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HomeMy WebLinkAboutPermit Building 2013-5-8 • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00733 www.springfield-or.gav permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/0812013 EXPIRES: 11/03/2013 STATUS DATE: 05/08/2013 APPLIED: 04/11/2013 SITE ADDRESS: 5274 CYNTHIA CT,Springfield,OR 97478 SCOPE: Manufactured Home on Private Lot ASSESOR'S PARCEL NO: 1702333400227 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace manufactured home on private lot OWNER: OVERALL JEFFERY D Phone Number: 458-205-1689 ADDRESS: 5274 CYNTHIA CRT SPRINGFIELD OR 97478 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Manufactured Home Installer A ACTION MOBILE MOVING 8 DEMOLITION LLC CCB 197745 08/21/2014 541-935-1786 Plumbing Contractor A ACTION MOBILE MOVING 8 DEMOLITION LLC CCB 197745 08/21/2014 541-935-1786 Electrical Contractor A ACTION MOBILE MOVING 8 DEMOLITION LLC CCB 197745 08/21/2014 541-935-1786 L INSPECTIONS REQUIRED Inspections 5100 Site Inspection Site Inspection: To be made after excavation but prior to setting forms. 5370 MH Installation 5999 Final Manufactured Dwelling 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 or 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. .;I IS Ow er ti•ntra •r Signature Date ATTENTION: Oregon law requires you to • follow rules adopted by the Oregon Utility NOTICE: Notificaiion Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK ihoot OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification \NY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 5/8/2013 10:38:53AM Page 1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD '�- - 225 Fah St (` TRANSACTION RECEIPT Springfield,OR 97477 -.`^ OREGON 541-726-3753 811-SPR2013-00733 www.springfield-or.gov 5274 CYNTHIA CT perrnitcenter @springfield-or.gov RECEIPT NO: 2013000903 RECORD NO: 811-SPR2013-00733 DATE:05/08/2013 DESCRIPTION ACCOUNT CODE/TRANS_CODE AMOUNT DUE:;;,7 Manufactured Home Placement 224-00000-425602 1017 437.00 Manufactured Home State Issuance 821-00000-215009 1089 30.00 Planning-Minor Review-City 100-00000-425002 1231 119.00 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 90.88 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 62.39 SDC: Total Storm Administration Fee 719-00000-426604 1180 7.66 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 52.44 Technology fee(5%of permit total) 100-00000-425605 2099 21.85 TOTAL DUE: 821.22 ,- PAID ,PAYMENT TYPE - � PAYOR cgCASHIER:�LarzsoN COMMENTS�, , - " ' ._-_-AMOUNT_. ,.,__., Check Jefery Overall 821.22 3976504623 TOTAL PAID: 821.22 • `�t+�p n (� '„ ;SirDEPARTMENT`USE ONLY'° { 0 ' ,.j V EED O. V.��ir� y.. v 7PRINGFIELn E?'u^Sjpdrl ...: Yt'., aim a ct en r 2- a.. I d „ ^! Pemntno.: s/i 7 225 Fifth Street ♦ Sorinefield.OR 97477 ♦ PH/541)726-3753 • FAX15411726-3689 .'!.eifr Manufactured Dwelling/Recreational-Park Trailer Date: 4-/1111/3 Placement Permit Application This permit is issued under OARS 918-500-0105 and 918-525-0370. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. , L`OCALI GOVERNMEN f f'APPROVALS,r"; r.}; �;'", ,�'`�'� , t3 , `FEE SCHEDULE ,° ok,..h ativ7 ' x�, Zoning approval-Verified: ❑ Yes ❑No Description Qty. Cost each Total Property is within flood plain: ❑ Yes ❑No (I)Manufactured dwelling Sanitation approval verified: ❑ Yes ❑ No (a)Placement(includes placement, ' ``t'+r`CATEGORY OFkCONSTRUCTIol∎Ini tmj electrical.feeder,water/sewer $437.00 $LR7 -- connection): "0 Residential ❑ Government ❑ Commercial (b)Reinspection(no.of hrs.x fee per hr.): $80.00 $ e E JOB�.SITE,`„'INFORMATION AND LOCATION`rE°`k Placement permit can only be obtained by homeowner or Oregon-- Job site address: G� licensed manufactured dwelling installer. 7a�14 ( I1khtt, CA - < J (2)Recreational-park trailer City: 65{ ' County:����1 3 (a) Installation(includes stand and State: r 2 ZIP: L $437.00 $ n 6( I �1 lot preparation;support blocking; Subdivision°( Space/lot no.: anchoring;temporary steps;plumbing, mechanical,and electrical): Reference "jy Il u'a-r "1Taxlot 6029-1 (b)Reinspection(no.of hrs.x fee per hr.): $80.00 $ g x DESCRIP�TIONEOFA WORkl .; y=_I ""' �,t��rr-- - (c)Each additional inspection:(I) $80.00 $ /e6-7,Z GTZC r.-t�/V Q/,, n2/ v',1-7E— /`-7E t or Electrical service permit to be obtained only by homeowner performing Year Manufactured: I C 4 work or signing supervisor of Oregon-licensed electrical contractor J performing work #Bedrooms 9 Sq.Ftg 131-H Value v t3 .ra": ;tIFEE'+SCHEDULE�`iy, itf , "; Til- r 3 .Pa z.r ,. , PROPER'fiY OWNE1-W- a1414;.?¢d�r"Q',t; (3)Surcharge, 12%(.12 x total,equal to l or 2): $ v l Name: )e.ccr 00v4 \ (4)State administrative fee for 1 Address: �' manufactured dwelling(item 1) $30.00 1 $30.00 a I C�S✓���`o' �,-�s only,OAR 918-500-0105(5): City: ccic State: c2 IZIP: Cp-177 (5)Technology Fee, 5% $ Phone: --el --pa yeN,.. Fax: - - TOTAL fees and surcharges (3+4+5): $ E-mail: 4#1/3 This installation is being made on residential or farm property owned by me or a member of my immediate family,and is exempt from licensing reggirements under OAR 918-5)5'0010. g Q.V,Viet �, QPSignature J /) (� IUVI nr, G� V _� 0;t iii k,n0 TRA CT INSTALLATION x r,? " & �) Business name: A"AA- .nA IP o.w t I�I,�t/ 6 V "- - Address: a57I(/ e.i Kroi A 0 I-' . City.:: V��7f (I State: a( ZIP:w-7 ye Phort t 'j511 j`')') Faxcl1 ct 7� E-mail: Co i7 () Co / t CCB license no.: I ct'nt-IS MDI license no.: ICl(�-I C/� / 9I� Ce 70'{ Print name.: a��� G�r�\� Signatti • LL O LL Q FM M Cn z AJ lML LU C/)C �/i / d m«E ioc� EL� � y T N N � CoE U UO r act mc— r cr F- ° c 0 tll 3 A Vin O m V O 'u, o Z O AkW 'Oo� � i Dc.+ � A e��n 11-41 n �3 LcY1�t� c,� j�ka5 S13 -?3 3 / 417 -- /7� 333 t/ po227 .: I i aI ©MO�Ji1�, e �J �1iENTION: Oregon law requires you to `oflow adopted by the Oregon Utilit n+ ter• Those rules a e set forth R 952n J hr ugh OAR 952,.001', AR 952 JOT �e s Of the rules b 0080. You may obtathe center (NotpR, in One number for ell0�'egon UYihy Notif+c for ir. 39 Indicate which direction is north with an arrow (HAIL,1=SP1(" Ir ;14P Ir11fl RK wli'l I aNOT �U r �JP