HomeMy WebLinkAboutPermit Electrical 2006-10-3
SPRINGFIELD
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689
BLECTRICALPERMIT APPLICATION, I
City Job Number COv0 200 b - 0 11- b L(
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Date '
LEGAL DESCRIPTION:
\702- '5300
61 '36D
Service Included
JlUIt-s~vcl' f0~~eA-
Permits are non-transf(rabie and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is ' Modular Dwelling Service or ' Z. $50. DO. / 0 (:)
Suspended for 180 days. \" i IU'I,\;;;~fficlej:v . '
'"'n law t:l..., I r-
t~:{cbNTID!Cro~Yf~~~'~I~~}~~y,~~(i2tlJ)\l~e oreCJ.~~;:\J;\~~i~'i:~~;~~;;t.~~dJ~rt',iiti~~)i}t.~'~:~}!~,'t~i-~~\ti~i~~1~'~~~~(tM~\?,~~~~
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') \11 \;;11"'1' __- b^ '"" copies 01 ~ll
o D You ma'1 ? Qt. . the tsl~~h6ms to 40.0. Amps $ 75.0.0.
Wi. , l!~eQrSgOII I
'i ~ <0 (. { rDJmber I~ 'I, :v..s1)h:~~." 4L~Dl Amps to,IDDD Amps $163.0.0.
City~ \ V\ _}- Phom,Cen,er:J '(I' ( rOver 100.0. Amps/Volts $375.0.0.
.' Re,connect Only $ 50..0.0.
10.0.0. sq. ft. or less
Each additional SOD sq. ft. or
portion thereof
$10.6.0.0.
JOB DESCRIPTION:
$ 19.0.0.
Supervisor License Number U .., ''I , 5, c. ~.r~~~~t~t~i~:f:t~I~~]t6~~~~~~dr~~~~~~~~~~
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Expiration Date lO 10,1 - ,,' Installation, Alteration or Relocation
l lC I U In' 20.0. Amps odess $ 50..0.0.
Constr. Contr. Number v P?'m1IYs~A' I EXPIRE tfon~W~D Amps' , $ 69.0.0.
, . I 0 ltvrr~RIZED UNDER THIS PE4~M~is N,OiOD Amps " ',_ $10.0..0.0.
Expiration Date \ IY.__ _ -(jOR 13 '\BANDO~f.JHu0amps or 100.0. VoItssee "B" above.
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. " . . . PERIOD D "~B") ~1i"C'~'" ,.ts':~~:~ ,>I"~l.-t-~";};~~~I.~."','t:,"r.~,):..-.".';:~> ::..;:ll.'~;~ ~,'f,:r~...rl,)"t...""\/;.'.l ;"~::,\\/:~'i::-::~~:~'
. xgnature of Supervlsm Elect1)l.q-lpf111) 0 A Y . ". . ()""E ~"~~"";;,";U.:~~~L,,";~;:~~})f;\~j)d;;S;~.I7~:~;J~;:t~t(i;::;)~J:;ijii-J!k:t~tF:::~.\t~),Jb~tj~';:~:ii.:.:;sr;:.~
- , \ '
\ f\ . \. , II' A ^ A ^ I New Alteration or Extension Per Panel
I J V~k _ j \J VV \A,\. V " . · , One Circuit $ 43.0.0.
I '" . . . I P:sL~. ~:~i~d::~~:~~~~:~~'With. '$ 300 .
I Owners Name ~I*rti _ 5 - '.'_"~,,.'..,.,.'",._..,.,,' ,..._,,",'.,'~'.'.',.' ,., ,..,.'"....,---..,: .. .., ,,"",' '...r'--..
i Address I (2( ( C-c:o(ct" ~'^-~ (" ( E. Sr~~i?~~'1i~:~~~~,~~:(~AH~i~~{f.~~~~Th~i'i,liEm~:~i{~;#'~~K!;i'~i~II~11.?W~~~
\\ ci.,60ld (~V~, Phone i L? Q P:::~:;::;;~:._>'_..."'.._._"$'~~~~...e.~..,,_.
1'- ,\
~ Sign/Outline Lighting $ 50..0.0.
\ OWNER INST ALLA nON Limited Energy/Residential $ 25.0.0.
)fhe installation is being made on property I own which Limited Energy/Commercial $ 45.0.0.
JS not intended for sale, lease or rent., " Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
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4 'l'SUBTOTAL OFABOVE'~~'..'''..,'''''...''''''''"'','';.\
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~ ~ Del 2-01 z...cru'i
726-3769
8% State Surcharge
10.% Administrative Fee
5% Technology Fee
( 0 C;:>
8
10
s-
Owners Signature:
TOTAL
12;
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Shared Drive(T:)/Building Fonns/Elecu;cal Pel111il Application 8-06,doc ,
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.ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2006-01264
ISSUED: 10/03/2006
APPLIED: 10/03/2006
EXPIRES: 04/03/2007
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54 I -726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 Daisy St 77
ASSESSOR'S PARCEL NO.: 1702330001300
Springfield TYPE OF WORK: Manufactured Home in Park
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Manufactured home in park
Owner: SANTIAGO ESTATES ASSOC LLC
Address: 11211 GOLD COUNTRY BLVD STE 10
GOLD RIVER CA 95670
Contractor Type
Electrical
Manuf Home Inst
Plumbing
'~n5~OU \V
I CONTRACTO~ IN~O~l':M'fff)~i" \)~,\\\'J t
_'~ . \ \V\'1',VllOi'd d '0'/ \he ~e set \oft
Contractor ' f\\\ t=,N \at a009\e ,,\,\'\oel;ic:enCS{f\ 9ft~i>it\tion Date
BURRELL BROS EI\~P'~~SE~L~~f. 0 \\'\fb\<i~"&> ~ \he iU\ero&}20/2009
EMERALD LIFE S~~Gf@rm:~~@)O~ rfb~5-0' 0 e hof(fS/l8/2007
EM ERA LD LI FEST~M1>'M~~I~CO\)\~\~~~R.~o."e ~~~,:\ca'b'SY.) 8/2007
~t\~ ~-~, - C".C1."'\II.. .. .., '\\\J'"
\BuILDJ O,"'~P~RMA\Ifi[@' '2"Z~)'
. . '~~l 'Ot \ '\ ..80U"
r#}Cf\'StoJ$,~~n\'~ 6 Lot Size:
Height of Structure Sq Ft 1st Floor:
, Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a O{~~t)aMtd:
_t_".U ~"~:. ~'....L" ~7nV; \t: ~1\1 \~ N~\
DEVELOPNI'ENT rrt1N -: \\\5 ?E~w\
O~\IED Bt-.~DO~E~ fOBEQUlRED PARKING
Overl~~tl? ~~CED O~ \5 ~ Total:
# Stree~R~t~'{ ?E~\OD. Handicapped:
Paved ~ R<: Compact:
Phone
541-747-2724
541-463-2022
541-463-2022
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VN
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
Pae:e 1 of 3
.
.ITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: cOM2006-01264
ISSUED: 10/03/2006
APPLIED: 10/03/2006
EXPIRES: 04/03/2007
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description'
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
~
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Manuf Home State Issuance
Manufactured Home Conn - Plmb
Manufactured Home Feeder
Manufactured Home Placement
Manufactured Home Service
Amount Paid Date Paid Receipt Number
$30.50 10/3/06 1200600000000001482
$15.25 10/3/06 1200600000000001482
$24.40 10/3/06 1200600000000001482
$30.00 10/3/06 1200600000000001482
$45.00 10/3/06 1200600000000001482
$50.00 10/3/06 1200600000000001482
$160.00 10/3/06 1200600000000001482
$50.00 10/3/06 1200600000000001482
Total Amount Paid
$405.15
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work
day.
Manuf Home Set Up: When installation of all piers or stands is complete.
Final Manuf Home Set Up: After all required inspections are requested and approved and porches, skirting,
decks, venting, street address numbers, trees, driveway, etc. have been installed.
Manuf Home Plumbing: After home has been connected to water and sewer.
MH Service: Approval required prior to utility company energizing service.
MH Pedestal: Approval required prior to utility company energizing service.
Pae:e 2 of 3
,~q,
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
~ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2006-01264
ISSUED: 10/03/2006
APPLIED: 10/03/2006
EXPIRES: 04/03/2007
VALUE:
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
, information hereon 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 pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
.~t/{V~
Owner or Contractors Signature
Pa2e 3 of 3
10(3(06
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2006-0 1264
COM2006-0 1264
COM2006-0 1264
COM2006-0 1264
COM2006-0 1264
COM2006-0 1264
COM2006-0 1264
COM2006-0 1264
Payments:
Type of Payment
Cred itCard
cReccint I
c~f Springfield Official Receipt
~opment Services Department
Public Works Department
RECEIPT #:
1200600000000001482
Date: 10/03/2006
2:20:26PM
Description
Manufactured Home Placement
Manuf Home State Issuance
Manufactured Home Conn - Plmb
Manufactured Home Feeder
Manufactured Home Service
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Amount Due
160.00
30.00
45.00
50.00
50,00
15.25
24.40
30,50
$405.15
Paid By
GERALD WALTERS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 003699 In Person
Payment Total:
$405.15
$405.15
Amount Paid
)
Page I of I
10/3/2006
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Space #77
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