HomeMy WebLinkAboutPermit Mechanical 2000-12-28 (2)
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Job# 00-01834-01
Page 1 of 2
TRANS~:01-0004132
DATE:DEC 28 2000
AMT RECD:2 $ 67.20
CHANGE:
CASHIER: 061
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225 North Fifth Street
Springfield, OR 97477
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RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01834-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4531 Franklin Blvd Spr
Assessors Map#: 17033444
Lot: Block: Addition:
Owner:
Address:
Tax Lot #: 01711
Subdivision:
Shirley Thomas
4531 Franklin Blvd sp# 100
Phone Number: 541- -
City/State/Zip: Eugene, OR 97403
New Value: $0
Scope Of Work: Mechanical
Contractor Type
General Contr
This is a copy with a new Application Number
Contractor
Leesman Construction
835 N 8th Street, Harrisburg, OR 97446
Registration #
72082
Expiration Date
4/1/2001
Phone
541-995-6157
Office Use
Quad Area: Land Use: # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr, Type: Bedrooms: Heat Source:
Water Heater: Range: NOr!CE: Sq, Footage:' -
. . . THIS PERMIT SHALL EXPIRF: IFTHEWORK
To request an inspection call the 24 hour recording at 726-376~. ,b,IIJn!lR.~r~qn~r~~qJe~,l,td,~bE1~~r~i7;<9,9,nJ
a.m. will be made the same working day, inspections requestedlafter-7:00ca:ml.~will:lielmaaertlielfollowing
working day. CO;viiViENCED OR IS ABANDONED FOR
R . dl ^'t'.V0400'nAVOi::Olnn
equlre nspec Ions
Electrical
Rough Electrical
Final Electrical
Rough Gas
Rough Mechanical
Gas Service
Final Gas
Final Mechanical
- Prior to cover.
- When all electrical work is complete.
Mechanical I
AI IL-l '.. v' ,':~""7"''''' !?'....:'':'IJ'::);~.Ol! to
-Prior to cover. follow (["2., "lr1~"i.":' ',":hr Or-con Utility
-After line is installed and line ha~beeh~c6rinecteaitoiininifnUIli~ofcrri'e'~pm;Wte. Pressure tel
- When all gas work is complete. in UAR 852-00'j-OlJ'i IIlhrmlAIi OAr! a52-lJU'I-
- When all mechanical work is complete, You may nl]t8in :~'l)1i~c oPh'J rulss by
cl:llliil~ :ht: .;"nc..J'. \'~';lJ: 103 wlaphooe
nu,lIb.JrYJr 111.'. JI-;JO(l ~ti;it~' ,\Iotification
Ca;"'l'::"':~'. 'l-~..' L~'::~~~~44).
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Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
Fee
Branch Circuits WIO Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Minimum Mechanical Permit
Administrative Fee - Mechanical
Gas Fireplace
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
I Job# 00-01834-01 I
# Of Stories:
Current Units:
Census Code: Does not apply
Total:
Paid On Receipt#
Electrical
12/28/2000 4132
12/28/2000 4132
12/28/2000 4132
. Mechanical
12/28/2000 4132
12/28/2000 4132
12/28/2000 4132
12/28/2000 4132
12/28/2000 4132
.
Height (feet):
Proposed Units:
Page 2 of2
Value/Quantity
Fee Amount
2
$37.00
$2.59
$1.11
$40,70
1
$10.50
$.45
$4.50
$10.00
$1.05
$26.50
$67.20
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 t~ and that the project address is readable from the street.
/,.;d J;..,,, .
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Signature
12 - 2. Si' -<0 D
Date
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DEVELOPMENT SERK'R5i~.jiUi'flIr~~~lq"i'e specihc
-t e d does'{{l
. zon,ng, an I \)f2.. -
appfOVa.\. --
20ning- ~_.?-~.of) -:::
225 FIFTH STREET \ I -- q(~ __-
SPRINGFIELD, OREGOOe97477s,ig,nalUre ~
INSPECTION REQUEST:J,,-.u7~-3/69
OFFICE: 726-3759
1.
WCATION OF INST~TION,_
4'~ I t-r~lcJ,,,,-
77rUrl
LEGAL DESCRIPTION
/70 33,LfL{l(
=17!f
JOB DESCRIPTION
Il,vo C,D.r,A-.--co....
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 Dw~
Address ij5?:,/ ;:::;~...l;;//"
Ci ty fEua~ 974'c:;.~one
/
Supervisor License Number
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number VO - 133'1 - 0 I
3. COIIPLETE FEE SCHEDULE BEWV
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
1000 sq. ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
S/IId7 5~200 amps or less
~ /t>o 201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Expiration Date
Constr Contr. Number 7Z0g2-
Expiration Date
Signature of Supervising Electrician
City
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
M)sra~u;e: l ~
-~--~-----------~------
DATE: \2 --e.g ero
,,,,,,,"'.1< l' I: 1<-{13.~
RECEIVED BY: (\{!
$ 50.00
$ 60.00 .
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
D. Branch Circuits
Owners Name . .sh.);/~ L.... Yh8...-?&i<;
~'J New, Alteration or Extension Per Panel
Address <-(r-'JI r-~lCj,'" giveR -;d/t>O
One Circuit
5> f.f 0 Phone 5'"03 - '3 Zs - ~ 7 3~Each Addi t ional
Circuit or with Service
or Feeder Permit
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
$ 35.00
'JS
r
,
$
2
2.00
not included)
$ 40.00'
$ 40.0~~
$ 20.00"'""
$ 36.0f'g~
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