HomeMy WebLinkAboutPermit Mechanical 2001-08-23SPHINGFIELD
225 North Fifth Street
Springfield, OR97477
Job# 01-00918-01
RESIDENTIAL PERMIT
City Of Springfield
Gommunity Services Division
Buitding Safety
Page 1 of2
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Location ^l Proposed Site: 1319 00034th St Spr
Assess-,, t,laP#: 17023034
Lot: Block: Addition:
Job Number: 01-00918-01
Office:726'3759
lnspection Line: 726-3769
Tax Lot#: 09201
Subdivision:
clTY oF SPRINGFIELD, OREGON
Owner: Ben ShiPP
Address: 1319 34th St
Scope Ct'.f 'ork: N4echanical
Phone Number:
City/State/Zip:
New
541-726-7100
Springfield, OR 97478
Value: $O
Heat pump
Contractor Type
Mechanical Contr
Contractor
James Heating
115 Lawrence St, Eugene, OR 97401
Registration # Expiration Date Phone
\o
Office Use
-
Land Use:
\he 6;e
:00
the following
ta$
Quad Ar-::,:
# Of Unils:
Constr. T, ce:
Water Il ':t:
Zoning Code:
Bedrooms:
Range:
-Prior to cover.
-When all mechanicalwork is complete.
# Of Stories:
Current Units:
Census Code:Does not
To reqr:e.i an inspection call the 24 hour recording at 726-3769. All i
a.m. will be made the same working day, inspections requested after
working day.
Required lnspections
Rough l'irchanical
Final Mcc,. nical
Gonstruc:;cn TYPes:
Occupan:;'Groups:
# Of Bui!:lings:
# Of Bedrocms:
Handicap Access?
Area (, .;. F
Main:
1\\\g
Accessory:Total:
I
its:
Mechanical I
ie\
nrN
Job# 01-00918-01 Page 2 ot 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum [\'] echanical Permit
Administralive Fee - Mechanical
Less than i 00,000 BTU
Mechanical lssuance
State Surcharge - Mechanical
Total Mechanical
Mechanical
0812312001
0812312001
0812312001
08t23t2001
08t23t2001
6517
6517
6517
6517
6517
1
$33.00
$3.60
$12.00
$10.00
$3.15
$61.75
Grand T - l..1
By signalLr e, I state and agree that I have carefully examined the completed application and do
hereby ccr'1ify that all information herein is true and correct, and I further certify that any and all work
performc . ::r nll [g done in accordance with the Ordinances of the City of Springfield and the Laws of
the Stal - . ' Oregon. I further state that only contractors and employees who are in compliance with
ORS 7C . . 5 will be used on this project. I further agree to ensure that all required inspections are
req uestc -l at the proper time and that the project address is readable from the street.
Signatr:Date
$61.7s
8 -23^o t
*o*ui&i*r*
A
LiEited BnergT/Comn
5. SIIBTOTAL OT ABOVE
7f, state Sureharge
8Z Adninistrative Fee
,?:j ,rlllri ii l ll-i.:t::!:7
.'i^1-ltjr':.: I:-' :', I ,.: . -,'. '
r'5'J 1i 2ii' j.r'i;"i
i:!i.X 154 i; ,"jrj .liil.lriir
10 BOsV O?zo(
the following
ific land use glgglglgAl pEBl{IT AppI;gATION
ty Job Nrnber Ot-oO 7tg-ot
COUPI,ETB FBB SCEEDTTI,E BETCIC
Nev Residential-Single or
Hulti-FamilY per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Eaeh additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular Dwelling
Service or Feeder
s 8s.00
s 40.00
B. Services or leeders
Installation, Alterations
or Reloeation:
The lollowing
zoning. and not
225 rrrrE stnEEt
SPRINGFIBI,D, OREGON
IT{SPECTTON REQTIESf,:
OFEICE: 726-3759
VPE-
q oDate
1
Authorized
OF I}{STALI^ATTON3,/ +t-
Signature>r
I,EGAL DESCRIPTIOT{Sum
JOB i\ C_ t.ac'!rT-
Permits are non-transferable and expire
if vork is not started sithln 180 days
of issuanee or if vork is suspended for
180 days.
2. COITITACTOR INSTAIJA:TION O}ILY
Electrical Contractor ct*"i i--.
Address
city_lSr;i-. i t)Phone'"/;)t--G'irr
Supervisor Lieense Nunber
200 amps or less
201 amps to 400 amps
-401 anps to 600 asPs _
601 amps to 1000 anPS_
0ver L000 anps/vo1ts
Reconnect Only
200 amps or less
201- anps to 400 anps _Over 401 to 600 anps _
Over 600 amps or 1000 volts
$s0
$60
$100
$130
$300
s40
.00
.00
.00
.00
.00
.00
s ss.00
$ 80.00
see nBtr aEEE-
oo
00
$ 40.
$ 40.
$ 20.
Expiration Date lc /cl
constr contr. Number rlc ?* 1L Tenporary Serviees or Feeders
Installation, Alteration or Relocation
c.
Expi ration Date /
* Siguature of Supervising Blectrieian
2 D. Branch Circuits
ovners Name Be.N ff
Address t3t ? 3'/ *L
Ci ty 5 ( r=,\Phone -726'7/oo
OENER INSTALLA:TIOH
The installation is being made on
property I oun vhich is not intended
for sa1e, fease or rent.
ovners Si8Bature:
DAIts: ()
E. l.liscellaneous (Service/feeder not included)
-Each installation
Nev, Alteration or Extension Per Panel'q3
one circuit / s s{na v3
Each Additional /
Circuit or vith Service
or Feeder Pernit $ 2.00
Punp or irrigation
Sign/Out1ine Light irrg_
Limited Energy/Res
rl@(f
Lll
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C}fJ
I:)
Lt'.u
qCI
(f
b"l,'Ji:Jr5rF"t
TqTq-
$ 1s.00