HomeMy WebLinkAboutPermit Electrical 1992-5-8
SPIIIN(;.FIELD
e fOI/OWln . ~
7.0ning. ~nd~pr~Jeet,l~ dllllll1ltiild Ii ~
225 FIITH STREET apP,<>val. 080 not req~liV ~peCmtig~_~AL P'ERHIT APPLICATION
SPRINGFIELD, OREGON 97477 lon'ng Lnf2... If I r\I{AIl 'I
INSPECTION REQUEST: 726-3~1t ~/"'I - , _ City Job Number '-'\ l .J,' N-J
OFFICE: 726-3759 ~ '7::> _
AuUtO<iled Sigmllllre
1. L(3Tgt)'p~rm~(D \ O~ A.
\ E{GO~~~ ()8\{yJ
t ~B~~~)~ '
Permits are non-transfera~ 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
Heritaae E1 ect
Address 855 West 24th Avenue
City
EUQene
Phone 344-1500
SuperYisor License Number 9455
Expiration Date
10/1/
New Resl e 'al-Single or
Multi-Family per dwelling
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
unit.
Cost
Sum
$ 85.00
A
$ 15.00
$ 40.00 -Zb
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number 63137
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
12/27/
Signature of. Supervising Electrician
/?ddv [(). ~ qrs-5
Owners ~~~etAO~~'~~ D.
AddressJ Iq ~lJJ J\ n~
City [JU1.Ul.L Phone (o~(ofrB.q
OVNER IN~TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~: --=-~---~~r~~ :~~~~----
RECEIn If: r .......
RECEIVED BY: r
~
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Oyer 600 amps or 1000 volts
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see liB" above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Addi t ional
Circuit or with Service
or Feeder Permit
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 2.00
not included)
$
$
$
$
(;;[) .CD
~J~~
40.00
40.00
20.00
36.00
. ",...."'"
R~SIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Oil ice: 726.3759
SPRINGFIELD
LOCATION OF PROPOSED WORK:
N/A
630
\1 C)~~(.i() \:~
BLOCK' .3_
ASSESSORS MAP'
,-/(0
LOT'
OWNER:
ADDRESS'
CITY'
Lochaven Partners
1199 N. Terry St.
Eugene
DESCRIBE WORK' Mobile Home set UP
NEW
x
REMODEL
ADDITION
STAT'"
OR
JOB NUMBER
q \ Ol4-l
225 Fifth Street
Springfield, Oregon 97477
r::./~IVLJ
Ort~f7 '
N/A O~Ci)
TAX LOT'
SUBDIVISION'
Lochaven
PHONE:
688~ (n\c}{9
...
ZIP: 97402
Accessorv Value $ 17'tJ--..
Value $ i~!2Ec;,
DEMOLISH
.- Concrete stringers -
87922 LaPorte Dr.. Eu~.
OTHER M.H.
855 I~. 24th
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing lnsp.
o Framing - Prior to cover.
o Wail/Calling Insulation - Prior to
cover. .
o Drywall - Prior to taping.
o Wood Stove - After Installation.
D Insert - After flreplac'e approval
and Installation of unit:
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
~dewalk &.Orlveway - After
excavation Is complete. forms
.and sub-base material In place.
o Fence - When completed.
o Straet Trees""; When all required'
trees are planted.
...
CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR'
GENERAl' Ernie & Son I s 87922 LaPorte Dr.. Eug. 41497
PLUMBING: Harrison Construction 1441 N. Hwv. 99 20-236PB
20-280C/63137
41/.97
EXPIRES PHONE
2/2/92 484-6505 -I
689-7762
.I
2/2/92 484-6505
344-1500
\ (? ~)\t ') - OFFICE USE -
QUAD AREA: LAND USE: l \ ~(") FLOOD PLAIN'
. OF BLDGS' . OF UNITS' r ZONING CODE: '\ 1 ) t:..-
OCCY GROUP: ~~ CONSTR. TYP'" . OF BDRMS: '~~
-FE. -
. OF STORIES: HEAT SOURC~' SECONDARY HEAr. ~
p../ 7'j
WATER HEATER' RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will b,
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Final Plumbing - When all
plumbing work Is complate.
D Final Electrical - When all
electrical work Is complete.'
o Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
l
MECHANICA" Ernie & Son I s
ELECTRICAL'
Herita2e Electric
o Temporary Electric
D SlIe Inspection - To be made
aHer excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
v--fJ Footing - After trenches are
~ excavated.
D Masonry - Steel locallon, bond
beams, groullng.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to IIl11ng trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulallon or decking.
o Post and Beam - Prior to floor
Insulation or decking. .
o Floor Insulation - Prior to
decking.
'R-Y$'anitary Sewer - Prior to IlIIlng
~rench.
. ~Ytorm Sewer - Prl'or to tilling
{;.trench.
!r-.t)waler LIne - Prior to IIlllng
P trench.
D Rough Plumbing '- Prior to
cover.
MOBILE HOME INSPECTIONS
. . . I
locking and Sel.Up - When all '
blocking Is complete.
mblng Connections - When
home has been connected to
water and sewer.
~ctrlc81 Connection - When
blocking, set,uPI and plumbing
Inspections have been approved
and the home Is connected to
the sarvlce panel.
~Inal - Aller all requlrad
,Inspecllons are approved and,
. porches, skirting, decks, and
venting have been Installed.
.J
.Lot ,faces' ~Type .
Lot sq. Itg. Interior I P.L.
IN
Lot coverage Corner Is
Topography Panhanc.Jle Iw
Total height Cul,de.sac
.. IE
oii ,...t ...'..
I . THE PROPOSED WORK IN'1'HE "
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be algned
and approved by the Hlslorlcal
Coordinator prior to permit Issuance.
Selbacks
HSE GAR ACC
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT. a .lU\LUE _
)~,~95
Main
Garage
Carport
I,' I' APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condill
construction shall, In all respects, con for
adopted by the' City of Sprlngfl ,Including the
Development Code, regulat the c structlon anc.J use of
buildings, and may be susp de or revoked at any time
upon violation of any provlsl of salc.J orc.Jlnancos.
Plan Check Fee:
Date Paid: ,~
Tolal Value Recelpl Number'/
Building Permit Fee d Recel7
State Surcharge
Total Fee (A) PI..... Reviewed By Dale
SYSTEMS DEVELOPMENT CHARGE (Sj)C)
(B) ,q rlSj)2-.
PLUMBING PERMIT
ITEM
, FEE
Fixtures
Residential Bath(s) N'
Sanitary Sewer
FT.
):):')
as
8Q
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
~~ c;u
,~.'lS
f)~. 15
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaur.l Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Venl
Mechanical Pel'",lt
Issuance
Stale Surcharge
Total Permit
o
,~
J~..~~
(D)
MISCEl.LANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sldewalt ~ It
\L{ -IT..)
Curbcut
It
Demolition
State Surch;:orge
Total Mlscel.anecus Permits (E)
TOTAL AMOUNT OUE (excluding electrical)
(A, B. C. 0, and E Combined)
~tD
Systems Development Charge Is due on all undevelopec.J
properties within the City limits which are, being Improved.
ADDITIONAL COMMENTS
By signature. I state and agree, that I have carefully examined
the completed appllcallon and do hereby certify thai all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
wlfh Ihe Ordinances of the City of Springfield. and Ihe Laws
of Ihe State of Oregon pertaining 10 Ihe work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further cerllfy that only contractors and employees who
are In compliance with OAS 701,055 will be used on this
project.
I further agree to ensure that all required Inspections Bfe
requested at the proper time, that each address Is readable
from the sireet, Ihal Ihe permit card Is localed at Ihe Iront
of the properly, and the approved set of plans will remain
on Ihe slle at all times during construction.
Signature ,)J;.A/I~ ~;/.A. d' . dL
Dale
VALIDATION: Lie::
RECEIPT NUMBER \~~ 0'-0 ....
DATE PAin h ID.Y& "
.PH.~ ~t;
AMOUNT RECEIV
RECEIVED BY
.....-' . .;.. ...
.
DEVELOPMENT SERVICES
PUBUC WORKS
METROPOLrrAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726,3753
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield
that vith the approval of the attached
manufactured homes viII be placed at
Springfield, Oregon, City Job Number
Ii
Development Code, I understand and
permit~on~f t e fo~oying
,I::)?> .6 tJ .\ OJ\. ')
L\ \ .
agree
Class A Manufactured Home. A manufactured home of not less than 24
feet in vidth and 16% (not less than 2:12) roof pitch, vith exterior
dimensions enclosing a space of at least 960 square feet, vith roofing
and siding materials that are commonly used or compatible vi,th si te
built homes. /
o
Class B Manufactured Home. A manufactured home of not less than 12
feet in vidth and 16% roof pitch, vith exterior dimensions enclosing a
space of not less than 500 square feet, vith roofing and siding
materials that are commonly used or compatible vith site built homes.
I further state, by my signature belov, that I have been provided vith the
folloving information:
- Mobile home blocking
- Sanitary sever connection
- Vater line connection
Electrical connection
- Street tree standards
- Minimum requirements for permanent steps
SiC~(j if fJL!IJY
.,s---- to - Q :J...
Date