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HomeMy WebLinkAboutPermit Mechanical 2000-12-12 . . .. I Job# 00-01779-01 1 Page 1 of2 TRANS#:01-0004017 DA TE : DEC 12 2000 AMT RECD:1 $ 26.50 CHANGE: CASHIER:059 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-01779-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 1452 Quinalt St Spr Assessors Map#: 17032532 Lot: Block: Addition: Tax Lot #: 01100 Subdivision: Owner: Address: Coleman 1452 Quinalt Phone Number: City/State/Zip: Springfield, OR Value: $0 Scope Of Work: Mechanical New Gas piping water heater and fireplace insert Contractor Type Mechanical Contr Contractor ABC Stove Service PO Box 108, Dexter, OR 97431 Quad Area: # Of Units: Constr. Type: Water Heater: /', , ~'lIo "- '. Registration # 4? ~ ~'\ ~ 4.{.... ;or:' . a, '? C :ro.c:..:\ ' -rJ,;.-. ... 14.~ . ~ (,.. ~ ";;( Offictt.lJ~.!r _ ',; '/ ...... ~.. 'C' Land Use: ~, ~ ,,' Zoning Code: Bedrooms: Range: Expiration Date Phone 541-937-8618 < r # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: - , ., working day, " ~.. To request an inspection call the 24 hour recording at 726-3769, All inspections r~queste'd.before 7:00 a.m, will be made the same working day, inspections requested after 7:00 a.m. ~iIIlie nfl!d.e>the following .- ..;; ~ ~, . v (.~... ..., -~\'"r-1,,'...1 "~, ...,. ~ .' :.r,... , 0..1.;0,. ~ U~ R . d I t' """ '? '" '" ,.it , equlre nspec Ions " 'C' -02 u,-< ", , --I "i'..1.(S) v, '~, ,I '\, Mechanical '0-:> .- ,)., "" - '7[(\ '/0- ''It. - Prior to cover~ -(j> ~ -After line is inst{i~ede~C\i1ine has been connected to a minimum of one appliance, - When all gas work is complete. - When all mechanical work is complete, \ . \) Rough Gas Rough Mechanical Gas Service Final Gas Final Mechanical Pressure te! Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 iArea (Sq. Fee';)~- 1 Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: . ~ . Job# 00-01779-01 Fee Paid On Receipt# Mechanical 12/12/2000 4017 12/12/2000 4017 12/12/2000 4017 12/12/2000 4017 12/12/2000 4017 12/12/2000 4017 12/12/2000 4017 One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Gas Fireplace Mechanical Issuance State Surcharge - Mechanical Total Mechanical Grand Total . Page 2 of2 Value/Quantity Fee Amount I 1 $2.00 $2.50 $.45 $6.00 $4.50 $10.00 $1.05 $26.50 $26.50 1 1 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 fu er agr e to ensure that all required inspections are req~..':1t ~:rop~me and that the pr ect /Jess is readable from the street. / \/~// _ f/) /2 ~2 -& (signature . // /Y Date