HomeMy WebLinkAboutPermit Mechanical 2005-10-27 (2)
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Building/Combination Permit
PERMIT NO: COM2005-01528
ISSUED: 10/27/2005
APPLIED: 10/27/2005
EXPIRES: 04/27/2006
VALUE:
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21:- .i, :, St...,ct,Springficld, OR
541..;. .-,.1 Phone
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I ':SS: 3348 DOUGLAS DR
., ; I' ARCEL NO.: 1802062103200
Springfield TYPE OF
Mechanical Only
TYPE OF USE: Alteration
Residential
1'1: - r -.:SCRIPTlON: Heat pump, air handler, and ductwork.
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IOWSBY SCOTT F
J.1~R DOUGLAS DR
~ ;'RINGFIELD OR 97478
Phone Number: 541-659-6847
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J 9O:NT-R.\CTOR INFORMATION I
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Contractor ~<v '\,~~ y"\.I~ License
COl\1 FOr.'t~Q.W~C\'\\<V\.l 460
<.' ~ S~\>-~<v~ ~<Q'i-;'! BUILDING INFORMATION'
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. ~~~ <:<.<! ~~\;) \;) \;)~ ~\J\;) # o~ Stories: Lot Size:
: ....,'!JaI\5~{>(l.lfiJ~"Y.,; ::-\. -Xy.,; HeIght of 0 Sq Ft 1st Floor:
~ ':CIlP"~)~ ~'<; <;::, \;)"f. Type of Heat: OV '1.~,\ Sq Ft2nd Floor:
"",ll'lIction\:i'\:'nll.'O WalerType:,,~ .,~ f:S' SqFtBasement:
~ ~\ . ~'O i0 v \0 .
~:J"SII'IIClil1\~ Range Type: o.v' R,O <,'0' ~'0" Sq Ft Garage/Carport
" Energy Path:l' ~'O o~'O 'if-e ",,,'I: <,-0'\ Sq Ft Other:
. '{,I> '0 " S0-J ,'0
Spnnkle~" >,'S' ,s,e O'r en/a 0"'0 Occupant Load:
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I DEVELOI~~';ENT'iNFORMA-iioN:i~,C;I>'
__\\" ,-'0' ~'<J' ,\J (..1.)'<; . '-' ,- ~.
,\0-.~' r)2-" '0'0 \" 0''0' 0~'\ <:}><~
,;,\ "Overlay(Dist:.;i'~ ~ ^" '1:"-
f' ~C''' ~,v A'''\ _,v ro" o.....?:>~
\0 ,~tf.St~eet(T;re~~,~," d"?'CS ()'0'
""P\ r,av~(1..Dr~y_e'Rqd:) ,,:0
',\' ro~ of L~t" Coye'r~ge:
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~:. Typc
Expiration Date
0612712007
Phone
541-726-0100
REQUIRED PARKING
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Total:
Handicapped:
Compact:
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IPUBLIC IMPROVEMENTSI
Sl ., .. "\\',.,. Available:
S "'lction:
Sidewalk Type:
DownspoutslDrains
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I Valuation Descriotion I
Type of Construction
$PerSq Ft
or multiplier
Date Calculated
Square Footage
or Bid Amount
Value
1 of 2
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. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-01528
ISSUED: 10/27/2005
APPLIED: 10/27/2005
EXPIRES: 04/27/2006
VALUE:
Total Value of Project
Fces Paid'
... nOIl
..1 !sslIance Fee-
'lislr:lti\,c Fcc
'llrl'hargc
~ Ullit Up to 10,000
Amount Paid
Date Paid
Receipt Number
1200500000000001625
1200500000000001625
1200500000000001625
1200500000000001625
1200500000000001625
1200500000000001625
. 'qlls~l11('nt Mechanical
$10.00
$4.50
$3.15
$8.00
$12.00
$25.00
10/27/05
10/27/05
10/27/05
10/27/05
10/27/05
10/27/05
.'olal Amount
$62.65
I Plan Reviews I
T . an inspcction call the 24 hour rccording at 726-3769. All inspection requested before 7:00
a. . made the samc working day, inspcctions requested after 7:00 a.m. will be made the following
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!} ~It'challical: Prior to Cover
. '.Ierhanical: When all mechanical work is complete.
'. I stale alld agree, that I have carefnlly e,amined the completed application and do hereby certify that all
'"n'lIl1 is true aud correct, and I further certify that any and all work performed shall be done In accordance
'lIanees of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein,
.. occur ANCY will be made of any structure without permission of the Community Services Division,
f-.'ly. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used
"ct.
",e to ellsure that all required inspections are requested at the proper time, that each address Is readable from
.t I he permit card is loca at the front of the property, and the approved set of plans wiD remain on the site
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ir:lcfors Sign:lttlre
Date
2 of 2
-~ City Job Number 6?~ 2.0{) S -D ~5 'Z.8,
C) LOCATIONOFrROPOSEDWORK: 304-<6 -VooqJao ~
C) ASSESORS MAP:
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rtJ.! CITY:
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Q: CONTRACTOR'S NAME
'" GENI:RAL:
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SPRINGF.lELD
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CITY OF Sf~GFIE:bri, OREGON. ~~
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22" FlnH STREET . SP~NGFlELD, OR 97477 . PH:(04]) 726-37"3 . FA)(: ("41 )726..3689
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TAX LOT:
~WNER: --=t:28W(\ l-.lel6Crl
ADDRESS: ~ I
PHONE: ~
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~IATE:
ZW:
VALUE:
ADDRESS
CONST.
CONTRACrOR #
EXPIRES
PHONE
PLUMBING:
MECHANICAL: CON\...(i......+ ~ \ r\\,'\
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ELECT~CAL:
MECHANICAL PERMIT
PLUMBING PERMIT
ITEM
FEE
ITEM
FEE
Exhaust Hood
Vent Fan No.
Wood Stove/Insert/Fireplace Unit
Fixtures
Residential Bath(s) No.
Sanitary Sewer
Water
IT.
IT.
IT.
Storm Sewer
Mechanical Permit Subtotal
**Minimum of $45.00
~,-
Plumbing Permit Subtotal
"Minimum of $40.00
State Surcharge 7%
Stale Surcharge 7%
Administrative Fce 10%
Issuance Fee
Administrative Fee 10%
TOTAL MECHANICAL
-
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IDOl. -
TOTAL PLUMBING
M~enaFllre(Jj] ·
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Plft]mQi]ug
Shared Drive(T:)/BuiJding Fonns/Pem,il Worksheet 3-04,doc
· Mis,~e)naneouS'
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r.;: 225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Jf'b/Journal Numhl'r
COM2005..0 1528
COM2005..0 1528
COM2005-0 15:'8
COM2005-0 15:'8
COM2005-01 ~:'8
COM2005..01528
Payments:
Type of PaYllIl'lIt
Check
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10/27/2005
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RECEIPT #:
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jlL,ty of Springfield Official Receipt
.elopment Services Department
. Public Works Department
1200500000000001625
Date: 10/27/2005
2:27:20PM
Description
Air Handling Unit Up to 10,000
Heat Pump
MinimumlAdjusbnent Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
raid By
COMFORT FLOW HEATING
CO.
Am.., nt Due
8.00 .
12.00
25.00
10.00
3.15
4.50
$62.65
Item Total:
Lbeck. Number Authorization
Received By Batch Number Number How Received
Amount raid
jmp
31692
In Person
$62.65
Payment Total:
$62.65
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