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Home My WebLink AboutPermit Electrical 2001-04-02SPRINGFIELD Job# 01-00288-01 RESIDENTIAL PERMIT Gity Of Springfield Community Services Division Building Safety Page 1 of2 Job Number: 01-00288-01 Office:726-3759 Inspection Line: 726-3769 Tax Lot#: 00105 Subdivision: 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2576 00016th St Spr AssessorsMap#: 17032434 Lot: Block: Addition: ctTY oF SPRfiNGF1ELq OREGON Owner: John Purscelley Address: 2576 16th Street Scope Of Work: Mechanical lnstall heat pump & air handler Phone Number: City/State/Zip: New 541-747-8051 Springfiled, OR97477 Value: $O Contractor Type ElectricalContr Mechanical Contr Contractor JB Electric lnc 4065 W 1 1Th #18, Eugene, OR 97402 Marshalls Heating 41 10 Olympic Street, Springfield, OR 97478 Registration # 104929 Expiration Date 3t14t04 Phone 541-687-5770 541-747-7445 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 Electrical Rough Electrical Final Electrical Underfloor Mechanical Rough Mechanical FinalMechanical - Prior to cover. -When all electricalwork is complete Mechanical -Prior to insulation or decking. - Prior to cover. -When all mechanicalwork is complete. Job# 01 -00288-01 # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total: Page 2 of 2 Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Feet) Main:Accessory: Fee Paid On Receipt# Value/Quantity Fee Amount Branch Circuits WO Feeder or Service Branch Circuits With Feeder or Service State Surcharge - Electrical Administrative Fee - Electrical Total Electrical Electrical 0410212001 0410212001 0410212001 0410212001 4816 481 6 481 6 48l 6 1 1 $35.00 $2.00 $2.59 $1.11 $40.70 Mechanical Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Mechanical lssuance State Surcharge - Mechanical Total Mechanical 03t26t2001 03t26t2001 0312612001 a312612001 03t26t2001 4767 4767 4767 4767 4767 1 $e.00 $.45 $6.00 $10.00 $1.05 $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 allwork 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 $67.20 Paqe\ o1?. l!{}l{,$;k iir..l{:iiii SPRINGFIELE t'f,I[.r]lf,R ]", ttlii nMT nfFn.n * Ti Eiinlll t\LLfU.l-'1, L',J"JU Illllii,ii-'f . lr,in!Illl . F/\CllTf ft ' Ofl,r.UnrJl lILt\ r UUJ 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2576 00016th St Spr AssessorsMap#: 17032434 Lot: Block: Addition RESIDENTIAL PERMIT Gity Of Springfield Community Services Division Building Safety Job Number: 01-00288-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 00105 Subdivision: 01Job# ctrY oF SPRINGFIELD, OREGON Owner: John Purscelley Address: 2576 16th Street Scope Of Work: Mechanical lnstall heat pump & air handler Phone Number: City/State/Zip: New 541-747-8051 Springfiled, OR97477 Value: $0 Contractor Type MechanicalContr Quad Area: # Of Units: Constr. Type: Water Heater: Contractor Marshalls Heating 4110 Olympic Street, Springfietd, OR 97478 Registration # Expiration Date Phone 541-747-7445 Underfloor Mechanical Rough Mechanical FinalMechanical office use _ Land Use: Zoning Code: Bedrooms: Range: Required lnspections Mechanica! -Prior to insulation or decking. -Prior to cover. -When all mechanicalwork is complete. # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at726-376g. All inspections requested before 7:00a'm' will be made the same working day, inspectio:ns requested after z:00 a.m. wi[ -be maoe the followingworking day. Area (Sq. Feet) Main: # Of Stories: Height (feet): Current Units: proposed Units: Census Code: Does not apply Accessory:Total: Gonstruction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? [ Job# 01-00288-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Mechanical lssuance State Surcharge - Mechanical Total Mechanical 03t26t2001 03t26t2001 0312612001 0312612001 0312612001 4767 4767 4767 4767 4767 1 $9.00 $.45 $6.00 $10.00 $1.05 $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 at the proper time and that the project address is readable from the street. nature $26.s0 .4a/.,;fr )-/ SPT. ;FIELO D EVELO P M E NT S E RVICE S D E PART M ENT tollowing proiecl as submitted has anc does nol requ rre sPecific t otal ?-Orrlng 225 FIFTH STREET SPRTNGFTELD, OREGON 914V7 INSPECTTON REQI EST, l?9:.1J"69:,e,;aru,.oFFICE: 726-3759 1 TT o AIIATION LEGAI DESCRTPTTONo3 o DE Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALI,ATTON ONLY B PERHIT APPLICATION ty Job Nunber h/ OO )8tro/ COHPTBTE FEE SCMDULE BELOS Nev Residential-Single or MuIti-Family per dvelling unit. Service fncluded:Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 $ 40.00 Services or Feeders fnstallation, Alterations or Relocation: the lollowing r land use 3 A s 1s.00 Electrical- Contractor eaaress4 C llr *# Ci ty Pho Superv i s License Numb :,)?(',r) Expiration Date Constr Contr. Number Expiration Date Signature ervising Electrician 200 amps or less S 50.00 40i. amps to 600 amps - $100.00 over 1000 amps/voIts - $300.00 Temporary Services or Feeders Installation, Alteration or Relocation )nY c 0vners Addres 200 amps or less 201 amps to 400 amps -Over 40L to 600 amps over 600 amps or rboO-TofTs One Circuit I Each Additional Circuit or vith Service or Feeder Permit I Ci Phone ALLATTON The installation is being made on property f ovn vhich is not intended for sale, Iease or rent. Ovners Signature: + D. Branch Circuits th Nev, Alteration or Extension Per Panel Eove $ 40.00 $ ss.00 see llBtl a $ $ $ $ $ 3s.00 $ 2.00 6: ^-,a E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0ut1ine Light ing_ Lirni ted Energy/Res Limited Energy/Comm 5. SUBTOTAL OF ABOVE 77o State Surcharge 32 Adninistrative Fee TOTAL 0ft: 0el 00:, offir:) r.J 40 40 20 I(:)(}(:) $mFJ cl.. r.JDATE: RECEI RECEIVED B )- 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3;5s FAX r511 i 726-36i?