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