HomeMy WebLinkAboutPermit Building 1999-08-05OTT OF SPruNGFIEI-O,
Location of Proposed Work: 1850 17TH ST.
Assessors Map #z 1-7032524
Lot: 4 Block:
a
NOTICE:
THIS PERM lT SHALhBffiBfrtEIHHlrOH( Ap p r, r cAr r oN
AT.ITHOHZED UNDEB TI.f,SPEMilTRBT{CFF IEIJD
con EircED oR ts ffimqffi$HBlffi :ff :,?,"' -o*
AiIYIfl}DAYPERIOD.
225 North Fifth street
Springfield, OR 97477
Page 1
Job Number: 990978
Office:
Inspection Line:
726 -3t 59
726 -3769
Tax Lot #:
Subdivision:
03002
RONALD PARK
Owner: BOYD ,TENSEN
AddrESS: 39537 MOHAWK LP
Describe Work: MANUFACTURED HOME
General
Electrical:
Phone #: 933-1555
ciry/state/ zip: MARCOLA OR, 97 454
t/!caut .w lcqLlttcu,NEW
Phone
B 689-7762
8 344-4928
QUAD AREA: 2RNW
OCCY GROUP: R3
SQ FOOTAGE: 2356
-- oFFrcE usE --
LAND USE: 1150
CONSTR. TYPE: VN
# OF BLDGS: 1
INSUL PATH: P1
To request an inspection, call the 24 hour recording at 725-3759.
A11 inspections requested before 7:00 a.m. will be made the same worki-ng day,
inspections requested after 7:00 a.m. wil-I be made the following work day.
--- REQUIRED INSPECTIONS ---
FooTING - After trenches are excavated.
FOUNDATION - After forms are erected but prior to concrete placement.
ldAr{uF HoME/MOBTLE HOME SET UP - When all blocking is complete.
ROUGH ELECTRICAL - Prior to cover.
SHEAR WALL NAILING - Before covering sheathing with finish materials.
FRAMING - Prior to cover.
WATER LINE - Prior to filling trench.
SANITARY SEWER IJINE - Prior to fill-ing trench.
STORM SEWER LINE - Prior to filling trench.
I{,AI\TUF. HOIIE/MOBII,E HOIIIE ELECTRICAL - WhCN blOCKiNg, SCTUP, ANd
plumbing inspections have been approved and home is connected to panel-
[I,ANUF. HOME/I{OBILE HOME PLITMBING - Af ter home has been connected to
water and sewer.
PEDESTAL - Prior to cover.
FINAL ELECTRICAL - When aII el-ectrical work is compleLe.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
FINAL SET UP - After all required inspections are approved and porches
skirting, decks, venting, house numbers, etc. have been installed.
Lot Coverage: 28 ZLot Faces: E
Topography: 2
House
Garage
N
1,7
$/Square Feet
BUILDING PERMIT ---
Sguare Feet xftem
ylaan
Val-ue
0.00
siPFINGFIELD
Contract,or
GOODEN HARRI
1441 HWY 99N
SAVE ON ELECTRI
PO BOX 23454
dnn
Lot Sq. Ft.: 8218
Lot Type: PANHANDLE
Setbacks
swE
13 15
49
SPRINGFIELD
Job Number: 990978
CITY OF SPruNGFIEIT',
Page 2
Garage
MANU/ HOME
FTG/FDN
Total Value
Building Permit Fee
Surcharge/admin
TOTAL FEE
514 UU
00
00
00
18.34 ao ,527
44 , OOO
4 ,200
EO 1aa
(A)
10,50
/l,o{
cdw{
7 2/.,r{
PLI'MBING PERMIT ---
ftem
Sanitary Sewer
WaLer
Storm Sewer
Mobile Home
Plumbing Permj.t
surcharge/admin
TOTAL CHARGE
50
50
50
Fee
25.O0
25 .0O
25 .00
15.00
(c)
90.00Jfr
tr.f
7.0 o
77. cto
--- MISCELLANEOUS PERMITS
Mobife Home
State fssuance
Surcharge/admin
CITY SDC
Wf LLAIV!\LA]dE
TOTAL MISCELLANEOUS PERMITS
105
30
10
2 ,157
1, 000
00
00
so 6Za
10
UU
(E)3 ,902 .60
(Excluding Electrical )
unleee otherwiee noted
- - - TOTAL A}TOI'NT DUE - -.
(A, B, C, D, and E combined)7
1tfiK
--- BUII,DING VALUE, PI,AN CHECK A}iID BUILDING PERMIT ---
This permit is granted on the express condition that the said constructj-on
shaII, in a1I respects, conform to the Ordinance adopted by the City of
Sprlngfield, including the Development Code, regulating the construction and
use of buildlngs, and may be suspended or revoked at any time upon violation
of any provisions of said ordinances.
Plan Check Fee: 71.83 Date Paid:
Received By: AL WARD
Plans Reviewed By: AL WARD Date:
Building Site Reviewed By: BOB BARNHART
o7/1,e/ee
oB/05/ee
Receipt Number: 034906
--- ADDITIONAL COMMENTS
DRTVEWAY REQUTRED TO BE PAVED
By eignaEure, I state and agree, that I have carefully examined
the completed application and do hereby certify that aII informatlon hereon
is true and correct, and I furLher certi-fy that any and al-l 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 wil-I be made of any structure without permission of the
Communj-t.y Services Division, Building Safety. I further certify that only
contractors and employees who are in complianee with ORS 701.055 will be
used on this project.
/
CITY OF SPruNGFIEIT',
!sPRII{GF!ELD
Job Number : 99097 B Page 3
I further agree to ensure that all required inspections are requested at the
proper time, that each address is readabl-e from the street, that the permit
card is located at the front of the property, and the approved set of plans
wilf remaj-n on the site at all times during constructi-on.
8-s-71
Signature Date
--- VALIDATION ---
Receipt Number:
DaLe Paid:
Amount Received:
Receiwed By:
03 flz
r
>).
C,ITY OF OBEGO'V
The rollowing proiect as submitted has the tollo{ing
;;il;';;;"i;ei not require specific land use
-SPRTNGFIELO
Reconnect 0n1Y
One Circuit
Each Additional-
SUBTOTAL OF ABOVE
7% State surcharge
32 Admini.strative Fee
TOTAL
ELECTRICAI PERHTT APPLICATION
Ci ty Job Numbe, nq' o17I
FEE SCHEDTILE BELOV
225 FrFTE STREET aPProval
SPRINGFIELD, OREGON 9
INSPECTION REQIIEST*: .orricst 726-3759 n"t"
74'ilning
726-3769
1
hrirnorlzeo Signature
TOCATION OF ALI,ATION7
Ph,". Lfiw|bG
ult,l,1
COMMENCED OR ISABANDONED FOB
ABBfl,dhAtraHo'd88 $
201 amps to 400 amPs _401 amps to 600 amps _
601 amps to 1000 amPs
Over 1"000 amps/vo1ts
A. t@TGEdential-Single or
THH tEF4IMd:fr {p FEritnr #fifth x
AUTHORIZED UNDER TH|S EEEft&T lS NOds
85.00
$ 1s.00
$ 40.00
t Sum
009
sq. ft or portion
Permits are non-transferable and expire thereof
if vork is not started vithin 1B0 days Each Manuf'd Home or
of issuance or if work is suspended for Modular Dvelling
L80 days.Service or Feeder
2.COMRACTOR INSTALI.'ATION ONLY B. Services or Feeders
Electrical contrac tor .fur1et llAfdq Eled
InstalIation, Alterations
/r4lr Relocat ionI
Address 200 amps or less
Supervi sor icense Number ilC e. S
Expiration Date
Expiration Date
f.s tric
0vners Name c
Address t*bo /7fl*
Phone Ae3:/6Sa
Ci ty
Ci ty
OVNER INSTALLATION
The installation is being made on
property f ovn vhich is not intended
for saIe, lease or rent.
0mers Signature:
DATE:
C. Temporary Services or Feeders
lnstal}ation, Alteration or Relocation
s s0.00
s 60.00
$100.00
$130. 00
$300.00s 40.00
200 amps''or less $
201 amps to 400 amps
-
$
over 4bL to 6oo amps
-
$
Over 600 amps or 1000-7ofTs s
40.00
55.00
80.00
aboveee ilBr
D. Branch Circuits
Nev, Alteration or Extension Per Panel
Ci rcui t or vi th Servi c5
or Feeder Permit -)
60
$ 3s.00
$ 2.00 I
E. Miscel-l-aneous (Service/feeder not included)
-Each installation
Pump or irrigation $
sign/outline Lighting- $
t imited Energy/Res $
Limited Energy/Comm
-
$
40. 00
40.00
20.00
36.00
RECETVED
3'7 7
5 6c
:
Itt- ot - nD
consrr contr . umaer )0 ' //3L.
JOURNAL O 'OB NO
ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY:Ba-r'o lnarzaa6 {cru<e n)
LOCATION
DEVELOPMENT
BUILDING SIZE
1. sroRM pRATNAGE #:'^: \?Eb
: 2763
MPERVIOUS SQ. FT 4{4{x $0.232 PER SQ. FT
2. SAMTARY SEWER-CITY
NO. OF PFU'S X$48.27 PER PFU
(See Reverse Side)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER PM PEAK HOTIR TRIP
X I,Ot X5486.73PERTRIP
x _ x s486.73 PER TRIP
4. SANITARY SEWER-MWMC
A. REIMBURSEMENT COST:
NO. OF FEU'S I x 24z,z6 PER FEU
B. IMPROVEMENT COST:
NO. OF FEU'S I y z<,zrtpER FEU
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATTVE FEES:
BASE CHARGE (suBToTAL ABOVE) X .0s
^9LSDC Coordinator
ATTACH'A.WPD
SIZE-SQ. Ft.
s lt os+,41
s 86?, -gG
g 44t , Lct
s z4z,7L
S z<.zt:
<$ -a7,os->
$ 10.00
$ zro.?t
$ z,ez-;,I t
$ t=/,4
S
Date: 7 -21-?7
TOTAL SDC S z_r Z.<- ro
@hg
R Zr'> ,4/ / 7 rrt
FIXTURE UNIT CALCT-- A.TION TABLE:Number of Nerv I res X Unit Equivalent = Fixrure Units(NOTE: For remodels, calculate only the ..T additional fixtures)
FIXTURE TYPE NUMBER OF
NEW FIXTURES
2--
LTNIT
EQUIVALENT
FIXTURE
LINITS
Bathtub.........
Drinking Fountain.......
Floor Drain...
Interceptors For Grease/Oil/Solids/Etc
Interceptors For Sand/Auto Wash/Etc..
Laundry Tub/Clotheswasher/Ivlop S ink..
Clotheswasher - 3 Or More............
Mobile Home Paik Trap (l per Trailer).
Receptor For RefrigeratorA[ater S tation/Etc...........
Receptor For Commercial S ink/DishwashevEtc......
Shorver, Single Stall..
Shorver, Gang.
Sink: Bar, Commercial, Residential Kitchen..........
Urinal, Stall/Wa11.....
Wash Basir/Lavatory, SingIe...........
Toilet, Public Installation.............
Toilet, Private...............
Miscellaneous:
CREDIT CALCULA TION TABLE: Based on assessed value
credits
TOTAL FIXTURE LTI\IITS
If improvements
X $ /{,eu<>e7,or
2
I
2
J
6
2
6
6
I
J
2
I
2
2
I
6
4
+
2-
z_
2
occurred after annexarion date in table, calculate
/Head
---E-
tN.
Credit for Parcel or Land Only If Appl
Improvement (if after annexation date)
icable 4,47
(Rate X Assessed Value)x$
(Rate X Assessed Value)
CREDITTOTAL -$ b7.a{"
Year
Annexed
Rate per $ 1,000
Value
, 1979 or before
1 980
1981
t982
I 983
1984
I 985
I 986
t987
1988
s4.47
4.38
4.32
4.20
4.03
3.88
3.68
3.38
3.03
2.62
Year
Annexed
Rate per $ 1,000
Assessed Value
I 989
1990
1991
1992
l 993
1994
1995
1996
1997
r998
2.18
1.75
1.35
1.17
1.03
0.86
0.71
0.57
0.39
0.18
RUNOFF COEFFICIENTS FOR STORM DR{INAGE
(For Estimating purposes Only)
Residential...
Industrial......
Governmental..
0.4
0.9
0.5
0.5
FIXUNTT.WPD IMPERVIOUS AREA: TOTAL LOT SIZE X RUNOFF COEFFICIENT
I
II
z_
A qseccerl
Commerical.
CITY OF OREGO'V
SPRI. IELO
D EVELOPM ENT S ERWC ES DE PARTM E NT
MANUFACTURED HOME LAND USE AGREEMENT
As required by the City of Springfield Development Code, I agree that
permits, one of the following homes will be placed atq
Zfr,225 FIFTH STREET
SPRINGFIELD, OR 97477
(541 ) 726-3753
FAX(s41) 726-3689
Springfield, Oregon, City Job Number
,/'
Y Type I Manufactured Home.
2tu1 4,ut,.-
i tu};
aeer oy frow attache d
g_s-v4
A multi-sectional (double wide or wider) unit with an enclosed
floor area of not less than 1,000 square feet, that has a nominal roof pitch of 3 feet in height for each 12
feet in width, that has no bare metal siding or roofing, and that has been certified by the manufacturer to
have an exterior thermal envelope meeting performance standards which reduce heat loss to levels
equivalent to the performance standards required of single family dwellings constructed under the State
Specialty Codes.
Type II Manufactured Home. A unit of not less than 12 feet in width with an enclosed floor area
of not less than 500 square feet, that has a nominal roof pitch of 2 feet in height for each 12 feet in width
and that has no bare metal siding or roofing.
The manufactured home shall be placed on an excavated and back-filled foundation not to exceed 6
percent slope within l0 feet of the perimeter enclosure. The perimeter.foundation wall surrounding the
home shall be constructed of stone, brick or other masonry materials, and with no more than 24 inches of
the enclosing material exposed above grade.
I further agree to meet all land use and City Code requirements of the above mentioned parcel within 60
days of the date of issuance of the manufactured home set up permit. These requirements may include, but
are not limited to the items listed below. Specific land use requirements regarding your parcel are noted on
your approved set up plans and/or permit and your partition approval ifapplicable:
o Street Trees
o Paving Driveway
. Minimum 32 square foot storage structure
o Completion of partition approval
o Removal of any existing structures as noted on your partition approval
o Signing and recording of any required partition, easement, improvement agreements, etc.
o Final lot grading
. City Sidewalk and curbcut installation
. Any outside agency approval as required i.e., Division of State Land approval.
By my signature below, I agree to complete the above mentioned land use requirements.
owner Sigrfanire Date
6s-7
Contractor Date
I
Willamalane
Park & Recreation District
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
Job. No. 19"oq.r g
NAME:\\
ADDRESS:
LOCATION OF PROPOSED BUILDING SITE:
Street Address:\B 11$ St
PlatName: \tO
PHONE:- [656
STATE:zlP: Q.7.l,
Tax Lot Number:o 3UbI
appropriate dwelling(s). SDC calculations and dwelling t
Y Manufactured home not in a park
X $1,000 per unit = $\ CIrO CD
1. DEVELOPMENT TYPE (Check
ype detinitions
1e
on the baclc)
A Single-Family Detached
Single Family homd
NO. OF UNITS
B. Singte-Family Attached
NO. OF UNITS X $924 per unit
C. Multi-Family Apartment
NO. OF UNTTS X $692 per unlt
D. Manrrfactured Home Pafk
NO. OF UNiTS X $699 per unlt
WILLAMALANE SDC
2. SDC CREDIT (r appncabte) SDCAayer must fuoi[sh proof of
Willamalane Credit approvat. See SOC Credit Worl<shoet.
3. TOTAL WILLAMALANE NET SDC ASSESSED
(lf SDC reduoed (or Credit)
R\\
DateD&etopment Services Oepartrnent
City of Springfield
$
$
$
$
$
$
ld
Oq
A.rg - G{i - 99 Cl9 : SOA
c )ctTY
P.02
225 FIFTE STREET
SPRINGFIEIJ), oREGoN 97q77
lHllE$l'?tnfrf8ffi ti,., 7 ?,f.;2G8F",,,,,,..
follow rules adbpted by the Oregon Utiiitl,-
Dts}(lNGFrtsLu
One Circuit
Each AddltlonalClrcult or vith Serviceor Feeder Peruri t - 'Z
SuLlT0ll/il. 0Ir ntiOVE
'1 %S; ta I r: 5u r (ilIal-.1; e
3)j r'.dmi rr i.s t r-a t ivc: Fcc:
TOTAI,
EI.^EC-T&TCAL PERHIT APPI,ICATTON
clry Job t{'.uber 1f O?7 v
LEGAI e: the tel
util
JOB DESCRTPTTON
*a.c., cc
Persrits are non-transferable and expl restarted vlthln 180 daysif vork ls suspe nded for
Y
ELtz"
hb;r r
cYf -5ool
/ 2L21
3. COHPLEIE ITEE SCTIEDIJI.E BELOV
A. $&I$Fidential-sing)e or
Tfi l$ PEmctrElq 66y cFEtrmE WOR|(
ArmvclnzHyofr btsffn rs pEnuur rs ruor
COMMENCEDORISABATTTOO.IVL=#FON COSt SUNr
AI0PFoEA?FEmo-Dless -- $ Bs.ooEachadditlonal500-
sq. ft or portionthereof $ 15,00Each Hanuf ,d Eoure, or
-Hodular. Dvelllng __ _;il;ti"; ;;-F;;ffi, _?_ $ 4o.oo g0^
.I}. Services or FeedersInstallatlon, A). terationsor Relocation:
1.
Ci ty
Supe
in OA 1
re set fortir
952-001 -
t,
ephone
Phoue
rvls Li cense Nunrbc r
200 amps or less
201 anrps to 400 amps =.-
401 amps to 600 amps --
601 amps to 1000 amps
Over 1000 arnps/voIts
-Reconnect On1y
$ 50.00
$ 60.00
s100.00
$ 130. 00
$300.00
$ 40.00
*q 35.00
$ 2.00
_ffiv
-c.l--L,g-O
NN.s
s"
\
\
4s.
\
Expiration Date -ol-ar
constr contr. Nurnber /U6Yf )O
Expirarion Dare ll'tO -Aoao
Slgnature of Supervlsing Electrician
0vners Name /t*t'*r,
Address ->71/ 7 /4arl a,,,t F
clr lh,o-a,/+Phone clJ I -/t,f I
OIINf,{, INSTALLATION
C- Temporary Services or Feeders
fnstallatlon, Alteration or Relocation
D. Branch Circui ts
200 arnps"or less $ 40.00
201 amps to 400 anps -- S 55,00
0ver 401 to 600 amns
-
$ 80.00
Over 600 amps or fbOOE-fts scc *Bft aE?E-
I'lew, Alteration or Extension Per Pancl
Thc lnstallation ts bclng made on
proper ty I ovn uh j. ch i s tro t ln tandedfor sale, Iease or rent.
E. Hiscellaneous (Servlcc/feeder not irlcludad)
-Each lnstalLatlon
Pump or irrlgation _Sign,/Outline Light ing_
Limi red Energy/Res
I.i nri ted Iinergy/Comm
61-a'
Osncrs Si glra tltre:
s 40.00
$ 40.00
$ 20.00s 36.00
c
-1
DATE:
RECE
ITP,CEI\.TO D
"n
f,h^(ha d-o-
-L
--
--@tutsss 13:25 s4lEBBsoeE- tl ttrr tD ,ftlE 0g: la FAlll7rdtrt0
"-4F3b7 U
zls ttEtt sraEgtsE[rrePIII,, 0lE0]I 97a7t
Il$AGtIOfl TEQUBS'I; ?25-3169
O['l:lGE;r 7U-r739
l. tsc6rr0tl oP
UCTL !E8C&ISrI0[{
JAMES HARDII.]G
CITY OF SPRINGFIEO
aPan oTrELD
ET.8Sf,RTCAI Pzf,ltrl APTLIqAITUq
Ctty Job 1
3. ConPrrrflp PB8 SC@FA EglOC
A. Nec E,rcldcntial-slngle ot
ltultl-Peally pcr duclllng untt.
. Serrice facluded:Ireos Coct
PAGE 81.
Goo2
JC8 DESCll"rrOll [i100 aq.f t. or leea
Urch rdcrsronal 500
cq. ft or portiou
thcreof,
iach llanuf'd f,ornc. or
-lhdulrr.'Dtrcll1n9
Serviee,or Iecder
Servicas or fcedcrcInotrllatlon, Altcratlons
or-f,clocattoni
3utroTfi, 0F tlolrE7I Stetr $urcbergd3t tdrlnletntlve Feell}irL
Sun
s 85.00
s 15.00
$ 40.00
ternlrs ea€ non-trenrtercble and expireIt rotlt ig not strrtcd vlrhin f80 dlyrof lssuenee or lf vork is suependqd tor
L*O dayc,
2. AdOilA TOR IIT$AI'.ATION OEq,Y
Ehctrlcal Gontractor
(hnrrc
otilER a{s8Alllrlfi{
fhe installrtlon is bclag nade on
proprr?y f ovn uhiih la not tntendedtor trle, lute ot rent.
OuaGts Sitnrturer
DtlE:rlclu
200 mDs'ur l.st
2Ol uia to {00 rrpo Tovrr {01 to 600 enDt
-Oser 5OO .r9r or tOOOEIT-te
Ennch Ctrcults
s .0-00i ss.m *
i go.oo
-tea nli abovr
tanr AlterEtlon or &(tenaion trr Pencl
Erch Additlonal, Clrcult or rith Scnrlce
or Fdeder Pcrolr
-
S 3-00
E. ltlscrllrorouc (6crv1cr/f.cdcr noE hcllrd.d)
-Ereh instdlrtion
Duilp or lrrlgrtlon
Slgl /0u tIr nc- Lt gtr t rng-
Ltaltcd Enerty/Bes
Llmitcd lnergylConn
-
t.
q
cL w &tgtAg* Phow Ji&L)Qt*
EugcrYfuLs Lleensc ltuafcr L?A a S,
or krsto {00 unr
-to 600 eais
-to 100O aipa-
rnpr/volts!
-
0n1v
3 50.00
s 50.00
s100.00
sllo,@
s300.00 F
trri rrtion Dere lD/ Ot / O t
f,ecounect
constrcorir' **@ TcnDorerY Scrvlccs or Frdcrs
rngtoUstlon' Altcrrtlon pr Balocatlon
c.
D,
s .0.00
s 40.00I 10.00
s 36.00
*--.F-
-..........,..._
-
, ofitEcorvry oF sP,RINGFIELD
TEIIYED,
5
Ctty Phone--_<
t
8!lr8
BrDtrrtton prt"_l/lJ*L?. *
fo*.
OF SPR'AIGFIELD, OREGON
oE/lotgg TtrE 08;{4 FAI 5{lTZ6g680 CITY OF SPRINGFIELD
gPiltsrlELO
EIACTRICA.T PERITIT AIPLICATION
CI ty Job Nnubet qq'q1'Z
3. CotrPr.ErE FEE SCEEDUTA DELOI
A. Neu Bcsidcntial-Slng1e or
[u]ti-Famlly pcr dvelllng untt.
Service rneluded:
Cost
I 85.00
thcreof
Each llanuf'd f,onc. or
$ 15.00
llodular. DvelIlng
9ertice or Feeder $ 40.00
$ 50.00
s 50.00
$100.00
tnps
100,0
$130.00
Ovor snPs
0n1y
/voIts $300.00
Reconncc t $ 40.00
@ ooe
-b u1u
2?s ttvtB srSERI
sP&IlIGrrErr, oREGoN 97477
I}ISEECf,IOil REQUEST: 726-3?69
OEFICE;I 726-3759
1.I.S€A:TION OP INSTALI.ATION
t DtaD fl r+1
Perri(s areit votk is s
of istuanee or i
180 days.
Addres
Supervisor License Nurrber Nb LS
ExP irotion Dare tolot I e)
Constr Contr.
Explration Da
translerable and qxpire
tartcd vithln 180 dryrf vork is suspended for
Nunber
f tems
1000 sq.ft. or less
urch addltlonal 5O0
sq. ft or portion
tng-
Llmi ted Energy/Coatnt
Sum
,ffi,q)
2, CGIITRACTOR INStrALI.ATION ONLT ,E, Sarvices or Feedcrs
Installatton, Alterations
El,ectr ical Con trsctor ation;
or less
201 to 400 aatps
city fita?n?.Pnone bS8-*91.c 401 to 600 anps---\J 601 ro 1000 arps
Cta - tuDsq C. Temporary Servtces or Fecdcrs
Installet ton,Alteration sr Relocatiqn
o
cian
0vncrg Naoe
Addrcss
ci Phone
OIINEB INSIAIJ.ATTON
?be installation is belng made on
propesty I ovn vhich is not inrended
lor sale' loase or rent,
Omers Signature:
DATE;
E lllsccllanoous (Scrvice/fecder not lncluded)
200 amps''or lcss S 40.00
0vrr 401 to 600 etnP3 -_ S 80.000;;; 600 aups or r6oo-i6trIts see nBn aW6-
Branch Circul ts ; .-
Neu, Alteratlon or 8x(ension Per Panel
One Circuit
Eaeh AdditionalCircul! or vith Servicg^or Peedcr Pernit _dJ.
-Each lnstallation
PumB gr lrrlgatlon
Sign/Outltne Ltght
Llnlted Energy/Bes
D.
$ 35.00
s 3.00
$
$
$
s
.00
.00
.00
.00
40
40
20
5. SUBTOTAL OF ADOVE7[ Stcte Surcharge
3tr Adntnlstrrtlve Fse
TOtrALRECEIVED
A
or,
t
amPs
anps
aEPs
,urcy or.)Pr.i'ngr.].erq sasn Keglsrer SysLem
- Development Services
.;or transact ions dated 990811 to 99081i
.i.';
,rDetail lIstj-ng
.r Pri-nted oB/3L799
Itl-\
/ !.' i '
;(
acti on
Nunber Date
03s178 OB/LL/9e
:'t.,{'
,l1O:52:32
Building Transaction
990209
15.00
l-.05
,45
15.00
1.05
.45
33.00
)'
6
1i.
l\
0
tl
I
I
I
!
Payee
HUNTER TRRGSTION
Anount Pr
Owner Enrp ID
FOR 879/9L1 RIVER KN NANCY M.
ftem
005 Plunbing
099 State Surcharge
098 38 Admin Fee
005 Plumbing
099 State Surcharge
098 3t Admin Fee
Tota1 ovred:
Account Project Misc
1 0e000 40425 6a2
82100000215004
10000000i25605
10000000 125602
82100000215004
L0ooooo04 266a5Check: 33. O0
l:*
EnE/Public Woi'ks Transaction
Number Date Payee
035179 O8/tt/99 coODEN HARRiSON
. t.;t,.
Item Anount pr
300.00LLz Deposit
004 Eiectrical 84. OO
099 State Surcharge 5. Ba
098 38 Adnin Fee Z.5ZTotal owed: 3gZ.4A
I ; ' : t]l'i ,.,r. at'
Owner E:qp fD
FOR 1B6C 1.77H STREET NANCY M.
Account Project Misc821-00000215500 pavlng prol
i0000000426La2
82100000215004
10000000426605Check: 3 92.40
B r'. r.'.ii
l, 'r';r
Buiiding' Transaction
99i 085
Amount Pr
35.00
2 .15
1. 05. 38.50
O*nef
FOR 418 56TH STREET
Account Project Misc
1000c0c04 26102
82100000215004
i0000c00 126605Check: 38.50
Number Date Payee
035180 O8/L1,/99 KS ELECTRTC
piDz M.
Em,
LI]
Iten
004 Electrical
099 State Surcharge
098 38 Adnin FeeTotai owed:
Voucher ID I n)--
I
Payment Handling Qode w
r.i,ria
:," -
ErIrtl,{;'a=519191
Report lD:SPRA103
Voucher ID : 00014592
Handling Code : RE
Harrison,Gooden
1441 Hwy.99
Eugene, OR 97402
City of Springfie' .
Voucher
Account Fund 91g SubGlass BY
Vendor Number:
Voucher Date :
lnvoice # :
Approver:
Operator:
Gross Amount :
Proi/Grant
0000004090
Apr 06, 2000
4-6-2000
Puent,David
wrLS5940
300.00
Amount
300.00
Description
Paving deposit refund
215500 821
Comments: Paving Ok'd by Tom Marx and Dave Gadomski
)jbT
l{bo nw
2000