HomeMy WebLinkAboutPermit Mechanical 2004-8-17
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01022
ISSUED: 08/17/2004
APPLIED: 08/17/2004
EXPIRES: 02/17/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6354 C ST
ASSESSOR'S PARCEL NO.: 1702342403200
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install heat pump and air handler
Owner: MARK CHAPMAN
Address: 6354 C ST SPRINGFIELD OR 97478
Phone Number: 919-690-8023
I CONTRACTOR INFORMATION I '
,~\a'?-.'&
Contractor Type Contractor' ,\\'t. 'l~ \)\ License
Mechanical MARSHA~lN~r t.~\' \S ~ 25790
".\\)"\C~. ~\\ s\\~~~i~\\\S ~~tJJILDiNG INFORMATION I
\' ~,?t.~ \) '0~rv ~fQ~~
# of Units: \\\~ \\a,\\\lt; '\),a'\\ \~. # of Stories:
Primary occUIi'a'ri~~l1~ ~ ,?t.\\~~' Height of Structure
Secondary OccUiJ ~~tv~ Type of Heat:
Primary Constru~ \ype Vlhr Water Type:
Secondary Construction Type: Range Type:
# of Bedrooms: Energy Path:
Sprinkled Building: n/a
Expiration Date
12/23/2005
Phone
541-747-7445
Lot Size:
Sq Ft 1st Floor:
Sq Ft2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Overlay Dist: oU \0
# Street Trees Rqd: ~U\teS 'l \}\\\\\'f
Paved Drive Ra8i\ \a'IJ te Ote~O{\ i\ \Ot\\'
% ~\~~WI~~t\:)'i \'{\e ~eS ate S~2~00\"
~\1~~(u\es ad~~{. ~'(\os~\~'{\ O~: (\)\e5 '0'1
'~.v ~,.!{. 'e5ol(. ~ono
I Pl) ~{G ~\ . .~e \e\e~. ...~\\on
. ~ ':'I ~o\e. ":""'.1IllO\~\Vo'"
\t\ 0 0 ~ou {(\a: on\et. ~ U\\~w,l\:~.{llk Type:
009' ~e c~ gOn 2.'3~).
Ca.\~\n9 ~ ot \'{\e ?te~eOo--'3'3'4jij'wnspoutS/Drains:
nUrn'oet 6en\et \5'\ . '
Total:
Handicapped:
Compact:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pae:e 1 of 2
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
Heat Pump
Minimum/ Adj ustment Mechanical
Total Amount Paid
I Fees Paid I
Amou'nt Paid
$10.00
$4.50
$3.15
$8.00
$12.00
$25.00
$62.65
I Plan Reviews I
Date Paid
8/17/04
8/17/04
8/17/04
8/17/04
8/17/04
8/17/04
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01022
ISSUED: 08/1712004
APPLIED: 08/17/2004
EXPIRES: 02/17/2005
VALUE:
Receipt Number
1200400000000001225
1200400000000001225
1200400000000001225
1200400000000001225
1200400000000001225
1200400000000001225
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.
,.1:.":::.....
'. -;...~ -'
Reauired Insnections I
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 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, 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
~Jti~
6' -="-
wner or Contractors Signature
Paee 2 of 2
B-/7-O<-(
Date
225 Fifth Street
Sp"ringfi~ld, Oregon 97477
541-726-3759 Phone
~~y of Springfield Official Receipt
''''''elopment Services Department
Public Works Department
RECEIPT #:
1200400000000001225
Date: 08/17/2004
12:01:55PM
Job/Journal Number
COM2004-0 1 022
COM2004-0 1 022
COM2004-0 1 022
COM2004-0 1022
COM2004-0 1022
COM2004-0 1 022
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Air Handling Unit Up to 10,000
Heat Pump
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Payments:
Type of Payment Paid By
Check MARSHALLS INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 18145 In Person
Payment Total:
Amount Due
3.15
4.50
8.00
12.00
25.00
10.00
$62.65
Amount Paid
$62.65
$62.65
8/17/2004
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