HomeMy WebLinkAboutPermit Electrical 2003-10-9 (2)
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J:'; i 225'~IFrH SJREET :'" ",..f\ i""'-)f'! (, (: i ~ ,'" ELE, ,UCALpERMIT APPLICATION
><.:, I 'SPRINGFIELD OREGON:97477 !;,: >Ii',! r;CJ,"i !', ", i\:';" ,.', "
: .' > ,,':: . i" INS~ECiION R'E:QUEST:'n'q:37,6{:'=;" r.:'.:S:~;' tH :;:;:Cih::~oh ~ii:;;;hC/CO~ 2.003.... :b I 0 Jb
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I Multi-Family per dwelling unit.
LEGAL DESCRIPTION Set'vice Included:
I 701. 3300 0 I 3crc
B. ,Set'vices or Feeders .
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Installa~ion, Alter~~:~j~ns~~:, ,,'i<::', ':,",
RelocatIOn: /',:'", ,', ,,: ...'!.;:'" , "",: ,,' ":}"',
Burrell Bros. Electric l/:",:\ ,',~ ' ~ ~ .:':~, ... ',\
40159 Booth Kelly Road 200 amps or less' ',' , ' "$63.00.','
Springfield, Oregon 97478 20 I amps to 49'O"aI~1pS' , ' - " $ 75.00
, ~~'" L-~~' ,:',,~.., 401 amps to!~60amps :. " ',$125.00 '
" i'" 0:'. \,,/(:,:;....',:~:,,:' .<,,'6Ql amps t9)OOOamps" $163.00,
Supervis,OrLiceils:e1Ntlillbe~~l.L"~~"'\" , -::' ' Over,)Oq0 mnpslVolts . $375.00
i"';', ". j \ ':: ~'" ~^~;" ' >' ,,'~.," ~~,<r,\:<.,",", " t. f' 'yo 1 ,,> .. '.. $
~ t.l, '~ >'1J~: :' ",\~>,':~t;J: A"~> f{1~\~:;r''''~~~~'::~<' t~~\- %~>;:'r,'~{ \'<\ ,Reconnect n y ,,' A,' ',;~ ,: ','.:'. 50.0.0
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EXplratloll,Date, ''-<:;:)\~~ ".~,,,'i;'"l t~"", ~,~^.,\'.,:r-!;;;,'\"', ~"",I,;:'<'V,),~~~"d>'"\),,, ',.', .,'
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-hCohstr_~?ntr. NUl11b,e~~~t.:...C . '\,.";:::"~S\,:t:,' ':f.Ir~t;lll.iti~)ll; A.I!~nition or Rclo~atiol1
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'" '~';,E~pirationDate ',\-:;:.\j~~~:"c.",''':'':i;'nl~e\E:'':. :20~<1I~;~tw\~~\fn-\EWOP.K,' ,,$50.00,
,::',,::':<:~~~,::., ~. ,. ""-"~'~--""~;"'~BMft'fMNa\1\)9s"tb~4t9~W~1\SN01,', :'$6?00,
~,/,,::'.:..'i,"::', St~t',,~,}~tu, r,c;or~~,tJler\'ISmg Electnclan ,\-\\'$ P \2E1r~~~iti'A~~J \H.tlh fOR' , \', $100',00
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:,i" ' , "', , ~:'\J';' " ' D. Branch Cit:C'li'its ' .
'i~cr'sN:amc:S~:$:.AtC:6':-:; 'e-s 1- Ne\v.lAIt~n{tion orJ~:xtension Pe/P,~ne1
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,Ad'dress.'.>, :';.$r ."'",;t>n~j),V:S, s, On~'Cir6uit'>> ;: ,: $43.00
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: ,,' ' ,', ',' ~it,' ,.:' ,.-' ',,: " "Phone", ~~'iJ{'Q"f.Oregon ~"li!~ ~1t~8i~ Qi~itbJ ,or with Servi?e" :
" .', " " " , ' ':f' 'IIow rules adopted b~tp:~e er Pe.onlt"eHo~ " $ 3.00
, , , ' " "" 0 Those ru $5 ~,1b1 0 ,
OWNER INSTALLATION: ", tT aUon Center. ".,.., (')~*' 9.52~OO "
The installa.tion. is bei~g made o'ri'.O , '~ 952-0.0.1 ~O'MlisbJ"1~JG~~~'6rViru(~'S~er not includ~d)
property I o'\vn which iSBo! in,tende'cPA YOU may obtain,.c(ij~~~~l l'I~i~one _
for sale, ,lease or rent.. ,', )1)90.. . h center. (NIO~p~~~dl\ f n ' $)0.00
" ',', :. , ' , _" ' , ' '. ~ '" ca\hng t e the Orego$il!!Um~\.iit1lf.:Il\YR@MP $50.00'
, Ownet's:Signature: , ,,',' numberior . 1 ~BOeil3i3~zm4~/Res $25.00
,;, , ,'.. r~l"\tt\f'l~ L'" dE Ie $4-()0
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Items Cost
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JOB DESCRIPTION ' . d haJt~~q~i1fiJ'lgr less
f'IIl,f- Sbtl~"L-U<. 1-~^""inn oroiect as sUb.mlt~pecifi~awhP,~lhional 500
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)', zoning, and does () , _ sq, ft or portion
Permits are n:<?n-transferable _~re f..A. D(<---- thpr'~e-f '
if work is n?(started within 180 days zoning--:-Oc; -o~ ~ach ~1111f'~ Home or
of issuance br if work is suspended for lO. -'0 \ Modular Dwelling
, : Date - vJ ~
180 days. .,~: S' ature Sa v lee or reeder
: ... .. :', Authorized 19n
$106.00
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$ 19.00 "~
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$ 50.00'~
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2, CONTRAGTOR INSTALLATION ONLY
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MinimUl~l EI~ctric.Permit)nsJlcction Fee is S45.00 + Surcharges
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4, SUBTOTAL,OF:ABOVE
7% StateS~u'ch\lrgc
8% Adniinistrath;e Fcc,'
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3.)0
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01016
ISSUED: 10/07/2003
APPLIED: 10/07/2003
EXPIRES: 04/07/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 Daisy St 87
ASSESSOR'S PARCEL NO,: 1702330001300
Springfield TYPE OF WORK: Manufactured Home in
Park
TYPE OF USE: New Residential
PROJECT DESCRIPTION: MH in park
.
Owner: SANTIAGO ESTATES ASSOC LLC
Address: 11211 GOLD COUNTRY BLVD STE 10 GOLD RIVER CA 95670
I CONTRACTOR H~~uRMATION .
Contractor Type
Electrical
Manuf Home Inst
Plumbing
Contractor
BURRELL BROS ENTERPRISES INC
FATHER & SONS OF OREGON INC
FATHER & SONS OF OREGON INC
License
136446
100726
100726
Expiration Date
08/20/2005
06/29/2005
06/29/2005
Phone
541-747-2724
541-689-5090
541-689-5090
VN
I BUILDING INFORMATION I
# of Stories: ,\\'t- ~~~ Size:
Height of Structure ,~'t- ,'" ~\\ 'CO ~q Ft 1st Floor:
Type of Heat: ~\.. 't-i-\' S \''t-~ \) ~\)%q Ft 2nd Floor:
WaCet, T~~::'\\~ a ,\\'\ (\f\~~ Sq Ft Basement:
"'ir\'U~ 1\\" ~ ,vv
b.\\)Rang~yp : \ \\\\)~ c- ,,~~~ Sq Ft Garage/Carport
\"" ~ y..... ,d.~ \) \~ t"
\\~nergy,",r~th: ~~ \ ~, Sq Ft Other:
~\J\~~'t-~CJ't-~'l \''t-~\\j Impervious Surface Area:
(', \\'. C\'.' J
,I DEVEI;QP'.N,lElNT INFORMATION I
.
REQUIRED PARKING
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
'IOU \0
% of Lot Coverage: 'eQU\te5 l '\\\\\'1
n \a.'J\/ t goO v {\\
_ ,",;.t:I\.\'Otego~ ';:} ~\n0 Ot: ;...:'" ~e\.QS ~
PUBLIC IMPROVE _ '. s( 9\5,'0050 tU\S O~ gS'l...ov \
~o . ~\\\st.. . ~h'lQU~'o II 'oS tU\\ID9
~ \\ce.\\OO 0'\ _00 slliewal~l~Ife: '\: hOOe
'\0 \ 952-0 ~\O cO\' !l~ \l.?I\s9 . (\
\ O~p.. '({\a'l O'O'lJo'{,~Ul$i.Uts11Jr~B\"\Ca\\O
0090. 'IoU \"e ceo\S{, 00 \)\\\\\'J \ 44).
ca.\\\og \"e O{S~ no_~~2-2'3
hat ,ot . '\ -8v
nufiW ce(\\et \5
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Pae:e 1 of 3
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.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01016
ISSUED: 10/07/2003
APPLIED: 10/07/2003
EXPIRES: 04/07/2004
VALUE: $ 19,500.00
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
19,500,00
Value
Date Calculated
Description
Total Value of Project
$19,500,00
$19,500,00
10/08/2003
~
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Manuf Home State Issuance
Manufactured Home Connection
Manufactured Home Placement
Manufactured Home Service
Amount Paid
Date Paid
$25,50
$17,85
$30.00
$45,00
$160.00
$50.00
10/7/03
10/7/03
10/7/03
10/7/03
10/7/03
10/7/03
Receipt Number
2200200000000001627
2200200000000001627
2200200000000001627
2200200000000001627
2200200000000001627
2200200000000001627
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 7:00 a,m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
1 ManufHome Set Up: When installation ofall 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 ManufHome Plumbing: After home has been connected to water and sewer,
4 MH Service: Approval required prior to utility company energizing service,
Paee 2 of3
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01016
ISSUED: 10/07/2003
APPLIED: 10/07/2003
EXPIRES: 04/07/2004
VALUE:
Status
Issued
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 Community Services Division, Building Safety,
I further certify that only contractors and employees who are in compljance 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, . '
/0/7/03
Owner or Contractors Signature
Date
..
Pae;e 3 of3
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield OffiCial Receipt
Development Services Department
Public Works Department
Date: 10/07/2003 8:32:55AM .
Amount Paid
160.00
30.00
45.00
50.00
17.85
25.50
$328.35
Receipt #: 2200200000000001627
Job/Journal Number
COM2003-0 1016
COM2003-01016
COM2003-0 1 0 16
COM2003-0 1 0 16
COM2003-0 1016
COM2003-01016
Description
Manufactured Home Placement
ManufHome State Issuance
Manufactured Home Connection
Manufactured Home Service
+ 7% State Surcharge
+ 10% Administrative Fee
Item Total:
Payments:
Type of Payment
CreditCard
Paid By
GERALD WALTERS
Received By
djb
Check Number
Batch Number Authorization Number
How Received
In Person
Payment Total:
Amount Paid
00018 610323
$328.35
$328.35
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Electric, Water &
Sewer Service
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14' --.
28'
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16'
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Front Porch
10' X 10'
Carport
-- - -- -- -- --- - -- -. Awning
.-- 13' X26'
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10' X 12'
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Granada Estates
5335 Daisy St.
Space #87
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