC ftJ 10 /2-!ir~3 f 'o';;;er or dontractors Signature . Date Paee 2 of2 225 I\'ifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1266 COM2003-0 1266 COM2003-01266 COM2003-01266 COM2003-01266 Payments: Type of Payment Cash Change Job/Journal Number COM2003-01266 COM2003-01266 ,COM2003-0 1266 COM2003-01266 COM2003-0 1266 Payments: Type of Payment Cash Change City of Springfield Official Receipt Development Services Department Public Works Department ~ Receipt #: 2200200000000001899 Description + 7% State Surcharge + 10% Administrative Fee Heat Pump Minimum! Adjustment Mechanical ~Mechanical Issuance Fee- Paid By ASSOCIATED HEAT ASSOCIATED HEAT Received By djb djb Description + 7% State Surcharge + 10% Administrative Fee fleat Pump Minimum! Adj ustment Mechanical -Mechanical Issuance Fee- Paid By ASSOCIATED REA T ASSOCIATED HEAT Received By djb djb Check Number Batch Number Date: 12/18/2003 2:07:22PM Amount Paid 3,15 4,50 12,00 33,00 10.00 $62.65 Item Total: Authorization Number How Received In Person In Person Payment Total: Amount Paid $70.00 ($7,35) $62.65 Amount Paid 3,15 4,50 12,00 33.00 10.00 $62.65 Item Total: Check Number Batch Number Authorization Number How Received In Person In Person Payment Total: Amount Paid $70,00 ($7.35) $62.65