HomeMy WebLinkAboutPermit Mechanical 2001-2-28
,
.
.
I Job# 01-00151-01 I
.
Page 1 of2
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:
Address:
CARL NICKELSON
842 RAINTREE WAY
Phone Number: 541-741-2878
City/State/Zip: SPRINGFIELD, OR 97477
Scope Of Work: Mechanical
New
Value: $0
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.
Final Electrical
Required Inspections
I Electrical
- When all electrical work is complete.
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. F~,~)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
.
,
.
.
Job# 01-00151-01
.
Page 2 of2
Fee
Paid On Receipt#
Electrical
02/28/2001 4576
02/28/2001 4576
02/28/2001 4576
Value/Quantity
I
Fee Amount
Branch Circuits W/O Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
1
$35.00
$2.45
$1.05
$38.50
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
Mechanical
02/22/2001
02/22/2001
02/22/2001
02/22/2001
02/22/2001
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$65.00
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 further agree to ensure that all required inspections are
requested at the proper time and that the project address is readable from the street.
Signature
Date