HomeMy WebLinkAboutPermit Mechanical 2000-12-18 (2)
...
1....- jSPRINOPIELD
~~),';/"IJ.'f~/:r:J:J1J
225 North Fifth Street
Springfield. OR 97477
.
.
I Job# 00-01802-01 I
Page 1 of 2
TRANS#:01-0004065
DATE:DEC 18 2000
AMT RECD:2 $ 53.00
CHANGE:
CASHIER:059
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01802-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3530 Game Farm Rd Spr
Assessors Map#: 17031540
Lot: Block: Addition:
Owner:
Address:
Tax Lot #: 03100
Subdivision:
Bill Ticer
3530 Game Farm #76
Phone Number: 541-746-6514
City/State/Zip: Springield, OR
Alteration Value: $0
Scope Of Work: Mechanical
replace Furnace
Contractor Type
Mechanical Contr
Quad Area:
# Of Units:
Constr, Type:
Water Heater:
Contractor
Associated Heating and Air Cond
PO Box 412, Eugene, OR 97440
p.-,;.~. ',Office Use"', '
fello'" ..,' ~.. . , ,
", [and Use:'
Gl,I...... ,~. " _ t ,I,
, ~Zoning Code: . . .
IGI.:.,. -lltr-;ill'/:II'-"
'1~.,Bedrooms: .. . ~ir ...,
Range:
Registration # Expiration Date
Phone
541-683-2590
-.. .;". -;~.=-t1~O
,: ,lr ~;",rm !J~i::ly # Of Buildings:
.,' ... 1 - .' ....., ..... -,1-
, - I...., ""Occupancy Group:
"I. l,\'l );'~-'}.)"H t5 .
. I ea ource.
~, ,1 "'1 l3l)lSq. Footage:
\, -,.!::.'I
To request an inspection call the 24 hour recording at 726-3769. AII'in~p~~tioWrrequested 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.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
[Ar~a (Sq, Feet)
_ Main: Accessory:
Rough Mechanical
Final Mechanical
Required Inspections
Mechanical
- Prior to cover.
-When all mechjliji~a-'}Y?rk is complete.
T~:IS PEH'JjIT SH,^,Lt E)(rl'1""~"'" '~.' ..,,~
Al ITdO:1;:::D Ui':OEj:' T;-/I::-Y"
CC'\.';!'.'I~i'!~~_::J 01-1<:: i . ~ .~. ':~,.....
.. '-I'
A, \'1:":"1 ~'I:'\,;'- - l'"
, # Of Stories:' '..
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
,
-
'...
,
.
Job# 00-01802-01
.
Page 2 of2
Value/Quantity Fee Amount
I
Fee
Paid On Receipt#
Mechanical
12/18/2000 4065
12/18/2000 4065
12/18/2000 4065
12/18/2000 4065
12/18/2000 4065
1
$9,00
$.45
$6.00
$10.00
$1.05
$26.50
$26.50
Minimum Mechanical Permit
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
rtqUested at the p~o~time and that the project address is readable from the street.
\')~~~~\(\_'~C\~~~ ~~\rt\J \~-\~..ro
Signature G Date