HomeMy WebLinkAboutPermit Electrical 2005-11-4
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Owners Name G("~ V A(r~ ~ID4.,> ScrviceorFeederPermit S 3.00
Address :J 7"7 t' . Fr,4.., ~(~_ ~ /" J E. [~1~:~f,[~Ii~~~t~~At~!!;~~!F!~~3E~~JE~t~~~!l~{;;1
S?FD Phone bK7-<i?3U
ELECTRICAL PERMIT APPLICATION
City Job Number ~ 'Z-c.:oo S- - C> C> $' '3 C>
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LEGAL DESCRJPTION
t 7 (;> 'J "S41.( z...
c::.21.{ 0 0
JOB DESCRIPTION
HI H- s: b(l...V l L€:"'
, Permits are non-transferable and expire if work is
,f<, not started within 180 days of issuance or if work is
Suspended for 180 days.
2. [wjf~g&!ti~g~Emgie~i
Electrical Contractor &ar fI'{J Elect LL C
Address tb &X' q tl
II ./ fht 953-67((7
citylrt'<t, Jf'.l Y r~rzft.one~
Supervisor License Number qtVo )'
Expiration Date 1(~O/-o7
Constr. Contr. Number /Jt' Z 91{
Expiration Date q;. 4S-07
t~'lJ'7"
City
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent
Owners Signature:
Inspection Request: 726-3769
Date
3. ~<j&iiiill~1?ll~Il~g~,~~iJli;fl5WE;;l;j??if?
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A. ~;Ne~j>R~ide..nt!ak:SiIigl(oi~jiJti"F.amily:p.er~d)yCl!.ing .:ulliti*":~;:
"1f.......>'O.-".._-.'-._~~..:~,>_~,~:..I'., ._' .'.-Q~.,..,._..._. .......:"-'...._C'. .....'.....'>/':.....--. .:-o.~t'o......___"., ~l..r._:"':."'.....
Service Included
I 000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
S106.00
S 19.00
Each Manufacf d Home or
Modular Dwelling Service or
Feeder
/ S50.oo
s-o
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B. !i;Seiyices: of F'eeders'-4Ji1~tallatioit; :Alter,a tions'o(Relocation~. ;,.
~'6.~~;:.-;.;..:;:-~k::'.:--4:"..&..",,~:.."',:"""':":!.1.'I::";:l~;:';c.:.:;:::;;.lt~,>;,;3.:~~~,'1:::.~."".r,:i::'\:~' ,:o:.\~,~':!:':"':':"!:':;"';;': ,~,:~~'..,.,:.;:::".
200 Amps or less S 63.00
20 I Amps to 400 Amps S 75.00
401 AJtlpiilQl~psregon law requires '$1!i5~.'00
601 A1ilpSllli qOOol~ppted by the uregorS~J6~i.too
OvetJr~61l11er. Those IUlt:~ ~:..t: J3j5~~IP
R~M~2.001-001 0 thrOl-,\,l" ~n" 'S"50~00"
0090. You may obtain copit:~ u, "'''' rUles bY
'.'T""''''..~z;'~,";:<;<E;:;''R,'C?1k!:'i''''' t1'fe."'fdltFih1""\''';5;$;';<;~,..... ,,",,;.].
C. ~~em~_~.JJ~A'JCi5'.o['.;F~(Jers~ ;'!;) '~~Z-Jt:\.~~jt.t:'(~:.~,s;..~~-~;,~,~'3~Y'~~.~4
""'="riurrlbetf6hne'O{eg6ft1i'iJffiY"NlJ'.l+itiiitlliW-",;'<'b;';'-"~"j.
1 t II Ii. . . '" -",.,~ '0 'R~"I'" "'22.- ?344).
os a a on,. ~AUUn;or' e OC8uuO'
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
S 50.00
S 69.00
S 100.00
Over 600 Amps or 1000 Volts see "B" above.
D. t~~~!e~~~9!!E4~~~~i7f~:~~~~~~~l~~#~.[~&~~~~t~i~,?~~
S 43.00
Pump or irrigation S 50.00
Sign/Outline Lighting S 50.00
Limited EnergyfResidential S 25.00
Limited Energy/Commercial S 45.UU
iWi~~RMj!,W!.t)JfRE:~f:T'Hi.>>tQB'K~:,;~urChargeS
AUJ~~~~M1trlS\Nillf~::l' . S-O
~~~~~~NDoNEtnOR"'-'~~- . :3 ~b
10% Administrative Fee $'00
~8~
TOTAL .J
Shared Drive(T:)lBuilding FonnslEJeclrical Permil Application I-oJ.doc
.
. CITY OF SPRIr~\Jnlj,LD
Building/Combination Permit
PERMIT NO: COM2005-00530
ISSUED: 08/05/2005
APPLIED: 05/05/2005
EXPIRES: 05/03/2006
VALUE: $ 15,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
, 541-726-3769 Inspection Line
SITE ADDRESS: 3998 FRANKLIN BLVD SPACE 3 Eugene
ASSESSOR'S PARCEL NO.: 1703344202400
TYPE OF WORK: Manufactured Home in Park
,
. PROJECT DESCRIPTION: Replace manufactured home in park
TYPE OF USE: New
Residential
.., Owner: GREEN VALLEY ENDEAVORS LLC
Address: 3998 FRANKLIN BLVD
EUGENE OR 97403
Phone Number: 541-687-8322
I CONTRACTOR INFORMATION I
# of Units:
, Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
.- Secondary Construction Type:
, # of Bedrooms:
Contractor' License\O Expiration Date
BEAR MOUNTAIN ELECTRIC LL~\ \3'# !eC\c~iJit98)\i\i\'i \\"1 08/0612007
SUNBURST CONTE.!'1,~QIM.l&rqq ~S,\"Ie ?.,~ilZ?9se\ \O~\ _ 03/09/2007
SUNBURST CO~P9~i\I\HO ~.~'INC-~~I~WS2-0 ,,,' 03/0912007
\O\f"BUIJJIjING:iNFORMATioN'i e !~;;e
~o\\. P- 95't.-v~ 'o\3\n v~, . \\"Ie w\e? \\On
in 01>' ,/~corSi~r~,s,e!. \~o\e'\i\\\'i ~0\\\,C3 Lot Size:
R-3 0090i\i\-lteiJllit~~~t5\'S!Jfre 032_2344). Sq Ft 1st Floor:
03 ,Type:O('Heat:\ _\\00-3 Sq Ft 2nd Floor:
urn \.... .,.,,(\~
(\ Wa~r,\'Fype: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
Phone
541-953-6747
541-461-6541
541-46 I -6541
Contractor Type
Electrical
Manuf Home Inst
" Plumbing
VN
I DEVELOPMEN. m~uNdATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
. Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPROVEMENTS I ~~
Sidewalk Type: Co \f ,,~~ ~~Q"
AtJiK?~y..~ ~\A\\~"
\\Q'\\C~~~1~~~t~~~~~\) ~Q~
\\-\\<21 ~Q?>\'L't.U \) ()~ \<21 ~~~
f>.\}i ~'t.~,,'t.Q ?l.~\QQ.
"O\f. Yl\) \)~,
f>."' \
'. Notes:
PaeeIof3
Status
Issued
, 225 Fifth Street, Springfield, OR
: 541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
. Description
ManufHome
Tvpe of Construction
Manufactured Home
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Mannf Home State Issuance
Manufactured Home Conn - Plmb
Manufactured Home Placement
+ 10% Administrative Fee
+ 7% State Surcharge
Manufactured Home Service
Total Amount Paid
.
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00530
ISSUED: 08/05/2005
APPLIED: 05/05/2005
EXPIRES: 05/03/2006
VALUE: $ 15,000.00
I Valuation Descriotion J
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
15,000.00
Value
Date Calculated
Total Value of Project
$15,000.00
$15,000.00
08/08/2005
Fpp<. P"itI I
Amount Paid
Date Paid
Receipt Number
$20.50
$14.35
$30.00
$45.00
$160.00
$5.00
$3.50
$50.00
8/5/05
8/5/05
8/5/05
8/5/05
8/5/05
II/3/05
II/3/05
11/3/05
1200500000000001144
1200500000000001144
1200500000000001144
1200500000000001144
1200500000000001144
2200500000000001534
2200500000000001534
2200500000000001534
$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.
I ~lrr..i~n~ne~tions I
Manuf Home Set Up: When installation of all piers or stands is complete.
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.
Manuf Home Plumbing: After home has been connected to water and sewer.
MH Service: Approval required prior to utility company energizing service.
PalZe 2 of3
.
. CITY OF I)rKll'1\.Jt<1J!..LD.
Building/Combination Permit-
PERMIT NO: COM2005-00530
ISSUED: 08/05/2005
APPLIED: 05/05/2005
EXPIRES: 05/03/2006
VALUE: $ 15,000.00
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 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
..
.
Paee 3 of3
225 Fifth Street
SpJ'irigl1eId, Oregon 97477
541-726-3759 Phone
'~
Job/Journal Number
COM2005.00530
COM2005-00530
COM2005-00530
Payments:
Type of Payment
Check
~
.'
.
III
,
:1
1
.
.
o
,
'\1,
;1
)
'0
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I
11/3/2005
e
RECEIPT #:
Descrlptlon
+ 7% State Surcharge
+ 10% Administrative Fee
Manufactured Home Service
Paid By
GREEN V ALLEY
ENDEAVORS
Wir";~.~~.~~-..-'_._- [,'
.~ :
- ~-'
City of Springfield Official Receipt
evelopment Services Department
Public Works Department
2200500000000001534
Date: 11/03/2005
Item Total:
Check Number Authorization
Received By Batch Numher Number How Received
djb 1912 In Person
Payment Total:
Page 1 of 1
IO:47:46AM
Amount Due
3.50
5.00
50.00
$58.50
Amount Paid
$58.50
$58.50