HomeMy WebLinkAboutPermit Mechanical 2005-4-22
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00459
ISSUED: 04/22/2005
APPLIED: 04/21/2005
EXPIRES: 10/22/2005
VALUE:
SITE ADDRESS: 630 RA YNER AVE
, ASSESSOR'S PARCEL NO.: 1703331400909
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New Residential
ATTENTION: Oregon law requires you to
~nn\A'r..I.oC'..,"""",,,,+,,,,,,,&o...&L.__ _ ......
Notification CeRh~nel1l\~\I~D;~~5lk7j6i'?'~~~1
In OAR 952-001-0010 through OAR 9t..2.001-
0090. You may obtain copies of the rU~L)s bv
vu!.'i"1:i "'" ""lilt". \'~Ote: me telephone
I CONTRACTOR INFORMA'I'fON't( for the Oregon Utility Notification
'tenter is 1-600-332-2344).
License Expiration Date Phone
460 0612712005 541-726-0100
PROJECT DESCRIPTION: Heat pump and eoiI
Owner:
Address:
RICHARD WARKENTIN
630 RAYNER AVE
SPRINGFIELD OR 97477
Contractor Type
Meehanieal
Contractor
COMFORT FLOW
# of Units:
Primary Oeeupaney Group:
Seeondary Occupaney Group:
Primary Construction Type
Secondary Construetion Type:
# of Bedrooms:
Front yard Setbaek:
Side 1 Setbaek:
Side 2 Setbaek:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer A vaiIable:
Special Instruetion:
Notes:
Description
Type of Construetion
BUILDING INFORMATION I
R-3
# of Stories: Lot Size:
Height of Strueture. Sq Ft 1st Floor:
Type of Heat: .." 1\:':: Sq Ft 2nd Floor:
Water Type: 1 r dS f'lli",. T Sh"USq FtB~s~~eri't{ \',l, ,1\
Range Type: AUl Hlik,ZtlJ UNiJlSq~Ft Gaiia'geiltI.r,;ortJ I
Energy Path: C{jlvll\';U~lilD Ok I~S,qlf.tJ?!Jtei;::U [-UK
Sprinkled BuiIdin~i~Y 1lJO uW? PlKiL,!:te,eupant Load:
I DEVELOPMENT INFORMATION I
VN
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handieapped:
Compaet:
I PUBLIC IMPROVEMENTS'
Sidewalk Type:
DownspoutsfDrains:
I Valuation DescriDtion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Projeet
Fees PlIirl.l
Fee Deseription
-Mechanical Issuanee Fee--
+ 10% Administrative Fee
+ 7% State Sureharge
Boiler/Comp Up To 100,000 btu
Heat Pump
Minimum/Adjustment Meehanical
Amount Paid
Date Paid
$10.00
$4,50
$3,15
$12.00
$12,00
$21.00
4/22/05
4/22/05
4/22/05
4/22/05
4/22/05
4/22/05
Total Amount Paid
$62,65
I Plan Reviews I
.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00459
ISSUED: 04/22/2005
APPLIED: 04/21/2005
EXPIRES: 10/22/2005
VALUE:
Reeeipt Number
2200500000000000471
2200500000000000471
2200500000000000471
2200500000000000471
2200500000000000471
2200500000000000471
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.
By signature, I state and agree, that I have carefully examined the completed applieation and do hereby eertify that all
information hereon is true and correet, and I further eertify that any and all work performed shall be done in aeeordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work deseribed herein, and
that NO OCCUPANCY will be made of any strueture without permission of the Community Services Division, Building Safety.
I further eertify that only contraetors and employees who are in eompliance with ORS 701.005 will be used on this projeet.
I further agree to ensure that all required inspeetions are requested at the proper time, that eaeh address is readable from the
street, that the permit eard is loeated at the front of the property, and the approved set of plans will remain on the site at all
~imes during con~
/~b~
Owner or ~ntraetors Signature
L.Reouired \IIsnectiow
Rough Meehanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
-.~-
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Page 2 of2
'I- ,;(.;( - oS-
Date
225 Fifth ,Street
Springfield, Oregon 97477
541-726-3759 Phone
.
."~>"~'!.I'I!.L'! , _ ._ ~
Wir"
, t
, " -- ;
aity of Springfield Official Receipt
'lllllll5evelopment Services Department
Public Works Department
Job/Journal Number
COM2005-00459
COM2005-00459
COM2005-00459
COM2005-00459
COM2005-00459
COM2005-00459
Payments:
Type of Payment
Check
:'
"
"
"
4/22/2005
RECEIPT #:
2200500000000000471
Date: 04/22/2005
Description
+ 7% State Sureharge
+ 10% Administrative Fee
Boiler/Comp Up To 100,000 btu
Heat Pump
Minimum! Adjustment Meehanieal
-Meehanieallssuanee Fee-
Paid By
COMFORT FLOW HEATING
CO
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 29523 In Person
Payment Total:
Page I of I
9:59:22AM
Amount Due
3,15
4,50
12.00
12,00
21.00
10,00
$62,65
Amount Paid
$62,65
$62,65