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Home My WebLink AboutPermit Mechanical 2002-07-18Job# 02-00857-01 COMMERCIAL PERMIT Caty Of Springfield Community Services Division Building Safety Page 1 of 2 SPRIilGFIELD 225Fifth Street Springfield, OR97477 Location Of Proposed Site: 1192 00030th St Spr AssessorsMap#: 17023034 Lot: Block: Addition: Job Number: 02-00857-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 01500 Subdivision: ctrY oF SPR7NGFIELD, OREGON Owner: Ramona Peterson Address: 1192 30th Street Scope Of Work: Mechanical lnstall SUB approved H/P Phone Number: Gity/State/Zip: New 541-741-0894 Springfield, OR 97478 Value: $0 Contractor Type MechanicalContr Contractor Marshalls lnc 4110 Olympic St, Springfield, OR 97478-5620 Registration # 25790 Expiration Date 12123t2003 Phone 541-747-7445 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: Al-tEt\ {ollow Notrtic in OAR N To request an inspection call the 24 hour recording at 726-3769. All a.m. will be made the same working day, inspections requested after 7:00 a.nn working day. Required lnspections Mechanical ifl!-trsu,",sii,ffiff dh$:ff Br iRVHi"b'^V Pinioo Rough Mechanical Final Mechanical Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main: -Prior to cover. -When all mechanicalwork is complete. # Of Stories: Height (feet): Current Units: Proposed Units: Census Gode: Does not apply Accessory Total: Job# 02-00857-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical Minimum Mechanical Permit 8% Administrative Fee - Mechanical 3hp - - 100,000 BTU Mechanical lssuance State Surcharge - Mechanical Total Mechanical 07t18t2002 07t18t2002 07t18t2002 07118t2002 07118t2002 9977 9977 9977 9977 9977 1 $33.00 $3.60 $12.00 $10.00 $3.1 5 $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 at the time and that the project address is readable from the street. $61.7s 7/d,> Signature i^tZ 2:5 FIFTH STREET SPRINGFTELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 I. LOCATION OF INSTALLATION 1192 30th Place ELECTRICAL PERMI' 'PLICATION 3. COMPLETE FEE SCHEDULE BELOW A. New Residential-Single or Multi-Family per dwelling unit. Service Included: has the tollowing Items \and \.lse 1000 sq. ft.. or less 500 e@ thereof Manufd Home or Modular Dwelling Service or Feeder 5. SUBTOTALOFABOVE uNtruf, 7o/o State Surcharge 8% Administrative Fee iTtx'sr''i t' o/34 JOB DESCRIPTION theHeatdhandler Permits are non-transferable and 2qnrn9explre if work is not started within Cost Sum $106.00 $ $19.00 $ $s0.00 s rW0RK IS NOI ron00 $75.00 $12s.00 $ sr63.00 $ $375.00 $ - $s0.00 $ - $50.00 $ - $6e.00 ._ $100.00 $ - of issuance or ifwork is suspq$6$Sg6o 180 dap. 2. CONTRACTOR INSTALLATION ONLYI Signature you Ic Electrical Contractor JB ELECTRIC, lNC.Relocffi PEBMIT SHALL Instalffi[$ffations Supervisor License Number 3872S Expiration Date 1ot1tM Constr Contr. Number 37587C ccB 104929 Exoiration Date '1011102 3l14lV Signature of Supervising Electrician Name Ramona Peterson Address -same-Ciry Sprinqfield, OR 97478 Phone 741-0894 The installation is being made on properly I own which is not intended for sale, lease or rent. Owners Signature: n Utility B. Services or Feeders or EXPIRE IF THE UNOER THIS PERMIT 200 OR IS AEANOOSIED 201 PEBl00,-401 601 amps to 1000 amps Over 1000 arnps/volts Reconnect Only C. Temporary Services or Feeders 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts see B above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with S".,i*- or Feeder Permit I E. Miscellaneous (Service/feeder not included) -Each installation Pump or inigation Sign/Outline Lighting _ Limited Enerry/Res Address 4685 lsabelle Street "iv c!&sEf$ffi iffii'd$ffi W'' $ $ s $43.00 $ 43.00 $3.00 $ 3.00 s50.00 $50.00 $2s.00 $45.00 $ 46.00 $ $ $4s.oo S $3.22 $3.68 $JB Job #02477 TOTAL $ 52.90 cityJob tr^or, 0'; CC(57 O/ ,,. '1r:lL