HomeMy WebLinkAboutPermit Mechanical 2002-1-2 (2)
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I Job# 02-00001-01 I
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Page 1 of 2
TRANS#:01-0007658
DATE: JAN 02 2002
AMT RECD:2 $ 61.75
CHANGE:
CASHIER:061
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SPRINGFIELD
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00001-01
225 North Fifth Street
Springfield, OR 97477
Office:: 726-3759
Inspection Line:: 726-3769
Location Of Proposed Site: 4795 Franklin Blvd 36 Eug
Assessors Map#: 18030220
Lot: Block: Addition:
Tax Lot #: 02900
Subdivision:
Owner:
Riverside Mobile Home Park
Install gas furnace
Phone Number: 541-746-6014
City/State/Zip: SpringfieldPOR
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Community Seryic~s piVJ'tJo'l\:\ o':;:"',.~J<1~:t'!!mibll~: 02-00001-01
Building Safety. s.) <\\1> rf...e, ,~p . ~:.o'-
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.,,0 ",0 \.(,0:00 ,.9:.-' Office: 726-3759
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::I" ri{:-'v-f>\ ~ <~c.:lnspection Line: 726-3769
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Franklin Blvd 36 Eug
Alteration
Address:
4795 Franklin Blvd
Scope Of Work: Mechanical
225 North Fifth Street
Springfield, OR 97477
Location Of Proposed Site:
Assessors Map#: 18030220
Lot: Block:
4795
Tax Lot #:
02900
Addition:
Subdivision:
Owner:
Cindy Ward
4795 Franklin Blvd sp 36
Install gas furnace
Phone Number: 5410726~204
City/State/ZiP~\~~~8f 97405
c~~lterati~~\?l ~~?>~~~~e: $0
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Contractor CO\'J\~~~ ~'1 ~e!llttration # Expiration [)ate
Service Specialists 1\.~'1 ",COO\) 140770 2/8/2002
45559 McKenzie Hwy, Vida, OR 97488
Phone
541-736-3940
Address:
Scope Of Work: Mechanical
Contractor Type
Mechanical Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupanc:y Group:
Heat Source:
Sq. Footage:
...
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I Job# 02-00001-01
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
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Page 2 of2
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Quad Area:
# Of Units:
Constr. Type:
Water Heater:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections requested bafore 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made ':he following
working day.
Required Inspections
Mechanical
Rough Mechanical
Gas Service
Final Mechanical
- Prior to cover.
-After line is installed and line has been connected to a minimum of one appliance. Pressure te!
-When all mechanical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
r- Mechanical
01/02/2002 7658
01/02/2002 7658
01/0212002 7658
01/02/2002 7658
01/02/2002 7658
01/02/2002 7658
Value/Qu antity
Fee Amount
One to Four Outlets
Minimum Mechanical Perrilit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
1
$4.00
$29.00
$3.60
$12.00
$10.00
$3.15
$61.75
$61.75
1
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 complianc:e with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
req~.I: pro er time and that the project address is readable from the street.
Sign-ature '- ~ ~?.-