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Home My WebLink AboutPermit Mechanical 2001-11-13SPRINGFIELD 225 North Fifth Street Springfield, OR97477 Location Of ProPosed Site: AssessorsMaP#: 17021942 Lot: Block: 2594 00038th St SPr Job#01 -01 248-01 Addition: Page 1 of2 Job Number: 01-01248-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 08900 Subdivision: h, RESIDENTIAL PERMIT CitY Of SPringfield CommunitY Services Division Building SafetY Owner: Address: Scope Of Work: Mechanical Contractor TYPe MechanicalContr Bob ShimP 2594 38th Street Phone Number: City/State/ZiP: New 541-744-0117 7B lnstall new gas service and water heater Contractor Marshalls Heating 4110 OlYmPic Street' 97478 a .)\o9 Date Phone 541-747-7445 Office Use Land Use: Zoning Code: Bedrooms: Range: Quad Area: # Of Units: Constr. TYPe: Water Heater: # Of Buildings: OccupancY GrouP: Heat Source: Sq. Footage: Torequestaninspectioncallthe24hourrecordingatT26-3769.A11 a.m.willbemadetnesameworkingday,inspectionsrequestedafter inspections requested before 7:00 7:00 a.m. will be made the following working daY. Construction TYPes: OccupancY GrouPs # Of Buildings: # Of Bedrooms: HandicaP Access? (Sq. Feet) Main: # Of Stories: Current Units: Census Code:Does not aPPIY Total Height (feet): Proposed Units: tr-' 5\r Accessory: Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Mechanical lssuance 11t13t2001 11t13t2001 11t13/2001 11t13t2001 7234 7234 7234 7234 1 $4.00 $41.00 $3.60 $10.00 {$o C'TY OF OREGON (\' Job# 01-01248-01 Fee Paid On Receipt# Value/Quantity Fee Amount State Surcharge - Mechanical Total Mechanical Mechanical 11t13t200',t 7234 $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 time and that the project address is readable from the street. sig re o4 $61.75 21t2, Page 2 of 2 u225FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726'37 69 OFFICE: 726-3759 I. LOCATION OF INSTALLATION ELECTzuCALPERMIT PLICATION City Job Nr o-/ 0a- 3. COMPLETE FEE SCHEDULE oo 7a Y -ot BELOW 2594 N 3Eth St LEGAL DESCRIPTION JOB DESCRIPTION AC/ HP Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor JB rc. tNc. Address 46811 sabelle CityEuqene. OR 97402 Phone-il1-687.5779,- Supervisor License Number 3872S tlffi@fpate 10t1lo4 A. New Residential-Single or Multi-FamitY Per dwelling unit. Service Included: Items 1000 sq. ft.. or less Each additional 500 sq. ft or portion thereof Each Manufd Home or Modular Dwelling Service or Feeder B. Services or Feeders Installation, Alterdions or Relocation: 200 amps or less 201 ampsto400 amPs 401 amps to 600 amPs 601 amps to 1000 amps Over 1000 amps/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 Sil or Feeder Permit I E. Miscellaneous (Service/feeder not included) -Each installation Pump or inigation Sigr/Outline Lighting - Limited Energ/Res Limited Energy/Comm t1 0a . 1,1 4). o 6qrt Cost Sum $106.00 $ $19.00 $ $50.00 $ $63.00 $75.00 $125.00 $163.00 $375.00 $50.00 $ $ $ $ $ $ l[f-E'mr!,#$'fiH0ffif;$Y{Uil8{fW $s0.00 $69.00 $100.00 $ Signature of Supervising Electrician Name Bob Shimo Address _r City Sprinqfield, OR97478 Phone 744-0117 The installation is being made on property I own which is not intended for sale, lease or rent. Owners Sigrrature: 5. SUBTOTALOFABOVE rrNrrur 7o/o State Surcharge 8% Administrative Fee $43.00 $ 43.00 $3.00 $ 3.00 $s0.00 $50.00 $25.00 $45.00 $ $ $ $ $46.00 $3.22 $3.68 JB Job #02426 TOTAL !45.00 $52.90 -l!t $- $- $-