HomeMy WebLinkAboutPermit Mechanical 2004-8-5 (2)
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. Ltl t' OF ~t'K1NGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00971
ISSUED: 08/05/2004
APPLIED: 08/0512004
EXPIRES: 02/05/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4018 FORSYTHIA ST
ASSESSOR'S PARCEL NO.: 1702314407900
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: InstaU ac
Owner: MAEPA ROSEMARY Z
Address: 4018 FORSYTHIA ST SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
MARS HALLS INC
License
25790
Expiration Date
12123/2005
Phone
541-747-7445
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BUILDING INFORMATION I .t
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# of Stories: \~ \\\~ e:
Height of Structure ~i-'?\'r.~ ~'r.~\\ Fftft 1st Floor:
TIl\l\liat~ ~\\t>-\.\. \\\\~ '? rJ~~\) ~'tt 2nd Floor:
\~te~ ~\ Ij~\)~'r. l'>t>-~\) Sq Ft Basement:
'\l\~ 't.\) O'r. \~ ~ Sq Ft Garage/Carport
E~~~ !\I~~\) ~'r.\O\)' Sq Ft Other:
SP'i!J~Jl.te"d\'B"i~~\> nla Occupant Load:
. ) ~\\\l
I DEVELOpMENT INFORMATION I
REQUIRED PARKING
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage: __you-
ON' oregon - A__ Utilitf
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I PUBLIC IMP~tJ.\CHMi~:f. 1l\C)S8~:W:952.oo'.
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calling the :e oregon Utll\!.AA\..
number'or ... ,~~
centef ...
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pal!e I of2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Minimum/Adjustment Mechanical
Total Amount Paid
.
I Fp.p.s P3id I
Amount Paid
Date Paid
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00971
ISSUED: 08/05/2004
APPLIED: 08/05/2004
EXPIRES: 02/05/2005
VALUE:
Receipt Number
1200400000000001190
1200400000000001190
1200400000000001190
1200400000000001190
1200400000000001190
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.
$10.00
$4.50
$3.15
$8.00
$37.00
8/5/04
8/5/04
8/5/04
8/5/04
8/5/04
$62.65
I Plan Reviews I
I Rp'olJirp.rl \lwlp.~tion\J
Rough Mechanical: Prior to Cover
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 he used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readahle 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
times:'iztr1tio"j-1/ ft) -S -0<-/
t!:3c.",,;;;~{!~
Pal!e 2 of2
Date
.
~
i 225 Fi~th Street
- .
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-0097I
COM2004-00971
COM2004-00971
COM2004-0097I
COM2004-0097I
Payments:
Type of Payment
Check
8/5/2004
RECEIPT #:
_ of Springfield Official Receipt
WVelopment Services Department
Public Works Department
1200400000000001190
Date: 08/05/2004
Description
+ 10% Administrative Fee
Air Handling Unit Up to 10,000
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+ 7% State Surcharge
Paid By
MARSHALLS INC
Received By
djb
PaRe 1 of I
Item Total:
Check Number Authorization
Batch Numher Numher How Received
18122
In Person
Payment Total:
2:57:42PM
Amount Due
4.50
8.00
37.00
10.00
3.15
$62.65
Amount Paid
$62.65
$62.65