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Home My WebLink AboutPermit Mechanical 2000-07-28SPRIilGFIELD Job# 00-01 168-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1438 Vera Dr Spr AssessorsMap#: 17032432 Lot: Block: Addition: Job Number: 00-01 168-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 00700 Subdivision: ctTY oF SPR1NGFfiELq OREGON Owner: Lloyd lverson Address: 1438 Vera Drive Scope Of Work: Mechanical Phone Number: City/State/Zip: Alteration 746-970-5 Springfield, OR Value: $O Contractor Type MechanicalContr Contractor Comfort Flow Heating Co 1951 Don St Ste D, Springfield, OR 97477-1993 Registration # Expiration Date Phone xi*ffik: ftISPERMIT SHALL #F'Hg-tr THISPERMIT "iHE woR'/b 41 -7 26-01 OO ISNOf Office Land Use: Zoning Code: Bedrooms: Range: UNDER ANY 180 DAY P FRIOD. # Of Buildings:Quad Area: # Of Units: Constr. Type: Water Heater: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at 726-3769. Ail a.m. willbe made working day. the same working day, inspections req uestedlful folloutr .Th eCenter Rough Gas Rough Mechanical Gas Service FinalGas FinalMechanical Construction Types: Occupancy Groups # Of Buildings: # Of Bedrooms: Handicap Access? -Prior -After -When all gas work is complete. -When all mechanicalwork is complete. ce. Pressure ter # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Main (Sq. Feet) Accessory:Total: Required rulos 9624( ttt€ Oregon _ r ,la.f been Job# 00-01168-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical One to Four Outlets Minimum Mechanical Permit Mechanical Administrative Fee Less than 100,000 BTU Mechanical lssuance State Surcharge For Mechanical Permit Total Mechanical 0712812000 07t28t2000 07t28t2000 07128t2000 07128t2000 0712812000 2705 2705 2705 2705 2705 2705 1 $2.00 $7.00 $.45 $6.00 $10.00 $1.05 $26.50 1 Grand Total By signature, hereby certify I state and agree that I have carefully examined the completed a pplication and do 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 emp loyees who are in compliance witho1.055 will used on this project. I further agree to ensure that all required inspections are at the time and that the project address is readable from the street. sig re Date $26.s0 CITY OF SPRINGF'E T.O, O,fJiH. G$l''J SPR. JFIELO urrtLrrlUU U+ r.JL;lr Zoning LtCK- g oD-L(tDate Authorzeo Srgrrature 225 FIFTE STREET sPRrNGrrEL,D, oREGoN 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. I,OCATION OF LEGAL ooffi Electrical Contracto ,LS ttcan, Address 0.o 6qL /f3 ? Ci ty pnone b*&-/6// Supervi.sor License Number 3/?7S Exp iration Date 1o or) Constr Contr. Number Expiration Date o s ture of Su sing Electrician 0wners Name Address / V 3s Dot brzr,)e- PERI{IT APPLICATION City Job Nurnber -o its o 3. COHPI.,ETE FEE SCEEDT'IJ BELOV A. New Residential-Single or Multi-FamilY Per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 Sq. ft or portion thereof Each Manuf'd Home- or Modular Dwelling Sertice or Feeder $ 8s.00 s 1s.00 $ 40.00 Sum Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if work is suspended for 180 days. B. Services or Feeders Trlnstallation, Alterations . lb (zt+lu*{ or Relocation: OVNER INSTALLATION The installation is being made on property I ovn r,rhich is not intended for sale, lease or rent. Temporary Services or Feeders Insiallaiion, Alteration or Relocation 200 amps"or less 201 amps to 400 amPs - Over 401 to 600 amps over 600 amps or 1000-volTs Branch Circuits Nev, Alteration or Extension Per Panel onecircuit I s35'oo Each Additional Circuit or vith Service or Feeder Permit - $ 2'00 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/0utline Lighti.g- Limited EnergY/Res - Limited Energy/Comm c. E 200 amps or less 201 amps to 400 amps -401 amps to 600 amPs - 601 amps to 1000 amPs- Over L000 amps/volts - Reconnect OnlY SUBTOTAL OF ABOVE 7% State Surcharge 32 Administrative Fee TOTAL s s0.00 s 50.00 $100.00 s130.00 s300.00 s 40.00 40.00 55.00 80.00 see [Br'aEove $ $ $ D 1) Ci ty J Onners Signature: z?6 -?'n iPhone s 40.00 $ 40.00 $ 20.00 s 36.00 5 -2 1, DATE:t! PACEIVED J ffirc: LJI ifil \UL . i{ +o3 ,13I JOB t A=c 2. COI{TRACTOR INSTALI,A:TION ONIY - C.r^ €