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Home My WebLink AboutPermit Electrical 2007-5-14 ZON Lf)~ INITIALS \J~ DATE 5-l6 .'rr, SOURCE fY'\ <; 225 FIFTH STREET. SPRINGFIELD, OR 97477 0 PH:(541)726-3753 0 FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ('./0 fV) 7--OD I - ()n02J t.4~~~TIO~c::~:l::~ # 4f- t i LEGAL DESCRIPTION: A/~ !J1t1 k [" h6YYLL Je.e-J: r JOB DESCRIPTION: ~ '[()~ ~? 3<f. a~ 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 (} (" e<; ~ GI ~"c... b ~t"" Address '" k3. slt4~ <;.+.- l Phone S:.4-C r"7" 7 "" ~ (, City ~P~(.J Supervisor License Number .3 .J"lJb 5 Expiration Date I D /07 Constr, Contr. Number 2 0 3 Expiration Date l - I - "2. ~ 0 y-- Signature of Supervising Electrician fi_,. Owners ~am~~.k ~ InaNlo-l j LL~ Address 1:Jg',ztJ ~bb f2.,. ~p Ci~,.J?('(\ Phone OWNER IN~Li:h2~<I The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Date S"'- ( 4' - () 7 . 3. .u CaMPLETE FEESCHEDVLE BELOlV A. New Residential - Single orMul~i-F~miJyp~r dwelling unH. . Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Each Manufact'd Home or Modu\Wff~~fl}<g Service or I $50,00 DO ~ Feeder l,. ~ i, ,CJ ,~~ . ...~'. THIS PPRnAf't' ... ........ -- . B.Se~Cfrfilw; ~R' ,i e~tlerSl:flflst..at!';\tPmtfter,atiQl1s or Relocation: >~UI,IZED.UNDER -', ,t-,I,HF. WORK 200 XgMI~rSiW9ED OR IS A;~~~fERfvj}T$I,~.- J~q])T 2011Jth~sM@@JAVrw>~R/OD .fWUNFD ~.OO 401 Amps to 600 Amps' $125.00 601 Amps to 1000 Amps $163.00 Over 1000 Amps/Volts $375.00 Reconnect Only $ 50,00 C.Teritp~l"ary Services or Feeder; Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps . $100.00 D.~fl~!:~'5~i~~[~ ~Af&~@11W1mift~gff~rJAR 952~(V'. eQOOi,rdfutu may obtain cooip.:; ~f H._ r'$,il3':OQ EadIi~~ ooP}t~f.!t ....ith' . t ~, .~ . u as . s '. p~PJ>' . (rvoIS. .he talep!lPsso OOWI~.nrr~6regon Utnlty Notificatior ': ~ ""')"" ....1"f.I~D.,r}1.f p.- ..'., . E. Miscellaneous (Service/feeder not iiti:n.lded) -Each Installation 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 $45.00 + Surcharges 4. . r "3- '2)0 8% State Surcharge 4 ~ 10% Administrative Fee S trO 5% Technology Fee ?- "GI TOTAL k/ e-. Shared Drive(T:)/Building Fonus/Electrical Pennit Application 8-06.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00621 ISSUED: 05/01/2007 APPLIED: 05/01/2007 EXPIRES: 11/15/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4475 DAISY ST SPACE 46 ASSESSOR'S PARCEL NO.: 1702323406500 Springfield TYPE OF WORK: Manufactured Home in Park PROJECT DESCRIPTION: Manufactured home in park NOTWt'I:YPE OF USE: New Residential T~I~ PE~~II ,S~ALL EXPIRE IF THE WORK .tJT, W~1llb'iJ unlut/i I HIS PERMIT IS NOT COMMENCED OR /S ABANDONED FOR ANY 180 DAY PER/DO. Owner: COUNTRY MANOR LLC Address: 13825 SW WEIR RD BEA VERTON OR 97008 I CONTRACTOR INFORMATION I Contractor Type Electrical Manuf Home Inst Plumbing Contractor FATHER & SONS OF OREGON INC FATHER & SONS OF OREGON INC FATHER & SONS OF OREGON INC License 100726 100726 100726 Expiration Date 06/2912007 06/29/2007 06/2912007 Phone 541-689-5090 541-689-5090 541-689-5090 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # of Stories: Lot Size: Height of Structure: Sq Ft 1st FloBr: Type of Heat: n \aW ret\Il'F$~rYd'FlJa~,~: waterIEN,.'ON:orego b the ~agOf:\~\!M: Range ~.' . " ,fU\e$ adopt,ed Yse ru~tCG, l6Q~~~rport Energ 'fl '1\00 center. ,.hO ftOPtf(\l~:-OO Sprin.,n ~~01-0~~~~t.~r~~~~8t~t~:\ - ___.:.L ~_.~. ~- - N te' toe It:IQ..,t.-f, I DEVELOPMI!OOR\ltr ' . 0 '.. titication v~..m ~on Utl\ity N~)REQUlRED PARKiNG BUfnbertor . A .-."('\ ,,1')t',-?~4 . Overlay ist:, - Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: R-3 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00621 ISSUED: 05/01/2007 APPLIED: 05/01/2007 EXPIRES: 11/15/2007 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 Amount Paid Date Paid Receipt Number + 10% Administrative Fee $20.50 5/1/07 1200700000000000480 + 5% Technology Fee $10.25 5/1/07 1200700000000000480 + 8% State Surcharge $16.40 5/1/07 1200700000000000480 Manuf Home State Issuance $30.00 5/1/07 1200700000000000480 Manufactured Home Conn - Plmb $45.00 5/1/07 1200700000000000480 Manufactured Home Placement $160.00 5/1/07 1200700000000000480 + 10% Administrative Fee $5.00 5/15/07 2200700000000000747 + 5% Technology Fee $2.50 5/15/07 2200700000000000747 + 8% State Surcharge $4.00 5/15/07 2200700000000000747 Manufactured Home Service $50.00 5/15/07 2200700000000000747 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. ~eouiredJnsnections 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 Service: Approval required prior to utility company energizing service. Pae:e 2 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-00621 ISSUED: 05/01/2007 APPLIED: 05/01/2007 EXPIRES: 11/15/2007 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 ofthe 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 Pae:e 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00621 COM2007 -00621 COM2007-00621 COM2007-00621 Payments: Type of Payment Check cReceintl RECEIPT #: Description Manufactured Home Service + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By ROBIN L. RUTHERFORD Cjf.' of Springfield Official Receipt L Jopment Services Department Public Works Department 2200700000000000747 Date: 05/15/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 736 In Person Payment Total: Page 1 of 1 8:37:37 AM Amount Due 50.00 2.50 4,00 5,00 $61.50 Amount Paid $61,50 $61.50 5/15/2007