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Home My WebLink AboutPermit Electrical 2007-5-30 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION / City Job Number (O~C> 7- c:::> c:::> 70 ? Date 2. Electrical Contractor ~CitLt. E1ecl-v-\t. L.L.C- 200 Amps or less ~ 0... '4 201 Amps to 400 Amps Address t'lJ I V \)~ I ~ DD 401 Amps to 600 Amps 601 Amps to 100~mbU to 1~itP.i~4lmbl\l:or~!~~if~\-'\ UtiUty folloW rules adoP~~~~~I~s are set fori -..lo~@tion Center. 0 Supervisor License Number ~C ~~~r;'2.o01-QO \ \ ~O . You may obtain cOle hOl}6 Expiration Date \ 0 0 \ 0 - T '\1' the centlmt~ttlat6n, ~~~tIQ~ o~ Wcation ~a ,rna . anUl1\k\'i Notlflc~ ' ,'- . '0 1 -number for the 9(j)9Ji~~1' "'....'" "~44)' Constr. Contr. Number ---.lJJI U t\ I 201 Amps to 400 Amps " 1\I \ M \ l 401 Amps to 600 Amps ExpIratIOn DatdJO V1 t,{)O Over 600 Amps or 1000 Volts see "B" above. D. ~ >> NOTICE: ~ ~,' ~ Tlli3 rERMIT ~~~[t~~grl~~lfcuTm~VtRRf\ ~ L. I' ~ 11 AUTH OR IZED L$~HWiEf{oif11:l6:ltt'?!P~ltT IS NOT Owners Name (OtA..~J JV ~~ENCED Address /3 gz ~ S c.J LeI 6lrdt. 1 ~O OAf City,?~~ Phone ~ 1. l.{l{7') LEGAL DESCRIPTION 17JZ 52J<.f L)bJ"C:> JOB DESCRIPTION tfH ft- -- SMvl~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. City fucyt1e Q1l/ol >hone Signature of Supervising Electrician 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 3. A. 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 s-O ( B. $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel $ 43.00 $ 3.00 Pump or irrigation $ 50,00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. S-O 8;0 State Surcharge C( 10% Administrative Fee 5' T~~L ...~ ~"",- t 61 r:::-- z SO Shared Drive(T:)/Building Forms/Electrical Permit Application I-03.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00769 ISSUED: 05/30/2007 APPLIED: 05/30/2007 EXPIRES: 11/30/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4475 DAISY ST SPACE 96 ASSESSOR'S PARCEL NO.: 1702323406500 Springfield TYPE OF WORK: Manufactured Home in Park TYPE OF USE: New Residential PROJECT DESCRIPTION: manufactured home in park Owner: COUNTRY MANOR LLC Address: 13825 SW WEIR RD BEA VERTON OR 97008 I CONTRACTOR INFORMA TION . Contractor Type Electrical Manuf Home Inst Plumbing Contractor CAMP CREEK ELECTRIC LLC JERRY PAUL OTT BAXTER PLUMBING & ROOTER LLC License 164877 69455 169028 Expiration Date 06/0912007 09/26/2008 03/1312008 Phone 541-746-1471 541-935-2696 541-935-6696 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I BUILDING INFORMATION I YOU to ,~.", \aW reqUireS . , . ENT1(ry?~h't];qe~n Oregon Utihty Lot SIze: R-3 ATT \Jl.e~p(~tH~ot~~ \ are set tor Sq Ft 1st Floor: tollow r.u Y~We1ihOse ru es R 952-00 Sq Ft 2nd Floor: vaohncatlol~ij~i~tO thrO~gh QA e ru\eS \ Sq Ft Basement: In O~1=\ 95~an~lflftn COpies ot th hone Sq Ft Garage/Carport 0090. YouER!\ ~:(Note: the tale.p. . Sq Ft Other: ca\rmg 'Sp~i e ~rfiI8WgJtility Not"}~atlon Occupant Load: 1--1 ft"\r the ey, _ _ /\t", A A\ ',6'EVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street Trees Rqd: Handicapped: rf~ltfJ:ive Rqd: Compact: nil~ PER~IfSWALL EXPIRE IF THE WORK ~l;TII(}:1I:[O ~~C~H T~'~ Di=Ql\AIT I" I\InT I PUB4I~rW~Wl\fl~(~Stf3ANDONED FOR ANY 180 DAY PERIOD. Sidewalk Type: Street Improvements: Storm Sewer Available: Special Instruction: Downspouts/Drains: Notes: Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-00769 ISSUED: 05/30/2007 APPLIED: 05/30/2007 EXPIRES: 11/30/2007 VALUE: 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 + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Manuf Home State Issuance Manufactured Home Conn - Plmb Manufactured Home Placement Manufactured Home Service Amount Paid Date Paid Receipt Number $25.50 5/30/07 1200700000000000642 $12.75 5/30/07 1200700000000000642 $20.40 5/30/07 1200700000000000642 $30.00 5/30/07 1200700000000000642 $45.00 5/30/07 1200700000000000642 $160.00 5/30/07 1200700000000000642 $50.00 5/30/07 1200700000000000642 Total Amount Paid $343.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. ~e(]uireCUnSDections I Manuf Home Set Up: When installation of all piers or stands is complete. 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. 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. Pa2e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00769 ISSUED: 05/30/2007 APPLIED: 05/30/2007 EXPIRES: 11/3012007 VALUE: 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 Commuriity 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. ~ ;C.---G,,-"-.f:ry M4kIJ.r Jlfl/P ,5-30-0> Owner or Contractors Signature Date Pa2e 3 of 3 225 Fifth Street Springfield,' Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00769 COM2007-00769 COM2007-00769 COM2007-00769 COM2007-00769 COM2007-00769 COM2007-00769 Payments: Type of Payment Check cReceintl Item Total: Check Number Authorization Received By Batch Number Number How Received RECEIPT #: 1200700000000000642 Description Manufactured Home Placement Manuf Home State Issuance Manufactured Home Conn - Plmb Manufactured Home Service + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By COUNTRY MANOR LTD djb Page 1 of 1 136 Cj+..r of Springfield Official Receipt l elopment Services Department Public Works Department Date: 05/30/2007 8:33:26AM Amount Due 160,00 30,00 45.00 50,00 12.75 20.40 25.50 $343.65 Amount Paid In Person Payment Total: $343,65 $343.65 5/30/2007 \ "t. >..t .~~f :~f;', ..... e J,ot / \' ~1 --I ~ . 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