HomeMy WebLinkAboutPermit Mechanical 2001-4-24
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I Job# 01-00413-01 I
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Page '1 of 2
TRANS#:01-0005044
DA TE : APR 24 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 003
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00413-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 2072 Firth Ave Spr
Assessors Map#: 17032512
Lot: Block: Addition:
Tax Lot #: 05600
Subdivision:
Owner:
Margaret Henstorf
2072 Firth Ave
Phone Number: 541-746-9885
City/State/Zip: Springfield, OR 97477
Alteration Value: $0
Address:
Scope Of Work: Mechanical
Replace exist natural gas furnace
Contractor Type
Mechanical Contr
Contractor
James Heating
115 Lawrence St, Eugene, OR 97401
Registration # Expiration Date
Phone
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
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.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
[Ar~a (Sq. r d)
_ Mam: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Mechanical
04/24/2001 5044
04/24/2001 5044
04/24/2001 5044
04/24/2001 5044
Value/Quantity
Fee Amount
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
1
$9.00
$.45
$6.00
$10.00
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Fee
State Surcharge - Mechanical
Total Mechanical
Grand Total
Job# 01-00413-01
Paid On Receipt#
Mechanical
04/24/2001 5044
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Page 2 of2
Value/Quantity
Fee Amount
$1.05
$26.50
$26.50
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 pro.,per ~hat the project address is readable from the street.
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Signature
4 - UJ ~tJ /
Date