HomeMy WebLinkAboutPermit Mechanical 2001-2-22
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I Job# 01-00151-01 I
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Page 1 of2
TRANS#:01-0004514
DATE:FEB 22 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER: 003
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00151-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 842 RAINTREE Way Spr
Assessors Map#: 17033424
Lot: Block: Addition:
Tax Lot #: 01417
Subdivision:
Owner:
CARL NICKELSON
842 RAINTREE WAY
Phone Number: 541-741-2878
City/State/Zip: SPRINGFIELD, OR 97477
New Value: $0
Address:
Scope Of Work: Mechanical
REPLACING EXISTING GAS FURNACE
Contractor Type
Mechanical Contr
Contractor
Associated Heating and Air Cond
PO Box 412, Eugene, OR 97440
Registration # Expiration Date
Phone
541-683-2590
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections 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
working day.
Required Inspections
Mechanical
Rough Mechanical
Final Mechanical.
- Prior to cover.
-When all mechanical work is complete.
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:
L
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Fee
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
Job# 01-00151-01
Paid On Receipt#
Mechanical
02/22/2001
02/22/2001
02/22/2001
02/22/2001
02/22/2001
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Page 2 of 2
Value/Quantity
Fee Amount
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$26.50
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 projecl. I further agree to ensure that all required inspections are
requested at the proper time and that the project address is readable from the streel.
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Date
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DUPLICATE RECEIPT DUPLICATE RECEIPT
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CITY OF SPRINGFIELD
225 FIFTH STREET
SPRINGfIELD, OR 97477
(541 )726- 3753
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WELCOME TO DEVELOPMENt
SERVICES AND PUBLIC WORKS
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REG-RECEIPT:Ol-0004514 C:FE6 22 2001
CASHIER 10:003 I :35 pm A:FE6 22 2001
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1006 MECHANICAL PERMIT $15.00
JOB~:01-00151-01
1099 STATE SURCHARGE(7X) $1.05
J06#:01-00151-01
109B ADMIN FEE(3X) $0.45
J06#:01-00151-01
1087 MECHANICAL ISSUANCE $10.00
JOB#:01-00151-01
TOTAL DUE $26.50
RECEIVED FROM:
ASSOCIArm HEAlING
CHECK: $26.50
TOTAL rENOERED $26.50
I CHANGE DUE $0.00
____L____ .__._. ___________u._ -. -._____
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*PaY Name :AS30CIATED HEATING
*Mail Addr :PO BOX 412
*Cty/St/Z :EUGENE OR 97440
*Site Addr :642 RAINTREE WAY
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_.________ ______ _______________________ 4_
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THANK VOU!!!!!!
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