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Home My WebLink AboutPermit Mechanical 2002-08-22SPRINGFIELD Job# 02-00901-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 ol 2 Job Number: 02-00901-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 01800 Subdivision: 225 Fifth Street Springfield, OR97477 Location Of Proposed Site: 1495 00030th St Spr AssessorsMap#: 17023034 Lot: Block: Addition: oITY OF SPRINGFTELD, OREGON Owner: Pauline Jenkins Address: 1495 30th Street Scope Of Work: Heating System InstallAC and coil Phone Number: Gity/State/Zip: New 541-746-5517 Springfield, OR 97478 Value: $0 Contractor Type MechanicalContr MechanicalContr Contractor Home Comfort Heating & Air Conditio PO Box 24205, Eugene, OR 97402 Comfort Flow Heating Co 1951 Don Street, Springfield, OR97477 Registration # 84164 00460 Expiration Date 6t2512003 6127t2003 Phone 541-345-2838 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: Heat Pump Sq. Footage: To request an inspection call the 24 hour recording at726-3769. 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 working day Required lnspections Rough Mechanical Final Mechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Feet) Main: -Prior to cover. -When all mechanical work \g0 # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Accessory:Total: \l,e \e t0\\ Job# 02-00901-01 Page 2 of 2 Fee Paid On Receipt#Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit Minimum Mechanical Permit 8% Administrative Fee - Mechanical 8% Administrative Fee - Mechanical Less than 100,000 BTU Less than 100,000 BTU Mechanical lssuance Mechanical lssuance State Surcharge - Mechanical State Surcharge - Mechanical Total Mechanical 07t26t2002 08t22t2002 07t26t2002 08t22t2002 07126t2002 08t22t2002 07t26t2002 08t22t2002 07t26t2002 08t22t2002 10063 1 0387 10063 1 0387 1 0063 1 0387 1 0063 1 0387 1 0063 10387 $33.00 $33.00 $3.60 $3.60 $12 00 $12.00 $10.00 $10.00 $3.1 5 $3.1 5 $123.50 1 1 $123.50 Signature oatJ'- " L 225 FIFTH STREET SPR]NGFIELD. OREGON 9 7-I77 INSPECTION REQLIEST:'7 26 -37 69 OFFICE: 726-3159 o3 F LEGAL DES City Joh N 3. COMPLETE FEE SCHEDULE BELOW en' Rcsidential-Singlc or dl'elling unit. sq.ft. umber C<: ELEu .JCAL APPLI CATION Items Cost $ r06.00 $ r 9.00 $ 50.00 A. N, CRIPTION -jC, 3 o/.\ -fhe and does JO D.ESCRTPTION Perruits are llorl-transferable and if u'ork is not started ryithin 180 of issuance or if rvork is suspended for 180 days. zO S\gnaturQ Each Manufd Home or Modular Drvelling Service or Feeder 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders : , Installation, Alter Electrical Contractor k { E/€cfl. i (cnfu/(,-41. Relocation: 'ations or 200 amps or less 201 amps to 400 amps 40I lmps to 600 amps Oirer I000 Over 401 to 600 alllps $ 63.00 $ 75.00 _ $ 125.00 $I63.oo ---_- $375 _.$ o S C. Name t S/, t,t av6-dt/7Phone Over 600 amps "8" above D. Branch Circuits t.\cri Altcraliorr or Extcnsion Per Panel One CircuitAddrcs 'i he insttrllation is being niade on property I orvn rvhich is not intended for sale. lease or rent Orvners Signature. g Each Additional Circuit or lith Senice or Feeder Pennit _ $ E. l\Iiscellaneous (Sen,ice/fecder not inclutled) -Each instrllation Pump or irrigation $50.00 Sign/Outline Lighting $50.00 Limited Energl'/ltes $25.00 Limited Energv/Comnt - $+5.00 Nlinimum Electric Permit Inspection Fee i.s SJ5.00 * Surchlrges d. SUBTOTALOFABOVE 7o/o Stfie Surchtrge 8%n Administrative Fee n3 6t) -T O6 TOTAL calling Signirture of Super-r'ising Electriciln THE.WSfi.K I$ HOT ,I $+3.oo .J .,, Ss-(oo61-ri l'- arrtc l/!- SPRINGFIELD Job# 02-00901-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of2 Job Number: 02-00901 -01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot #: 01800 Subdivision: 225 Fifth Street Springfield, OR97477 Location Of Proposed Site: 1495 00030th St Spr AssessorsMap#: 17023034 Lot: Block: Addition: ctTY oF SPRTNGFIELD, OREGOI' Owner: Pauline Jenkins Address: 1495 30th Street Scope Of Work: Heating System PhoneNumber: 541-746-5517 City/State/Zip: Springfield,OR97478 Value: $0 \u 99 e 1- Date I ol o( New lnstallAC and coil Contractor Home Comfort Heating PO Box 24205, Eugene,SOiso Zoning Bedrooms: Range: Contractor Type MechanicalContr Quad Area: # Of Units: Constr. Type: Water Heater: ,-f,\ON Phone 541-345-2838 is1 # Of Buildings: Occupancy Group: Heat Source: Heat Pump Sq. Footage: Gonstruction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Feet) Main: # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Accessory:Total: \he \he Job# 02-00901-01 ), Page 2 of 2 Fee Paid On Receip# Value/Quantity Fee Amount Mechanica! Minimum Mechanical Permit 8% Administrative Fee - Mechanical Less than 100,000 BTU Mechanical lssuance State Surcharge - Mechanical Total Mechanical 07t26t2002 07126t2002 07126t2002 0712612002 07126t2002 10063 10063 10063 10063 10063 1 $33.00 $3.60 $12.00 $10.00 $3.15 $61.7s Grand Signature Date $61.75 30s392-02 /.1-t=r Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3184621 Web Address: www.ccb.state.or.us Permit #: Address: Issued t -,: Date Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and -plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fil1 in the appropriate blanks and initial boxes I and 2, andeither box 3A or 38: l. I own, reside in, or will reside in the completed structure I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. E 3A. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. applicant)(Date) copy to issuing agency permit file, pink copy to applicant.) ff2. 225 FIFTH STREET . SPRINGFIELD, OR97477 r PH:(541)726-37s3 o FAX: (541)726-3689 E LE CTRI CAL P E RM IT AP P LI CATI ON City Job Number Date LOCAT'ION OF INS'TALLATION COIVIPLET'E T-EE SCHEDULE BELOI\'1 3 2. O0NTRACTOR INS7?TIATTON ONLY LEGAI, DFSCPTPTI.)N JOB DESCzuPNON Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Electrical Contractor Address Phone Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name Address A. New Residential - Single or l\tulti-Farnil-v per drvclling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or $50.00Feeoer B.ServicesorFeeders_Installation,AlterationsorReloc:rtion: 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 6s $ 106.00 $ 19.00 City $ 63.00 $ 75.00 $125.00 $163.00 $37s.00 $ s0.00 C. Temporary Sen'ices or Feetlers Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch C'ircuits pno"")_H./;s{J7 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 * Surcharges New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit 7Yo State Surcharge l0%o Administrative Fee TOTAL $ 43.00 $ 3.00 h,'Iiscellaneous (Service/feeder rtot included) -Each Instaliatiort $ s0.00 $ 50.00 $ 25.00 $ 45.00 r Owners Signanrre:,4. suBrorAloFABow ,b3 '('{ I b'3'o 73-' r Inspection Request: Shared Drive(T:)/Building Fonns/Electrical Pennit Application l -03.doc ouyer nereDy above, the life conjunction w ith the indebtedness hereunder, conditions: (1)any such insurance is mpany,PO. Box 660028, Dal 75266-0028, and (2) the tnsu rance e is that for which an and (3)such in ce will not be if ln on or beforethe date of subject to the terms cond of the group policy issued to Seller and the certificate issued to The term of insurance as of the date the incurred and will na the original maturity date indebtedness. The al amount Ito indebtedness tober disch ce or the lf the r to its schedu matu will raKes nolrce Inat, tl a uredtt lnsurance of the person signing above ("lnsu s any refund of is entered insured in BUYER(S} By iii lf of this paragraph the on with interest in the Coll \ Buyer hereby acknowledges receipt of an exact copy of this contract. RETAIL I NSTALLMENT CONTRACT ira PAYMENT SCHEDULE: Buyer promises to pay Seller the UNPAID TIME BALANCE (ltem 7 above) in J{)...j:.....:.........:.......... installments as follows: (Toral No. of lnstallments) Forequ.at.successive tat5.....lfr...rG:t.}............ ............on . c,cn 1{ /77(...... andatikesumonthelikedateof eachmonth monthlyinstallments: thereafteruntil fullypaid,provided,however,thatthefinal installmentshall beintheamountof g.... Lffi...oi3...... .. . Forotherthan (b) equal successive monthly installments: Buyer agreesto pay Seller, upon acceleration of the above indebtedness, interest on allsumsthen owing hereunder at 1lzohper month if n-ot prohibited by law othenruise-at the higtiest rate [iuyer can legally obligate itself to pay. Any note taken herewith evidences Indebtedness.and.not payment. All amounts payable hereunder are payable at Seller'3 address shdwn below or at sJch.other address as Seller may specify from time to time in writing. Buyer and Seller agree that the "statement of Additional Covenants" set forth on the reverse side hereof constitutes a part of this agreement. No oral agreement, guaranty. promise, representation or warranty shall be binding on Seller. NOTICETOTHE BUYER:1. Do notsign this contract beloreyou read itor if it contains any blankspaces, exceptthat ildelivery of thevehicle isto be mPd9.!9 y.q, alterthis cdntract is signed, the serial numberorother identitying inforhation and ihe duedate of thefirst installment may be lilled in at the time of delivery. 2. You are entitled to an exact coDv of the contract vou siqn. 3. You have the right to pay off in ridvance the full ahounldue and to obtain a partial relund ol the finance charge. DATED f{ - 2\. 7 /'Pr.t/a@ , O, /D4/.#4/ rnsu ra cred to the th nd wi lated in with provided, however, that no refund will less than $2.00. if the ts the insurance is declined or otherwise does not become will promptly give notice to Buyer and shall promptly refund or amount of the insurance charge to Buyer. SELLER $.:ff€ be paid or ll be calcul ;235 iaftg*ifrn? pg . {Street Address of Seller! Place of Business) EdkFHE" a,E: 77zo'/ I (city, State and zip code) Kffi,{nffi,, ,,,,;, e .......................... partner pa rty must must sion and show corDorate title. sign. lf 5wner{s) or partrier, show whlch.} 8v ............... .......Title {lf co-buyer, co-partner or co-officer, sign here and show which.}/{7,r #-, Ja {street Addrass of Buyer's Residence or Place of Business) SpEt*'6a,r7E/d, d4 77 tz-g-. City, COUNw. Stsle and ZiP Code) 600985 (Rev. 11/87) Comm'l Veh-OR initial th ffis By ......... to Financial IS attai n such a 11 '/. e/ a or UE, luecurltY Agreementl ^Guth GsyrFAN The undersigr:9.?_lf"^rll",:li!g,9]l buyers. jointly and severally-(,,Buyer,,), having been quoted both a time sale price and cash sale price, haselected to purchase and hereby purchases from ihe unciersi!ned'seler (,,Setter,,itorthe tii"" iIiE pri"J jno*nnj;w i;A;li,-jtr;;;';;ffi;;;i;iJ;i-oi t t,asreement, the following describe^d property (herein, with;I present and future attiitrmenti, aices-rories. ,e;i;;;;;;i p;rtr, ]liprii., IOaitio"i,]"0 ittproceeds thereol referred to as "Collateral"): / ?73 Collateral Will Be Kept At (Address): /r.t;..r..rU-..3,O.. INSURANCE COVERAGE IIABItIil IIISURAl{CE C(IVERAGE F(lR B()DITY I]{IURY A1{Il PR()PERTY DAMAGE CAUSEI! T() OTHERS IS I{(lT I}ICLUDED II{ IH!S AGREEMEI{I. PHYSICAL DAMAGE INSURANCE COVEBING THE COLLATERAL IS BEOUIBED; howevel Buyer has the option of furnishing the required insura.nce either through existing policies or through an ag6nt or Oro'tierbi Buyer's choice. Buyer requests and authorizes Seller to obtain the insurance coverage checked below on the Collateral for ............... months from the date of this agreement, and for the premiullr3J"$;;a ,; ii;i_ orii:ii tnaHi:Eil E S .. ............... Deductible Fire, Theft, Combined Addirional Coverage, and $.......... .......... Deductible Collision; or D q . . . . ....-.. Deductible Comprehensive and $................ ....... .Deductible Collision. Buyer has obtained the required coverages through: (Agent's Name and Address) (Name of lnsurance Company) Trade-ln (Net Allowance) 1. cASHSALEpRtcE :...... ... $,55e!@- .<n 2. (a) Cash Down Paymenl ..... S /14rClC')" G3 (b) Trade-in (See above) . .... $ ...r:# . TOTALDOWN PAYMENT (a+bl./1.lic(!q #) 5... /t.OA.G...Clr 3. UNPAID BALANCE OF CASH PRICE (1 Minus 2t ..... .... . . s../5.....:ls-t..c*. 4. OTHER CHARGES (a) Physical Damage lnsurance ....-........... $. .€ (b) Credit Life lnsurance . . ... $. . .... .#...... (c) Official Fees .. ... $.. . * (d)other ... $. .... ..#-. ... (Describe) TOTAL OTHER CHARGES (a + b + c +d) 5. PRINCIPAL BALANCE (3 + 4) . 6. FINANCE CHARGE 7. UNPAIDTIME BALANCE (5+6} ...... 8. TIME SALE PBICE (1 +4+6) DELINOUENCY CHARGE: For each instal within of Description of Trade-ln : GrossAllowance...... Less Amount Owing To: .A/64/{_ County...Atg.UE state. Q8,.. ance of rity 'all interest in the absolute and all trl I ulzo Yo u.t Io Itr INSURANCE, if required by the included,s not a factor credit, is not Seller and is for Buyer Credit Life lnsurance:m$ in the approval of of the credit only. tr I lrJ2o Yo H I n Buyer ance, 4(b) ina if and in 4(b) - OTHER CHARGES} and aut Seller to obtain Credit Life lnsur- to the the cost thereof is included in Item Financial Life I Proposed Credit nsurance Company lnsurance set forth $ffs {fui,ac* ;sf s ,7*;c,r oL: ss.., s..8..." g*.below and/or from (insurance nY): ' in accordance separateAp n, Notice. Certif icate or Policydelivered to this date. Buyer does want Credit lnsurance. to SECURITY INTEREST: To secure ent the IIME BALANCE (ltem 7), Seller retains title to a in the Collateral regardless of any retaking and redelivery lateral to Buyer. CROSS SECURITY: Bu its due date, 57o of such i Collateral to secure the co of or Buyer agrees to pay to Sel nstallment. del BUYER . Date .......... ..... ..- - 6riv "n" peis"n qiy "ijn iu;;;, ";;;"; ;;;ii insri"nce corers onry thar person. Credit insurance does not cover any co-buyef,) to Se d of anst Seller; or to any assignee Year Make Model ldentification NumberDescription OLI/,4/r.4^/'trlCretqZTt€ PlO&iag--/erofZ-/?'^ 1"5'al/lZ"/ 6r 'x 87' APP aas Itrtt sctt cae fter eB?FO t tzyf NOTICE OF PROPOSED CREDIT INSURANCE of yer gra ha $.. $. .$.... ... in 2ibI - DOWN PAYMENT)