HomeMy WebLinkAboutPermit Mechanical 2000-8-21
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Job# 00-01278-01
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TRANS#:01-0002976
DATE:AUG 21 2000
AMT RECD:1 $ 30.00
CHANGE:$ 3.50
CASHIER: 059
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01278-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1074 Q St Spr
Assessors Map#: 17032614
Lot: Block: Addition:
Tax Lot #: 04100
Subdivision:
Owner:
Kham Phaanh Bounkhoun
1074 Q Street
Phone Number:
City/State/Zip: Springfield, OR 97477
Alteration Value: $0
Address:
Scope Of Work: Mechanical
New Gas Line for furnace
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Of6tiflcaf,Jile~ ~~d b~~hvi' I C"IUII e~ you h
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Quad Area: Lan~ ~je'YAR 952-001_0 t. hOse rUles afl:\:1N:SiUaJf,ings:
# Of Units: Zonmg '8Y(}e.rou maYOb~~Fthro~ghOAWs;~y Group:
Constr. Type: Bedroop;W~lImgthecemer (nNcoPleS'OfttMW ~ce:
Water Heater: i! Range: umberfortheOIi~ ote:thete/&n.: n~ge:
, , n _ UJoIOn J 1t'1;~ ' 9>>1 e
L, ~F;"lp,..,C' ., -Q"n J.it) (.Juur/car
To request an inspection call the 24 hour recording a,t 726-3769, All insp~2ao~S4~.quest~9rbefore 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
Rough Mechanical
Gas Service
Final Mechanical
Required Inspections
I ^'n,.r@~hanical
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- Prior t? c~v~r. !:~'~ PE~MIT SH II ev , . , .
-After line IS Installea :c!'Mil'~E19a~ ~een'C0'7i~e1-A'EQ.r:nlnlmUm of one appliance. Pressure te~
-When all mecha:DiGaIAWQrk~IS156m~efe,7iH/""PERM WaR/{
'~,v"V/t.:/VCED \) IT
AiVY180D ORISABANDONED ISNOr
A Y PERIOD. FOR
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Mechanical
08/21/2000 2976
08/21/2000 2976
08/21/2000 2976
Value/Quantity
Fee Amount
One to Four Outlets
Minimum Mechanical Permit
Mechanical Administrative Fee
1
$2.00
$7.00
$.45
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Job# 00-01278-01
Page 2 of 2
Fee
Paid On Receipt#
I, MechaniCal
08/21/2000 2976
08/21/2000 2976
08/21/2000 2976
Value/Quantity
Fee Amount
Less than 100,000 BTU
Mechanical Issuance
State Surcharge For Mechanical Permit
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.,0552.11 be used on this pro.ject. I further agree to ensure that all required inspections are '
requeste~,~' ~ ; properi ne and that the p~ct address is readable from the street. (7/ !-d-tJ
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Signatul'V7 Y, Date
$6.00
$10.00
$1.05
$26.50
$26.50