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Home My WebLink AboutPermit Electrical 2005-2-15 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-36~'1 ELECTRICAL PERMIT APPLICATION '%:.:"i"O-t City Job Number LOVIA-z..o-O Lj.-- () 11 b b Date ~,z-t~~:t;;)--S- ,7 '0 Q:~'" "'~ t o~. 3. COMPLETE FEE SCHljD ~'-O~Lm>1%., "'0 \9 0..... '{o ~ ~ u- IS). 0Q "'6 g.., ~;. ~iJ A. New Residential - Single or l\~)ti-al per &~~~g unit. (Si (""".. 0". <;>", Service Included ~~~ "?c, 0", ~ /! 1000 sq. ft. or less ~ ~1 .00 ,,~<o-t, Each additional 500 sq. ft. or a ?<l'(Si :;'10 portion thereof $ .00 Each Manufact'd Home or '\. . Modular Dwelling Service or J $~OO Feeder 1,\0 B. Services or Feeders - ~~g(f&\~lterations or Relocation: .. 00 \a.\N te6te~Of\ \}t\ \O~ 2{~~~b~~~ij'o'itne ~eS a.te S~~_Cf\'\" $ 63.00 p>-"r~t.~OJ\~<?d>tO<t~tU ~Ofl.~9 . ec.'O'I $ 75.00 Address 3Y rrCj ~ SP~ LLWA Y R.O \o\\~,~~~qb~~~~so\\ne:t^~e $125.00 ~o\\\\C"" ~t'L"C\(\'\ -v . ~?~ \e\e",..-. n CJ 'I ;).. - ;(71 tg . p.~9'2)\IH1P~ ~0d&(nl~N8{e.. \ne rJ.,...W:a.'UO $163.00 City CoT/'f16{~ ro~Phone 7 ~7 - 2A"'_9'Jf \0 09t9.$lU~~~tsf\ \}\\X\\'i ~A A'\. $375.00 00 .~~ ~.~go ~?;2.'3""'" $ 50.00 C U{t\'oet \ot ~et \$'\.&0 ~ Tem~~~ry Services or Feeders 1. LOCA110N OF INSl'ALLAI10N --51--.1 ~ ''fO (l.. 5 Y j H ,. ~ LEGAL DESCRIPTION {SoZ 0 LfZ I o -z. 'ZOO JOB DESCRIPTION 11JH- Fcr:;'~AL Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor D A- V ~ () V..J. W 12:- 0 fi Expiration Date lj/'~oS )0/1/2007 ( ( Supervisor License Number Constr. Contr. Number ) (p ) 2> ~ / 9/)//')(~ "' t I .tJ:.:;j~EI~'~: L/ Expiration Date .. Owners Name CUP. T All M Lg G2 Address 5 P-Uo PdA 'Y--'LA;~ City . ~O F L 0 Phone J;t9 - 7.:J.. en 0 OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 so Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel ~'h~J.~t. as~<ldit 6K~itfuE If ,nc WO~~3.00 1~i~M~~den~lS~tTH\S PE8M\1 \S N@13.00 A\J~~\9R\f~> ...... \S .ABANOONE~ fOR .. E.cOi'4liUU:~m..P<%er^\)e/feeder not mcluded) -Each InstallatIon ANY 180 DAY PeRI\.). . 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. SUBTOTAL OF ABOVE S-O J5"o 7% State Surcharge 10% Administrative Fee ::500 5B~ TOTAL Shared Drive(T:)/Building Fonns/Electncal Pennit Application I-03.doc Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01166 ISSUED: 10/25/2004 APPLIED: 09/21/2004 EXPIRES: 08/15/2005 VALUE: $ 32,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5216 FORSYTHIA DR Springfield TYPE OF WORK: Manufactured Home on ASSESSOR'S PARCEL NO.: 1802042102200 Private Lot TYPE OF USE: New Residential PROJECT DESCRIPTION: Replace existing 24x56 double wide MH wi 28x40 double wide MH. Owner: Address: NIBLER CURT M 2085 RIVERVIEW ST EUGENE OR 97403 . _'" 'J.oU to _ \-aVJ {equ": . \}\\\\\'1 I CONT~~l~IM'O.iwm~O set 10nn p..\ \ \::. S adO?\;:;d 0 e tu\e'" 8 952'00~" Contractor 1o\\0\N {~\e centef. 1n ~'n~p..f\ ~vePI""lItion Date DAVID CHARLES N'M~J.n~a\\on .00\.oQ'\~ \h~~o\ the nor(&;/I212005 DAVID WILLIAM W~lJ)p..p. 952 {{\a'l ob\a\O ~~~e(}'t\e \e\~~\ca\~~7 /2006 JANIC KRENZ 0090. '(O~'hP. ceot~f._, ~fl1l8\\'l ~~) 11/20/2005 I Bu~~k"--\ e\ # of Stories: 1 Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Phone 503-355-2557 541-942-2718 541-689-9225 Contractor Type General Electrical Manuf Home Inst 3 Electric Electric Electric Path 1 nla LofSize: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 6,970 1,120 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 VN I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 20.00 5.00 5.00 55.00 5.00 Overlay Dist: Total: # Street Trees Rqd: 2 $Handicapped: Paved Drive Rqd:' \'r Ye'i '.J'JOR''Compact: tt~f~b}fGove{l\S~fl.ll r..'I-.?\Rt. tW\.~{l\ \S N01 1\-\\S ?_t.~~~~ \ \NDt.R 1~~~\~nNtD fOR I PUBLId-t~F'ki-:lY.\~j';~mN~s",i, I"'DV1 /, . - ,,,,,...Y. :~\!.uo.. '\ it$ ~fl.~~ '\80 Ol\'l r \,.. . Sidewalk Type: Downspouts/Drains: 2 Street Improvements: Storm Sewer Available: Special Instruction: Notes: Pae:e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction Foundation Only Use Bid Amount Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Foundation Permit Manuf Home State Issuance Manufactured Home Conn - Plmb Manufactured Home Placement Plan Review Major - Planning Storm Sewer - 1st 50 Feet Temp Power 200 amps or less + 10% Administrative Fee + 7% State Surcharge Manufactured Home Feeder CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01166 ISSUED: 10/25/2004 APPLIED: 09/21/2004 EXPIRES: 08/15/2005 VALUE: $ 32,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 4,000.00 Value Date Calculated Total Value of Project $4,000.00 $4,000.00 09/21/2004 ~ Amount Paid Date Paid Receipt Number 2200400000000001179 1200400000000001511 1200400000000001511 1200400000000001511 1200400000000001511 1200400000000001511 1200400000000001511 1200400000000001511 1200400000000001511 1200400000000001511 1200500000000000191 1200500000000000191 1200500000000000191 $39.39 $36.06 $25.24 $60.60 $30.00 $45.00 $160.00 $103.00 $45.00 $50.00 $5.00 $3.50 $50.00 9/21/04 10/25/04 10/25/04 10/25/04 10/25/04 10/25/04 10/25/04 10/25/04 10/25/04 10/25/04 2/15/05 2/15/05 2/15/05 Total Amount Paid $652.79 I Plan Reviews I Initial Review 09/23/2004 09/22/2004 APP SKG PlanniDl! Review 09/23/2004 10/08/2004 APP TAJ Needs survey because of minimum setbacks. Public Works Review 09/23/2004 09/29/2004 APP CS New dwelling smaller than existing no SDC fee required Structural Review 09/23/2004 10/05/2004 APP DLM 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. 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. Manuf Home Set Up: When installation of all piers or stands is complete. Final Building: After all required inspections have been requested and approved and the building is complete. Paee 2 of 3 CITY OF SPRINGFIELD C Status Issued Building/Combination Permit PERMIT NO: COM2004-01166 ISSUED: 10/25/2004 APPLIED: 09/21/2004 EXPIRES: 08/15/2005 VALUE: $ 32,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ManufHome Plumbing: After home has been connected to water and sewer. Storm Sewer Line: Prior to filling trench. Temporary Electric: Approval required prior to Utility Company energizing pole. 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 Pal!e 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone C'lty of Springfield Official Receipt velopment Services Department Public Works Department Job/Journal Number COM2004-01166 COM2004-0 1166 COM2004-0 1166 Payments: Type of Payment CreditCard 2/15/2005 RECEIPT #: 1200500000000000191 Date: 02/15/2005 Description + 7% State Surcharge + 10% Administrative Fee Manufactured Home Feeder Paid By DAVID WEBB Item Total: Check Number Authorization Received By Batch Number Number How Received djb 304626 In Person Payment Total: Page 1 of 1 8:58:49AM Amount Due 3.50 5.00 50.00 $58.50 Amount Paid $58.50 $58.50