HomeMy WebLinkAboutPermit Electrical 2003-12-31 (2)
~: .", ,~ '2':25 FIFTH STREET ;. -; ~\ ;;', j< , . " .:: : :; : :', ::'" ELEaCAL PERMlT APPLICATION
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: . .. " 1 . INSPECTION REQUEST: .726:3169'''-; ~ I ,---::' ,e.' :' Tify'Joh NumhcrCOIM c.003' ~ 0 J Z 9' .0,
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Y;':.~:, 1;",'1. LOCATION;Of'lNSTALLA1TQN ~"::",;,,,'~~:,,::"'~I:\::::J:;\, i ~,~:, \'." :,' '. '
':'>' ',}. 53-3'~ L:-';b'f! i"s '-7'>: /~l J#t- c:g::g::;~"..:_} ~.> N~~~;~'R~;identilli,si~glc or'~'",:, :\ ~ : '--
Multi,Family }leI' dwelling unit.
Service Included:
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LEGAL DESCRIPTION
\702. 3300
0/300
Items Cost
JOB DESCR~TION , t s submitted has thl{lt1~rR. or less
J1Il-t >~&\~J;~~e~n~ require specific IT!lPc~~ldditio,nal 500
,., zoning, I ;-...,." ~ sq, ft or DortlOn
.' approval. v\.,./y- ~
Permits are rion-transferabre ana ex~iWlng _ mereof
if work is I19,(.'started within 180 days 0 \a- - ~ ,- o\~ elldrlvianllfd Home or
ofissllance2r~fwork is suspood6Mv" r~ J&.V ~lodt~lar Owelling
180 days, :';~':'z Autl',onzed Slgnatu ServIce or Feeder
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$106,00
$ )9,00 '
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B. Sel'vices or Feeders . . ;.:..' '.
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Installation, Alterations or,
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Relocation: ,:\ ':;, " .' ;, .' ""
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Burrell Bros. Electric ~;f', i":~, '." ','. '. ,- , " . '
40159 Booth Kelly Road ~"":,)~;,,, 200 amps or less' .' .' ...' $ 63,00
Springfield, Oregon 97478 I,L"':, >'.... 201 amps to 4d6'~IilP;~' '., .' ',' $75,00
, .~~~ '-:-~L..~ ...... ;!~~::':~,,~ ~~i.:.:,' ,'>',401 amps t~(60Qamp~, '"'~., '-, $125,90 " .
" [-? "~I \':<. ',< /~;.:,,:.t~;;,"';~5;~: ,<';..:" ,,;. " I '~q 1 amps ~o 1009 amps ' , . . $) 6~ :00. .
Supervis!?FJ::.ic~.n~,e!Nt!iB~er'\.~~~;":'\.~~~ ":"", ''', '; . Over.,lOOO:' amps/volts, $~75.00 '
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. ",,".' '".:" ,:"\, ,:...:' ',' -",I,''',,,,,;., .;;"ijf,"',' :,' I" Reconllect'''''Illv " . $ 5000 '
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t,.::,; ~',: ~;1JirationDate': c' \9-\.\::)~,,:: ~~ ,> .i:.:~: ,:::< ~;'.- < ,,'. ',:'>' ' ':: '..'.',:, ,", . '~ ," , O"'~ '
(< : ~;" ,.,:,:',':' :-: \:,' '" ;,,'\,' ,:;\~;'.\" ':~1."" ,\:':::,>:, ' '.C-: Tcmpon\.i:y ScrvicesYor Feeder~ t. \r l\-\t.,~ '1
,:' '~'eon~tr.~9~tr, Nui'n~er1.b'~~::('.':'~'; ,:,:;<" '., :', " i~stam\f!W.J;.'Alt~rat~'\~\!.tRdl~~~H)ef\~\1 \S-~O '
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I,' ";,.:'~.: ;;Expiration Date '\~\b\(" :~:.::' :.,' ,?,.:: ':,:~",': >";\"'~):?) 12e~\ (~W~~e~~ Q.le. ~e~~QQr. $50~OO '
"''''('i''.':',';-, "'...."'",:"jl>,.:d'j., ,.,' P2en. "~\9~cAt\n\V' .' $6900 '
~. .':{~\.>,.~t~:Si~;).;,l,~ure.,of ~uJlerYising Electrician ">.._~,,~~, .,-,:~.,jG5A~~~~~QQ 2~~Q. ,'," $100,00
:::) :',...,.:+ ~ . "{J"~LitiJ' <t "~. ">" ?J "~B~'lb~ ,amps ,Ot!,~9~,vo1ts see. -I, ' ,
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::,,:~ .,i:y~' ~l~rs~:alne~~+' ~,('~':~;:.:;t:~-/;a.ic-s D. Bral~~~v,7lSf~1~~ion or Extension Per'~(~nel
;.. "":' }~d~:;'ess:,:;',JtIH,\:~ofJ:'~J~'7 ~~ on:~:~~ir;l~it \ ;;.\ OU\o. '. ,$43,00
" ....:.c;;v~+e,~~,:cA.hO~,;.. ~~NI\ON.,t&:~::~fu6~9*~ervi" $ 3.00
';:,' OWNER INsTALLATioN' p;. {U\eS 3, (~,."O~ DO"'~ > \@~ \ "
, ,.' " Theinstalla~icinis:beif).g made 011', ~0\~~\H \\~ ~~~urt$l~~~~~~(''\\d€J.{mfrt~CllIded)
" ~. ,'prop~erty I,o\vnwhichis nci!interded .'.. -\o\\~\ce: sz-R01-, (~~\~'~l$.ffi1)rn&OA \e\etlno. '. ,
, . .'. .' for s'~lie, lease ofren!:'" " ,\ O"'~ 9 u tn~~~_fl~ O~~~'i~~e tlot\\\Cat\on . $50,00
'. .... . ,',>,.;,., ,'.~, 0090.'(0 \ne~~6'u ~U~\'1t~44). $50,00
',",:. OrrncI's S}gnature: ",. . .... ca\\\ng ~o{ \'t\R1-Q~~ t'\~~e?-- $25.00
. .' . , ' , ." .' ...' . nu",b.e{ rr~llci111n~1rEI}ergY/C0I11m $45,00
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2, CONTRACTOR INSTALLATION ONLY
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l\'linimuIll Electric Permit InS)lection Fce is $45.00 + SurcharHcs
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4. SUBTOTALOF ABOVE,
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7% Stat~ SUrCh!lrgc
8% Administratiyc Fcc
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TOTAL
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01290
ISSUED:, 12/30/2003
APPLIED: 12/30/2003
EXPIRES: 06/30/2004
VALUE: $ 12,000.00
Status
Issued
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5335 Daisy St 88
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 ASSOCIATES LLC
Address: 11211 GOLD COUNTRY DR STE 100 GOLD RIVER CA 95670
I CONTRACTOR INFORMATION I
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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
BUILDING INFORMATION.
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction 'Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
R-3
",..
SETBACKS
I DEVELOPMENT INFORMATION. \av-J faQU\fas 'j~\\\t'/
Ot\.\.Q{a90n ."e ou~t;U~ihlWR>MRKING
-r"'I"e.t'l1'\ \.... ~ed '0'/ \ afe 5 '
Overlay Dist: /1.\ , U\eS ad09 1'"Ose fU\efo,t.~9S2...o0
# Street Treestll~~ '. On cantef. 0 \,,\'oU9" ~,'t~~1\RP€lf. \
Paved Drive .~,\ca\\ C.2_00'\--09~ ,I', Moi>\eseompA~~one
nl\f' 9.., o'o\a\n . \"a \6\' . \\On
% of Lot Cov&,U '(OU '('(\a'/ tsf. ~~o\e. W\'/ t'l0\\1\Ca
00 c~\\\{\9 \,,_~~; o\'eg~~ ~~~_2344).
e;U' \- , . '\-".,
I PUBLIC IMPROVEMIDN'l'S. r,......~,... Ie '
Sidewalk Type:
Front yard Setback:
''0, Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available: OR~
Special Instructi9!l:'\CE'. E'fJl\Rc \F 1\-\c 'N M01
Nu \ . WI\i S\-\~ll PERWI\1 \S \'~
Notes: i\-\\S Pt.~ItO lINOER i\-\\~\OONCO fOR
~Ui\-\OR NCE.O OR \S ~B{\\'~
COWlWlE. O{\'i ~cR\OO.
{\N'i '\ 80
Downspouts/Drains:
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Paee 1 of 3
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. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: 'COM2003-01290
ISSUED: 12/30/2003
APPLIED: 12/30/2003
EXPIRES: 06/30/2004
VALUE: $ 12,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description I
Manuf Home
Tvpe of Construction
Manufactured Home
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
12,000.00
Value
Date Calculated
l.~~
Description
Total Value of Project
$12,000.00
$12,000.00
12/30/2003
~,
Fee Description Amount Paid Date Paid Receipt Number
+ 10% Administrative Fee $25.50 12/30/03 1200200000000002670
+ 7% State Surcharge $17.85 12/30/03 1200200000000002670
Manuf Home State Issuance $30.00 12/30/03 1200200000000002670
Manufactured Home Connection $45.00 12/30/03 1200200000000002670
Manufactured Home Placement $160.00 12/30/03 1200200000000002670
Manufactured Home Service $50.00 12/30/03 1200200000000002670
Total Amount Paid $328.35
IJ:jo 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 Manuf Home Set Up: When installation of all 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 Manuf Home Plumbing: After home has been connected to water and sewer.
4 MH Service: Approval required prior to utility company energizing service.
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Pal!e 2 of 3
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-01290
ISSUED: 12/30/2003
APPLIED: 12/30/2003
EXPIRES: 06/30/2004
VALUE: $ 12,000.00
Status
Issued'
225 Fifth Street, ~pringfield, 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 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 10,cated at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
VWtf2f!t?--- '
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. Owner or Contractors Signature
Date
Pal!:e 3 of3
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 1290
COM2003,01290
COM2003-01290
COM2003,O 1290
COM2003-01290
COM2003-0 1290
Payments:
Type of Payment
CreditCard
Receipt #: 1200200000000002670
Description
Manufactured Home Placement
Manuf Home State Issuance
Manufactured Home Connection
Manufactured Home Service
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
GERALD W ALTERS
Check Number
Received By Batch Number Authorization Number
djb . 000262 615193
city of Springfield Official Receipt
Development Services DepartIl!!nt
Public Works Department
Date: 12/30/2003
1:16:53PM
Amount Paid
Item Total:
160.00
30.00
45.00
50.00
17.85
25.50
$328.35
How Received
In Person
Payment Total:
Amount Paid
.
$328.35
$328.35
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13'
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Front Porch
6' X 12'
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Awning"
7' X 14'
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t Rear Porch ;.
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Electric, Water &
Sewer Service
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Carport Awning
12' X 26'
NORTH
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Granada Estates
5335 Daisy St.
Space #88