HomeMy WebLinkAboutPermit Mechanical 2001-1-4 (2)
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I Job# 01-00016-01 I
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Page 1 of 2
TRANS#:01-0004178
DATE:JAN 04 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 059
CITY OF SPRINGFIELD, OREGON
225 North Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00016-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4531 Franklin Blvd Spr
Assessors Map#: 17033444
Lot: Block: Addition:
Tax Lot #: 01711
Subdivision:
Owner:
Shirley Thomas
4531 Franklin Blvd sp# 100
Phone Number: 541- -
City/State/Zip: Eugene, OR 97403
Alteration Value: $0
Address:
Scope Of Work: Mechanical
Electric Furnace
Contractor Type
Mechanical Contr
Contractor
James Heating
115 Lawrence St, Eugene, OR 97401
Registration # Expiration Date
Phone
Off'c U .......................r'>';'.oet':;
I e sa r'-!C"...........,':;~.....lG ~.~..I' n~"
ATIEI'tP ...,;...... .,~~. ,,.\~f"lr.'...!,T. ':
Quad Area: Land Use: f II '" -ll\e~ '1001)\3,." 1'1 # Of BUJldll}gs:
. 0 Oy~ 1 " . r. ' IIOc.. ..11 c. .,..... .
# Of Units: Zonmg CodeN' \',ficaliOr ~8r:lc" ,n..", Occupancy,Group:
o . . U. l1ro"!'\t"lf )..,,,", '1:/(". v
Constr. Type: Bedrooms: in OAP, \J52-001-U I ~ l ~n..,lj~at,~?,ur(;\l':".
Water Heater: Range: 0090. You ,118" 'JtMlr.~.:, Sq'1~02,~$le;l._
ca\lll!~ .1Ie; .........;..- _ . ,_ ... :;("j:;;'~'
To request an inspection call the 24 hour recording at 726-,~Z;~.9.:l..AII;inspections-request.ed 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.
Required Inspections
I Mechanical
-When all mechanical work is complete.
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
rArea (Sq. Feet)
Main: Accessory:
Fee
Minimum Mechanical Permit
NOTICE: WORK
THIS PERMIT SHALL EXPIRE IF THE OT
~IITHORIZEDUNDERTHISPER~~IS~
# Of Stories:D OR IS ABANDOHeiglitl(feet):
~DI\I\IVIt:I~",r;
Current Units:PER10D Proposed Units:
~I\IV 11ln u/;y ,
Census Code: Does not apply
Total: ~
Paid On Receipt#
Mechanical
01/04/2001 4178
Value/Quantity
Fee Amount
$9.00
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Job# 01-00016-01
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Page 2 of 2
Value/Quantity Fee Amount
Fee
Paid On Receipt#
Mechanical
01/04/2001 4178
01/04/2001 4178
01/04/2001 4178
01/04/2001 4178
1
$.45
$6.00
$10.00
$1.05
$26.50
$26.50
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
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
requested at the proper time and that the project address is readable from the street.
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Signature - ~
04- zoe> I
Date