HomeMy WebLinkAboutPermit Mechanical 2005-2-10 (2)
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
.~ CITY OF SPRINGFI~LD
Building/Combination Permit
PERMIT NO: COM2005-00164
ISSUED: 02/10/2005
APPLIED: 02/10/2005
EXPIRES: 08/10/2005
VALUE:
SITE ADDRESS: 4957 FORSYTHIA DR
ASSESSOR'S PARCEL NO.: 1802042203300
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install heat pump and coil
Owner:
Address:
SHARON BONINE
4957 FORSYTHIA DR
SPRINGFIELD OR 97478
Phone Numher: 541-
_" \0
.\'(e':l '1-, \,,\\\"1
I CONTRACTORINF0RMAU'ION I
"d~J," 'o'l \'(\" - S '(J.\" - ?_QIJ'
Contractor, .-t' Ot;.'O'?wcj ose \,,\e Or-?o '2fic~ris't
MARSHALLS I~~,e" :;O~\e\. \~.",\O"~~ ,,\ \~ei~7~e
\1..' . -, ,- -........ .......~.- \"'\'.~ ,",0"
. ,\,(;'(J.\\" .BtlII;DINGIINFORW,A Tl@Nf
~()~r-?- 9'-" ~'(J.'l v~~. ~~; \),}}..~ ~......).
\1'1 9Q,~O 'I\\,#(Jlf'':j fi~ ';,'1':/:1
1M' '(J.\'i\I'~~~~. .' of~~ure
c ,,~'Oe\ ~c\'hieat:
VN ~ ater.Type:
Range Type:
Energy Path:
Sprinkled Building:
Contractor Type
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
Expiration Date
12/23/2005
Phone
541-747-7445
nla
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I P,UllbI€'.IMPROVEMEN'E5.I,E \1' I\-1E V<JU~~
. CD'~\ \ v'" ,-- nCIl'~n IS N
1\-1\S 1'0."" \J"OER 1\-1\S r L Sidewi1lk Type:
OR\7.EO " NOONE\) tun
l\\Jl\-1 ENCEO OR IS 1\'01\ DownspoutslDrains:
CO\'JI\'JI 0 Ol\'{ PERIOO,
I\N'{ "\8
I Valuation Descriotion I
I I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
.
. CITY 01< ~rKlI'lunELD
Building/Combination Permit
PERMIT NO: COM2005-00164
ISSUED: 02/10/2005
APPLIED: 02/10/2005
EXPIRES: 08/10/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fp.p.~ P.\lirl'
Fee Description
-Mecbanicallssuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
BoilerlComp Up To 100,000 btu
Heat Pump
Minimum/Adjustment Mechanical
Amount Paid
$10.00
$4.50
$3.15
$12.00
$12.00
$21.00
Date Paid
2/1 0/05
2/10/05
2/1 0/05
2/10/05
2/10/05
2/10105
Receipt Number
3200500000000000053
3200500000000000053
3200500000000000053
3200500000000000053
3200500000000000053
3200500000000000053
Total Amount Paid
$62.65
I Plan Reviews I
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.
Rough Mechanical: Prior to Cover
Final Mecbanical: 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 witbout 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 tbe site at all
times during construction.
~/Z~ ..d~--
:z -/O-cJc~
Owner or Contractors Signature
Date
Paee 2 of2
225 Fifth Street
Springfiel~ Oregon 97477
541-726-3759 Phone
.
~r~I!!!!!!.F1,',~._-'--~_.-- "
IIiL ,.
". i
,,__~~ _"'-.,' ....f
City of Springfield Official Receipt
eelopment Services Department
Public Works Department
Job/Journal Number
COM2005-00164
COM2005-00164 .
COM2005-00 164
COM2005-00 164
COM2005-00 164
COM2005-00164
Payments:
Type of Payment
Check
2/10/2005
RECEIPT #:
3200500000000000053
Date: 02/10/2005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Boiler/Comp Up To 100,000 btu
Heat Pump
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
MARS HALLS INe
Item Total:
Check Number Authorization
Received By Batcb Number Number How Received
djb 18453 In Person
Payment Total:
Page I ofl
2:28:42PM
Amount Due
3,15
4.50
12.00
12,00
21.00
10.00
$62.65
Amount Paid
$62,65
$62.65