HomeMy WebLinkAboutPermit Building 2002-4-18
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Job# 02-00454-01
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RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00454-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 7085 Thurston Rd Spr
Assessors Map#: 17023521
Lot: Block: Addition:
Tax Lot #: 00600
Subdivision:
Owner: Robert Thompson Phone Number: 541-746-8710
Address: 7085 Thurston Road City/State/Zip: Springfield, OR 97478
ATTEfJ,\JTiON:Or.eyon l.&w requires YOLi to
Scope Of ~gfi~w ra~sa~lf8bted by the Oregon Utility Ne~. 'H:>iCeD Value: $0
Notification Center. Those rules are set forth r}_ '~, L EXPIRF I~ TI-IF WODl(
in OARlOO1j.eeO~ ~~lffdirilY2l'agh OAR 952-00,1- T',,\,: ,iT SHAL ' ,- __. ..," . 'H"
UUl::1U. YOUmaYOOlalll(;UfJl~,::;UI L"~IUI~~UY Aln'L{\";j:.:.:~;)UNUt:H !HI,,'~'::I"1" '. .
Contractor T"Jkting memab.tQJ\Note: the telephone_ . Registrat~qlJ.f#!" E.>cpiration 9~h Phone
Mechanical CHRfper ~oM'fQf?Pf&W~Y~Ii~~ification i.A. :0046QAY' ~~RI~di2~/~0~~ ... 541-726-0100
CfgrWrr6bk~?r~~~~pnngMld, OR 97477ANY 180 O. .
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
. Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day.
Required Inspections
Mechanical
Rough Mechanical
Gas Service
Final Mechanical
- Prior to cover.
-After line is installed and line has been connected to a minimum of one appliance. Pressure tes
- When all mechanical work is complete.
!'
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Job# 02-00454-01
Paid On Receipt#
Mechanical
04/18/2002 8653
_04/18/2002 8653
04/18/2002 8653
04/18/2002 8653
04/18/2002 8653
Page 2 of 2
Value/Quantity
Fee AmoiJnt
Minimum Mechanical Permit
8% Administrative Fee - Mechanical
Less than 100,000 BTU
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
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 proper time and that the project address is readable from the street.
rt~~ ~;I--R/) . V'/J~/(}?
signatufi/J Date
1
$33.00
$3.60
$12.00
$10.00
$3.15
$61.75
$61.75
225FIITHSTREET - SPRINGFIELD, OR 97477 - PH:(541)726-3753 -FAX: (541)726-3689
LOCATION OF PROPOSED WORK:
J.--; ,," /5-" .- / ".'.~
ASSESSORS MAP: / Co _.L.. -...) ~",2 (,' L.: (:."" ( , >
(~ ' .
:::~,~~~~<-il~bID~~
CITY: ~\ptt IX STATdO ~
::~,Rll~':::D:,.i~TIrL)l <~~O~
PERMIT WORKSHEET
1D65 -(hU.6tbh l'koNJ
J ,.-} 06 'v:s Y c/
,-"l/l j'-\.J -~:p~.~~
City Job Number l. _ .L...t-c--+j-"... ..-- ~
TAX LOT:
PHONE:
,ilfa.--rJ7 to
ZIP: &11 Lf7 g
OTHER:
VALUE:
NAME
ADDRESS
PHONE
ARCHITECT:
CONfRACTOR'S NAME
GENERAL:
PLUMBING- 'I. . .A " I\...
MECHANICALf~11 J'~{JvJ ~ i~
ELECfRICAL: V -
ADDRESS
CON ST.
CONfRACTOR #
EXPIRES PHONE
l(;tJ J
r '"\,. rt l t.~
' 1..."""1 \ '::;;; -"':.J,/
uho
b/3 12bo (rAJ
ITEM
Main
Garage
Carport
SQ. IT. X $/SQ. IT. = VALUE
ITEM
FEE
Fixtures
Residential Bath(s) No.
Sanitary Sewer IT.
Water IT.
Total Value
Building Permit Fee
Administrative Fee
State Surcharge
Total Fee
Stonn Sewer
IT.
Plumbing Permit
Administrative Fee
State Smcharge
Furnace
Total Plumbing Fees
Exhaust Hood
Vent Fan No.
f;;;:::'~" Urn!
Demolition
_~~i
I
Mechanical Permit
State Issuance
Administrative Fee
State Surcharge
Total Mechanical Permit Fees
/1' r,~'
L-f~' ,-
J () . CfL)
~ ,.-""
L.") < I )
?::>. (.C;
( (j / - -7 ,,----
State Issuance
Administrative Fee
State Smcharge
Total Miscellaneous Permits
Pmws ]2/01
...
1. LOCATION OF INSTALLATION
7 OC;?:) 7'7u d/.57'7vt Lf:{
ELE,-_.<1CAL PERMIT APPLICATION
2251:'11:' Itl STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
cr-OJ
COMPLETE FEE SCHEDULE BELOW
A. New Re~dential-Single or
...o\\o~:MuIti-Family per dwelling unit.
~e ,l> \>'i:> Senice Included:
o7Jboo '3-'i:> \'3-'-
\~e6. :6\\\V
\)'Q~ e 'i:>~
JOB DESC~ION . v\'3-'i:>~eo..~\\ )J~
G j"Cl _, U/VJILa /".L.- i\';; O\~j~ (\0\ \r ,()
~o'l' 0 ()
...o~- 'i>?
Permits are non-transferabl~\tfu~~x~irer-~
if work is not started within l-'8~~davs 1,0(\\
of issuance or if work is suspetfded 'for
180 days.
LEGA;I: DESCRIPTION
1702.-'3521
Items Cost
SUI:n
\)\0
?J.Y.
c,:/:t
-..",,8 , eP
\,> (\L:
sq. ft. less
ach . Itional 500
or portion
thereof
Each Manufd Home or
Modular Dwelling
Service or Feeder
$106.00
$ 19.00
$ 50.00
...~\
~ ~,-~~, -:{ " .:-,
lr'"'~"'- ,-_:. .>.,ii..\+,
E h Additi a.\:'flrrcuit or with Service
, . ,,' \~o"t "tn\it . > .
r" J ..
- 0 . .\
E:\Misce)ll).l!eous ~eni~e/fee(f~r not included)
.. .:Each insl~Ilation1'.
Pump 'or)n~t>~Bhf?>.J'
. ~~gnj@~fl)ne Lighting
:',:Bniited EnergyIRes
Limited Energy/Comm
$50.00
$50.00
$25.00
$45.00
Minimum Electric Permit Inspection Fee~ + Surchai'ges
,""-
l{)
JI>
36"
S/~
4. SUBTOTAL OF ABOVE
7% State Surcharge
8% Administrative Fee
TOTAL