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Home My WebLink AboutPermit Mechanical 2000-12-21SPRINGFIELD Job# 00-01823-01 RESIDENTIAL PERMIT City Of Springfield Gommunity Services Division Building Safety Page 1 ol 2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2433 00011th St Spr AssessorsMap#: 17032611 Lot: Block: Addition Job Number: 00-01 823-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot #: 04600 Subdivision: ctrY oF SPRfiNGFIELq OREGON Owner: Mary Kay Ankeny Address: 2433111h street Scope Of Work: Mechanical Phone Number: City/State/Zip: Alteration 541-726-5582 Springfield, OR97477 Value: $O Contractor Type MechanicalContr Contractor Comfort Flow Heating Co 1951 Don St Ste D, Springfield, OR 97477-1993 Registration # 460 Expiration Date 6t27t01 Phone 541-726-0100 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 a1726-3769. 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 lnspections Mechanical I Rough Mechanical FinalMechanical Construction Types: Occupancy Groups # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq Main: - Prior to cover -When all mechanicalwork is complete. # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Accessory:Total: Job# 00-01823-01 Page 2 ol 2 Fee Paid On Receipt# Value/Quantity Fee Amount Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Mechanical lssuance State Surcharge - Mechanical Total Mechanical Mechanical 12t21t2000 1212112000 1212112000 1212112000 12t2112000 41 00 41 00 4100 41 00 41 00 1 $9.00 $.45 $6.00 $10.00 $1.05 $26.s0 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 of Oregon. I further state that only contractors and employees who are in compliance with o 1.055 will be on this project. I further agree to ensure that all required inspections are req at the time and that the project address is readable from the street. Date $26.s0 lz CITY OF OREGOA' 225 FIFTE STREET approval SPRINGFIELD, 0REGON 9742dnins )bk 726-3769 ,i- Auinoflt6d signature ION SPF FIELE, ELECTRTCAT PERHIT APPLICATTON City Job Nunber t: o -otgzs-6 I FEE SCMDULE BELOII The tollowing proiect as submitted has the lollo^wing l;;;;;;";ei not rdquire sPecitic land use INSPECIION REQIIEST,: oFFrcE: 726-3759D^rn 1 LEGAL DESCRIPTION l'z'o\ zct I 6vCoo JOB Permits are non-transferable and exp re if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INST Electrical Contract Addre o.) Ci ty vnone (o tf-/6// Supervisor License Number v _f Expiration Date Constr Contr. Number 7 OErf , Expiration Date L J S ture. of pe s Electrician 0vners Name Address o))' cit Phone P6'9str2 OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for saIe, lease or rent. 0rners Signature: DATE: Nev Residential-Single or Multi-Family per dvelling unit- Service Included:Items Cost A. C. E 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home. or -Modular Dvelling Service or Feeder $ Bs.oo $ 1s.00 s 40.00 Sum 10n a66ve ALLATI0N ONLY B- Services or Feeders ^ u InstalIation, Alterations ,tl&e<&.e--g-81u"fuUrr Reloca t i on : 200 amps or less $ 50.00 201 amps to 400 amps - S 60.00 401- amps to 600 amps - $100.00 601 amps to 1000 amps- $130.00 over 1b00 amps/vo1ts - $300.00 Temporary Services or Feeders Installation, Alteration or Relocat 200 amps"or less $ 40.00 201 amps to 400 amps - $ 55.00 over 4bl- to 60o amps - $ 8o.oo 0ver 600 amps or 1000 voTts see "Bil Branch CircuitsD Nev, Alteration or Extension Per Panel onecircuit I $35.00 Each Additional Circuit or vith Service or Feeder Permia -J- S 2.00 Miscellaneous (Service/feeder not included) -Each ins tall-at ion Pump or irrigation _-Sign/Outline Lighting-- Limited Energy/Res -- Limited EnergY/Comm SUBTOTAL OF ABOVE 7% State Surcharge 3Z Administrative Fee TOTAL -;- ffi--DI)--1*-mofrF+ts-r:? (3 (= ..D,-.. mCfL,) / f-J r:-l F, ---::F--| F{m{r+t,fp -.F+:--IU 7f,DS. O -----.--.Z:.€ltlJ$.*:RKAfr. Fr"" Cr(3lf,\ $ 40.0Q. s 40.0qs 20.0-di go.ffi'rl RBCEIVED B 2Zzo o 5