HomeMy WebLinkAboutPermit Building 2002-11-20
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II' thecenter.(Note:thetelep 0, PERMIT NO.:
ca Ing U Tt Notification
number for the Oregon tll ~'>,116 \ ISSUED:
Cente' i~ 1-R(10-:.'t'l?-
APPLIED:
EXPIRES:
City of Springfield
Mechanical Permit
Status: Issued
MEC2002-00115
11120/2002
11120/2002
5/20/2003
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax NOTICE: L EXPIRE IF THE WORK
541-726-37691nspection Li~~I~~~~~\ri ~~~~R THIS PERMIT IS_NOT
SITE ADDRESS:COMl;'6~tIB~~~ANUUI~tU run Springfield
ASSESSOR'S PARCEL NO.: Af1.~dHJitUJJ~ . TYPE OF WORK:
TYPE OF USE: Residential
PROJECT DESCRIPTION: Install new gas line, service and two applicances (water heater and gas
dryer)
New
OWNER/APPLICANT:
BARON ANTHONY S & T AMI
2336 DUB ENS LN
SPRJNGFIELD OR 97477
MECHANICAL CONTRACTOR:
ANTHONY BARON
+ 7% State Surcharge
+ 8% Administrative Fee
-Issuance Fee......
Dryer Vent
Gas Outlets 1-4
Minimum/Adjustments - Mech
3.15
3.60
10.00
9.00
4.00
32.00
CCB# Expiration Date:
Date Paid ReceiDt Number Cashier
11/20/2002 1200200000000000267 llh
11/20/2002 1200200000000000267 llh
11/20/2002 1200200000000000267 llh
11/20/2002 1200200000000000267 llh
11/20/2002 1200200000000000267 llh
11/20/2002 1200200000000000267 llh
Desc rintion
Amount Paid
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 worldng day.
Reouired Insnections:
1 Rough Gas: After line is installed and capped if not attached to an appliance.
2 Gas Service: After line is installed and line has been connected to a minirnum of one appliance. Presure te:
this point.
3 Final Gas: When all gas work is cornplete.
By Signature, I state and agree, that I have carefully examined the completed application and do hereby certiry that all
information hereon is true and correct, and I further certiry 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. I
further certiry 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 at the proper time, that each address is readable from the
street, and that the approved set of plans, ifapplicable, will remain on the site at all times during construction.
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Owner or ContractolS Signature
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Date
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