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Home My WebLink AboutPermit Electrical 2006-4-7 The following project L ~~- ~ L as the foliowin~ Z , and does nO~~d use g sp~~('~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (54'f)726-36li'J ELECTRICAL PERMIT APPLICATION ALJlFionzed Sign~rE;' City Job Number Ct:>M zeo 6 - 00 Z I 3 Date If /7/0 b I 2 OR,rINS10 B. . ........,~-'"',. , ~_NT\ON: ~ 'h .~r;8~U".ll\l " 1 ar:nJiad bv LI,8 I~""JJ II 'J Electrical Contractor v . \ .ru os 200'AmRs or,leSS\as are S3t lioiih /' .. tiliication CE27H;ArritP~~~40g;Amp'sR o5?-001- (04 Z- -:7/~ H "'-OO"I-OUIU UIIOuSl1 ~ .. '" Address ~~- v v C. 401LAmpsC~6p' OOc:An'ipille rules by OOC'u You may Ouldl. I "..N -. ," ~ ~ the 8g\11'~~P~H~~00~nips~~ho~e Phone 72-1 -/9 9 f ,Oveo1000~mp"sl.W'oItsotlflcatlon bar or lilt: I V::;1"" .. (IUIII v cent~r9gnp5l88@11JY.i2-2344), C;~"5'- S (0 / ( /0'7 Installation, Alteration or Relocation / I 200 Amps or less Constr. Contr. Number f;1 :5 (s 7 201 Amps to 400 Amps "7/'( / 0 (/ 401 Amps to 600 Amps Expiration Date ~ Q I , q:y~r 6QQ.1\mesor 1000Voltssee "B" above. Signature of Supervising Electrician D.;~ranchCirc~its ;;J _ /) A JJ. u.) ~ if('} I A ~. New Alter~~on: ~l~m\per Panel I~ · I~ ~lrn\;~. \\ S\1MJ'e.~~u\t' RUIn \~ Nt;)' f/ ..-.- 1\-\\5 t't?Mf,D \.lN~~~Mfii~~I~Pf1~~i\With /' I - :1 r 1\1..IU:\95\\2 0 ~1~,t..Na~~Permlt Owners Name ~ "" ? ~ :s:.~t.~Cf,D Iv Address z.bG r { MI1-tf!1. ~'~80 Dl\l'f <; ?P;~ Phone 7Cf7 - 3c:> ?, 1. LOCAI10N01?INS1'ALLATIO 2.,bb ~ w1~ A L t' LEGAL DESCRIPTION }70:SZ~(L( 07000 JOB DESCRIPTION J11tf St2v'L/~lYL ,/ C'V't:~: +- Permits are non-tf:.nsferable aniexpire if work is not started within 180 days of issuance or if work is Suspended for 180 days. City ~ o Supervisor License Number Expiration Date City OWNER INST ALLA nON 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. d\~elling 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 z $50.00 /oe> elocution: $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 c. $ 50.00 $ 69.00 $100.00 / $ 43.00 $ 3.00 :s -Each Installation Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. /03 9' 'Z '( /0 '30 \"2-(~-==- 8% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 1-06.doc 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: COM2006-00213 ISSUED: 03/21/2006 APPLIED: 02/23/2006 EXPIRES: 09/24/2006 VALUE: $ 13,246,00 SITE ADDRESS: 2665 MAlA LP ASSESSOR'S PARCEL NO.: 1703251407000 Springfield TYPE OF WORK: Manuf Home w Garage/Carport Private Lot TYPE OF USE: New Residential PROJECT DESCRIPTION: Manufactured home with carport Owner: GARY JURGENSEN Address: 2665 MAlA LP SPRINGFIELD OR 97477 Contractor ~~_ c:, -.- n. Hft&~~~equi~Jq!rUltJpn Date HARRISON JACOBSON INC I L.N II~N. Ore%6447 05l/ll;U2007 , Illes adopteo ov the Oregon ,-,"Yo.y RALPH W BROWN ",~~:\'(~:;~n 'r.enter. 6.3rM'~e rules are sQ,~/~/g-V08 EMERALD LIFE STYLE l!.~Sl~S~~2%01-0ol67f~POUgh OAR 99~LW~007 HARRISON JACOBSON fN~: " .,_ -'J ~h+lR4;J;7,nit:>C:: nf thp. rg?J~7t2fl07 I BUILDI:N~G"iNFIQR;MAffiION\I)te: the tele~ho~e number for the Oregon Utility Notification # of Stories Center is 1-800-332-3344)Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Electric Sq Ft 2nd Floor: Water Type: Electric Sq Ft Basement: Range Type: Electric Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: Contractor Type General Electrical Manuf Home Inst Plumbing # of Units: 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 : REQUIRED PARKING Overlay Dist: Total: 2 # Street Trees Rqd: 1 Handicapped: Paved Drive Rqd: Yes E ~\iiP.act: % of Lot CovA~e: t:')(f~:@W 1\-\ \S ~a1 \\01\\1 ' "\ S\-\t>.\.\.. ~ ?E~N\\\ ,',1.c. o~p.~\ \m~c 1r\\S . H(U t:nR I PUBLIC IMP~~~l)~ \S t>.'aM~UU F II I d CON\ n nl\'-' ?E~'8i~e\valk Type: u y mprove ~ '\ Bu vt\ 1 Yes I\N Downspouts/Drains: 20.00 5.00 6.00 26.00 0.00 Phone Number: 541-747-3099 I CONTRACTOR INFORMATION I Phone 541-689-7762 541-729-1500 541-463-2022 541-689-7762 1 R-3 U VN 5,663 1,620 3 I DEVELOPMENT lNFORMA nON I Curb and Gutter Notes: Storm drainage piped to curb face at weep hole 2/27/2006 CAS Page 1 of3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00213 ISSUED: 03/21/2006 APPLIED: 02/23/2006 EXPIRES: 09/24/2006 VALUE: $ 13,246.00 225 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 $19.00 $1.00 Square Footage or Bid Amount 434.00 5,000.00 Value Date Calculated Total Value of Project $8,246.00 $5,000.00 $13,246.00 02/23/2006 02/23/2006 Carport Carport Foundation Onlv Use Bid Amount ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $90.09 2/23/06 1200600000000000190 Addressing Assignment $31.00 3/21/06 1200600000000000324 Foundation Permit $68.40 3/21/06 1200600000000000324 Garage/Carport $99.60 3/21/06 1200600000000000324 Manuf Home State Issuance $30.00 3/21/06 1200600000000000324 Manufactured Home Conn - Plmb $45.00 3/21/06 1200600000000000324 Manufactured Home Placement $160.00 3/21/06 1200600000000000324 Plan Review Major - Planning $150.00 3/21/06 1200600000000000324 Sanitary Sewer - 1st 50 Feet $45.00 3/21/06 1200600000000000324 Sanitary Sewer - Improvement $438.61 3/21/06 1200600000000000324 Sanitary Sewer - Reimbursement $576.61 3/21/06 1200600000000000324 SDC MWMC Administration $10.00 3/21/06 1200600000000000324 SDC MWMC Improvement $865.31 3/21/06 1200600000000000324 SDC MWMC Reimbursement $82.03 3/21/06 1200600000000000324 SDC Sanitary/Storm Admin $130.80 3/21/06 1200600000000000324 SDC Transpo Admin $65.37 3/21/06 1200600000000000324 SDC Transpo Improvement $805.70 3/21/06 1200600000000000324 SDC Transpo Reimbursement $182.69 3/21/06 1200600000000000324 Storm Drainage Impervious Area $962.54 3/21/06 1200600000000000324 Storm Sewer - 1st 50 Feet $45.00 3/21/06 1200600000000000324 Water Line - Ist 50 Feet $45.00 3/21/06 1200600000000000324 Willamalane Manuf Home Private $1,000.00 3/21/06 1200600000000000324 + 10% Administrative Fee $10.30 4/7/06 1200600000000000427 + 8% State Surcharge $8.24 4/7/06 1200600000000000427 Add, Alter, Extend Circ Ea Add $3.00 4/7/06 1200600000000000427 Manufactured Home Feeder $50.00 4/7/06 1200600000000000427 Manufactured Home Service $50.00 4/7/06 1200600000000000427 Total Amount Paid $6,050.29 I Plan Reviews I Initial Review Plannine Review 02/24/2006 02/24/2006 02/24/2006 03/01/2006 APP SKG APP TAJ Paee 2 of 3 CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2006-00213 ISSUED: 03/21/2006 APPLIED: 02/23/2006 EXPIRES: 09/24/2006 VALUE: $ 13,246.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 02/24/2006 02/27/2006 APP CAS Storm drainage piped to curb face 2/227/2006 CAS Structural Review 03/21/2006 03/21/2006 APP 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 Reouired Insoections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. 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. Framing Inspection: Prior to cover and after all rough in inspections have been approved. 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. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Manuf Home Plumbing: After home has been connected to water and sewer. Final Plumbing: When all plumbing work is complete. 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. 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 Pa2e 3 of 3 225 Fifth Street Springfield, Oregon 97477 ., 541-726-3759 Phone Cj~' of Springfield Official Receipt L lopment Services Department Public Works Department Job/Journal Number COM2006-00213 COM2006-00213 COM2006-00213 COM2006-00213 CO M2006-00213 Payments: Type of Payment Check 4/7/2006 RECEIPT #: 1200600000000000427 Date: 04/07/2006 Description + 8% State Surcharge + 10% Administrative Fee Manufactured Home Feeder Manufactured Home Service Add, Alter, Extend Circ Ea Add Paid By RALPH BROWN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1791 In Person Payment Total: Page 1 of 1 9:30:44AM Amount Due 8.24 10.30 50.00 50.00 3.00 $121.54 Amount Paid $121.54 $121.54