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HomeMy WebLinkAboutPermit Mechanical 2000-1-10 , . .~- JOD# uu-uil026.Q1 , Page 1 of 2 TRANS#:01-0000198 DATE:JAN 10 2000 AMT RECD:2 $ 27.06 CHANGE: CASHIER: 042 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-00026-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 979 Filbert Ln SPR Assessors Map#: 18020523 Lot: Block: Addition: Tax Lot #: 00201 Subdivision: Owner: Michael Ditlefsen Address: 979 Filert Lane Scope Of Work: Mechanical Phone Number: 541-741-0679 City/State/Zip: Springfield, OR 97478 New Value: $0.00 Install gas fired fireplace, change water heater to gas, and install freestanding gas fireplace in recreation room Contractor Type Mechanical Conlr Contractor Michael Ditlefsen 979 Filert Lane, Springfield, OR 97478 Registration # Expiration Date Phone 541-741-0679 Quad Area: 5RSc # Of Units: Constr, Type: Water Heater: Gas Office Use . Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Gas 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. Rough Gas Rough Mechanical Gas Service Final Gas Final Mechanical Required Inspections I Mechanical I - After line is installed and capped if not attached to an appliance. - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure test don - When all gas work is complete. - When all mechanical work is complete. ..~ - . Zoning: FloodPlain? D Wetlands? D Journal numbers 1: 2: Comments: . I Job# OO.Q0026.Q1 Overlay District: # of Street Trees: Page 2 of 2 Land Use: Pave Driveway? D 3: Additional Requirements: Glenwood Area? D Required Attachments: Source Locn: Material: Planner: Urban Growth Boundary?~ Quantity Of Fill: Supplier: Drainage: Floodway FEMA: Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D iArea (Sq, Feet) I Main: Accessory: Fee One to Four Outlets Minimum Mechanical Permit Mechanical Administrative Fee Equipment Not Itemized on Permit Gas Fireplace Mechanical Issuance State Surcharge For Mechanical Permit Total Mechanical Flood Plain FEMA: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Paid On Receipt# Value/Quantity Fee Amount MeChanical 01/10/2000 $2.00 $.00 $.47 $4.50 $9.00 $10.00 $1.09 $27.06 $27,06 198 1 2 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 at the proper time and that the project address is readable from the street. ~;~ ~ -;:jMl_/tJ_~v Si!liiature Date