HomeMy WebLinkAboutPermit Mechanical 2000-11-27
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Job# 00-01716-01
Page 1 of 2
iRANS#~01-0003865
DATE:NDV 27 2000
AMT RECD:2 $ 26,50
_ CHANGE:
CASHIER: 061
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01716-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 2564 J St Spr
Assessors Map#: 17032544
lot: Block: Addition:
Tax lot #: 00503
Subdivision:
Owner:
Brandon Miller
Phone Number: 541-726-9207
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
2564 J St
Scope Of Work: Mechanical
gas service
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day.
Rough Gas
Gas Seniice
Final Gas
NOTICE:
THIS PERMIT SHALL EXPIRE IFTHE WORK
-After line is installed and line has been connecte'd';ffiHORrrnlrrrilii:li\Nm5iTeTapplraT.iBMIP~ss'i)ne te!
- When all gas work is complete. COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Required Inspections
Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
Fee
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code' Does not apply ATfENT'ON:O~eg0n lavv reqUIres VOl I try
. follow rules adopted by the Oregon Utilill
Notification Center. Those rules are setfo;:11
in OAR 952-001-0010throuQh OAR 952-00 .
'~O;C. '.'vu ;-I~a); v~~Q.~;~ ~E,~~~:; :,~ ~~: :";":::: ~)r'
Paid On Recelpft!;.lllinn t~glY~/,gJl~mt!Ye: the t~~8o~tw?~nt
Mechanical numb_ohm the Oregon Utility Notification
11/27/2000 3865 Center is i-80n-$~~?-~?344). $2,00
11/27/2000 3865 $13.00
11/27/2000 3865 $.45
11/27/2000 3865 $10.00
Total:
One to Four Outlets
Minimum Mechanical Permit
Mechanical Administrative Fee
Mechanical Issuance
Fee
Job# 00-01716-01
Paid On Receipt#
Mechanical
11/27/2000 3865
Page 2 of 2
Value/Quantity
Fee Amount
State Surcharge For Mechanical Permit
Total Mechanical
$1.05
$26.50
$26.50
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
~~ that the project address is readable from the street. / / I 97 Iou
/ ' J /
Signature 1...7 Date