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HomeMy WebLinkAboutPermit Mechanical 2002-9-4 (2) , . . .. " I Job# 02-01058-01 I Page 1 of 2 TRANS#:01'0010516 DATE:SEP 04 2002 AMT RECD:2 $ 61.75 CHANGE: CASHIER:003 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-01058-01 225 Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 3530 Game Farm Rd Spr Assessors Map#: 17031540 Lot: Block: Addition: Tax Lot #: 03100 Subdivision: Owner: Jerry Pitts 3530 Game Farm Road Phone Number: 541-744-9175 City/State/Zip: Springfield, OR 97477 Repair Value: $0 Address: Scope Of Work: Mechanical Replacing electrical HVAC unit. Contractor Type Mechanical Contr Contractor Associated Heating & Air Conditioning Inc Po Box 412, Eugene, OR 97440 Registration # Expiration Date 106275 ~;;~;'t- Phone 541-683-2590 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. Final Mechanical Required Inspections I Mechanical I -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# Mechanical 09/04/2002 Value/Quantity Fee Amount Minimum Mechanical Permit $33.00 . .- . Fee 6% Administrative Fee - Mechanical Less than 100,000 BTU Mechanical Issuance State Surcharge - Mechanical Total Mechanical Grand Total Job# 02-01058-01 Paid On Receipt# r Mechanical 09/04/2002 09/04/2002 09/04/2002 09/04/2002 . Page 2 of 2 Value/Quantity Fee Amount I 1 $3.60 $12.00 $10.00 $3.15 $61.75 $61.75 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. \/IA -L/.U/ L -'t4rutCI)~ s{~ature tJ/ ~() 2- Date . Oregon Construction Contra.B~ard>> License Details . Page I of I OREGON CONSTRUCTION CONTRACTORS BOARD License Details as of September 6, 2002 8:32 AM LICENSE NUMBER: 106275 NAME: ASSOCIATED HEATING & AIR CONDITIONING INC ADDRESS: PO BOX 412 EUGENE OR 97440 WORK PHONE NUMBER: 541-683-2590 LICENSE STATUS: Not Active - Expired EXPIRATION DATE: 8/31/2002 ENTITY TYPE: Corporation LICENSE CATEGORY: General Contractor/All Non-Exempt (Has EMPLOYER STATUS: Employees - Must Have Workers' Comp Coverage) DATE FIRST LICENSED: 5/10/1995 FINANCIAL PACIFIC BOND COMPANY: INSURANCE COMPANY BOND AMOUNT: $ 15000 BOND EFFECTIVE TO: 8/31/2002 View Bond Historv INSURANCE COMPANY: AMCO INS CO INSURANCE AMOUNT: $ 1000000 INSURANCE EFFECTIVE 3/21/2003 TO: View Insurance Historv View Claims Historv View Associated Names View X-Reference Licenses View SIC Codes View Buildino Codes Division License DF!tails Print this Page' QUERY MENU CCB HOM!; Send mail to Web Administra.tor with questions or comments about this web site. Page Last modified: June 19. 2002 "QUERY COMPONENTS READ liVE DATA C,'j_~"'''':''~ ~ .,,,.v::."~\.IlJ,,I;IIJ.C'V, .".. ..' ..-..t~., ..,....rJ.~ ",' . State...ofOn~nnn I i:lhilitv !=;;t::ltp.ment http://ccbed.cc b. state.or. us/B ill/regno222 .asp ?regno= I 06275 9/6/2002 , ,!II CC;B - Find A Licensee - Results. . Page I of2 Find A licensee - Results LICENSE 106275 NUMBER: NAME: ASSOCIATED HEATING & AIR CONDITIONING INC ADDRESS: PO BOX 412 EUGENE OR 97440 WORK 541-683- PHONE 2590 NUMBER: LICENSE Active ENTITY Corporation STATUS: TYPE: EXPIRATION 8/31/2004 LICENSE General DATE: CATEGORY: Contractor/All Non-Exempt (Has DA TE FIRST EMPLOYER Employees - 5/10/1995 Must Have LICENSED: STATUS: V\brkers' Comp Coverage) FINANCIAL BOND PACIFIC INSURANCE AM CO INS COMPANY: INSURANCE COMPANY: CO COMPANY BOND $ 15000 INSURANCE $ 1000000 AMOUNT: AMOUNT: BOND INSURANCE EFFECTIVE 8/31/2004 EFFECTIVE 3/21/2003 TO: TO: Associated Name Information license Number Entity Type Name Description ASSOCIATED 106275 PRE HEATING Previous Name AND AIR CONDIT' BROOKS 106275 PRE [IND], Previous Name KEVIN NEHEMIAH BROOKS, 106275 CPO ANNETTE Corporate Officer LEE BROOKS, 106275 CPO KEVIN Corporate Officer NEHEMIAH Bond Information license Number Bond Company Bond Number Bond Amount Effective Date 201 - FINANCIAL 106275 PACIFIC INSURANCE 91000793 $15,000 3/30/2000 COMPANY 106275 342 - MARKEL INS CO 93003746 $10,000 8/31/1998 106275 342 - MARKEL INS CO 96049274 $10,000 5/10/1996 http://ccbed.ccb.state.or.us/new_web/asp/new_ search_results -print.asp?regno= I 06275 9/16/02 " ,. . CCB - Find A Licensee - Results 27-CONTRACTORS BONDING & INS CO . Page 2 of2 106275 142925 $10,000 5/10/1995 Insurance Information license Number 106275 106275 106275 106275 Insurance Company . Policy Effective Effective Polley Number A t From To moun ACP7501 01 0208 1000000 3/21/2002 3/21/2003 9273085 1000000 3/21/2002 3/21/2003 02CL006585 500000 3/21/1998 3/21/2000 34912717 500000 5/4/1995 10/10/2010 264 - AMCO INS CO 185 - FEDERATED MUTUAL INS CO 160 - MILLERS CASUALTY INS CO-MERGED INTO MILLERS INSURANCE CO #449 92 - TRUCK INS EXCHANGE Specialized Training Information Name No rL'cords l"elUrllcu. Description DISCLAIMER: Information concerning contractor credentials and specialized training has been obtained by the Construction Contractors Board (CCB) from contractors who want this information noted in their licensing records, The contractor must also notify the CCB if the credenlial has expired or terminated. As a result, the CCB does not warrant or guarantee the existence or accuracy of the information about the credentials or specialized training. SIC Codes SIC Code 1711 Description Plumbing, Heating And Air Conditioning http://ccbed.ccb.statc.or.us/new_web/asp/new _search_results yrint.asp?regno= 106275 9/16/02