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Home My WebLink AboutPermit Electrical 2005-12-16 . . . t '.. . ~PR~~~~~.~,-~ . fI\ VI ~~~c:,.~;~ , i.l 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ,;.~0~-J!',?1" ~ - , ELECTRICAL PERMIT APPLICATION <; <;V'O ,,0~" ".. . - b -7 O,0.-;aU,V I ......:: City Job Number CO W' 'Zt='~\ - 0 I ~ Dale ~,O\0 J:>'L.- -I (:)/0 C ,.;,<:-<b ;-00' ././,/ 3. fCOMPLE'J:El:'f:E~S€f.[EDrlvnJEJ-dw -/ c' , ,,-- 0' ~,"J/ ./ 'j)J'\ ,o.J. 1.-0 /' "Ii; ,(0 A. n'iew Residelltial:'" Sillgl~l\'!~lfi':Familyper,dWellilliiullit..) O?>''''' l-':'v Service Included ,J' \~....' I. I LOCATJONOFINS1'ALLilTJON II 2-D I~A V-v j't:i-'" ';:or I \2. LEGAL DESCRIPTION /703 "2.7'3 I ~ 0 G.oo 111/-1 -- re-~-~lL 1000 sq, 1\, or less Each additional 500 sq. 1\, or portion thereof $106,00 JOB DESCRlPTlON $19,00 Permits are nOIl-lransferable and expire if work is Each Manufact'd Home or nol slarted wilhin 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder 2. [CONTRACTOR INSTALiXiI()NozYii~ ,\~~~~}jri;rvicCs o'~.~Jeders:!,'i~Jiailation, AlleraliilIlsO~ Reloc~lioll:" ?o.v' 0 V \0''- Electrical Contractor Cu Y1I\. r Lv ~f'5lf~,~' '~(je\" 2,60' Amps or less Q,v' ",. " ,,,-,':ie. 'C'~ ~ 0... 1\' "Ie <)'0'\ 1\>\<' \SL.; ,}fO 1 Amps to 400 Amps Address Y.U. IJCli<\crtg:Qfj{'(\o",e",o.\' v~ \\,e I ,~QI'A!"ps to 600 Amps A\:..'..... SV' e" '\'XW...... S"" ,:\'00 \ 'J"\ ~\ '",.l\>W Ce'0" r-,\'0' a9\e '(\e \e '601.Amps to 1000 Amps City fUCLl'1 ~ '1,J,(-\:o...'Ph'dn~@'YL,?(.4~:1 \:~\\'1 ~~~~ver 1000 AmpsIVolts I ~o"'\\V~ ",<:,'1- ~-a.'\ V' 'l.e\' ~ ~'0 '0,\ ']; ?-?r Reconnect Only , 01" -{o\> r:,e'0 01eg C),':>'" Supervisor License Nu~\?,'0;BQ3\''3S~,(J C. I'Temporar.yServicesor ~'ceders \ D I~~\\)\'S:J'I' (O,e~' I II' AI . R I ' Expiration Date '"' I nsta ahoD, teratlon or e ocatlOD ( $50,00 5'"0 $ 63.00 $ 75.00 $125,00 $163,00 $375,00 $ 50.00 I Signature of Supervising Electrician 200 Amps or less' 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above, D. I Branch CircuilS $ 50,00 $ 69,00 $100,00 Constr. Contr, Number \ lo t\. <lii Expiration Date D lo I ()Cj , L.. DD l ." I New Alteration or Exlension Per Panel . One CirCUIt . ,~~ Each Additional Circuilp~( (\ _ . . .1\11 I;. I. _ ~I" Service or Feeder Ps:rf{lh't. \<';) ~<;) $ 3,00 Owners Name I-AI r":...ew I'.D. t: r"- ,c. ~ ~)....' !? Address II ZO r".rIlICtN ,$L. E.I Misc~~~~Qf.fv~~'tder 1I0t inclllded)-Each Installatioll I :?<'?-" '\"~ f:JV\'\ S.~l::~ Phone 91.3 -/O~~~. ~~~~~g~llPh~ $ 50,00 \\$\ ~y"'f. ~~~),?~j1ting $ 50,00 OWNER INST ALLA TION '\~ ,,\\<;)~~(l.;t~6YfReSidential $ 25,00 The installalion is being made on property I own which~\') ~~~~t'qj~ Energy/Commercial $ 45.00 is not mtended for sale, lease or rent. I:l ~Wn1h,um Eleclric Permil Inspeclion Fee is $45.000\+ Surcharges Owners Signature: 4.I'SiJBTln:ALOFABOVE! 5D ,. !-"'O 7% State Surcharge ~ 10% Administrative Fee S"o, S-8~ ./{;7 ~ , - ~ $ 43,00 CIty Inspeclion Requesl: 726-3769 TOTAL Shared Drive(T:)lBuilding FormslElectrica! Pennit Application 1-03.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01657 ISSUED: 11129/2005 APPLIED: 11/29/2005 EXPIRES: 06/16/2006 VALUE: $ 15,000.00 Status: Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line . SITE ADDRESS: 1120 FAIRVIEW DR SPACE 12 ASSESSOR'S PARCEL NO.: 1703273100600 Springfield TYPE OF Manufactured Home in Park TYPE OF USE: New Residential PROJECT DESCRIPTION: MANUFACTURED HOME IN PARK ~ Owner: l. Address: Contractor Type Electrical ManufHome Inst F AIRVlEW MOBILE HOME PARK '-. .. i"~\I: Orep,on law requires you Rhone Number: 1120 FAlRVlEW DR NO 16 "\,' wi'" adopted by tile Oregon Utility SPRINGFIELD OR 97477 , . l1C~ Center. Tilose rules are set forth III Of\,-{ ~OL-UU'I-UU1U 1nrOUYll vt'\n ::;J.,U:'-VU I- I €ONTRAc:rOR(INFORMA:rIONc ,e rules by calling tile center. (Note: me lelephone Contractor number for the OregonILiCel:lseotifiCExiliration Date CAMP CREEK ELECTRIC LI!:Jlmter is 1-800,1'6487.7344), 06/09/2007 , JANIC KRENZ 157768 11/20/2007 913-1024 ", ; ~ Phone 541-746-1471 541-689-9225 I BUILDING INFORMA nON. ., #ofUnits: Primary Occupancy Group: Secondary OCCUpWlCy Primary Construction Type Secondary Construction , # of Bedrooms: # of Stories: Height of Type of Heal: Water Type: Range Type: Energy Patb: Sprinkled Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Fl Garage/Carport Sq Ft Other: Occupant Load: nla " p I DEVEWPMENT INFORMATION' REQUIRED PARKING Overlay Vist: f. we\il~ # Str~~E: S\1t>.LL f.Y-PIRf. If :~1 I~~capped: Paved ~.~t\R.9il;.A11 Of.R 1\'\\S pf.R,V1 ou'R'mpact: % ofL ~~l/i~O UN S t>.Bt>.NOONf.O f "f.NCf.O OR I ["("\Nl':' , .....: { r~olnrL IPUBLIC IMPoo.VE~N'TSI Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutsiDrains . Notes: ,\ I of 3 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone , 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction Manufactured Home Manuf Home Fee Description + 10% Administrative Fee + 7% State Surcharge Manuf Home State Issuance Manufactured Home Conn - Plmb Manufactured Home Placement ':;' + 10% Administrative Fee ", + 7% Stale Surcharge Manufactured Home Feeder Total Amount . . CITY OF SPKll'luJ' IELD Building/Combination Permit PERMIT NO: COM2005-01657 ISSUED: 11/29/2005 APPLIED: 11/29/2005 EXPIRES: 06/16/2006 VALUE: $ 15,000.00 I Valuation Descrintion I $PerSq Ft or multiptier $1.00 Square Footage or Bid Amount 15,000.00 Total Value of Project Value $15,000.00 $15,000.00 Date Calculated 11/29/2005 FI'e~ Paid I Amount Paid Date Paid Receipt Number $20.50 $14.35 $30.00 $45.00 $160.00 $5.00 $3.50 $50.00 11/29/05 11/29/05 11/29/05 11/29/05 11/29/05 3/2/06 3/2/06 3/2/06 1200500000000001759 1200500000000001759 1200500000000001759 1200500000000001759 1200500000000001759 2200600000000000259 2200600000000000259 2200600000000000259 $328.35 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 complele. Final Manuf Home Set Up: After all required inspections are requested and approved and porches, skirting, decks, venting, street address numbers, lrees, driveway, etc. have been installed. Manuf Home Plumbing: After home has been connecled 10 water and sewer. MH Electric: When blocking, selup and plumbing inspections have been approved and the home is connected to the panel. " 2 of 3 ~ , I . . CITY OF SPRINGFIELD Building/Combination Permit- PERMIT NO: COM2005-01657 ISSUED: 11/29/2005 APPLIED: 11/29/2005 EXPIRES: 06/16/2006 VALUE: $ 15,000.00 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line : By signature, I state and agree, that 1 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 wiD 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 wiD remain on the site "' at all times during construction. Owner or Contractors Signature Date . .. .. ,. . 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ,Ij" "'. J(lh/Journal Number COM2005-0 1657 COM2005-0 1657 COM2005.01657 " Payments: ; Type of Paymeul ,- CreditCard , ;:- . 0\ :r \it '(' " ,)1; 3/2/2006 . RECEIPT #: Description + 7% Stale Surcharge + 10% Administrative Fee Manufactured Home Feeder Paid By LONNIE JENKINS ~~ lilt ..-tty of Springfield Official Receipt .velopment Services Department Public Works Department .' , 2200600000000000259 Date: 03/02/2006 Item Total: Check Number Authorization Received By Balch Number Number How Received djb 097505 In Person Payment Total: Page I of 1 1:15:49PM Amount Due 3,50 5,00 50.00 $58.50 Amount Paid $58.50 $58.50 ~