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Home My WebLink AboutPermit Mechanical 2001-05-09Job# 01-00474-01 RES!DENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 SPRINGFIELD 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2525 00035th Pl Spr AssessorsMap#: 17021942 Lot: Block: Addition: Job Number: 01-00474-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 04700 Subdivision: ctTY oF SPRfiNGFfiELq OREGON Owner: Ann Smith Address: 2525 35th Pl Scope Of Work: Mechanical heat pump Phone Number: City/State/Zip: New 541-744-6286 Springfield, OR97477 Value: $O Contractor Type ElectricalContr MechanicalContr Gontractor K S Electric PO Box 24933, Eugene, OR 97402 Schoolcraft 2155 Musket, Eugene, OR 97401 Registration # Expiration Date 6127t01 Phone 54'1-688-1614 460 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 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 the following working day. Required lnspections Electrical Rough Electrical Fina! Electrica! Rough Mechanical FinalMechanical -Prior to cover. -When all electrical work is complete. Mechanical -Prior to cover. -When all mechanical work is complete. I t Job# 01-00474-01 # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Page 2 of 2 Construction Types: Occupancy Groups # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main:Accessory Total: Fee Paid On Receipt# Value/Quantity Fee Amount Electrical Branch Circuits WO Feeder or Service State Surcharge - Electrical Administrative Fee - Electrical Total Electrical 0511612001 05/16/2001 05/16/2001 5379 5379 5379 2 $37.00 $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 05i09/2001 05/09i2001 05/09/2001 0s/09/2001 05/09/2001 5241 5241 5241 5241 5241 1 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 at the proper time and that the project address is readable from the street. $67.20 .f-/6-o Signature Date $9.00 $.45 $6.00 $10.00 $1.05 $26.s0 SPRINGFIELD Job# 01-00474-01 RESIDENTIAL PERMIT City Of Springfield Gommunity Services Division Building Safety Page I of 2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2525 00035th Pl Spr AssessorsMap#: 17021942 Lot: Block: Addition: Job Numbe r: 01 -0047 4-01 Office:726-3759 I nspection Line: 7 26-37 69 Tax Lot#: 04700 Subdivision: crTY oF SPRINGFIELD, OREGOTV Owner: Ann Smith Address: 2525 35th Pl Scope Of Work: Mechanical heat pump Phone Number: City/State/Zip: New 541-744-6286 Springfield, OR97477 Value: $O Gontractor Type MechanicalContr Contractor Comfort Flow Heating 1951 Don Street, Springfield, OR97477 Registration # 460 Expiration Date 51312001 Phone 541-726-0100 Quad Area: # Of Units: Gonstr. 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. the Oreno I liilitv irlnti on Rough Mechanical FinalMechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? (sq. Required ln Mechanical - Prior to cover. -When all mechanicalwork is complete # Of Stories: Current Units: NOTICE: THIS P AUTHORI IRE IF THE WORK HMIT IS NOT Census Code: Does not apply IS ABANDONED FOR Main:Accessory:Total: 180 DAY PERIOD Job# 01-00474-01 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 05/09/2001 05/09/2001 05/09/2001 05/09/2001 05/09/2001 5241 5241 5241 5241 5241 $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 o 701.055 used on this project. I further agree to ensure that all required inspections are at time and that the project address is readable from the street. S nature Date $26.50 olqlct 1 CITY OF OREGON 225 FIFTE STREET iitrNerrslo' oREcoN 9 INSPECTION REOIiEST: orrrCgt 726-3759 Slgnature land use SPFIINGFTELO PBRUIT APPLICATION CitY Job Numbe =01 - oo4'71{ -o1 3. COUPLETE I'EE SCffiDULE BELOS Nev Residential-S Multi-FamilY Per Service Included: ingle or dr.relling uni t '1 LOCATION OF AJ Permits are non-transferablg tll expire i;-;;;k i" .,ot =i"tted vithin 1Bo daYs of issuance or ii-"ott is suspended for 180 daYs. 2. CONTRACTOR INSTALT'ATION ONLY 1000 sq.ft. or less iictl a,iaitional 5oo sq. ft or Portion t hereo f Each Hanuf'd Home' or Modular Duelling Service or Peeder One Circuit Each Additional Circuit or vith or Feeder Permit I tems Cos t $ 8s.00 $ 15.00 I $ 3s'oo a. ION o4:too Sum I Electri tract .B' Services or Feeders a ^ il,:#ila&*;: ;, ^' : ".::":il:nl r,.u ',{ oBK,<;i tiliffi =6i'Eg*ffiffi[}- il;i,ii =0ve*.t'&0U0'I[f:,'uo'ts - g 40.00Reconnect 0n1Y C. TemPorarY Services or.Feeders Instatlati'"''eii"t"tion or Relocation Ci tY Superv Li cense Number Expiration Date /o 6 ConStr Contr. Numler o 7 Expiration Date /) Signature of SuPervising Electrieian s AOOru", Ci tY toltc Address 3L 200 amPs"oT less $ 40'00 201 amps to aoO a*Pt l $ 55'00 Over 401- to 600 aTP:^--'--- S 80'00 0ver 600 "*p!-ot fbOO-r6Tts see rrBrr above D. Branch Circuits : " Nev, Alteration or Extension Per PaneL Servi ce.I s2 rvice/feeder no .00 t included)OTII{ER INSTALT.ATION The installation is being made.on Droper ty I o\rn "fti"ft is iot intended ioi's"IL, lease or rent' 0rners Signaturel E Hiscellaneous (se -Each installa t ion $ 40.00 Pump or irriga tion Sign /0utIine L igh t ing-$ 40.00 Lini ted EnergY/Res $20.00 Limi ted EnergY/Comn $36;i$0 ---{ 91, SUBTOTAL 7% state 3Z Admin TOTAL OF ABOVE Surcharge DATB ,o r': F,JLI DS' LrJ. t-Jrn -^] c) !! {1 FJ Tfi L."iRECEIVED 5 istrative Fee . $ 40.00 Name 3 &a pnon* 7 vY:'@tL ,