HomeMy WebLinkAboutPermit Mechanical 2004-7-28 (2)
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. CITY OF ~rKlI"u"'Jj,LJJ
Status
Issued
Building/Combination Permit
PERMIT NO: COM2004-00938
ISSUED: 07/28/2004
APPLIED: 07/2712004
EXPIRES: 01128/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeetion Line
SITE ADDRESS: 2171 RANCH CORRAL DR
ASSESSOR'S PARCEL NO.: 1703244305400
Springfield TYPE OF WORK: Heating System
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: Install heat pump and air handler
Owner: JEAN S FOSTER LIVING TRUST
Address: 2412 RANCH DR SPRINGFIELD OR 97477
# of Units:
Primary Oecupane
Seeondary Oecup~
Primary Construe
Seeondary Constr
# of Bedrooms:
I CONTRACTOR INFORMATION I
Contractor .p.)! License
HOME COMFOR~'lJJ~~R 84164
~'- UlfititlDfNmNEORMATION I
.~~'39~\~o~~JJ!1 ....
,~~~~~cture
- ,flY;: Jtj)~ d11. ~ eat:'
~~ ~~~~ pe:
~~~~ geType:
~~. (JO (JO '\l Energy Path:
~~~"O\) Sprinkled Building:
Ci7" \:J'
Expiration Date
06/25/2007
Phone
541-345-2838
Contractor Type
Meehanieal
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Oceupant Load:
nla
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist: ~~~'\
# Street Trees Rqd: ,\~ped:
Paved Drive Rqd: ~~ ~ ~~i:
% of Lot Coverage: \..~~ f;, ~~~\~~ f(
,~~\;l '\~ ~~\"
A<(.', f S'''3(,.~ '1l>.~
I PUBLIC IMPRO~~~~~~~ \)~~ f;) ~~.
'\~~;,"'~~~~~~ Type:
~~~ \<Qf;;:) ~ownspoutsmrains:
~~"'
Frontyard Setbaek:
Side 1 Setbaek:
Side 2 Setbaek:
Rearyard Setbaek:
Solar Setbaeks:
Street Improvements:
Storm Sewer Available:
Speciallnstruetion:
Notes:
I Valuation Descrintion I
Deseription
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Caleulated
Total Value of Project
Pal!elof2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00938
ISSUED: 07/28/2004
APPLIED: 07/27/2004
EXPIRES: 01/28/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeetion Line
I Fp.p.~~
$10,00
$4.50
$3.15
$8.00
$12.00
$25.00
7/28/04
7/28/04
7/28/04
7/28/04
7/28/04
7/28/04
Receipt Number
1200400000000001152
1200400000000001152
1200400000000001152
1200400000000001152
1200400000000001152
1200400000000001152
Fee Deseription
-Meehanieal Issuanee Fee--
+ 10% Administrative Fee
+ 7% State Surcharge
Air Handling Unit Up to 10,000
Heat Pump
Minimum/Adjustment Meehanical
Amount Paid
Dilte Paid
Total Amount Paid
$62,65
I Plan Reviews I
To Request an inspection caU 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 Rp.lluirp.rJ T nonp.c1ions I
lr I fir r'iiiiiW' 1 1
Rough Mechanieal: Prior to Cover
Final Meehanieal: When all mechanical work is eomplete.
By signature, I state and agree, that I have earefully examined the completed applieatlon and do hereby certify that all
information hereon Is true and eorrect, and I further eertify that any and all work performed shall be done In aecordanec with
the Ordinanees of the City of Springfield and the Laws of the State of Oregon pertaining to the work deserlbed 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 eontraetors and employees who are in eomplianee with ORS 701.005 will be used on this projeet.
I further agree to ensure that all required inspeetlons are requested at the proper time, that eaeh 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 eonstruetion.
f i?A,,(~
, ' - ,
raetors Signature
7 ..1 p., {J L/
Date
Pa~e 2 of2
:'.'l5 .-':~~h Street
Sprin~eld, Oregon 97477
541-726-3759 Phone
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JijJy of Springfield Official Receipt
.velopment Services Department
Public Works Department
Job/Journal Number
COM2004-00938
COM2004-00938
COM2004-00938
COM2004-00938
\ COM2004-00938
COM2004-00938
Payments:
Type of Paymeut
Cheek
7/28/2004
RECEIPT #:
1200400000000001152
Date: 07/28/2004
11 :35:23AM
Description
+ 7% State Sureharge
+ 10% Administrative Fee
Air Handling Unit Up to 10.000
Heat Pump
Minimum/Adjustment Meehanieal
-Meehanieal Issuance Fee-
Amount Due
3,15
4,50
8,00
12,00
25,00
10,00
$62.65
Paid By
HOME COMFORT HEATING
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 11099 In Person
Payment Total:
$62,65
$62.65
Amount PaId
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