HomeMy WebLinkAboutPermit Mechanical 2002-4-22
;
t'~ '
J
,
.
.
I Job# 02-00461-01 I
.
"'
Page 1 of 2
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00461-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3725
Assessors Map#: 18020613
Lot: Block:
Jasper Rd Spr
Tax Lot #:
06800
Owner:
Claud Herndon.
3725 Jasper Rd.
Addition: Subdivision: ,w '"' 'v 'v
~ ",.,., ,~nill 0\:.1 ~v
A1TE;:I'lIIU'~'V'~~":'- - he Oregon UtllllY
Phone Numbewr. ru~.1Uc.?9,.0::1iO'l>Y t set loon
tOIlO + T):l.\l,se rules are
CitY/StatpgiP:;ati(sp'F1l\'~fi8/JltOiRr8~~~lVAR 952-001-
New in OAR 952-00 V~luerin ($OJies of the rules by
0090. you ma, Note' the telephone
calling the cen~:~ ( on Uiility Notification
number!Or:~~,~ L~nn-::\32-2344).
Address:
Scope Of Work: Mechanical
New forced air heat pump.
"",,,,,on__ -'.
Contractor Type
Mechanical Contr
Contractor
Dean Heating and Air
4301 Main, Springfield, OR 97478
Registration #
133733
Expiration Date
2/23/2003
Phone
541-767-0626
Office Use
Quad Area: Land Use: # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr. Type: Bedrooms: Heat Source:
Water Heater: Range: '. I'-C' Sq. Footage:
..'l..J1 - . ._, yl.Jl"'\n.,
" c'. liT SHALL E)(PIHl:: 11- 1 ~l .
To request an inspection call the 24 hour recording at 726-3769. All iilibpe&ions reque~~d.before 7:00
a.m. will be made the same working day, inspections requested after At90,a:m; will be'mliile the following"
working day. , _ ') ("J 1-, \~' ,: l[.\J1 ;...u run
CUI'~" ..
Required InspectionsANY lOUUt'I" ;-:f.18~-
Mechanical I
Rough Mechanical
Final Mechanical
- Prior to cover.
-When all mechanical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
D
:3: -f
-0:::::1:::0
DD
a:!--1~
0..#
C":I aD..
I> ..-00
(,0 N;!JI---L
::c I
1-I("""J(:t3.NO
mI l"..JO
;:ODe'" a
.- Zj--Lr-..)co
QG1- ocr-.
I--LfTl-.,JOCO
1-...1... t.J"1f'.JC)
~~ i
.J
.
Job# 02-00461-01
.
Page 2 of 2
Fee
r
Paid On Receipt#
Mechanical
04/22/2002 8680
04/22/2002 8680
04/22/2002 8680
04/22/2002 8680
04/22/2002 8680
Value/Quantity
Fee Amount
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
10,000 Cubic Feet or Less
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
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 roject. further agree to ensure that all required inspections are
reqrr~~n hat th roO ct address is readable from the street. 1 / ZZ ,..-O~
Signature Date
1
$37.00
$3.60
$8.00
$10.00
$3.15
$61.75
$61.75
190:1J3IH8\j3
:39N\!H3
06' Z!j $ Z: G331J lfj\j .
ZOOZ WA\!fj:31\jG
\:U8000~ 10: #8N\j1Jl' ,
'. ,
.
"
r'
\
"
;"
I
',\
,
'"
.".' ,..
If''.'. .
, "
,
'.
:';.'
I.
.
I
I
},
I.;
'. '. ~ .:
,:.1,::
'"
I,
, .
l
- '22.,FIFTIiSTREET~.. '" - ,. ,.-. -.. ,,- ..
;), .' \ . , ~,\ t . 'I ~ t . '\'! '
: \ : SPRINGFIELD, OREGON 97477 i', :, ;! .., r, ,.. l
.~ ::INSfECTIONREQlWsT: 726.37,69-.::;-'llS:-'lTi ; Cii/JOh~';mher o2-ooLf{,(~OI"
; I 'OFFICE: 726.3759, . : I' i' II ., "I '; i I I'; I.. .. .
!. i -' ; ! " ,: I .' ;.: \ it.:.':! :T~~;~llllin l-r-~ :3'.COMPLETE FEE'S!=HEDULE BELOW': .
/ I ;1. LOCATI9.N OF INSTAL~"'1lllillNg,:arld~eo~ehb~~:u~ml<<edhasth~fOllowin9' . ..
:3 ')~S". ')~.~' f2oa:J ~ approval- ,---- A. Wc{,~~~fHI!h'iln!l!ll\llgle or -.-..... ---..------ .... .
/tOZ06/3 065"00 ZOning toIL Multi-Family per dwelling unit.
LIJ.GA" DESCRIPTION 0.,. ~ ~ 1-0 'Z- ~cmcc ;".:..Ied:
Ke<,~ Qe!-o:> I Items Cost
q<-.,0
ELE_CAL"PERMlT APPLICATION.
;' ,', ,.~.
~:
Sum
'......\Il\.mzeo :Signature
JOB DESCRIPTIO\, "1000 sq.ft. or less'
A-.Ul~ ;L O<w1(J\ C! ,fr.C.c.J.I""";b" Each additioual 500
'fVl''''''''~!, ~ \ -\eo..r. eU\~ (,OPt- J '3otl- .. sq. ft or portion
Permits arc non.transferable and expire Lc..\...:\,J ,n f'11::,l.,'il' thereof
if work is not started within 180 days ~<V\(e- ,Each ManuI'd Home or
of issuance or if work is suspended for Modnlar Dwelling
180 days. Service or Feeder
$106.00
,
$ 19.00
, ,,~..
:
!
! ,
.' 'J :.'
. .
$ 50.00 2'
2. CONTRACTOR INSTALLATION ONLY B. Se,'\"ices or Feeders
'.' .
] . --= /J Installation, Alterations or. . "
Electrical" COllt~acto~ {Z,...","" C!t"cJ ~YtQf;" Relocation: j"" . . ,~ "
Address 4'~/~'-3 <blJ~re \t?J}'." 200 ampsorles/'. " .' c;: ~~~i:~~~,
_',' '/II /0'07\7';>' '.. 201 amps to 400 amps ~.$75.00_.
CIl)'l>iI<-.4r~I..ILt..PllOne qt9'-71dy......... '\ .401 amps to 600 amps 'w :~$125.00~:
.. "\ \. , Cijr{./' r.,(~....... '(,01 amps t6100p.alllJl''S'".\", " $163.00 "
! I ' ",,\l'-'" U\\"" - ,"-.
SupervIsor License Number ,,~\ L.<:::', OverslQOO nmR~voltS ~\ot\'n. ~ $375.00 ~
IJ ". '. . \O\,,'.OR~'5Jil.fil19rllis;lese .\)Il" $ 50.00
Expiration Date "2 - D ~ - <:.?... . ji\;'tt'C~~ ~ au09\6 '!'nose N\ 0ji\;e9~~ s '0'1
~ ~.' n ~. \0\\0'1'1 'it\ 'FS!llliii'la{t ~\\6Iie~ o~ '!\c'M~'r~(\a
'-Constr ,(:ontr Number ',..-L 00 ex::.. 'o~il\Ca\l"..lJ!'Jtilll\1~olll\~ICl.?tj~,!,j.fR<!i~eali!,n
"', -_~ . . \~ .Q9;J~ 0'<to,'3\ ~e'.W'<1. ~I\ca.\'v.
.'-., -................ . '1)01;"" U,~'3'1 . 1.~~0 "\\\'1\,\0 .
">ExpiratLOnDale q -b?-~~O~ \OQ9Q.~0 \'ne&OO\~Wj~orl~~g~.2;Y;A). ,
. ~-C!!\\\I)\\ lot 'J0151,\,P,3ji14oO'amps
Sign,..lure ~f.~uJlervising Electrician I)U~'Oe cat~",o;401 10600 amps.
'.' " .. O\"er 600 amps or 1000 volts see
_, )..~:,.:#P~ !lB" ab~)r"~- ......- \
. <: .Cr' . '0- D. Branch Circuits
Addre~n '\~ \Z;~ f? ~ . One Circuit ',,\!, \~ ""~ ,10. ~n'\ .$43.00 _
"--H"- ,- ~T .' " ': ., ~\t-~'~~~'~ .
City (n.cIJ'.1ff 'Phone ?;;){.p - (( Or; O,\t~':~i.Wl~~\~"l~~~_If~~I'\'ice
. ~. ~ ?~yo}lF',\~~~i.!o.f>,\\~~ ~ $ 3.00 ~
OWNER INSTALLATION ' , 'i.'(.\~ @~~t~\J Qv. ~ IW
The installation is being made on ~i.~~~~I'O~""feeder not included)
property I O\\'I~ whIch is' not tntended CQ~ 1l,,~~"l;llsroli~tioh. . .
for sale. lease or reht. f>,\\'i \'l"ump or irngation . _ $50.00 '--
, Sign/Outhne Lighting $50.00
Limited Energ)"IRes $25.00
Limited Energy/Conlln" $45.00'
.,'.,
..:
$50.00.. .:
$69"09 ~
$100.00 ~,
'o'Yl1ci"s Signature:
I\linimum.Elcctric PCI:mit Inspection Fcc is 545.00+ Surcharges
rib .
4. SUBTOTAL OF ABOVE
70/0 State Surcharge
8% Administrati\'e Fee"""
3z2:
1{J
527.0
TOTAL
"-...
~
.,~
TRANS#:01-0008773
DATE: MAY 01 2002
AMT RECD:2 $ 52.90
CHANGE:
CASHIER:061
.
.