HomeMy WebLinkAboutPermit Electrical 2004-5-20
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ,; FMill~f)726-368
ELECTRICAL PERMIT APPLICATION .' Zoning
City Job Number (pj.Io\'Z...OOlt-OOL/'3>J Date Sho';;;'1 Dal. ,
, 1__ .' auth~iz.d Sipnalu,.. .
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LEGAL DESCRIPTION
1703 Z-7fO
o Lf 1.{C50
JOB DESCRIPTION
CI (L0...... ~ r
~. ~rf''^~t
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
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A. l1]'(ew,;Kesideiiti:il~l~j!!, 'g1' e:o'r,Multi"FamilYi,p' erJdw.elling"':unit., ,j
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Service Included
. I 000 sq. ft. or less
Each additional 500 sq. ft. or
, portion thereof
Each Manufacl'd Home or
Modular Dwelling Service or
Feeder
$106.00
$19.00
$50.00
ltt.C="~'--"m"'-"-'~'r:::~"""~"-'1t1 'E~;.'IL"""".~""'~"''''-''''''''''''~''''''_\\\~t\i'ol.~. ",.
2. CONT~~~~A:f.J0!!Of'jjR!2ir!Jij ~. ~,$,r,~~~il!,r"c:J:riStall",!!i?t!?~J,l,fti'!!!J.!t,~r,Relo~tion:
Electrical Contractor M . LJ/b",).";;--J;ve 200 Amps or less $ 63.00
" 201 Amps to 400 Amps $75.00
Address, i'5?57' 5&-~ v/b.u..J'lJ/,/e..... 401 Amps to 600 Amps $125.00
60 I Amps 10 1000 Amps $163,00
Over 1000 AmpsIVolts $375.00
Reconnect Only S 50.00
Installation, Alteration or Reloc,ation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D.Ir~~i1~€ir~i~~~~~~::~~~~
--_..~..-..........
" /./' /. .#.d. ./. A fiewAlteratio~or.Ext".nsionPerPanel I' '. ")
'JlC/./~ ./'7. ~.....__~ One Circuit $ 43.00. '1 .
Each Additional Circuit or with
Service or Feeder Pennit $ 3.00
~.~__~~iifr~ru1tio'n
~o'j Ica Ion te~ter. Those rules are set for1h . ... .
In ebInP~~."lJl)10 through OAn 8S2'.M1:0,00
OCSi~ltIl3yiOOQa81 copies of the rule;if 30.00
OWNER INST ALLA nON . "lll\i!lla m~aid/lllti4h: the telepllSRO '25.00
The installa\!~I\~ !jei!'g made on property I own which "t!fJJ.~ fg[e~~~Lllillty Nolifit'.AtJl'\rtS 45.00'
is not intende\l..Fd~Mr~AAffe~~l EXPIRE IF 1HE WOM:~imum EI~~~~~~lkNqR~~i~i~ Surcharges
1HIS P NDER 1HIS PERMI1IS N01 'Y'-''''-'"'''';J;I;'''~ . 'if~
Owners SignAtyi'it.lORIZED U ANDONED FOR 4. 'sUBmT~;qPiAB.oVE "J!I~~ /',.' I..f).
, COMMENCED OR IS AB , .... , "s-
\W 11\0 flAY PERIOD. 7% State Surcharge '51
. 10% Administrative Fee I.{ yo
(\ ~\h ~,.r-M TOT." d, ' r'J b5"'"
Inspection Request: 726-3769 \JJto...!. \ \)--' ~ 1 :::>....
_ to, 'llt\\1
\,,}J"'( Sh=d Drivc(T:YBuilding FormslElcctrical Pcomit Application 1~3.doc
City .."JJ?;'~1L2 q
Phone '2-2.. a' . 0"-35'
.f'1'i9-. -/35'~
-7' Z"5h :=;; ,
Supervisor License Number
. Expiration Date I F-.J ~ ,;:zOO L(
Constr. Contr. Number 54 C)O 9'
Expiration Date ;tz:r ,.. .....P~L)
Signature of Supervising Electrician'
Address
'20 ~O
'S ?f=i)
fL."" c, L. .J-
L,A--,A1Z.fl s+
Owners Name ,He-It::-N
City
Phone
c. ~f(~P:~ViSl~1t!&F:.~~~~
$ 50.00
.$ 69.00
$100.00
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00433
ISSUED: 04/16/2004
APPLIED: 04/16/2004
EXPIRES: 11/20/2004
VALUE: $ 25,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2150 LAURA ST SPACE 113
ASSESSOR'S PARCEL NO.: 1703271004400
Springfield TYPE OF WORK: Manufactured Home in
Park
TYPE OF USE: New Residential
PROJECT DESCRIPTION: MH in park
Owner: HELEN KNIGHT
Address: 2080 LAURA ST SPRINGFIELD OR 97477
Phone Number: 541-726-4943
I CONTRACTOR INFORMATION I
Contractor Type
General
,Electrical
Manuf Home Inst
Plumbing
Contractor License
HARDACKER & OLEARY DEVELOPMENT 79496
KIDD ELECTRIC INC 154009
HARDACKER & OLEARY DEVELOPMENT 79496
HARDACKER & OLEARY 79496
BUILDING INFORMATION I
Expiration Date
02/19/2005
01/27/2005
02/19/2005
02/19/2005
Phone
541-895-4307
541-942-1352
541-895-4307
541-895-4307
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
R-3
nla
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATIOis"i uregon law requIres you to
. . . . dopted by the ~i9I1YARKING
Notification Center. Those ruresare'iei forth
Overlay Dist: in OAR 952-001-0010 througf'iI'etAR 952-001.
# Street ~rees R(jlJ;)O. You may obtain copies'Otwl~~by
~aved Drive Rqd: calling the center. (Note: tt1&omlUlffibne
Yo of Lot Coverall'iumber for the Oregon Utility Notification
Center is 1-800-332-23441,
I PUBLIC IMPROVEMENTS I
. q
Sidewalk Type:
Street Improvements:
Storm Sewer Available:
Special Instruction:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Downspouts/Drains:
Notes:
Page I 00
.
. CITY OF SrKJ1~uFIELD
Building/Combination Permit
PERMIT NO: COM2004-00433
ISSUED: 04/16/2004
APPLIED: 04/16/2004
EXPIRES: 1112012004
VALUE: $ 25,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
~
Fee Description Amount Paid Date Paid Receipt Number
+ 10% Administrative Fee $25.50 4/16/04 2200400000000000371
+ 7% State Surcharge $17.85 4/16/04 2200400000000000371
Manuf Home State Issuance $30.00 4/16/04 2200400000000000371
Manufactured Home Connection $45.00 4/16/04 2200400000000000371
Manufactured Home Placement $160.00 4/16/04 2200400000000000371
Manufactured Home Service $50.00 4/16/04 2200400000000000371
+ 10% Administrative Fee $4.50 5/20/04 1200400000000000767
+ 7% State Surcharge $3.15 5/20/04 1200400000000000767
Add, Alter, Extend Circ $43.00 5/20/04 1200400000000000767
Minimum/Adjustment Electrical $2.00 5/20/04 1200400000000000767
Total Amount Paid $381.00
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.
3 Manuf Home Set Up: When installation of all piers or stands is complete.
I 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.
2 Manuf Home Plumbing: After home has been connected to water and sewer.
4 MH Service: Approval required prior to utility company energizing service.
5 Rough Electric: Prior to Cover
6 Final Electric: When all electrical work is complete.
Paee 2 00
.
. L11:r' 01' ~r1Ul~lJl'l~LD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2004-00433
ISSUED: 04/16/2004
APPLIED: 04/16/2004
EXPIRES: 11/20/2004
VALUE: $ 25,000.00
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 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 Commuuity 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.
Owner or Contractors Signature
Date
Pal1e 3 of3
225 Fifth' Street
Sprin'gfield, Oregon 97477
541-726-3759 Phone
.
Job/Journal Number
',:\ COM2004-00433
COM2004-00433
COM2004-00433
COM2004-00433
Payments:
Type of Payment
CreditCard
'\
It
\-
t
5120/2004
RECEIPT #:
8.P,~_RI~!3,'~'~,~_ '-_.,..__... ..
IIiL '
, ,
- '1)- "
. .
- ,
~--- ,
Jij}y of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200400000000000767
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Add, Alter, Extend Circ
Minimum! Adjustment Electrical
Paid By
APRIL KIDD
Received By
djb
Page I of I
Date: OS/20/2004
Item Total:
Check Number Authorization
Batch Number Number How Received
000389
020810 In Person
Payment Total:
9:47:05AM
Amount Due
3.15
4.50
43.00
2.00
$52.65
Amount Paid
$52.65
$52.65