HomeMy WebLinkAboutPermit Mechanical 2000-10-20
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I Job# 00-01571-01 I
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Page 1 of2
TRANS#:01-0003549
DATE:OCT 20 2000
AMT RECD:2 $ 53.00
CHANGE:
CASHIER: 059
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01571-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1453 Quinalt 5t Spr
Assessors Map#: 17032532
Lot: Block: Addition:
Tax Lot #: 02400
Subdivision:
Owner:
Donna Adkins
Phone Number: 541-726-7949
Address: 1453 Quinalt City/State/Zip: Springfield, OR 97477
Scope Of Work: Mechanical '" New,., . Value: $0
folln v,. ~
Gas piping for logset and water hEJ~,Wr,:~,rU/ef aaOI1l<o,
,nOARg,v..r..,enrtll In'. d,' ""','"
0090 y, 52-0Dl-0D1Ot~S~ '/fH. .', , '
Contractor Type Contractor call" ou m,RegistratidHI#JI. 'Expiration. Date Phone
mgth . .....'''(;OPIS' . .. '-',
Mechanical Contr Associated Heating and Air CBnchbtJr to €thcenrSI {illot,. :' '11,: ./. 541-683-2590
r foOr ,/,. '
PO Box 412, Eugene, OR 97440 r;"'n. '_ . tigOr., "lil' ,- '-., Jl,
'T,_;,_.
Office Use
Land Use: # Of Buildings:
Zoning Code: Occupancy Group:
Bedrooms: Heat Source:
Range;'TICt::. Sq. Footage:
I HIS PEIJ' 'h
To request an inspection call the 24 hour recording at 726~3'i;69., All inspections requested before 7:00
a.m. will be made the same working day, insp~l:iions/lEt'l!:!este(f'afflr('j:OO/aw.:~i1,1 be made the following
working day. COMMENCED V/VLJERTHISPERM V!OR/(
"'IIy'<o~.. ORIS,lIFV1.,,,..,. IT/SIIfOI
ReqUlre,d/lg~~l!1I~ns~~. 'c:.u I-OR
I Mechanical . I
-When all mechanical work is complete.
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
iArea (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt# Value/Quantity
Mechanical l
10/20/2000 3549 1
Fee Amount
One to Four Outlets
$2.00
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Job# 00-01571-01
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Page 2 of2
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Fee
Paid On Receipt#
Mechanical
10/20/2000 3549
10/20/2000 3549
10/20/2000 3549
10/20/2000 3549
Value/Quantity
I
Fee Amount
Minimum Mechanical Permit
Mechanical Administrative Fee
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 701.05 will b~~d on this project. I further agree to ensure that all required inspections are
request~. t e prflJer ti) aT.! at:e :~iS readable from the street. / tJ~
Signature"---- - V"'-' Date
V
$13.00
$.45
$10.00
$1.05
$26.50
$26.50