HomeMy WebLinkAboutPermit Mechanical 2000-10-25
05
2e8~~€$TaUE2000
sPRh\M.fF,HEDD<:J~ !$>4'T. 30
(54 II 7261::HAWGE:
FAX (5-) IE:ASIUER:'059
RLRr'l'RICAL PERMIT APPLICATION
vHY Job Number 00- 0 (536- 01
3. COMPLETE FEE SCHEDULE BELOII *
A. New Residential-Single or
',h i -F~ily p" d..Hi'. "". .. .
Service Included:
DEVELOPMENT SERVICES DEIlil/}TMFNT . .
... 111 follt5Wlhg project as submitted has the followl
zoning, and does not require specific land use
approval. 11 11
Zoning LA.......--
225 FIFTH STREET Date /0 - )$-tn)
SPRINGFIELD, OREGON 97477 .. W
INSPECTION REQUEST: 726_~6'gzed Signature
OFFICE: 726-3759
1.~pCATION ~ IN~TALLA'A'I,oN
4;016 u..;rtLD..' _ J.,-t;.
l~Gg ~~crtJ7ION 0(;8 ()Q
JOB DE~cru;XTION
. 1-1111-/(1,
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
if> - ~ 6 - 00
1.<0<;
t,/h
DATE:
RECEIPT II:
RECEIVED BY:
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Hanuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
volts
2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders
'T' -, r)' Installation, Alterations
Electrical Contractor,>J")I-ll-~CIlJf.)Jlt.or Relocation:
Addressl-/ NoS II ), / /,'-1'1 '4=\::;, ~ 200 amps or less
r- . . 201 amps to 400 amps
Ci tyt::.-UjellP . PhonE(c<ii.:~' "") 7-"'N) 401 amps to 600 amps
, /7 Q 601 amps to 1000 amps
Supervis License Number.. J '67/} L ) Over 1000 amps/volts
. . Reconnect Only
Expiration Date j{) / I /01
. , c.
Constr Contr. NUmber.iLlJd.9{]C} __
EXPirat:~Date ,,4,-/L!:..()t.!
'i'""';:J:~~~"i'i"
I J ~ D Branch Circui ts
Owners rYa.me '1Y) 1AA.a/nJ ffriUJ .
J New, Alteration or
Address LlO/6 'ff)(}j n ) -r
City 1f/2~(fJrhone 741- OaIP3
OIINER INS ALLATION
$ 40.00
$ 55.00
$ 80.00
see "B" above
Extension Per Panel
/ $ 35.0oS5()1)
One Circuit
Each Additional
Circuit or with Servic~(
or Feeder Permit ~
$
~(f)
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lightin~ $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 4.~. ()[)
7%. State Surcharge :~. () I
3% Administrative Fee /.01'1
TOTAL 4"7- ~O
2.00
;- -;,.".
.
I Job# 00-01536-01 I
.
Page 1 of 2
TRANS#:01-0003467
DATE:OCT 13 2000
AMT RECD:2 $ 32.00
CHANGE:
CASHIER:059
CITY OF SPRINGFIELD, OREGON
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01536-01
225 North Fifth Street
Springfield, OR 97477
location Of Proposed Site: 4015 Main St Spr
Assessors Map#: 17023141
lot: Block: Addition:
Tax lot #:
Subdivision:
Office: 726-3759
Inspection Line: 726-3769
*
06800
Owner:
Miriam Jones
Phone Number: 541- 74-1026
City/State/Zip: Springfield, OR 97478
Alteration Value: $0
Address:
4015 Main Street
Scope Of Work: Mechanical
Contractor Type
Mechanical Contr
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
rArea (Sq. Feet)
I Main: Accessory:
~
_ -::<-.0..).
..., .~o..o....~
-z<%.:'b~~
land Use: ~ ~ ~ ~.!!Of Buildings:
Zoning Code: ~ 'b ~ q~cupancy Group:
Bedrooms: ~, ~ <;;'Heat Source:
.- Q ~ '<::.
Range: ) ~ '3'> Sq. F.ootage:
I ....~ F '\'A /'" '''''V -r;.,.
'. . '6 - '%.....'0
To request an inspection call the 24 hour rec.oidi.~9' al72~~~769. All inspectio~7r~7stei b~~re 7:00
a.m. Will be made the same working day" In~pectlot.s ~equest7d after 7:00 a.m. Will beC~aq~th~ollowmg
workmg day. .,'~. '? (l~' ~ %! ~
'1-~Y,-6 ~""-k:
~, "'l. '/,., ,:,"> , .) V ......^ n
r . R~~~lr~~rL,:!sPl!.ctions Q'--U . '-1'-
I ;., 'c<.Mectianical .'... I '3'> l:?-
-Prior to cover. '. "Q'~....~~r~...u<l(."< .
- When all mechanical vfork:ls complet~. (1.'.
: ."yo~ O~%~~ ~, \.~ l;
~. 6< . 0 Q.. %, i?~ V.
. , <<. -...., " '^ ,. / ,
", ~ t' ~..>:'nu\ '2- .
'..~".~"" '" "& ~~, .J
':J'~ <Sl: '?- ~ .,I! ',_
.~ o~. ~ -::<: 12 c
J~' 0 (9O'?)4 .'
# Of Stories:' "'?:;, '?<!) C . Height (feet):
Current Units: q, - Proposed Units:
Census Code: Does not apply
Contractor
Marshalls Heating
4110 Olympic Street. Springfield, OR
97478
Registration #
Expiration Date
Phone
541-747-7445
Office Use
Quad Area:
# Of Units:
Constr. Type:
, Water Heater:
Rough Mechanical
Final Mechanical
Total:
",..
.-
.
Job# 00-01536-01
.
Page 2 of 2
Fee
Paid On Receipt#
Mechanical
10/13/2000 3467
10/13/2000 3467
10/13/2000 3467
10/13/2000 3467
10/13/2000 3467
10/13/2000 3467
Value/Quantity
I
Fee Amount
Minimum Mechanical Permit
Mechanical Administrative Fee
Less than 100,000 BTU
10,000 Cubic Feet or Less
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
2
2
$.00
$.60
$12.00
$8. 00
$10.00
$1.40
$32.00
$32.00
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 a per time and that the project address is readable from the street.
/hu. ~ A/.YJ /1)--( :5-c()
~~ ~ ~