HomeMy WebLinkAboutPermit Electrical 2004-4-12 (2)
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s submitted has the following
. F AiKDi(~fh)\l26~t require specific land use
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225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753
ELECTRICAL PERMIT APPLICATION
City Job Number c..o.wr WOlf....oO:3 7 b Date
Signature of Supervising Electrician '
) t n ~ 3 \!/IN..J~
\;d
Owners Name 5/J/VT/A-G-O t::-s'TfJTC-'"'S
Address -11Z I \ Go I J Co....'^- ~ J:/vd
City Co (J ~\ vl><2., c)+. Phone Pump or irrigation $ 50.00
.
to Sign/Outline Lighting, $ 50.00
OWNER INST ALLA TJ%regon laW reqUires y~~i\ity Limited EnergylResidential $ 25.00
ATTEN'TIU\ . hV the Oregon r . . .
The installaI~ l~rrn~gJ.l!d~ce'jitp&1h"ettx T mm~ll\olJ. set fort Limited Energy/Commercial $ 45.00
is not intendHl.~r S{\\5\'te~er!j))Erenr. Ose h OAR 952~irtimum Electric Permit Inspection Fee is $45,00 + Surcharges
.~o~~c: 952"001.001? t~~O~g s of the rules \j,'t,'.l\o~.lll ~.'" ...
Owners SllfBM{ffi!: 'y may obtalO cOple t lephori\3 t~f!JiB:'EC>J{JJ.. \ ~ (~
0090. ou 'Note: the e ,~'l>>, . ~ \\",.,..r: -
. the center. \ .' NotificatIon ,- :-0
calling I. ~hO ()reaOn UtIlity 7% State Surcharge 31? \
umoel ,Vf'tt - " QQ?-L344). ;>
n ,...__~M;C' 1.9.('1, '-, . 10% Administrative Fee ~c
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LEGAL DESCRIPTION
P,70Z 3300
JOB DESCRIPTION
,# IOlJ
O/3dO
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Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
t\.W. ,,<~~w.~{JTt~,.~....~t?~:q,;.:tt~-tffl.:ry'll.. ~;;...:;'{'!. ~~."ti~:y-"-&%'u'".tio. '<"'i.,.."..\.tW:'J""~$.T.:~"~'ffiAA''W'-tik'm'''~~.;<;w''>'-''''S'h~;-"g..~lo
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Electrical Contractor
~
\
Address
Burrell Bras, Electric
40159 Booth Kelly Road
Springfield, Oregon 97478
~~~l-~71-~
Supervisor License Number ~~~\. ~
City
Expiration Date
,~\~
"
Constr. Contr. Number ~~~~'-.P
\.'='\c:>~
Expiration Date
Inspection Request: 726-3769
A.
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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
$.1.9.00
.i'
to; \
- \
~
$50.00 \ ~(l ~:> ~~ ~
B.
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.. _ ~~T,,\~Wlf\~~1r~tl~\~1{l-r:e/~dNlo;P,:q;;:,.1.~~ :.~..t...~l;~~ .~} ?~-\1
, ' tei+atiolt"(obReroc;lti&i6~;;{~
"''' .. " .... "~.... ,.\. ~,"i'W"""^'4.,....~)f.j
;.'" - . .'" ~I.o.~ .-.t:':"'4~~ID
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/
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c.
Installation, Alteration or Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volt
h'
D.
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"
$ 43.00
$ 3.00
TOTAL
Shared Drive(T:)/Building Fonns/Electrical Permit Application 1-03.doc
.
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00376
ISSUED: 04/05/2004
APPLIED: 04/05/2004
EXPIRES: 10/13/2004
VALUE: $ 25,000.00
_~~'!!lt1;~f.I~~: '-'
Status ' Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 Main 104
ASSESSOR'S PARCEL NO.: 1702330001300,
Springfield TYPE OF WORK: Manufactured Home in
Park
TYPE OF USE: New Residential
PROJECT DESCRIPTION: M.H. setup in park (replacement)
Owner: SANTIAGO ESTATES ASSOC LLC
Address: 11211 GOLD COUNTRY BLVD STE 10 GOLD RIVER CA 95670
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Manuf Home Inst
Plumbing
Contractor
BURRELL BROS ENTERPRISES INC
RON CLOEHN
RON CLOEHN
License
136446
Expiration Date
08/20/2005
Ph9ne
541-747-2724
343-1966
343,-1966
BUILDING INFORMA nON I
# of Stories:
Height of Structure
Type of Heat: Forced Air Elect
Water Type:
Ra:~~~: .
,~ '\~ f;> ~
_\Q.~ ;,,~t.\\ _0.
~\,\, ~~9WiG~NT INFORMATION I
SETBACK~\~~. ~\ S~\'\\)~~ ~fQ~ '
Frontyard Setba~~ S \>'t.~~1...'t.\) ~ (J~ 'CO ~, Overlay Dist: . '
Side 1 Setback: \~\ ~~(J~ \'\CV~\) \>~~,\:j # Street Trees Rqd:
Side 2 Setback: ~~ ~~~ \)~ Paved Drive Rqd:
CV~ \~~ \0
Rearyard Setback:' h...\'\" % of Lot CQ~~~~;\'~'I
S S b k. f' \}\{~ ~\\\\''',
olar et ac s, ~ teOl t\Ot' 6Q'{\
_ \~ ^..S'tJ _0\ ,
-JU..I" ...'.C''''''1 - - to"'I - t";,
O....\.L \}ll'l'n 1G f .U~V . '.li'tNtfs-' \
~~~ '\""0 't:'M "," '~
~",,€ u.\eS a: ~~et, ~~ ~{0u.9J'(\ 0\ \'(\a t "'-ot'e Sidewalk Type:
~\o'!'l t ee\.... 0\ 0 ~ "as ~09\" t'
\0 . . ce.\\ot' 00\,0 \" cO'\) ,\'(\a \9 ~\\\ce.\\O Downspouts/Drains:
~o\\\'\ ~ 9f';)'l.' :\j'0'O\a: ,~0\9. 'X\\'! ~o
"o~ --(ou. ~a: 9'(\\at. 0"\,)\\ ??/)/J,".'
\ 0090'. \'(\e c e otaC} ('\('\,,?-'?-?--' ~
ca.\\\t'C) \ot \'(\ ;e".9>
...-n.'Oet ",''''~
t'u.~" (",..
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction, Type:
# of Bedrooms:
1
R-3
1
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
1,344
VN
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Pal!e 1 of 3
.'
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00376
ISSUED: 04/05/2004
APPLIED: 04/05/2004
EXPIRES: 10/13/2004
VALUE: $ 25,000.00
_~~~".N~.~llI;~,J.
. .
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Descriotion I
Manuf Home
Tvpe of Construction
Manufactured Home
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
25,000,00
Value
Date Calculated
Description
Total Value of Project
$25,000,00
$25,000,00
04/06/2004
~
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Manuf Home State Issuance
Manufactured Home Connection
Manufactured Home Placement
+ 10% Administrative Fee
+ 7% State Surcharge
Manufactured Home Service
Amount Paid Date Paid Receipt Number
$20,50 4/5/04 2200400000000000319
$14,35 4/5/04 2200400000000000319
$30,00 4/5/04 2200400000000000319
$45.00 4/5/04 2200400000000000319
$160,00 4/5/04 2200400000000000319
$5.00 4/13/04 1200400000000000469
$3,50 4/13/04 1200400000000000469
$50.00 4/13/04 1200400000000000469
Total Amount Paid
$328,35
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769, All inspection requested before 7:00a.m,
will be made the same working day, inspections requested after 7:00 a.m, will be made the following work
day.
3 Manuf Home Set Up: When installation of all piers or stands is complete,
1 Final Manuf Home Set Up: After a'lI required inspections are requested and approved and porches, skirting,
decks, venting, street address numbers, trees, driveway, etc. have been installed.
2 Manuf Home Plumbing: After home has been connected to water and sewer,
4 MH Service: Approval required prior to utility company energizing service,
Patze 2 of 3
_~~@J:f~9,,~miq~I'
.
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: COM2004-00376
ISSUED: 04/05/2004
APPLIED: 04/05/2004
EXPIRES: 10/13/2004
VALUE: $ 25,000,00
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 on the site at all
times during construction,
Owner or Contractors Signature
Pae:e 3 of3
Date
225 Fifth Street
Springfield, Oregon 97477
.
541-726-3759 Phone
.
JiIiY of Springfield Official Receipt
"elopment Services Department
Public Works Department
RECEIPT #:
1200400000000000469
Date: 04/13/2004
8:57:32AM
Job/Journal Number
COM2004-00376
COM2004-00376
COM2004-00376
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Manufactured Home Service
Payments:
Type of Payment Paid By
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
3.50
5.00
50,00
$58.50
Amount Paid
Check
BURRELL BROS
djb
3464
In Person
Payment Total:
$58.50
$58,50
4/13/2004
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