HomeMy WebLinkAboutPermit Electrical 2003-10-28 (2)
,.. -~;.>. .::-_:-'.: ;: CITY OF s( ?'NOFtEtD, OREGON' ,:'~ '
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225 FIFTH STREET. SPRINGFIELD, OR 97477 . PII:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number CoI'.I\:ZCO?:,'O\Oz.t Date \0 -1..6-03
1. fil!KOCA,' -'iioNI6itiNsfA.EifATioN~F1,'tJ
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LEGAL DESCRIPTION
n03 34- 4A- 00 "$0 \
JOB DESCRIPTION
~e,\L ~OM~ f'eE.:);:E..\L
Permits are non-transferable and elplre If work Is
not started within 180 days of Issuance or if work Is
Suspended for 180 days.
2. coNf~~.~~;~'~~R'1iNST~ilf7Z2~~if.4
Electrical Contractor . C ~ s ~AfC-+Y'C I TtI',C, .
Address p, D, BD'l \ L) ~ )_
City Sf.>{\ \~f tel Phone I Y 1- 2,<t~
I -. ~~ ~""
I I' . ...%' -# [::)Q:.
Supervisor License Number ,<g q^~~ (f:> <<.
~""",.-h":>' r;r'
Expiration Date \ D - Ob.,,, Q~ .P
~...,,~;~~< ~.
Constr. Contr. Numberr...G ;..J;:'iI. ~'I_Q::-":> "'~.
~'AO 17- .J~,
Expiration Date "\;' .~O:f :tf.;ifj'LjQ
'Y ('..' ~. <:1'
. fS" E'~I j,;j-~ n.<::
1 nature 0 upervlsmg ec:-:-v.an,"
~~
Owners Name ~~'t2OCI~ \l.Cl..LA.6E-
~ -
Address 4-S~ I f'~tJ..\.<.Uf.\ ~L\l~, "ttll~
City E u G.e:.t-l.E- Phone -, ~ 1-"1 <\13
OWNER INSTALLATION
The installation is being made on Y' ~y'..J I own which
is not intended for sale, lease or rent.
Owners Signature:
Inspection Request: 726-3769
3. fl;'C.O,' M-Pi1Ei1tlEE'SCHBD'T fij.@Q~
['i:lil'~~!~I:Ql::..l.~t;OJl~!l?""'."~~~' .. .
A. i~N~~RliS1li~iitilii,!si1lgnil1l'?M~fti'1EiMii~1p's~~t\1~~mljg"1lilii. . ,
lf4'l...lXr;~J..~L::~.:i'!l":.e "'['<ll~~p~ ..-~~It.:........ "'''''''\.;0... .".
Service Included
I 000 sq. ft. or leSs
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$106.00
$ 19,00
\
$50.00 $0.00
200 Amps or less ,0. $ 63.00
;;:;. .~.~
201 Amps to 400 Amps f' ....~ -f' ~ $ 75.00
401 Amps to 600 Amps ,;0'" ~v _~. s:J" -$1'25.00
~ ..$;> -J 'V h
601 Amps to 1000 Amps ~ ~IO'" c....1O ~ .~IO !f6kOO
bO o~"r:;,,9
Over 1000 Amps/Volts ,-<'. 0 ~1Oc, _"" ._10 if$~$"'OO
Reconnect Only . J .~ ...v "'v)>".... ;:,.10 ,~\SO.OO
S "","", '0 ~ - .....- 0'"
0'1 """...... _Cd 3$ ....~ 0". ~ ="',
C. nfelii....~lI'""lsi!iMl!l.t\~~~~\k._!l~_~
1!r.,..,~...m~lIi(:j"'~i~~~
..:F ~?$ {!I ,,>.; .~ _,0 "",<tI
<~..v " "v '" ,,, c-. ,,:.J
Instanatio'!i'A1'eratlon or .Relo~ation,.:,.J
~ -...~v u ~' 0"" '0' 00) ~ .
200 Al1)pS<<6~essJ' <.);r::s ~ 0~ ("1<; ~r::s . $ 50.00
201 AmP'!>..w400 imn.~ 00 ~0 .,c,' $ 69.00
,,0 ,'Wa-.';:''' 1<:' " ...
401 Amps te:ti9.Q>Ari1ps~ ....0... 1$:'9 $100.00
~ 0 ~',<S' ~ 0
Over 600 Amps'?f).9.\lO~\f<;I~.ee "B" above.
D. ~l!ii,.li[.liJ.Ig"'~J!~ ., '" . \'f;. --"
New Alteration or Eltension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Pcrmit
$ 43.00
$ 3.00
E. !iMili\Hliill~ijlm'ls~~c>Wfliil~i!1ld~1:-!"iWlli~rlill'inW~
m:t~~:':/'}'j"'1"itUi:Ul.~1U~~ . . ~t~~IJ!!tlt:t1U~..",;;....~, -, ~
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited Energy/Commercial
$ 50.00
$ 50.00
$ 25.00
$ 45.00 .
Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
4. J.f!SUBrof...mO~ABOVE_
riW-:~~~~g::::i}ii~~l~tff ,,~: ' , ' ,~ ,
7% State Surcharge
10% Administrative Fee
50,00
3,SO
,C;,QO
58.So
TOTAL
Shared Drivc(T:YBuilding formslElecbical Permit Application (.(I].doc
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225 FIFTII STltEET . SI'IUNGFIELIl, OIt 97477 . PII:(541)726-3753 . FAX: (541)726-3.689
ELEC11UCAL PERMIT APPLICA110N
City Job Number CON\. 'La::::>:,O; OlO-z.. \ Date \0- 'Le.-c~
Permit. are non-transferable and expire If work I.
not .tarted within 180 day. of Issuance or If work I.
Suspended for 180 days.
2 lifeONTRAGTORIlNSTAL'Di'fioN:(jNi"i!,)j
. ~~I.~lIli!IitNJl:'!-~"'!l'Vitb"'~l!~~~
Electrical Contractor G ~ S f/fC,,1YIC ,:JW:, .
Address P. D, BDi \ L) <6 7-
City SV{\rd~fiJ.Phone iYt-223b
L!"!()L\ S c. hfem'oPa"'S.;ijjj'eslCir;t'ieliers~~~Im.~
Supervisor License Number \)"-', . ~\I~~~~.,"."'''~'''~''<''l''~~
Expiration Date I D - 01- 04- _ ~\;)$'\rnstallation, Alteration or Relocation )
-, '\.* ~ 200 Amps or less l e . $ 50.00 So
,)~Lj CI !v~ ,"'~ '<..\;)~201 Amps to 400 Amps _-0",'~ ($ 69.00
q LJ <>{f <>~'<::' -~ 40 I Amps to 600 Amps c. ""- -.'l~'_ ,0$100.00
E . t' D t -/ - 0 ~ C-' ",,- 4lU :!\," 0'- C)V ""'-
xplra IOn a e ,,"" ~'J~" Over 600 Ampsor 1000 Volts ;.'" ?l\b.~~'V ~'?>
Signature of Supervising Elecirician "=>~~<S:''''~~ D. [>!ti]l!.i{![<i!W'Wll ' "[>.f ','"
\ . ~0-~~~' "~~OOS'~'1l'
~.. ." ",<(- ~ New Alteration or Extellsion'Pei'Panel~ ~0 ~v
,- '" (~ ....0 'Q~ r:,l()..$$ U ,0 ...,
c:-..~ ~ ~ . i'" One Circuit io..0'O i> 0 ,n". 0."> _0 $~3.QO
. ~~~"=> ~<;:s. '~~\,J~~' Each Additio nal ~~ui~r Mfu ~ o~- 0-:-"~~ '~t:A
S ~.u~~:'~ ~<:\... ~ r::: ServiceorFee~~Pe.9Witg."C"I,).,$'v ~ ~~ J1'3.00
Owners Name €-I,....,"l~. ~ q",- . . ~ ~"> _t>'!:' ~ ~'1l' ~ _~ ,,"J _ .
f :->d~ -tl. lr....~,l'''ijf''ia''.... ',l'~"Ei1' ""m~'~1Wl'rnl'm""~~ill1~'A
Address 4S~t ~f<;~~'-'-'I" OL\J~, ll') E. m~~="'il~ ' .e en", . i!)m~L",~",,~J~Y,ut~~
c "1 J\' '"2 (~,o.r.,'lf O:l~ ~ v 0 ,;.",
City >-0GS.f..I.E- Phone"l~ ~(","'l~ Pumporim~li~?-4.0-0>S'0io..OS' ~,. $50.00,
SignlOutline'1.!gh~g ~~o., io..,O /'" $ 50.00
Limited Ener-~siQe~? ( $ 25.00
!;YO''' ,,_
Limited Energy/Comrlil?'rcial $ 45.00 .
Minimum Electric Permit Inspection Fee Is 545.00 + Surcharges
4. ~~suBfoTMrOE~."'r(fVB_" '.~'''', ~~!l!l' C-o
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!l'.~.'..-l:...:~~:.;;..(.,_:c...?i1h'Jror.1=;~ift::.<.u.'i. 'ETI1,' ~ .;.....~
3.$0
5
5'8, So
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M2 ,"'-," ,.,.~... ..~. "'.'~'-~ll!!.o.-"~.l-_ ..fL', .....,.~.....OJJ~i!~~l,~lt'i:i!
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LEGAL DESCRIPTION
nO~3~4:6,.-~03C\
JOB DESCRIPTION
~~IL tl.o"e., E'c.~~E.n-
Constr. Contr. Number
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
3. ~,c6MpiiE'i'E: ':EE:SdfjEjjtl.tE'BEEO~~
~k;;....t';'-:I~~::..a:.::",g:..,-.._~."",,--~.~.._.,~~...-_._,......;;t: _
A ~"N".'""""R'r.. :d''''''''''I:~'IllS' 'lifll'I''''r.'!JIlM.'i'~I''!'''E'''''''IilP.'''''i'i1'''''1ill''~'''''''''C':tJ. .
. J ew eSI en! ....- ng e ,or,' u "" am. ",ne!i: ll'e mg nOl
r~-\::.\:.o'-)t1.~..u.:~lo'''''--~ff I"-'.;.. n^,t:.t.:.~~t:rM,-.,..-r:l......~_ ~;I"'...... >r~ 'lc.'~- lilU'=
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft, or
portion thereof
$106.00
$ 19.00
Ench Manufact'd Home or
Modular Dwelling Service or. $50.00 ~
Feeder .
-1lilllili:rr .1M1~'ltll~>c:~It~~~r
$ 63.00
$ 75.00
$125.00
$163.00
$375,00
$ 50,00
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
7% State Surcharge
10% Administrative Fee
TOTAL
Shared Drivc(T:)lBuilding FonnslElectrical Permit Application l-03.doc
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....---.....
.~cL,
215 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)71';..3753 . FAX: (541)716-3689 ~J?OvLJ. IN l
~~~o~~~~ PERMIT APPL1CAT1~: 10 Z$1)3 . \ f 'M:aS~'0& rd
3,. ~
10/28/03
09:50
'8'541 741 2473
C & SELECTRIC
~~~ CITY OF SPRINGFI
'< :'. CITY OF Sh<.lNGFtELD, OR
LEGAL DESCRlPTION
JOB DESCRlPTION
nnbl( 1J.,()lY\~ ~()M1
Permits are noJ-transferable and expire If work is
. not stsrted wIthin 180 days of Issuance or if work is
Suspended for 180 days.
. Electrical Contractor
Address
City
141-Z23lp .
Phooe
Supervisor License Nu nber
Expiration ~ '\;
Consll'. C~ ~ umber
Expiration Date
Signature ofSupervisiog Electrician
\.,:
OwoenName ~IHV\V1I<< \J i \l(1ae..~
Address ~~VII<lIVl ~i~d..!ltq
City ~ Phone 1Yl-7LJ73
.' OWNER INSTALLATION
The iostallation is beio8 made 00 property I owo which
is not intended for ssle, lease or rent.
Owoers Signsture:
Inspection Request: 716-3769
. ~:\:!tl;: ~:., :'i'': (';~..I,i I P1_;;....'~~..Vr.'~fJJ.V:' ;h.,.j.."
'i"-";',"FJ~I,;~,~t"I", ~'r"~,,~ ,,,.,,,.....;J Ui~ rl"-T~'o!.~K~jf'l~~"n,.r .::!,,~ '( :,~'\. ~
A..
. '~lIlKA'{P.l!m.M!!!l
. J;~.!t~'rtaJ
Servke Included
1000 ''I. fl or less
Each "lditionsl 500 sq. fl or
portion thereof .
Each Maoufact'd Home or
Modul ar Dwelling Service or
Feedel
$IQ6,OO
$ 19,00
$50.00
I "n,:l:\d~_, ~~l"1'.\1'1!1' 'flr~!",'!: ''''~''(:f:i ,~': ",.
~;~ ~-iI',j-{~~v;i';t~h ~l;:..A',~~ ~ ';. '.'i(;f:.;.,hr :~~:ml"; r"if1o~f;A..f/~
B. II
.1'11
200 Amps or less
20 I AJops to 400 Amps
401 AJops to 600 Amps
601 Amps to 1000 Amps
Over WOO AmpsIV olts
Reconicect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
c..
,Ii'll.,., 'r;~J..:iq;:r;4 ~'-l 'Filt .1 '1~)' '~~F"l, :', i.,,!~-;~,.."
.~f:I~,,"'~"l ),H _""I" .N', ,t.~ '.~.!llr,f'",...!;~1
~
InslaU"tion, Alteration Dr Relocation
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
D. ;;OAmf,s or ~OOO Vol~ see "B" abo~.
New Al!.eratioo Dr Extension Per Panel
Ooe Ciro:uit
Each Additional Circuit or with
Service',,, Feeder Permit
I
$ 50.00
$ 69.00
$100,00
50
$ 43,00
$ 3,00
....
Pump or irrigation $ 50,00
SignlOuiJine Lighting $ 50.00
Limited :Energy/Residential $ 25.00
Limited i:nergy!Commercial $ 45,00
Minimum Ele,,1r1c Permit Inspectloo Fee is $45.00 + Surcha'l:es
4.l1li
"~*~ 1~.;. i:~ :i.~" ~~~{),\:IJ ';'~,'~'H~~'\~~~i~:~'.:j;.~r:'
'50
"3,5D
'5
'5 ~,5'O
7% State Surcharge
10% Administrative Fee
TOTAL
8bi"'" Drivc(T:)/BulldlD. PormslEloclrical Penal, ApplicatioD '.03.doc
.~
.
LIlY V1'" ~:'I<'H'iljl'lELlJ
. B_ing/Combination Permit
PERMIT NO: COM2003-01021
ISSUED: 10/28/2003
APPLIED: 10/08/2003
EXPIRES: 04/28/2004
VALUE: S 20,000.00
. .,.:=::=::::::1___. _. .. .._..:t
Status:
Issued
225 Fifth Strcet, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4531 Franklin Blvd 119
ASSESSOR'S PARCEL NO.: 1703344400301
Eugene
TYPE OF
Manufactured Home in
Park
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: MH in park - set only no utility connections
Owner: SHAMROCK PARTNERS LLC
Address: 228 SIR FRANCIS DRAKE BLVD SAN ANSELMO CA 94904
Phone Number: 415-721-7734
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Manuf Home Inst
Contractor
C & SELECTRIC
JERRY OTT
License
3849
69455
BUILDING INFORMATION I
Expiration Date
09/01/2004
09/2612004
Phone
541-741-2236
541-935-2696
# of Stories: Lot Size:
Height of Sq Ftlst Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Ran&e Type: Sq Ft GaragelCarport
E~~3:. Path: Sq Ft Other:
~ ~~ Impen'ious Surface Area:
.,~ r.
..... I ~= ~ ,.....
I~Ve.l>flf.MENT INFORMATION I OV .~"".
..f1~' ~'(..'",~U 0o,~ -0~ ~'~bQUIRED PARKING
~--r- ~ ~'" ,$ o~ 0,0 >S,
Front yard Setback: :0- '\~ ~'S Overlay Dist: ~ 0(;$ 10,0 b'ltotlll:
Side I Setback: '$:.~ ~~ ~~ # Street Trees ~ ,0 0<; 0, 'b' <<-OJ ~~,*ped:
Side 2 Setback: ~. ~~ c:, ~~'S ~ ~ S:>' Paved Drive Rqd: >:-,q,; ;S0 ,s0 O~ ;S'l'CO'iDp8Ct:
~ ~. ~ <;;)~ :f5 0 'Q"". 0<;!f 0- ~0'(.'S:-v
Rearyard Setback: ~ ~<<J ~ {;> q,'<,Q;I. % of Lot Coverage: 10,0(;$00 0<; 0", 00, 0,-0.;;;.~
Solar Setbacks: ~ ,.;;,..~ ....<;;)Q;I. "''' ~ .s9 ~~ ,<",,'<:';f o~'< .:s'.~ ,y.'
~" ~~'" ~<r':--' <:'\'{- _,~ ,,-0 _'a . C'\ c. ..0 .:-....... _~
~':.\)~~,"O'V IPUBLlC IMPROVEM~N:;J;S'~0~:C)<;) ~ft.~v >:-'0~,,:;CI:-
" ~ ,. ,_ II!:) ~ 0" ~O 0"
~ ~ ~ ~o~ n>S ,sidewalker~pe:
, ~o 'b' f::,v ~ v'" V '"
,0 ~v <<- ~OV ~D'oW,~QootslDrains
,0 O~ ~ ,0' ,<<
" ~C)' ~'" 0' (rF
<;)<::5 Vq,;~
~"
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
R-3
VN
SETBACKS
Street
Storm Sewer Available:
Special Instruction:
Notes:
1 _~..,
,~~" '-~:;;.ffr~;fl~
-~~~~/iJ'"
~'A-,--;,~.
";-<~
~.
.
LII Y UI' :-iJ'I<:II'lljl'lt;LlJ
B"'iIlglCombinatiO!l Permit
,
...
~:
...~"
,.. ~".. .
......
.. Status: Issued"
. 225 Fifth Sir~et, Springfield, OR
541-726'3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO:
IS~UEO:
APPLIED:
EXPIRES:
VALUE:
COM2003'(l] 021
10/28/2003
10/G8/2003
04/28/2004
$ 20,000.00
I Valuation Oescriotion ,
[)esc ription
Manuf Home
Type of Construction
Manufactured Home
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
20,000.00
Value
Date Calculated
Total Value of Project
$20,000.00
$20,000.00
10/08/2003
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Manuf Home State Issuance
Manufactured Home Placement
+ 100/0 Administrative Fee
+ 7% State Surcharge
Temp Power 200 amps or less
Amount Paid
Date Paid
Receipt Number
$16.00
Sl1.20
$30.00
S160.00
S5.00
$3.50
550.00
10/8103
10/8103
10/8/03
1018/03
1 0128/03
10/28/03
10128/03
1200200000000002289
1200200000000002289
1200200000000002289
1200200000000002289
1200200000000002383
1200200000000002383
1200200000000002383
Total Amount
S275.70
I Plan Reviews I
To Request aD 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 ~~ii7\-\~lr~d Insnections I
I Manuf Home Sct 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 MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to
thc panel.
., -~ ~
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'. ; ~Jl..!!!.w-- I
,- ;'~ '"; . , . - '~" (
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""-~ ~.~..-:;:;%~,-q.;:-;~--- . .... =._--~,-_.-
. 1':~t:a~u~~: Issued
) ti~~j,~ifjh Street, Springfield, OR
~;;5i1ii"'7,26-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
..
L't: y tJI<' ~YK_ll~l-i!<'lItLlJ
Ruling/Combination Permit
- ,-'-~"~'.~:
PERMIT NO: COM2003-0r021
ISSUE)): 10/2812003
APPLIED: 10/08/2003
EXPIRES: 04/28/2004
VALUE: $ 20,000.00
By signature, I state and agree, that I have carefully examined the complcted application and do hereby certity 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 certity 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 perm it card is located at the front of the property, and the approved set of plans will remllin on the site
at all times during construction.
Owner or Contractors Signature
.., -~ .,
Date
225 Fifth Strcet
Springfield, Orcgon 97477
541-726-3759 Phone'
.Ioll/,Jllurnal1\umhcr
COM2003-0 I 021
COM2003-0 I 021
COM2003-0 1021
Payments:
Type of Payment
CreditCard
J~"'~D'~
~'~l
Receipt #: ] 200200000000002383
j)cscription
Temp Power 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
C & SELECTRIC
Received By
jmp
Check Number
Batch Number Authorization Number
000205 028134
City of Springfield OlfiCilii'Receipt' -
Development Services Department
Public \Vorks Department
Date: 10/28/2003
2:33:47PM
Amount Paid
Item Total:
50.00
3.50
5.00
$58.5U
How Received
Amount Paid
In Person
Payment Total:
$58.50
$58.50
.
.