HomeMy WebLinkAboutPermit Mechanical 2002-7-24
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I Job# 02-00887-01 I
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Page 1 of2
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00887-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769 ~
Tax Lot #: 00600 T
Subdivision:
Location Of Proposed Site: 6827 Main St Spr
Assessors Map#: 17023444
Lot: Block: Addition:
Owner:
Jerry Henry
6827 Main Street
Phone Number: 541-726-8796
City/State/Zip: Springfield, OR 97478
New Value: $0
Address:
Scope Of Work: Heating System
Contractor Type
Mechanical Contr
~t,
Registratio~~X.~iration Date
00460S:.~~'\~7/2003 541-726-0100
(.~~ ~~~..,~~ <<.
~'- '\>0" ~".
Office Us.!5\~ ~~ &~~
Quad Area: Land,u~~> ~'\ ~~'\) ~ ~ # Of Buildings:
!'\ v (.'X' x,'V 'V<t- ~'V'
# Of Units: ZOQing,gode:J: x,~ ~~ Occupancy Group:
Constr. Type: Bed~'m~~~~~C;:; ~ '( Heat Source:
Water Heater: Range.~(')~~,,'O~ 'V Sq. Foo~~pe:,
- ~, ",'Iv ,~'" ~""
To request an inspection call the 24 hour recording ~ 726-3769. All inspections reqUe~ea)lef6r~~7~'
a.m. will be made the same working day, inspections requested after 7:00 a.m. will.pil'~lla~ WlffqJiOwi09
working day. \1>~ 00 ,,,,'If- .,,'?J":J ~0""
o~ ,'S' ~0 ~- ~ ~0
R . d I . ~~ .'"'~. -{ 0 _",0 ",0 .,,~
equlre nspectlons .U' 0v 0"'- ~ 0' - '0" _ '/>'-
~. ~~ -<.,~ O-V "" ,0' .~'v
I Mechanical ",,011>00 "(\..0\' \:)~ 0~,0.'S'0 ~o~ .
-Prior to cover. ^~'" ~0"'ci" '\:)\:)'\7Y~G 0,0'~''\ ~'\
-When all mechanical work is comPI~~!I\~o~ $:l\)' 0""" 0\'~ o~..:s ':!;,'1:7,;
\0 ~,v'lJ' '?J':J'/; <$-1>\0~~ ~0(;f, ~\:);5
~o O~<<- .J,oo,) ~0 ~00 ,,'?3
.~ R). ~~ ~~ \""
, R)~ -s:,,<:o \,0 1..0\
I:l v'lJ' ~0 CP'"
~o,)~
Height (feet):
Proposed Units:
Install heat pump and air handler
Contractor
Phone
Comfort Flow Heating Co
1951 Don Street, Springfield, OR 97477
Rough Mechanical
Final Mechanical
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Total:
.
I;
Fee
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
Less than 100,000 BTU
10,000 Cubic Feet or Less
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
OAA~ ~f.rJlQf}
Signatur
Job# 02-00887-01
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Paid On Receipt# Value/Quantity
Mechanical I
07/24/2002 10031
07/24/2002 10031
07/24/2002 10031 1
07/24/2002 10031 1
07/24/2002 10031
07/24/2002 10031
Page 2 of 2
Fee Amount
$25.00
$3.60
$12.00
$8.00
$10.00
$3.15
$61.75
$61.75
{/1... C1 /0""2--
Date
A. New Residential-Single or
Multi-Family per dwelling unil.
LEGAL DESCRrPTlON Service Included:
1-1 a . 3s S" 4"'). 0 $"".g 0. 0 ubmitted h.olhe following
The,follOwin9 pro~e~~~~:qUire specitic land use
JOB DESCRrPTION zon,ng, and doe 1000 sq.ft. or less
A(")" (l u.t cu',naPprov.1. ('./~ __ E...;, "~",,ional 500
LU'llll~- -""2..A. ~'V' Ft '
-1/'11' v ~Q _Mp~1I0n
Permils arc non-transferabi't)8lllil ~'C ' /1;1,0 thereof _
if work is not started within A~il.8iIt~d Sign.ture --f.:d J !Oneil Manufd Home or
of issuance or if work is suspended for Modular Dwelling
I SO days. Service or Feeder
.
225 FIFTH STREET
SPRINGFIELD. OREGON 97477
iNSPECTiON REQUEST: 726-3769
OFFICE: 726-375.9 . '. . ,
,;,,; I
] LOCATION OF INSTALLiUION
~G,p, MA(~ St-
Burrell Bros. Electric
40159 Booth Kelly Road
Springfield, Oregon 97478 r
CIlY PhonclLf}:nZy
Supervisor Licensc'Number -.;/ 1 1- J.s
. /0 - I o..U.
Expiration Date . -- J6GfuL
\}Mi)'\\\\t~~ mk\~\"E}W~~~1'
~t;it~~'Jl\~""
A\Il~iW\\IlJ)t-~f SUjlervising Electrician
~~N:~N'~~~:"
Ad dress !>"IZ-
City 5f){./ (\
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. .' 1
'JJlXi Dl Crl:l'L De..
Phone
OWNER INSTALLATION
The installation is bei~g made on
property 1 o\vn which is not intended
for sale, lease or rent.'
. '
OH'IlCl"S Signature:
LA~ C~O'
UIL( (.6'htvw .
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ELECTRlCAL PERMJT APPLICATION
. ' ",' TP:~S#1.o/.-obio088
'City Joh Numl;er.6.'- ()() 91 }t;TE<:J'oiL 30 2002
.. AMT RECD:2 $ 80.50
3. COMPLETE FEE SCHEDULE BELOW CHANGE:
CASHIER:OOl
or-
l1ems Cost
Sum
$106.00
$ 19.00
$ 50.00
B. Services or Feeders
Installation, Alterations or
Relocation:
'.
200 amps or less $ 63.00
201 amps to 400 amps $ 75.00
401 amps to 600 amps $125.00
601 amps to 1000 amps $163.00
Over 1000'amps/yolls . $375.00
Reconnect Only . . ..' $ 50.00
-;-{i ~-~N110:\I':':"I'a:;Jr~.a\l\ f~'''1imE;~ 1.....--. h
C 11i~-- .. '.,~ ',c.,""~."rl"">hd,,nrt3gon Ullhly'
, t:W1)or.ar-y..~c.FvlceS',or~lfee eI"'S" , .'
.T"" II"" ~AIl'" ~"''''''t!R'JI''l'''~ "'" set fof'
l-Jy.n~ta aUon,' - eratlOn'or e ocatlOn' ' " '
inOAHD5:M01,Q010thmlloIiOA.R95i:-OQ,. '..
.0090. ,?QOJam!li'orllWItCOpies o[tM rules b$5000 _
. call~9ii!mp~(Jol\lPQ~'h\psa:jhetel~pnone $69.00 _
-rium~HdPllrlt9 €P.0.J~psUtiliW Nollflcatlor$IOO.OO _
OvU&,qPd~WPs.'lJ(l1000Slblts"'see ).
"811 aboye " .
.'- '.
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D. Branch Circuits
New Alteration or Extension Per Panel
One Circ~it'
G>()
r $4300 43
Each Additional Circuit or with serv~e . 0"
or Feeder Permit $ 3.00 "(:).
E. Miscellaneous (Service/feeder not included)
-Each installation
Pllrnp'or )rrigati'on .- "
Sign/Outline Lighting
Limited Energy/Res ,
. Limited Energy/Comm'
$50.00
$50.00
$25.00
$45.00
1\'linimum Electric Permit Inspection Fee is S45,00 + Surchargcs
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
7(). ro
.5'. (,,0
4.'10
Ko.50
TOTAL
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225 FIFTH STREET,
SPRINGFIELD, OREGON 97477 .
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
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~
ELaCAL PERMIT APPLICATION
City Joh Numher 02-00 "687-01
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3. COMPLETE FEE SCHEDULE BELOW
1. LOCApON OF INSTALI.,ATION
&; ~;;;7 rlJa/~
A. New Residential-Single or
Multi-Family per dwelling unit.
Sen'ice Included:
LEGAL DESCRIPTION
170'2. 34lf'i OObOO
. d has lhe !ollOwing
JOB DESCRIPTION ~~ !IOW, ~roiecl as sUbme,lI:pecitlC IllllQ()l~~.ft. or less
II' ~/,' 0 :dolll> .g reQUI< . .
/11, I N ~ _ ___(;I- Each addItIOnal 500
r appTO\la\ ~12... C"l ft vi ptJrtion
Permits arc non-transferable and exjilro1ing - I -6"2- therenf -
if work is not started within 180 d~ ~ .::::- "';.,j -Each Man!!fd Home or
of issuance or if work is susp~i\ll'ed for I"ra '7\~_ ",uaUlar Dwelling
o Slgnau - .
180 days. t....;lIlOrlZe ServIce or Feeder
Items Cost
SUm
$106.00
$ 19.00
$ 50.00
2. CONTRACTOR INST ALLA TION ONLY B. Services or Feeders
Installation, Alterations or
Electrical' Contractor kc s EJ ,,,,,Jt; r '1 (<MIUU I :r... c. Relocation:
Address G. (:) n "v 7l/~ 3J
/
200 amps or less
201 amps to 400 amps
40 I amps to 600 amps
60 I amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
City !llio~
'-uU-
Phone ?Jtf!. ~ [,2 7t
.
Supervisor License Number 3 (It? 7 ("
Expiratiou Dale / o,1r /0 t./
'. Constr Contr. Number 7 (j,s:-,p 'i Installation, Alteration,ortRclo-cation
. ',0 O' 1- \301' 7..'.J,u~'....- " t.:l "
If -T':\rrO,' ,-,;- · ~'Ji-";):'" ,I,
EXplfalion Date /;;L 7 Of () t./ !\\ '-' I. ',00.,:200' !rrl.ip~or']ess~ _. ~8't .vlth
I ." '>!\UII"C.. .....1l1l">cc;:j.....:'I
- 'C,l~ . ~-"i"1.('.~9r anips 10,~Q.Q,am~~_;)i)1-
Signature of Supervising Electrician Notillca\l~l\ O;'I_Ul2y~t40]I'to;600~~~Sn\l~l: :,\}
~ . i,l OAR 9;>2- I oOvci.,6.o0raiilptor'iooo,volts see
. I J '/ 0090. YoU ma~ '1J'~;bove\e:th3'te\3.p;!'''':-"
.h-/ '^' ./VlJ calling '1M cen,,,,l. "., Utility Not\\lcatlO
I ,'heOreoon 344)
# numbElO,.OBranch\Ci"rcuits)2-2'
--r r:" C~.'t"'r 15 -t t.'''' '''' .
Owners Name J P II { : n:Jt ,_I. v New AlteratIOn or Extension Per Panel
Address It, fJ 7 m CUfiv One CIrcuit _ J'r\~'f;!.OO _
(' r I~t. W \~O'\
City S1L-' to Phone 7.2(" - ~7 <j" G O\\t~r.Addit~'l!lf;.\.~~'tll?llf ~~~1v~
~ o~~Wl\-"\P~lAAt.? 1\\\S O~t.\).f@$ 3.00 _
1\\\S ?.\It.U \}~\J \1:, I\~t>.~\l
E. l'jI."Ud~lIli.~"~~~<'<'1I\l\'der not included)
CO~\B\'~I~U1h\\.I\J'
r>.\'-.~lm~Q,~f;;gation _ $50.00
SIgn/Outline Lighting $50.00
Limited Energy/Res $25.00
Limited Energy/Comm $45.00
C. Temporary Services or Feeders
$50.00
$69.00
$]00.00
OWNER INSTALLATION
The installation is being made on
properly I own which is not intended
for sale, lease or rent.
Owners Signature:
'<)0. )EIHSl;I:;
'.'1;';8
" ,,~, -.. ""3\1 l' '-'
J~ 'J~ ~ L ~~ ~ ~~
;OOZ W Jf'tJ: 3H!O
0[10TOO' 10 ~8N~Ml
I\linimum Electric Permit Inspection Fcc is S45.00 + Surcharges
TOTAL
t{b
3ZL
3b~
S- 2 J!-
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fcc