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Home My WebLink AboutPermit Electrical 2004-12-30 ",,,"",,"',., . ""NO"',",O""". ...("~);""m ,,^,,.(~, ~~ ELECTRICAL PERMIT APPliCATION. o~,;"" "'0 . 'lJIIJI' '7/ . / 0.. ~ O'Q/'~o. . City Job Number ('OW''"ZooY- OlhOO Dale I..... 30/0 ,,( <f, ~& ~ o&"''''&~/' , I '''1''\ "o~. "'0 c$'1S'. . 3.ItOO.......;~........~I...J~~~ _^'M.f~2!:.,. 'G' '''~~~.:!~ ~? . 'tY~@0'1 lS'/'. 6'....Q)". . ~.._~ ~j.,. " ',....:. ~ "'" ~ ~~.:M" " ," A. j ..QeD .81.S~ ., .'" -." e -~ i ~ ' 11o.~~~~s~':.'bNll!~"';.~yf1 1Il""""'",!~~~~~""_.'~-'-"'~li>iJlillJ 2. ~..."~.....",ll!",,,Bi~ B. !~~~f~!,,fM~~~nstl!lIa!,~~~~}lj.iilMi.~~I1mfiJ Electrical Contractor ~ ~ 'f/ e( }r/(2 ,,1jy. 200 Amps or less . S you to S 63.00 L!(:: I '........ J.-l\~ rO~Jlre Pi fJ 2f32/ A--.. ..... ". 20Bl\mps'to 400 m~sn Utility $75.00 'l"\ 12> V .1 ,r\ h" thp regU Address () ()^ ._,.", '; ..401 Amps.td600Amns.. set'lorth $125.00 .-. '.. ThOse ruleS ~'" C'N9~il / "I' ~,e601rAmp's to l~q~6NW952-001. $163.00 City ~ Y\.QJlQ._ Phone b<gb..:>~ 2,20obO.Rl~il&~ri:D<f\lnl\fle rules by $375.00 ~'-'-'] 'R,..ht~'11 CQOJI'~'S Ut 0090. 'Y",u ma econnec, on Y the telephone $ 50.00 calling the center. (Note....,...on . .. Supervisor License Number 4/l.\ 'f S "limber ICC!~~W"~ .:i~~ Center IS - 1 DID t \ (J -, Installation, Alteration or Relocation \Sl,..~/8- Expiration Date 9:; ! \ Y IDS 1. ~!'~OM.:6ft~~:~ ~ -..-"~~. ~ -l"'.'-:-"- ..,.~ . , '2-42..1 vnA-IA- /.... LEGAL DESCRIPTION /703, ZSIl..( JOB DESCRIPTION j IJI/J-. c;f,.vc.... ~ Fe-e{JGi .. f Permits are non-transferable and expire If work is not started within 180 days of issuance or If work is Suspended for 180 days. o Z'g()O Expiration Date Constr. Contr. Number Signature of Supervising Electrician ~ ~ Owners Name H-e;'Y\' ..., Address?e> (5<:>~ City l':u.6-t5tG Phone 'jJ'r.A^ lc::..o...,J 9t 9/ '5 1::$7- D91tt:, OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact' d Home or Modular Dwelling Service or Feeder z... $50.00 100 200 Amps or Jess 20 I Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "8" above. D. iil!1:'l\ii'l!!tY!iciii~~~~ New Alteration or Exlension Per Panel One Circuit S 43.00 Each Additional Circuit or with I Service or Feeder Permit - .. J S ~.OO "n~y..f'. .. ..J r~p,\Ei:. ~r \t1~' U;:~, E . ....'*II-~.~(:<r.t"".."'r.~~i1'.." .-e-t." ,.,,,,,,,,- 'E '[ aneoust ",eo/' .~~ """IitoO"'ll . uae .- a ^ \ \1\-101:\\LtU_ UQ''; ~\S. ^ BP-.NOONt PiririP. orrmganon" " $ 50.00 r.m'",~1 ,,~-~ 0 / Sigi)(Oul ineJ-ightinif\\O . yo.OO u\\li\*J~~erg~lR~sidential /$ 25.00 Limited Energy/Commercial / $ 45.00 / Minimum Electric Permlllnspectlon Feeis 545.00 + Surcharges / \Wl........._~..,.r~~~oiH: t,<;t . .,.r~'" S 50.00 $ 69.00 $100.00 ~ 4. tJ /60 I 10 + .ll . 30 7% State Surcharge 10% Administrative Fee 0'" TOTAL 11/ -+ 3~ ~r::".i:"",;~';""'"~;;:'tri~~ -) Issued 225 Fifth Slreet, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF ~r.Kll~GFIELD Building/Combination Permit PERMIT NO:. COM2004-01600 ISSUED: 02104/2005 APPLIED: 12/30/2004 EXPIRES: 08/04/2005 VALUE: $ 59,078.00 . SITE ADDRESS: 2421 MAlA LP ASSESSOR'S PARCEL NO.: 1703251408800 Springfield TYPE OF WORK: Mannf Home w Garage/Carporl Privale Lol New ResidenliaI TYPE OF USE: PROJECT DESCRIPTION: Maia park lot 65 - Manufaclured home with carport I CONTRACTOR INFORMATION I, uires yoU to ml'. Oregon ",.. . ~q raQon Utility Contractor . ATlE.Nl\ ado~"'iCim's'e'e 0 ~~~i!:!!!lotitDate HARRISON JACOBSON INGO\\OW ru\e~enteI!044i7JSe ru\e~~R<<!?Jl!712.00s ROBS ELECTRIC INC Not\t\CatlO~_001_0~~661180Ug\1 i theW~.zOll5 HARRISON JACOBSON IN(i;, OAR 95 a o'!i~Op\es 0 e\9?;lqz(2jl05 HARRISON JACOBSON IN<O090. You.~ ~p.n~4~."ote: .~~e ~'nW.'liZ(;Wl5 BUILDIN(;,iNEbRM~'FI~~~~33i:2344). cent.., 1.:', 11 # of Stories: Lot Size: Heighl of Structure Sq Fllst Floor: Type of Heat: Sq FI 2nd Floor: Water Type: Sq FI Basement: . Range Type: Sq FI Garage/Carport Energy Path: Sq FI Other: Sprinkled Building: n/a Occupanl Load: . Owner: HENRY BRUNKOW Address: PO BOX 91913 EUGENE OR 97404 Contractor Type General EIeclricaI Manuf Home Insl Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Conslruction Type Secondary Conslruclion Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Selback: Solar Setbacks: Slreet Improvemenls: Slorm Sewer Available: Speciallnstruclion: Noles: R-3 U Vlhr 15.00 5.00 10.00 62.00 0.00 Phone Number: 541-689-0946 Phone 541-689-7762 541-686-5444 541-689-7762 541-689-7762 , DEVELOPMbj'l mrORMATION 1 REQUIRED PARKING OverlaYIDist: Tolal: . 2 I\lU, 'lL: # Slreet Trees Rqd: . 1 Handicapped: I H" "'" !:i '11 I "HALL EXPIRE - TO Paved'Drive Rqd:" l:Ves-iE WOF€ompact: A" 'W""'17C, \ I 'NDER T " % of Lot-Coverage: HIS P22l9.fn IS NOT COMMENCED OR IS ABANDONED FOR ^ "1\1 .oj "n ...... ...,. ........~.__ --... ........ . . .....u. I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspoulsillrains: Fully Improved Yes CurbsIde 5' Curb and Gutter Paee 1 00 Status Issued 225 Fifth Slreel, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Description Tvpe of Conslruction Carport Foundation OnIv ManufHome . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01600 ISSUED: 02/04/2005 APPLIED: 12/3012004 EXPIRES: 08/04/2005 VALUE: $ 59,078.00 I Valuation Descrintion I $ Per Sq FI or mullipIier $16.60 $1.00 $1.00 Carport Use Bid Amount Manufactured Home Fee Description Plan Review ResidenliaI + 10% Administrative Fee + 70/0 State Surcharge Addressing Assignment Building Permil Manuf Home Slate Issuance Manufactured Home Conn - Plmb Manufaclured Home Feeder Manufactured Home Placemenl Manufactured Home Service Plan RevIew Major - Planning Sanitary Sewer - hi 50 Feet Sanilary Sewer - Improvement Sanilary Sewer - Reimbursement SDC MWMC Adminislralion SDC MWMC Improvement SDC MWMC Re;mbursemenl SDC SanitarylSlorm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursemenl Slorm Drainage ImperVious Area Slorm Sewer - hi 50 Feel Waler Line - hi 50 Feet WlIlamaIane Manuf Home Private + 10% Administrative Fee + 7% Stale Surcharge Add, Aller, Extend Circ Ea Add Tolal Amount Paid Square Footage or Bid Amount 336.00 3,500.00 50,000.00 Value Dale CaIcuIaled $5,577.60 $3,500.00 $50,000.00 $59,077.60 12/30/2004 1213012004 12/30/2004 TolaI Value of Projecl Fpp<. PiWLI Amounl Paid $69.81 $84.97 $59.48 $31.00 $409.65 $30.00 $45.00 $50.00 $160.00 $50.00 $103.00 $45.00 $365.60 $480.80 $10.00 $865.31 $82.03 $94.69 $67.26 $772.49 $175.13 $487.64 $45.00 $45.00 $1,000.00 $0.30 $0.21 $3.00 $5,632.37 Date Paid Receipt Number 2200400000000001559 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158' 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000158 1200500000000000197 1200500000000000197 1200500000000000197 12/30/04 214105 2/4/05 214105 214105 214/05 214105 2/4/05 214/05 2/4105 214/05 2/4105 214105 214105 214/05 2/4/05 2/4105 2/4/05 214/05 2/4105 214/05 2/4105 2/4/05 214/05 2/4/05 2/15/05 2/15/05 2/15/05 Pal!e 2 of3 . . CITY OF ~t'Klr\jtJNt<.,L1J Building/Combination Permit PERMIT NO: COM2004-01600 ISSUED: 02/04/2005 APPLIED: 12/30/2004 EXPIRES: 08/04/2005 VALUE: $ 59,078.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax. 541-726-37691nspection Line Initial Review Plannin!! Review Public Works Review 01/06/2005 01106/2005 01106/2005 I Plan Reviews I 01106/2005 OK 0111712005 APP 0110712005 APP RJB TAJ CAS storm drainage piped to curb face 1/7/2005 CAS Structural Review 01106/2005 02/0212005 OK RJB 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. I Re()uir~eetion\l Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Manuf Home Set Up: When installation of all piers or stands is complete. . Final ManufHome 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 Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. MH Service: Approval required prior to utility company energizing service. Erosion/Grading Inspection: After all erosion measures are in place. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the bnilding is complete. 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. 1 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 Pa!!e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-0 1600 COM2004-0 1600 COM2004-0 1600 Payments: Type of Payment CreditCard 2/15/2005 . REC;EIPT #: _~""1lLD Iji....._._o..._ ............ '. I " ;J .-...... .. , . '_ _:. / _t ~ty of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000000197 Date: 02/15/2005 Description Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By DAVID LAWLER Item Total: Check Number Authorization Received By Batch Number Number 'How Received djb 032313 In Person Payment Total: Page 1 of 1 1:26:57PM Amount Due 3.00 0.21 0.30 $3.51 . Amount Paid $3..51 $3.51