HomeMy WebLinkAboutPermit Mechanical 2000-4-7
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Job# 00-00537-01
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Page. t of 2 . ~ ~,~ ~, .
TRANS#:01~0001171
DATE:APR 07 2000
AMT RECD:2 $ 26.50
CHANGE:
. CASHIER: 059
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00537-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 333 Blackstone St Spr
Assessors Map#: 17032334
Lot: Block: Addition:
Tax Lot #: 08400
Subdivision:
Owner:
Darlene Emerson
333 Blackstone
Phone Number: 541-746-0704
City/State/Zip: Springfield, OR 97477
Alteration Value: $0
Address:
Scope Of Work: Mechanical
Office Use
Quad Area: Land Use: # Of Buildings:
. # Of Units:."!'" itd~h~;fC&dfi!=iu;; ,em leqUlres you tt. Occupancy Group: '
Constr. Ty' pe: . " to!'~Re~Faeg,sqp ed by the Oregon Utility Heat Source.
"lotlfIGa[lO f \JtHn13r, Those rules aresetforth .
Water Heater: 'j OA~~9~~Ol-001 0 throuQh OAR 952-001- Sq. Footage:
. , uu~u. YOU may obtain copies of the rules by
To req~est an inspection call the ,24 hO, ~1~g~rQi~l:jter?~~qJ@f.lt~lh!Jil~13il6\iRrs ~equested before 7:0~
a,m. ~III be made the same working d~Yr.l~~t!tl@'s3~Attlflj~€tQotHltcnmnwllI be made the follOWing
working day. ('r.":,h.' :,. .1, "0n0.0.'1?')~44)" '
Required Inspections
I Mechanical
Rough Gas
Gas Service
Final Gas
Construction Types:
Occupancy Groups:
# Of BlJildings:
# Of Bedrooms:
Handicap Acces.s? D
-Area (Sq. Feet)
Main:
-After line is installed and line has been connected to a minimum of one appliance.
- When all gas work is complete.
NOTrCE:
THIS PERMIT SHALL EXPIRE IFTHE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COM~f:JySf6R~I:S ABANDONED FCt)fiight (feet):
ANY 1~mf~XtFffiftt~D. Proposed Units:
Census Code: Does not apply
Pressure te!
Accessory:
Total:
Fee
Paid On Receipt#
Mechanical
04/07/2000 1087
04/07/2000 1087
04/07/2000 108?
04/07/2000 1087
Value/Quantity
Fee Amount
Minimum Mechanical Permit
Mechanical Administrative Fee
Gas Fireplace
Mechanical Issuance
1
$10.50
$.45
$4:50
$10.00
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Job# 00-00537-01
Page 2 of 2
Fee
Paid On Receipt#
Mechanical
04/07/2000 1087
Value/Quantity
Fee Amount
State Surcharge For Mechanical Permit
Total Mechanical
Grand Total
By signature, I state and agree that! 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.
(. ::,d _'- \':;,.>._0. j,,' .3 - d7~() ()
Signature . Date
$1.05
$26.50
$26.50