HomeMy WebLinkAboutPermit Mechanical 2001-1-4
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I Job# 01-00012-01
Page 1 of 2
TRANS#:01-0004168
DATE:JAN 04 2001
AMT RECD:2 $ 26.50
CHANGE:
CASHIER:061
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RESIDENTIAL PERMIT
City Of Springfield
Community SerVices Division
Building Safety
Job Number: 01-00012-01
, 225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 339 Blackstone St Spr
Assessors Map#: 17032334
Lot: Block: Addition:
Tax Lot #: 08500
Subdivision:
Owner:
Stauney Adamson
339 Blackstone St
Phone Number: 541-747-5677
City/State/Zip: Springfield, OR 97477
New Value: $0
Address:
Scope Of Work: Mechanical
install gas furnace
Contractor Type.
Mechanical. Contr
Contractor
Home Comfort Heating & Air Condit*
Po Box 24205, Eugene, OR 97402
Registration #
84164
Expiration Date
6/25/01
Phone
541-345-2838
Office Use
Land Use: # Of Buildings:
Zoning Code: Occupancy Group:
Bedrooms: Heat S, ou~ce:you to
.1'0 00"'0 I?w"eal!lit:l~.
Water Heater: Range: AiTENTIO!\l. 1""'::.1" 'Sq..fqot~ge:, Utility
. -'__~"rl """ ~"p.dre!'o!UI .
fOllOW fUll::'::> Cl.\NI""Th-' P. rules are set 10m'
To request an inspection call the 24 hour recording at 726-3j~\6~ifibJltiraspe8ti8f.i's'r~q'd~stelaII:>YAO~8J~@0j01-
a.m. will be made the same working day, inspections requesteCi:hafteg"b:.ID(j)J~tlm,)QVilll trJWlMe\.the,folloy'v;jr:t~)\1
. III vrU . bt' Copies 01 [I.e I UI~~ J
working day. 0090. You may 0 al~ ." t lephone
R . d I ..n~\Iingthecenter. ~Not~..~~e ..~_~:~:...~til'\n
equlre nspev1.lons 'f "the uregulI U(IIILJ ..~...--
. ;;U~'lbel:j O. n) ","") 1'"J'::'!44)
Mechamcal I~enteris "1-8u' -v':;:!.,-~'-' .
Quad Area:
# Of Units:
Constr. Type:
Rough Mechanical
Final Mechanical
- Prior to cover.
- When all mechanical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories: NOTICFFf~i9..ht(fee!);"PIRE IF THE WORK
'T' HIS PEA~ati ~HALL L..^ .
Current Units: - ',' ," ,~r<mosed.g~its" PERMITlSNOT
Census Code: Does I'1IA~t)lI~'pr9'IZEOUNDI::. ~~ONEDFOR
,.m CQMM!NCEO OR IS ~
Total: ~N\f'~t\O DAY PERIOD.
.'
Fee
Job# 01-00012-01
Paid On Receipt#
Mechanical
01/04/2001 4168
01/04/2001 4168
01/04/2001 4168
01/04/2001 4168
01/04/2001 4168
Page 2 .of 2
Value/Quantity FeeiAmount
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanic~llssuance
State Surcharge - Mechanical
Total Mechanical
1
$9.00
$.45
$6.00
$10.00
$1.05
$26.50
$26.50
Grand Total
By signature, I state and agree that I have carefully examined the completed application and .do
hereby certify that all information herein is true and correct, and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of Oregon. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time and thaUhe-project-add(e~$_is readable from the street. '
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Signatur. - ZI C/ '-'. .
/- ty-dl/
Date
13
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