HomeMy WebLinkAboutPermit Mechanical 2002-8-1
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I Job# 02-00934-01 I
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
225 Fifth Street
Springfield. OR 97477
Location Of Proposed Site: 2223 Rose Blossom Dr Spr
Assessors Map#: 17032611
Lot: Block: Addition:
Owner:
Jerry Rybka
2223 Rose Blossom Drive
Phone Number: 541-746-3802
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
Scope Of Work: Mechanical
Install new heat pump and revise ductwork
Contractor Type
Mechanical Contr
Contractor
Comfort Flow Heating Co
1951 Don Street. Springfield, OR 97477
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
Job Number: 02-00934-01
Office: 726-3759
Inspection Line: 726-3769
Tax Lot #: 03225
Subdivision:
Registration # Expiration Date Phone
00460 6/27/2003 541-726-0100
\laO~'~~: .., ~\.l~' I EXPIRE IF 1HE~ORI\
\ "I;:) f .J;l.~'" DER 1HIS \'t~lVlll ,:, 1.01
t>.U1HORIZED ~~NQ ABANDONED FOR
COM\\~CBDlIgln .
ANY ~~~j:lV bbp:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:0,0"" reqUII3S you.t.o
a.m. will be made the same working day, inspections requested after 7:00 a.m..will.be-made(thINoliO\Ning OI<)Oon \)1'\:.Y
working day. J.\ \ \ t;;1'l \~-;; adopted b~' tI,o \ s ;re set \oiti ,
!aIlOW IU \'\tel ,hose III e 5?-001-
Construction Types: Notllication Ce 0010 through OAR 9 \ s by
Occupancy Groups: il'\ OAR 952-001- btain copies 0\ the r~o~e
# Of Buildings: # Of Stories: Heiglinfe'eti~ tnaYeOnter. 'Note: the te'et'~'lc~\iOn
1\,~"\heC , .,'ty\\!O II U
# Of Bedrooms: Current Units: Proposed Units: he Oregon UII 1 3A ")
O f\Ulilbenul I 00 33?-? ....' .
Handicap Access? Census Code: Does not apply C2i\tet is 1-8 - --
rArea (Sq. Feet)
Main: Accessory: Total:
Paid On Receipt#
Mechanical
08/01/2002 10142
08/01/2002 10142
08/01/2002 10142
08/01/2002 10142
08/01/2002 10142
Fee
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
3hp - - 100,000 BTU
Alter/Add to ea Appl Unit or System
Mechanical Issuance
ValuelQuantity
Fee Amount
1
1
$3.00
$3.60
$12.00
$30.00
$10.00
,
.
Fee
State Surcharge - Mechanical
Total Mechanical
Grand Total
Job# 02-00934-01
Paid On Receipt#
Mechanical
08/01/2002 10142
.
Page 2 of 2
Value/Quantity Fee Amount
$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.
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