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Home My WebLink AboutPermit Mechanical 2001-10-26- l5PRTNGFIELD Job# 0f-01195-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page Job Number: 01-01 195-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 02305 Subdivision: of2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 235 00017th St Spr AssessorsMap#: 17033631 Lot: Block: Addition crTY oF sPRtNcFrELD, OREGOI' Owner: Henry Miller Address: 235 17th St Scope Of Work: Mechanical Phone Number: City/State/Zip: New 541-746-2963 Springfield, OR 97478 Value: $O lnstall heat pump and air handler Contractor Type MechanicalContr Contractor Marshalls Heating 41 10 Olympic Street, Springfield, OR 97478 Registration # Expiration Date Phone 541-747-7445 -"i$"'P$l.i'::**o Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: b''l B 7:00 r.et be the following "o\ ,)\€P( To request an inspection call the 24 hour recording at726-3' a.m. will be made the same working day, inspections requested working day. Required lnspections MechanicalI Rough Mechanical FinalMechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? (Sq. Feet) - Prior to cover. -When all mechanicalwork is complete. \t €B # Of Stories: Current Units: Census Code: Does not hB,t\. :{ Main:Accessory:Total: (\1* Job# 01-01195-01 Page2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU 10,000 Cubic Feet or Less Mechanical lssuance State Surcharge - Mechanical Total Mechanical Mechanical 1012612001 1012612001 10t26t2001 1012612001 1012612001 1012612001 7103 71 03 7103 7103 7103 7103 1 1 $25.00 $3.60 $12.00 $8.00 $10.00 $3.15 $61.75 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 proper time and that the project address is readable from the street. Signatu Date $61.75 2 225 Ftr,TH STREET :lllrcrrE LD, oNEC,oN s7 47 7 IYlllgrroN REeuesr: 726_376sOFFICE: 726-3759 :: lgclrroN oF rNsrALLArroN 235 N 17th ELECTRTCALPERI4I: ITCATION City Job Number 3. COMPLETE FEE SCIIEDULE#Ehil.not reguire Zoning L-oA Cost Sum $106.00 $ Items as subm $19.00 $ $50.00 $ -(J $63.00 $7s.00 $125.00 $163.00 $375.00 $50.00 l LEGAL DESCRIPTION(70 3 3 63, /cz36f JOB DESCRIPTION 2Ton/10 KW Heat Pump w/ handler and EAC A. New Residential-Single or D61s Multi-Family per dwelligg; seruce Included: ,UB}eo signutr." itted has thespecific ,a follo wing nd USE $ $ $ $ $ o Permits are non-transferable and expire if work is not started within lS0 days of issuance or if work is suspended for 180 days. 1000 sq. ft.. or less Each additional 500 sq. ft or portion thereof Each Manufd Home or Modular Dwelling Service or Feeder 5. SUBTOTALOFABOVE Mililiutrr ?o/o State Surcharge 8% Administrative Fee 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor JB C. INC Address 4685 lsabelle City Euqene, OR 97402 phone-84-1-.6g7..S720_ Supervisor License Number 3872S Expiration Date 10t1to4 ccB Constr Contr. Number B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only C. Temporary Services or Feeders 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts see B above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit I Each Additional Circuit or wittrGvice- or Feeder Permit 2 E. Miscellaneous (Servicelfeeder not included) -Each installation Pump or inigation Sign/Outline Lighting Limited Energy/Res $ $ 1 Expiration Date 1Ol1lQ2 3l14lo4 Signature Supervising Electrician Owners HanrvMiller Address 23tlU_7th City Sorinofield. OR 97477 Phone 746-2963 OWNERINSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: $50.00 $69^00 $r00.00 $43.00 $ 43.00 $3.00 $ 6.00 $50.00 $50.00 $2s.00 $4s.00 49.00 $ $ $ $ $4s.oo $ $3,43 JB Job# 01-725 TOTAL $J 5 375A7C $ i: iiilH il,iu Tf! ..l,nii ! -1 I LlaIrru i lU!'{. "f}UU $-Fr