HomeMy WebLinkAboutPermit Mechanical 2003-6-23
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Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-00544
ISSUED: 06/23/2003
APPLIED: 06/23/2003
EXPIRES: 12/23/2003
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 208 ALLEN AVE
ASSESSOR'S PARCEL NO.: 1703233303600
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
PROJECT DESCRIPTION: Install AC, furnace, water heater and duct work/venting
New
Residential
Owner: SEYMOUR KATHRYN C
Address: 208 ALLEN AVE SPRINGFIELD OR 97~77
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Owner
Contractor
ASSURED AIR COMFORT INC
SEYMOUR KATHRYN C
License
106403
Expiration Date
05/1212004
Phone
503-880-8434
I BUILDING INFORMATION I
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# of Buildings: # of Storie~\\\~ ~G\
Primary Occupancy Group: R-3 H 'lJ,.~~~~~
Secondary Occupancy Group:, cX.:. ~\\~~~~#'~ ~~\) ~\j~
Primary Construction Type \\()'~6~~\\ ~\)~t~~I~
Secondary Construction Type: \\\\~ '\>t.: o.\lt.\) ~ ~~ype:
# of Bedrooms: ~\\\ap~C't.\) \)?~path:
~ C\~~~ n~ ~
r,v . ~(\ v
~~, ' I DEVELOPMENT INFORMATION I
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
SETBACKS
REQUIRED PARKING
Overlay Dist: Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd:olJ \:'0 Compact:
U\~eS 'I' "1')
% of Lot Coverage: , \<3.\N (eq rpn \.)'1.\\\ v::
, ,..) \ d'JUi ~"'J 'l.ne Ote ye 5e" \0 ,
,v"'" ,_....~p.OUJ ~..\ASa.. _....t')~{)O\
I PUBLIC)M~;'~OVE~~E.NmS'I\n~~~gn O/>-~:~~\es b.
. ",- 'o.\.\V" "\ .GIJ lOt .. ',p,5 0\ t , =....nOne
'~0(fi\C 9Sfl..-OQ \a\n c.S'ile~al~ ~y.pe:, 10n
. OP,,?' a" 0'0 I "Io'l.e. \t\ "\rn\\\\ca: \
\'l' ,,\ ,,'oU f{\ 'Je",~et. \'Downsvoutsl'Drains:
09v ., C \.\ n U~">J A)
, l,) c;.\\\n9 \~; \\ie Ote~~O~33'2.~Z~:Y\ .
u,({\Ue{ v~\' \s '\ ~
n , ce0.','
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
Square Foota2e
Value
Date Calculated'
Pa2e 1 of2
Status
Issued
CIll' OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-00544
ISSUED: 06/23/2003
APPLIED: 06/23/2003
EXPIRES: 12/23/2003
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project "
I Fees Paid-l
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Appliance Vent
Furnace - up to 100,000 btu
Gas Outlets 1-4
Minimum/ Adj ustment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$8.00
$12.00
$12.00
$4.00
$9.00
6/23/03
6/23/03
6/23/03
6/23/03
6/23/03
6/23/03
6/23/03
6/23/03
Receipt Number
2200200000000001104
2200200000000001104
2200200000000001104
2200200000000001104
2200200000000001104
2200200000000001104
2200200000000001104
2200200000000001104
Total Amount Paid
$62.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work
day.
I Reauired Insoections ,
1 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
2 Rough Mechanical: Prior to Cover
3 Final Mechanical: When all mechanical work is complete.
\,
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon 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 pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction. '
~/~~
G /23 (03
Owner or Contractors Signature
Date
Pal!e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00544
COM2003-00544
COM2003-00544
COM2003-00544
COM2003-00544
COM2003-00544
COM2003-00544
COM2003-00544
Payments:
Type of Payment
CreditCard
Paid By
PHIL DAVIS
Reccipt#:2200200000000001104
Description
Furnace - up to 100,000 btu
Air Handling Unit Up to 10,000
Appliance Vent
Gas Outlets 1-4
~Mechanical Issuance Fee-
Minimum! Adjustment Mechanical
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
djb
Check Number
Batch Number Authorization Number
000104 023242
City of Springfield Official Receipt.
Development Services Department
Public Works Department'
Date: 06/23/2003
11:00:25AM
Amount Paid
Item Total:
12.00
8.00
12.00
4,00
10.00
9.00
3.15
4.50
$62.65
How Received
In Person
Payment Total:
Amount Paid
$62.65
$62.65