The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2003-9-2 \. ~h ";::225 FIEI'H'.STREET Itll~ ~ ~:~h r;J :;';;~::' r~'~ EEE.C:.\L1PERMrF'APPfIGATIONi . rZ.~>i!. 0'-" "'-~.,....... ..-... . ",m '''~'J ,'! - ~J ,l ;W. ,...". ,--L'~,:,.."^'''"~)lj>'<9',,,,,,,,.!rn;.._ " rQ:l /'fSJ;RINGFlEUD, OREqON'9747'7 . "j !.,-~ '51 ~1#::"Ii'A i;'-At'-~i>?",;:a$'$!:;":liiflt1'.;<,,"~ ';!i'Li:1li'*' ' ~~~ ~),I~~yg~:r1Q*':~~lfE~-E?r126J3\62.~"! ;:j '~~'r.~' ~;l ?~CiiY''.Job N.iimIi'er:(;i.~~!;1~~l.,!i(])~:1'J\~:.r_1,1"";' ~:...,~"~ '-"OEFlG~p'~7.26;37tfl\~~'~ ra L~~ ~j ;;'", l' :1 E.:l bi:~{,;;,;~:~:1J)~~~~~!=~~:.:"',<. ".ll. :,,~ ~. '1 '/ kr'it-l ~~ ~ 1ih";1 ~~I",J:i.lt r.~ .:! ';' ," g,'ItS::O~lqETE FE~\~.p~l'?~~;B~!iOW.!\,l~'lt:: " 'r:.,,'fJ/j l,;ll. LO'CA'f<ION~~INSTALI.J/\TION ?1-.,I;,<;\";;:R~"' '. l/-k"'l..:! t;'\ ~ c "":'!>~,t.:- .~~~; '-;:"r,<" .~; '.:? It:! --"J> 1$}<2J ' I;,J IM}/;T',>i.1/ ;;;rr~SJt"'. . kl'''',;<o.. Ji;;k:."t.:J>~'~'.~';~';h, '".,;I!:r - L L "" I,..., t\:. e'\\~sruentIal'Smgle'or ""- ,'{'o0 \0", \I~0Multi-Family per dwelling unit. '{'o"~\'/}" S . Ildl . . 9" 0/')...\\00 e/.'\\\c e ce nc u el: 00 7 e,~~~Q s ~\t..'" . '0C\'O- "(eCl.. n.. t\~o'l (\0\ "Tl\:;' JOB>> ES CRIPTI 0 N d .,.,..i'''~ 600~ \..-c'" 'a-: 00 s . or less mil ~RvC C;N,.u.~ ' ,additional 500 y ",,,I,. '/}\ ~" sq. ft or portion S 1.0 o~ r",f\ Permits are non-transferable\llll'd expiW thereof. $ 19.00 if work is nJi~started within 180 days ,<;,,,..,\110 Each Manufd Home or ~: of issuance Bi'iifwork is suspen~'for 1-06 '0' Modular Dwelling :~~ 180 days. .~I, rr~,'{'oOI' Service or Feeder ".' $ 50.00 I"....~o~,,~ tj}j:H b :S1:J;z ~~,,~ 2. CONTR'AGTOR INSTALLATION ONLY B. Services or Feeders , :$',,:.,;,~, ;\rrJf~,' ..,1r4li' l-di' . . ..,\~' !,,~,I !'i? ,.~ {1;,1, InstallatIOn, AlteratIOns:". . ":'''''';''' f;o,.\,~} ElectriCal'~jcto~f).URiI'''' ,c.;..;;c..AiZ2iC ~c. . Relocation: $~; ,:~ '~~. ,~J~Z1 l~ . "~~ X~., . .. ,~, . .~H~~~ ~~~~~.t:i Address.~7,~i7_'k);eG~ L.P. " ....t~!.j '" 200 amps or le~'i':;~;''''"'''';" :;..": ....,~ Yo' ,~.Q9':'; ~ "iJl)j M f'''''1 tF1';f\ 4~'''>''' :~,.,:.'~ 201 amps to 400'iuni>s::;.:\'':;'''''~3;.r:,.,: ":'~"$'9g106' :,~~ '<Ii . Cit)'5,(;~_{~ t\~~:':;~hone 6t)?!~~!~~Z;:::~,'}:'~~~,~_~~ 401 amps t'1~oR!#1p~,~~1~~~~~~~; .;~ ,~~~j:~~~o<i~\:':~~~ ,~..r.Ji.j fJ:"\\ to:"f ,lis.," ~'/""l'o.-"';.601 ampsto'lOOO-amps"O .."'~ ..";o-qI63'00,,"~Ji" ~if.Jf~ SllP~rviscir~i'b~i(se~ll~~~r g~7(i-~.: ',- ;,.,.',;C\;;':;}} Z~;'~~;~'\9Y~r 1 o091i~-~~ZYoi'~~'~~~~~~:~$4 '~:'::{!:~~$3~{{OQ::;~':\'~ ~~r '~l r;':3,t:" !;,~r{~>~....l':...~, !.'l> .\~,":,l;o .;',.>....i; /....j."..". .'f,i::-ii:/.--'"Re,c6.1meEt,':onF;~',- '.~ ;;' '. J'~ .a~:P',~4,i~;.~1'-~,"-'~$"5b'-6b';',+' ":~,>~ ~'::.o:";~ r.;-,::..~.-.'t's::"~''L-:;'\t'" .\'.....f:,.;.,..:.' -"<<~'. ~~t:.t'~-'.~ _'~' 0-\-.\,./1,''' \ ,,,,{."";.~/:,;,,:...:~~~~4""~\~'~-~ ~'~..!f Expiratiori~:Pat~:~:.:I,~_:/~/~!i,7;;~mtA' _~;~ 0... '~<t.-_r ~. t:, ':~~"\"::\_':';:';'f ,."~~j:~;;~:, "\':i< ";"~ :~.;;: ~..~, >{if?{~~ <'x':i3:t~:'\;:j'.'1L.;S~::A;.4U ~~~t~ t;~("~1~~:~~:~~~f~'-~/1.;~;'. -l~'::' ~~~ y!': '":~~~1'e.~e:~ip?~K~)T ~ero~f~~vt)~~\:r~ 1:~',~;J~1~ ,i~f~~tJ h: .{, "Co-rt;tr to.l}tr"Num~e!, "/;e9<tJ9:,'6"i'.\!t.~. ~' . "'lnsti\ll~\l!i;~!\!"ra'tlOii'\'lf~Q~a!~oft.,:--. " .)"",:;~ ;-:,;:'~ ':~ f., Jfi, . ~4.7;;1'!i}~'::<:" :'-:f t~t~::?E.~ti~~~~~~:"'\'\~;~~il~fo~~~t:\~~~'Ji f";;\;~:, '~;i.'!f~l;~ ',. r;~F:plratlOnDnte /d/;;lOPi3. .".:,.' .~'~~::t.L-~O ~~A~~4~Sf~ ~;~,:~ ,;t:;:f:~;$..~o..o~~1..:.~;~ ~-. ". "\~'" . ,.' Q~::\~O' ''limps to'400'llIl1ps-:~"'" ':C"~''''' 'l.~"'$69!00"', '"" ttl,.l; q,fO;:..,.~'..::-t'.t'l':b-J.... ..~ l~~f ;.i...'i?\"'"<:.'!~..>t !:t.-><.y;.~ ~ '. A,..\t'...;.o""l'\'tsff'~;", ""./'" il~ . (""".l ~. ,>J~ig(1,;,(ure-\&f~uJlervising Electrician COWl \)j>; ~. \9,Ye....l401,~~ ~0~,a!llps_~~:~;k,:.;r*~t~::.6,~~~~0;,?0,,~,';,:;~ ~,,'lJ ".j'", 'lI"'<~ "'. ,"'" 'N~ \\)\) Over600'amps'orI000voltssee~'''',,' ,'. "',.^ "ii' i'~ t-- ~~'.;.,<f"', ~.", -r,..+". .~,:, .~'~-tt7:: t'\ ~ 3.::c..i <<-~ ...' !,':'.-." ..~~' .....~ tr'_h..~'~< . ~ 't,~~,.." .,':f '. ~.>,... ~ UB" "bo,'e .~~~~>.,)~,~,.~ . ~--. ,: "'", ,,~(.".~ ~.::t-~ ":M':"''''~X '.",&-:" -J't:- ~ '-'. -'?".... z:, (I .......l"~.~~}.''''..," ~,.'(IP""'ll~ ~W<.'''''';m-., .", :r'-.,~ ." '_A,f;,,<~ " ~ , -- ,..... Ii'I i~~"'~' ,;v~,.."..,,,) " ". ~.""" ~'.~~'C;_',-1.,",',,:- ./V/~- '. ..~. ,"'. ... ~<.~. : .'~ ~/. >~:ir 't"...~ ."So. .~'t:i 't '~J ' 1 ~ ~. 1.._ ~~...... \\~~ "';"11 ~'1;:;>)':f. ,...,~ ~p~ ~,.:'t~.i;;', {.":\,, ,;". i;'L . 0)'!t~;'Pt', . ',,~..: ,'" D. Branch Circuits .,,.:" '" <;:.E,';; I! "",/:;;" ;~ ""~);l"'W""" f.. ~","":1:._.' .~ 'A't: ,~~4, w~, A/c::ro.' ;.:~...~;-,. '-:r:: ~~""". ~1t:; ~,~~ \~I1Pr~.~t~:z... O'vn....ers\Nanie,";~ ~~~":.;V,".., U New! Alteration or.Extension perf,ipanel ~t::;;~. ~'Ii--;~J/j:..>>'.~'g; ..':'~,.1....;t~ "" "'";";-::""~'. ~"'''l"'''.J '-".""~ ..("""" ,~c ,. f!,li"'~~~\ f"'d I '<i~'~;:~.},,'4'$-'::r_ ,4"j:kll 1-1 ''''j1:-- ~.~:.;;.;; t li~"'~'- ..;!:j\:~" "''''-f:7 ~ ti...~~., l'~" -. C' '~~;'~-~" <;"",... J.l.. ""'ci , 1.~'1,.,," 'c0.. . ,!-Il,!:,.'.;'"_'.I.J'V'ti"., "':.e'{~~ " .~. --;:: _ hi: .....~ ~. '\ ,.' ~:J':-.t*'"' to :t-(,~ .t11','- '.::'~"...:''''' :;:>....~h/;l ...,.... ~ . '1~;'.r::"..,'P-<; .ot"'IA"l";'I,~."~~'- c- ./ "t',~ ~g;t: ~.... <;. '" .,,"'.'$-J-n-... ~;I;';:' g., . Address', ;'/..(,,;;,~'i',-. .1,yn'!'F((}f,,".';c> I One CircuitF' Bf,i "'.il>:,,... 0 $43'00~-","" '~i ~:~,~.,} %ff~' ~:~;..t~:,,~~~~kJl~~:S{1J;i,JiP. }!Fyif~'i"1 41 ~~~~ l~,.eQUlresit~"\~:*!:t.~ ,f~f~ ~.~'1i"".'J'FCit):,.''''',;;'''''5,P./~~P1i5~e~::; -.:,,If '\1\10:1\1 \Eh6jl'~i:lditIOlial:€iicUirorp,~lli Seij' icelB:'i.,;)!;:..";~"~?:,,,~ .f\.~1.'~'. :loe..o<.._.. , '{' n 1..l':Al1aLU:Q'v'...."+-';t:r':~.. res .~t;1l,n".(""l'><-1. "'~"llt_~..1. ~g:~::;~iIl!~;;i::~t~..}J~{l~'.-~ ~l~~.-fr..~'}.l~~~~K;r4~~~~}~ ;~l$' talloW rUoT,Feede~~ermih'i~~. ,~s a __~~.R$~3:00~_~'?~:f(&~??) -;::;.?':$ :1..,,:;}.,.....~, t''l:I~') '..........,. . ",I, .....~r.,.,.~ :"".,...:'''''--''' ~"'h(M,;.~~' . 1;-m"'~'irt;~l t)'-' " ^R 95e.r~"',"'l<!';"1 ::"P>~1t.~'~-"'" iJ.Y,,':t~<:l.'iJ' OWNER Il'!'STALLATION ';"1;:"';;11' Notilicati,{\J.~~""., ';'~::'=t'tu:.nl-Inl ,0" ~\ 's"tt.': '~':I~"'t1.~ l..~" ...',",-;NL...~ -t.~ ""~'T"'~;'~~,J'o/""t,':t 'i.:--;.t:i ~-!~.,~~f.! . Tl."'^"'.ot~Af' \1 . .y~~:--tli" . ",." r't i'$\ .$f-~;:;f~~11 ~'J-'j;'''~~ lfi')~' """. " ;rhe mstallauon IS Demg made'oO:':~j.:t .K.Mlscellaneous (ServlceJfceilerJnot mcludeU)""";"",,,,,J. ,~\(,"'. .;.).r'i"~';,@Jrt-.,':;.'.;tK:.,.,""lr",..~.,'+.... ,.,.. "',,1,.1'. .;,~ 'nUf"\'....k't'^'+\ ~,.r1:'\i\1\....\~uW'~.......;:;j hone'i-:O' r.,.,l'\;'.....,.ltll)~\~, . l~XJik".c."':>i?P~~p.~~}':<i'~~;~!~c;r.i.~ ':~t:.irit~ndedt(:, 090, '(9iJ~$~ins~1~a~on', ":;iP~ telep. . .i.~kt::;:'1~"f.~;~~: ~\i\:,"-::iff: ',for sale:~,lease-or;rent::; '::'i.s"J$;l'?ff..,::;., 0 \\',.;-..p,ump:or1irrigationo \-\!",tl, Notit\Cat'~$50.00~f""".;r..:) :r1;. S'''--:;-;, ";;...-"rk~lk' F' ".":':?\~"... l~',''''.<":~~... .9'" ca 'I~ I!.--- \- ~'.~-"I-T:\f.'\r.' .~ -. . ~'<c~ f"2~t.f~ "~:t<%"~i:"t(,\\;{*,lj;:'~!,;''':;.,:.~,:,, 'N~~~ ""eSlgIl/,0I1tline Iiighting,;, ""344). _ $50,90~' '"~"(:;; '" "'l."~ ~.dlk~,<'t"><-' ~ ~t''''''''';j; .,,<,~t'l.'i" ~~t:r'I"" , ;.].,~~ ournU. l \ "'. ~.. O"(,\,;;!~"~"'~ 'l"\ ~'..f:~~\";~~Owricrs~:Sigf1atur€:.if ,t:~)f;;,~ ".:"':!$~;:!1. ~,LimitedIEnergy!R~;$.{ :l$i $25.0Q~' ~~': :..,.J........;'1~_~ ~iT~....~.''''M~ J1f~~...s:.... f,;r;u~'-?ti..:"'..........:<<r. ~...~ ..",::"",- "' \.v.......~ ..,~ . ~-. J."'l ~ - '",- ',"1~~.( ttU"..;r4<l:~~;V;;' ~~~;1j~}.-~-oi., ~"I{"\7i.~:E~i.'fu~~1':?~~~}~'1~,. ~..LiinitedEnergy/Comm' .~; $45.0Qi:. : .,{'::;'" ~-r.:J:.;".:c,,~~':'-.' '...tP(-7-:.~' ,(~~~6\1-,:r~'i:':i~~:~!~;j,:,.,,~tl~ ~#1."" .....'?\{i~~;:,~ ~~~\;~}~;,- 11l,-,:,;r{,.1ot-",.., fi~~);:F~, -. ,"It:~.'.. ,."tJJ')":"'C"o:.~'i~~'h':l\{ft';jl:i:'i"'i'\"'~,";;;.J.;;.~''''-C;~~r:.~ ~ .~ '~,~f:;>'"r'~\'~",i'.-it'=, ",').:.'.1',,1. ~'qi)''""''';'~ ~;.".*,y;;'1f};.,.r.,.I.. """'~',~.. y.g'>' ,,,Jh:..' ,,:cr:~N1~''':'':.,. ,'" '.~ ~,., ..:~;-,:~-:'.';':":~~..:"'. <~~~'" ....~.'~" ~';'""-'~"~'.:""-',,' .' . , \:!:.~i~{'~: i,r.:;:::r~)..f~, . ;;:';'~;:F.' ,,~ . ... _ . ~t. ,. ',:~;;~. !;;'.::~~~~;:!.:~\ f::~(-;R:%~~~;.:..,.".'\~t'~~~F..p,~~~'$.f.;~~<:..~}~;;\t;,~;~~i. I\"lmmu.E1uEI~~t~~c,f~~ml~.;!n~pectlOn Fee IS S4~.OO + S\!.~.ch_:1rgcs '.:/;F-(,"';:--'~;;f.~'''1~ '.;.a:..'\~~;- '~I~.:'tZi;~~~fl;~;l'.('~;l~"';:4if~\-,;.,;."iJ'1~;~;;.~t.<;:J llt.'-:f j~.:,~k-)k~f;4j;~ ~~~''':' \:, ';.~~"t.'-;',~ ~~;.;,~ '''/,~i::~''* :qrl.::.t:.....q~.. " 'l,;':..'p\l~..y;"r;.~\~':'~hf.Jf, tt;):,"'~~~~:'r.;.~:,:r,;'?~ ~';"!.i- {'."~~~P'i..(t'~.,; \';:;.+f.' ~ / ~"@> ~':ft."~~'i5!::"~:F?k.'i#'.~t "';~~\:-:'~PJt!iI?it:i~f::~,'"1:P~&:.~~~;~lti.1:t., 4. SUBTOTAL:JJR-ABOVE" V, .~:.' :~.~~:ti. .f' ,+".:.,,~ ',..-.....,. ~. '1I'.~.,~"'~'.~- ;......:;.,...::J(~v,:i....::;; '"ii-~~' '"t;';'fi '~~". 1:1"'."-1 ",' it.'.. !,"";'w~"~.:~'~"'+i. 1 'I":.' '.e.~:';f'~t<i::.\;:r;1:.':;:.;' <I, ~. ."~:;,,-, 70/0 State SurcHarge' . ;>,. 7.. r'":;",.j;o:)!.~""'~~1--." - . '_"f: (5-lr'J~.~;4~~.:....fl.),;~~ >....:: 'l,i~,,'": d~ .-....~ '~_<' "t'4F. , ,.' ~~~:;"i;"~~B1'J ,~I?[t;l',?' '.":ri~.;.1.;;~0~;~'l~t ~. r~~t~i;,%~ 80/0 AdmInlstratIve,Fee: I a...:. ~:f'~i:':'P:(:i.u{h:. . ~.~~~':-.'f.;"35~~.""~'.'\'~,.: ~',. ,;",i~F4 -. ~~,,;"'..j~1,' ., ~~1',-:,~if"?':-:>3L,",-.....:~~%- ,~J.:'~9~ . i.. .~!~'(;~r.l'?7~!, . '~.~;:-" J 17 Ov :.;-:."",.;:;:;~jKt~..1-ii."!;!f~ 'J~: ",;~~,;~';;;'~~j~!,j,t<<.. TOTAL'~ - .,..\}J::;..io!1.t'f;ll;.tt1,~~zt,~;;;i:";"'~" ~-A~"'~.< "d[iJ};1~~~~l~~1f1;ifri ~,",-"I', 'y:::~., J.... ..l$ .-. '~. ,. '1!;;'~i;:.. .0;./;0' [ifi;l\' ~'.\,'\.fifl:ljH a~/'~ "~"l~.,' W"I.\'... ~'f~'[~ ~,~," ;", ~~~~ ~) $106.00 LEGAL DESCRIPTION 17033, 5''-(( Items Cost . CITY OF ~rKll'\jul'IELD Building/Combination Permit PERMIT NO: COM2003-00704 ISSUED: 08/05/2003 APPLIED: 08/05/2003 EXPIRES: 02/05/2004 VALUE: $ 700.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1263 MAIN ST SPACE 53 ASSESSOR'S PARCEL NO.: 1703354108700 Springfield TYPE OF WORK: Manufactured Home in Park TYPE OF USE: New Residential PROJECT DESCRIPTION: MH in park Owner: WOOD VALERIE J Address: 1263 MAIN ST SPACE 061 SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Manuf Home Inst Plumbing Contractor OWNER FATHER & SONS OF OREGON INC OWNER License 100726 I BUILDING INFORMA nON, \0 # of Buildings: # of Stories: S ':!OU 'X\\':! Primary Occupancy Group: Heighl<O,r-'Structo}i} \O~ . "'\..... "nv e\ Secondary Occupancy Group: ol'T-Yl!e !t.f\JI~t:~a S J:FJ Primary Construction Type VN ..o~ag 0 Wjlt\'r,'fYPe:'3' ~ 9~?; as \ Secondary Construction Type: ~;\\O~ OoQ\a -<:~nge !~pe:-J>I X"a ~u\ l'a # of Bedrooms: ",~e ,,\as a: ,,\a~' Energy'Path:~" 'a<\~O . 0:1' r '" ~v Ca" Q,\\J ,. Q\'<>- \a' Y. 'l>\\ \0\\0. _.,,~Ol'_ "Q'\'O _,,,,\l' c?_,,,,..\~a, NO'i.\\\C ~OO'II-~ <a~~ I~DEV.E1l0PMENi:iNFORMA TION I \l' () -{ \'\'1'" - U' - - f,)",,- CC9 . ~\\l'g ~ \~a . _ ,\,'00 Ca: 'f;)a~ \0 l'\0'Overlay Dist: l'U~ C0 # Street Trees Rqd: Paved Drive Rqd: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: % of Lot Coverage: Expiration Date Phone 06/29/2005 541-689-5090 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I NU II"~' EXP'Sl&\fa~~~.?RK THIS PERMIT SHALL THlc::. PERM\I~g I~~T AUTHORIZED UNDER ~~'rn~~~l-"O?rams: COMMENCED OR IS ABA AN'i 180 OA'i PERIOD. Street Improvements: Storm Sewer Available: Special Instruction: Notes: Pa~e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description + 10% Administrative Fee + 7% State Surcharge Manuf Home State Issuance Manufactured Home Connection Manufactured Home PlacemeDt Manufactured Home Service + 10% Administrative Fee + 7% State Surcharge Manufactured Home Feeder Manufactured Home Service Total Amount Paid . . Ul'i'OFSPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00704 ISSUED: 08/05/2003 APPLIED: 08/05/2003 EXPIRES: 02/05/2004 VALUE: $ 700.00 I Valuation Descrintion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project FpPf PiilIJ Amount Paid Date Paid Receipt Number $25.50 $17.85 $30.00 $45.00 $160.00 $50.00 $10.00 $7.00 $50.00 $50.00 8/5/03 8/5/03 8/5/03 8/5/03 8/5/03 8/5/03 8/28/03 8/28/03 8/28/03 8/28/03 1200200000000001901 1200200000000001901 1200200000000001901 1200200000000001901 1200200000000001901 1200200000000001901 2200200000000001453 2200200000000001453 2200200000000001453 2200200000000001453 $445.35 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. il?p~ 1 ManufHome Set Up: When installation of all piers or stands is complete. 2 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. 3 Manuf Home Plumbing: After home has been cODnected to water and sewer. 4 MH Service: Approval required prior to utility company energizing service. Paee 2 of3 ~r.:;:.,,' ~, a . . CITY OF ~rK11~tJt<l~LD Building/Combination Permit PERMIT NO: COM2003-00704 ISSUED: 08/05/2003 APPLIED: 08/05/2003 EXPIRES: 02/05/2004 VALUE: $ 700.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection 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 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. Owner or Contractors Signature Date Paee30f3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00704 COM2003-Q0704 C0M2003-00704 COM2003-00704 Payments: Type of Payment Check -~"-~,..." , WI",."...:,:",.,..,',...,..'..,' f" ," ," ; -::.--""" . " I ; ; ,~ '_. """'r,~ .' ,J Receipt #: 2200200000000001453 Description + 7% State Surcharge + 10% Administrative Fee Manufactured Home Feeder Manufactured Home Service Paid By SOUTH VALLEY ENT Received By djb (;heck Number Batcb Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department Date: 08/28/2003 2:59:54PM Amount Paid 7.00 10.00 50.00 50.00 $117.00 Item Total: How Received In Person Payment Total: Amount Paid S117.00 $117.00 . . . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line * , . CITY OF SPRII'ili1'l]<,LlJ Building/Combination Permit PERMIT NO: COM2003-00704 ISSUED: 08/05/2003 APPLIED: 08/05/2003 EXPIRES: 02/05/2004 VALUE: $ 700.00 Status Issued SITE ADDRESS: 1263 MAIN ST SPACE 53 ASSESSOR'S PARCEL NO.: 1703354108700 Springfield TYPE OF WORK: Manufactured Home iD Park TYPE OF USE: . New Residential PROJECT DESCRIPTION: MH in park Owner: WOOD VALERIE J Address: 1263 MAIN ST SPACE 061 SPRINGFIELD OR 97477 SETBACKS I CONTRACTOR INFORMATION I ,0 Contractor k;iC~~e Expiration Date Phone OWNER 0"'.... ..;)~ \O~ . FATHER & SONS OF OREGON INC ~~0~~0~'i.6.J?'V" 06/29/2005 OWNER ...~,!Q_O~ __~~ctJ~ .::,.0'" D. I BUlLDlNGaNF0RMiT1<:iN'r0 '~O''',~~p'' ;;r 0~ (;i'- J... ~ ~ ,t8-0 .&"v ,; (\~ ~~ ~O '0'" 0 O~ 6'Of ~rie,s: r:::, 'S' O~~ . 'S' ~. ~. Lot Size: -~'Hejgiit~orStr'Uctufe 0~0' .~'c\,,-Qr Sq Ft 1st Floor: <<;>- "GO ",,,, )..)- ~,."-" ..;)'00 ;iP A' ,'Type:of-Heat:N, ~- ^ ......'l: Sq Ft 2nd Floor: ~ . ,t\ ....,.,.. ('~ o~ ,,' O"!!)" VN 'SIo0 0water-lyp~: t::-,0 ~0(:$ ';:)C::f Sq Ft Basement: \0 ~,v Bf~i~iy~..e:~ 00 ....58 Sq Fl Garage/Carport ~O o~n~rg~<l.ath;'S' ~,,,, Sq Ft Other: '-$' f::jctJ'V -i:-f:' 0,\0 0~0 Impervious Surface Area: ("i r. __:'f' (', I DEVELOPMENT INFORMATION , ~~ '\~~ ~IRED PARKING Overlay Dist: ~~ ~ ~~'\tqJ9l: # Street Trees Rqd: ~{!. '2> ~~ ~~~Handicapped: Paved Drive Rqd: ......~\,.\,. a. '\~ -s..~c;j Compact: c: '" '0" "'~' ...~~ % of Lot COV&\~e:~~" \;)~\J ~ f' ~~,\S ~~ ~\~.'" ~~_~~~' ., '.f.ff.. l. ...1\, I PUBLIC IMPROV~~~~ ~~ c,~~ '\ Sidewalk Type: DowDspoutslDrains: 541-689-5090 Contractor Type Electrical Manuf Home Inst Plumbing # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Paee 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description . + 10% Administrative Fee + 7% State Surcharge Manuf Home State Issuance Manufactured Home Connection Manufactured Home Placement Manufactured Home Service Total Amount Paid . . CITY OF :sr'Klj~t"<lJ!,LU Building/Combination Permit PERMIT NO: COM2003-00704 ISSUED: 08/05/2003 APPLIED: 08/05/2003 EXPIRES: 02/05/2004 VALUE: $ 700.00 I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Fpp<, PiIiiJ Amount Paid Date Paid Receipt Number 1200200000000001901 1200200000000001901 1200200000000001901 1200200000000001901 1200200000000001901 1200200000000001901 $25.50 $17.85 $30.00 $45.00 $160.00 $50.00 8/5/03 8/5/03 8/5/03 8/5/03 8/5/03 8/5/03 $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. ~rprlln~npc.tions I 1 Manuf Home Set Up: When installation of all piers or stands is complete. 2 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. 3 Manuf Home Plumbing: After home has been connected to water aDd sewer. 4 MH Service: Approval required prior to utility company energizing service. Paee 2 of3 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00704 ISSUED: 08/05/2003 APPLIED: 08/05/2003 EXPIRES: 02/05/2004 VALUE: $ 700.00 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 OD the site at all times during construction. t/ ~ ';'u)fYm:iD . 1/ Owner or Contractors SIgnature Page 3 of3 -Azu;",C;; 0003 Date ~ / d t:> '3 111a; ,,-d 5' .3 , ..._........t:...........:...........~..... .. . . . "r: l.........~. . . . . " . ......,.1....................,.1..........+.......,..1"".........1...........1.......... .........+........+ '/ IA.H. . ... . ... ........................................................ . ... .;...........:.... . . .. . .:1: .".., '!:......'.t..........j......................i............:...........j I i ! -1...... 1._..:.. I . l_. ( t j ~ I l I ,.. ; , , ,. i , , , . ;<-- +--... , 1 1 i ':\ ~ . . ...---.. t.H:]. ": 1........ 'f" ...~" . ....j .r ........+..........j........... ..... t,. ......t...... ..+.... .,. ..+ "! ...f.... ....+. .:. .1 ....;. .....~.. ;,. .....-j-........(...... ..T'.............'.............. "~ .......... j...........~. .. ......!. .........j......... . 50 v .;;.1 ,-if,.. - - .j...... ....~.:.........! -1 ...~.. ....(......... :....:.~Jj.~.'i . .........j........tJ?~.l).,.,:.; ,...................................... .....~. ... .... .'!...... .... .. ...... ..~...... ... .~..... h.. h ~h' .......!.... h.h. ......+. ......................... ..~...... "i.. .;...r.h.j.........+.. I . ..t. . i . i ....t...i....!. : I ........... . ........,....L...H,..1 "H' I .........~...... ...~.......... ...........;..........f. ........c....... .j ..........f.......... ..........H...l...... f , 'h!...L...-!-. I ...I.. I ..;....1..+... I .L .t ....oj- ....;.........t .....;.. '''''~''h''' ..-!-...... . . . .h.............................. .....; . . . . . . . . . . ..........;...........i...".....j. . . I . !...i. ...;.....,... ...........i..........t... h....~.... .....1'..........;...... ....1 .........~.. ..................; ..~ .}..........t ........! '1 .....~ ..; : :" ....../.'1:1........................ :...i.. ...+.......h!...'.... .j...... ".....,....,._-~ .!.... .~..........~.: ......! . . . . ....'...h.......................................... . . . . . . . . ..........i . . . ..+..........i........".j ...;..........!.......".i. .......... I', . ...... .~. .....!..........j... ....~.. ........1..........,!. .........j .........oj- .........!.... "i" ;",,,, .~..........+.... ,:",!",,, .....1... ..........j........h.!..........j.......h.!. ..........i "'l ....+ .+ .......1 ........."j- ......i...... . . . i=RQr\+" , I!t:~,......... , . \1/ j ....'I:....:....h. ... ..........; S+,,€ ct ..i".... ..... i.... .... '1' ..... ....~...... ....1'.......... ........,:...~....s.e..J..1.."c.~..... :;l: : : ~oA:. ~ f' ......~......... .!.h. ""'rh... ....)...... ...1.......".. ". ..!........ .; ...f.........i.. ..........1' . . . ..........'..........!....1.....'........ ......... ......:...... .......... ...:l:r:t"'''+'''H'' . 1 """'f , .+.........j...f.....i I ' ................. ..... ""it."..".. ! ............. ...f .{........................ 'I. I / I Y.:L T, \ '.........' I , ..Iili ..~.........i..l..+ ..L......... ....i..... +.......... ...t'h' ......;.. ..~ ..c...",...f.. .....}.........{.. .f .; ..~.... ...........: .......-: ........~ .. :s -, () "- ~ \i} ~s:s . '. . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us I). . . \'" .../ ", " Pennit #: rOW,.z_oo~ 0 701.( Address: (z. (, 3> /!VI 41111 S T Issued by: ~fS 5r 53 75/103 Date: Statement: Information Notice to Property Owners About Construction Responsibilities No1e: Oregon Law, ORS 701.055(4) requires residential cons1ruction permit applicants who are not licensed wi1h the Construction Contractors Board to sign the following statemen1 before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architec1 and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statemen1. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~l. ~ 2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~ 3B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. Ifl change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. Yr:2tv,o_ ~tU~ .Lh/A-, .7;0063 (SignatUr~fpermit applicant) ,n 77 ' (Date) (White copy to issuing agency permit file, pink copy to applicant.) :'.~y_.:,:...owner.doc 03/11/03 Acting as !ur Own General C~tractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5}, passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For a State Business ill number, call the Business Information Center at 503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. ~. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. . Time: Make sure you have. sufficient time to supervise your employees. '. , - Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notifY building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owoer.doc 03/11/03 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00704 COM2003-00704 COM2003-00704 COM2003-00704 COM2003-00704 COM2003-00704 Payments: Type or Payment Cash Change Job/Journal Number COM2003-00704 COM2003-00704 COM2003-00704 COM2003-00704 COM2003-00704 COM2003-00704 Payments: Type of Payment Cash Change _~'N"""'" . 1Iii-;."'''''~'.'.',..,'"'''- ,...-,'~.1 ;..; I ,", .,'"",.,;r' .,.',' Receipt #: 1200200000000001901 Description Manufactured Home Placement Manuf Home State Issuance Manufactured Home Connection Manufactured Home Service + 7% State Surcharge + 10% Administrative Fee Paid By VALERIE WOOD VALERIE WOOD Received By djb djb Check Number Batch Number Authorization Number Description Manufactured Home Placement . Manuf Home State Issuance Manufactured Home Connection Manufactured Home Service + 7% State Surcharge + 10% Administrative Fee Check I"\j' umber Received By. Batch Number Authorization Number Paid By VALERIE WOOD VALERIE WOOD djb djb City of Springfield Official Receipt Development Services Department . Public Works Department: Date: 08/05/2003 2:50:42PM ' Amount Paid \tern Total: 160.00 30.00 45.00 50.00 17.85 25.50 $328.35 How Received In Person In Person Payment Total: . Amount Paid $340.00 (SI1.65) $328.35 Amount Paid 160.00 30.00 45.00 50.00 17.85 25.50 \tern Total: .).).1.6..:,5 How Received In Person In Person Payment Total: Amount Paid S340.00 ($11.65) $328.35 . . '" CITY OF S(~lNGFIELD, OREGON 0 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAXh(5dll<lWiIii1-ilfiIl9ctas submitted has the following .... ~,o- 200 Amps ~g;~:i.~{I.,\ .... A~~0 ......' 20L0W':'~ ~l'~ $'1 ~'sl'l~OO..M1o~!/.... O~ :!$l0 '9'" a ~""~\0 ,~0~ ~J A~s t()tUUO~P~~0 ~9 :l.00(,)~~ Qtlg"Ani ~'fv 1~0 . O{\ o ),.O~ ~,. .0" ""BP .",fl" '1J.~ ~'\~ ,,0" _,0(' Reciinnectl"unl~\0 ~'i.\v fv . .$-0 r.0\~ _co.'" CO"! "~ ~o ~( ~v ,}or "*~ ~0\0 ~ ". ----- ll1 ,n~O _o,.~\7:r;:J:J K;'Q"~{'.iuPOf,~1-~~ts or Feeders Yl . O~'''- ~ C?j ~ ~0\0~'0 ~0~0 ~/~'5 .. - - 'D ~^O~ ~O '\f;'0 ~gl~~n, Alteration or Relocation , \;)\;)$ ~~~~'O(\oo''Xmps or less $ 50.00 v ';Q"" 00' _?'~ 201 Amps to 400 Amps $ 69.00 , 40 I Amps to 600 Amps $100.00 O~er 600 Amps or 1.000 Volts see "B" ~~ov~ . D. ' Branch Circuits <.. .~\t;;j~ -< , _ _. ~\;..'t' ~t;;j\ _ . New Alteration or Extensi~'tI{i~\t-~t\P R- One Circuit ~iJl'\ ~~~ ~~ ~~ $ 43.00 Each Additional ~if-~ ~~t;;j'\\" se~~r ~efet~~~~~~ $ 3.00 ~~.~ ~Yv~ ~\)" R- ~~ffi}. - - - - - E. -<~c'l\I~ifll~9-I/"'j~r"_1'-"",eeder not included) -Each Installation .\ i,),\'0v &:.~,,\:.':';::{~~ - - -- -- - - -- . pu~~~~~ $ 50.00 Signl~ine Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial . $ 45.00 ELECTRICAL PERMIT APPLICATION City Job Number CD-'1ZC>o3 _ 00 70'1 Date I. LOCATION OF INSTALLA110N 12(,''3 mA-/N ST Sf' Ss LEGAL DESCRIPTION 1703"'!,.5'-{ / JOB DESCRIPTION 08700 j/l1 II- s (2. V c.... - Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name 57 c--fHt:-r-[ I..NOO l~ Address 126 J M A-//l( ::, r ::.Y' 5) City 5P?}. Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: -4/? ./~_I / fj O>-f'/7"y Inspection Request: 726-3769 loning. and does not require speCific land use / ; approval 'B S 03 Zoninr cA.1:>f--- I. ~'~-o3 3. COMPLETE FElt'ScJ:1J:wvLL; nJ::.LU W 9'(,j ;"'UUll,,lrtZea SIgnatur6 A. New Residential -Single or Multi-Family per dwelling unit. 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 $106.00 $ 19.00 / $50.00 5""0 B. Services or Feeders - Installation, Alterations or Relocation: $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges s-o ::>50 )--0 0 r .5"8~ 1 Shared Drivc(T:)JBuilding Fonns/Electncal Pennit Application l-Q3.doc 4. SUBTOTAL OF ABOVE 7% State Surcharge 10% Administrative Fee TOTAL