HomeMy WebLinkAboutPermit Building 2004-11-5
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..c CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01289
ISSUED: 11/05/2004
APPLIED: 10/19/2004
EXPIRES: 05/05/2005
VALUE: $ 63,331.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5268 DAISY ST
ASSESSOR'S PARCEL NO.: 1702333404610
Springfield TYPE OF WORK:
Manuf Home w
Garage/Carport Private
No~ Residential
TYPE OF USE:
PROJECT DESCRIPTION: MH with garage replacement of existing mh
Owner: GENEVA TAYLOR
Address: PO BOX 1462 SPRINGFIELD OR 97478
Phone Number: 541-954-8608
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Plumbing
Contractor
HARiUSONJACOBSONINC
ROBS ELECTRIC INC
HARiUSONJACOBSONINC
License
66447
156678
66447
Expiration Date
05/07/2005
08/14/2005
05/07/2005
Phone
541-689-7762
541-686-5444
541-689-7762
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
1
R-3
U-l
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
384
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
44.00
5.00
11.00
49.00
5.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
2
Yes
21.80
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Fully Improved
Yes
Sidewalk Type:
Curbside 5'
Curb and Gutter
Downspouts/Drains:
Notes:
Pae:e 1 of3
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01289
ISSUED: 11/05/2004
APPLIED: 10/19/2004
EXPIRES: 05/05/2005
VALUE: $ 63,331.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description I
Foundation Onlv
Garal!e
Manuf Home
Use Bid Amount
Garal!e
Manufactured Home
$ Per Sq Ft
or multiplier
$1.00
$24.30
$1.00
Square Footage
or Bid Amount
4,000.00
384.00
50,000.00
Value
Date Calculated
Description
Tvpe of Construction
Total Value of Project
$4,000.00
$9,331.20
~50,000.00
$63,331.20
10/19/2004
10/19/2004
11/05/2004
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $90.09 10/19/04 1200400000000001486
+ 10% Administrative Fee $50.46 11/5/04 1200400000000001577
+ 7% State Surcharge $35.32 11/5/04 1200400000000001577
Add, Alter, Extend Circ Ea Add $3.00 11/5/04 1200400000000001577
Building Permit $138.60 11/5/04 1200400000000001577
Manuf Home State Issuance $30.00 11/5/04 1200400000000001577
Manufactured Home Conn - Plmb $45.00 11/5/04 1200400000000001577
Manufactured Home Feeder $50.00 11/5/04 1200400000000001577
Manufactured Home Placement $160.00 11/5/04 1200400000000001577
Perm ServlFdr 200 amps or less $63.00 11/5/04 1200400000000001577
Plan Review Major - Planning $103.00 11/5/04 1200400000000001577
Sanitary Sewer - Improvement $36.56 11/5/04 1200400000000001577
Sanitary Sewer - Reimbursement $48.08 11/5/04 1200400000000001577
SDC Sanitary/Storm Admin $9.44 11/5/04 1200400000000001577
Storm Drainage Impervious Area $104.16 11/5/04 1200400000000001577
Storm Sewer - 1st 50 Feet $45.00 11/5/04 1200400000000001577
Total Amount Paid $1,011.71
I Plan Reviews I
Initial Review 10/21/2004 10/21/2004 APP SKG
Plan nine Review 10/21/2004 10/29/2004 APP TAJ 2 street trees are only required if
there are no trees now.
Public Works Review 10/21/2004 10/22/2004 APP CAS
Structural Review 10/21/2004
Structural Review 11/03/2004 11/03/2004 APP TCM
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.
Paee 2 of 3
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. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01289
ISSUED: 11/05/2004
APPLIED: 10/19/2004
EXPIRES: 05/05/2005
VALUE: $ 63,331.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Reauired Insnections-t
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.
Foundation: After forms are erected but prior to concrete placement.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Drywall: Prior to taping.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
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.
Final Building: After all required inspections have been requested and approved and the building is complete.
Underfloor Drain: Prior to cover or placement of concrete.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Manuf Home Plumbing: After home has been connected to water and sewer.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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 e permit ard is located at the front of the property, and the approved set of plans will remain on the site at all
times duro g 01 S ruc I In.
-v '-^"~
Owner or Contractors Signature'- .J
u - s- 01'
Date
Pal!e 3 of 3
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DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 2 0 3 = 6
I DRINKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
CLOTHESW ASHER / MOP SINK 1 1 3 = 0
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK i DISHWASHER / ETC. 0 0 3 = 0
SHOWER, SINGLE STALL 0 2 2 = -4
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 1 3 = 0
I SINK: COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
SINK: SINGLE LA V A TORY /RESIDENTIAL BAR 2 2 1 = 0
URINAL, STALL / WALL 0 0 5 = 0
TOILET, PUBLIC INSTALLATION 0 0 6 = 0
TOILET, PRIVATE INSTALLATION 2 2 3 = 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 2
"EDU (EQuivalent Dwelling Unit) is a discharge eQuivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
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MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$I,OOO
ASSESSED VALUE
. .,. . .: $5.29.'i ::...:.::.."....
, :......$529
$5.1
.' $5.1
,$4 98
.......$480
. '.: "$4.63
. :$4.40
. ':'. .......... $4.:01 . ..............,..;;.,
/...:$3:67.:......:..::....,:.:;'..
; .....:.::.$322::"..:.:,'
. '. .$2.,7~:" . .
. > $2.25
.: $1.80
,.. $1.59
$'145
$1 :25...
:::',$1.99' ,.....,:.
" ":.$0.92,
.", ,.'. $0.72::,.;:'
$0.48. '.'
.... $0.28'
::::,b.:':('.~~:~::: '.
IS LAND ELGffiLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGffiLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
=,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29 = ,
o
TOTAL MWMC CREDIT
$0.00
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225FIFJH STREET
SPRINGFIELD, OR 97477
, (541) 726-3753
FAX (541) 726-3689
www.ci.springfield.or.us
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield Development Code; I understand and agree that with the approval of
, the attached permits, one of the following manufactured homes will be placed at ~ ~ .
, ,'f)~ ~~ , ) Spring.field, Oregon,City Job Number ~ 2.C\:ld~ ol"~ 21tt ' '
Type I Manufactured Home: '
A multi sectional (double wide or wider) unit with an enClosed floor area of not less, than 1,000 square feet,
that has a nominal roof pitch of 3 feet iri height for each 12 feet in width, that has no bare metal siding or
roofmg, and that has been certified by the manufacturer to have an exterior thermal envelope meeting'
performance standards which reduce heat loss to levels equivalent to jQ,e performance standards required
f~r single family dwellings at the time of construction. ' ~ initials '
Typ II Manufactured Home:
A unit not less than 12 feet in width enclosing a minimum floor area of 500 square feet, that has a
nominal r fpitch of2 feet in height for each 12 feet in width, that has no bare metal siding or roofing,
and that has en'certified by the manufacturer to have an exterior thermal envelope meeting performance
standards whicn duce heat loss to levels equivalent to the performance standards required for single
family dwellings at e time of construction. initials
I further state, by my signature below, that I have been provided with the following information:
Manufactured Home Blocking, Water Line Connection, Street Tree Standards, Sanitary Sewer Connection,
, Electrical Connection, and Minimum requirements for permanent steps.
I also understand that the manufactured home shall be placed on an excavated and backfilled foundation
not to exceed 6 percent slope within 10 feet of the perimeter enclosure, enclosed at the perimeter with
stone, brick or other concrete or masonry materials approved by the Building Official and with no more
than 24 inches of the enclosing material exposed above grade. '
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Ignature
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Date
226 Fifth'Street
, Springfield, Oregon 97477
541-726-3759 Phone
.
JIiY of Springfield Official Receipt
"elopment Services Department
Public Works Department
;;/jJob/JournaI Number
~.1<. l
,'( COM2004-01289
COM2004-01289
COM2004-0 1289
COM2004-01289
COM2004-01289
COM2004-0 1289
COM2004-0 1289
COM2004-01289
COM2004-01289
COM2004-0 1289
COM2004-0 1289
COM2004-0 1289
COM2004-0 1289
COM2004-01289
COM2004-01289
~Payments:
,~
Type of Payment
CreditCard
:~"
loUt
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11/5/2004
RECEIPT #:
1200400000000001577
Date: 11/05/2004
lO:24:37AM
Description
Manufactured Home Placement
Manuf Home State Issuance
Storm Sewer - 1st 50 Feet
Manufactured Home Conn - Plmb
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Plan Review Major - Planning
Building Permit
Manufactured Home Feeder
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Amount Due
160.00
30.00
45.00
45.00
104.16
48.08
36.56
9.44
103.00
138.60
50.00
3.00
63.00
35.32
50.46
$921.62
Paid By
WILLIAM B HARRISON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
dIm ' 072236 In Person
Payment Total:
$921.62
$921.62
Amount Paid
Page 1 ofl
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Sep-30-04 03:14P P.02
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22S FIFTH STREET. SI'Rl,'IIGFIELD, OR 97477 · PH:(S41)726-J753 · FAX~:n)726-3689 , ::,,\i~:",::,'" ,,~ '.:{i:
ELEl;jKlCAL PER.."t1.IT APPLICATION ~.:o"J/,,'O~o ' ,.\'..,.',,:;,.... ~V1 >,
City Job Number OI-DJ 21/1,1 Dale ~.()/;::"Jd~L IYfi"h.:f '
o ~ ,U!/CJ
1. '::l.09.ATIONOFTNSTALI.ATlOIV"::;'::,':" 3. :CO~P~l~ :EEerJ:iE~~:~f."'LOW", ' ..
, , ..' , ". . r-1' .~,;.l.I1oF -s-'" "
>U~ Da./')lJ ';, ,,;..O~~~h. ,_,~, ,..-6190~~/itElO' ", \'. ",
LEGAL DESCRIPTION ( A. ,;~,e~R~~t~~nti~~~ln .~ or UItl.FlI/i(.y~~~-1dW~lIinll unit'
t1-oz.~) >t.I 0'-/'-(0 Service Included t.-"-El /..1 ~/C'I.?/':'o~
, ." 0' t..3J:1,.,
JOB DESCRIPTION 1000 sq. ft. or less f-:, S IOIWt!iJ7-,>~
/ .-l Each additional 500 sq. ft, or "f (., ~ . _
fA-fJJW.Jw.jvreJ. ^~ }l~uPMUJ'7'f<<t~ portion thereof ~~.... ~oo
Permits arc non-trans1era'ble and expire if work is Ench 1Y.llllUfllct'd ~ome ;)r ~~
,.- not started within 180 da)'~ of i!isuance or if work i~ Modular Dwelling Service or I "'" $~O.OO )5, aD
Suspeoded for 180 days.' . F:::eder
. r":;t . .; ',. ::::::';. ~'i:, .. .. ":;'.'; ..
c. :~',T.ellll'<irary S~nic~' or FeederS
~, .'" w. '.. _ .. . ';"".' , .. . ... _ .
~ : :'...
t '.:( .<.;~~~~~<(~~:.i:Y~~ . ,:...~
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~~
Illlitallarioll, .-\l[eration or Relocation
200 Amps or less
20 I Amps 10400 Amps
401 Amps 10 600 Amps _,___
Over 600 Amps or 1000 Volts see "a" above.
........-'.. .... ..,1 . .. ..... . .
D; :~:Bhln'ch 'ciii'cuiu .' i",\, ' '.' ,
....h ;". .. . I.. ;~,. ",;,..,. ;" ...' , ..,.:;
New Alteration or Extension Per Panel
Que Circuil
Each Additional Circuit or with
Service or Feeder Permit
$ .50.00
$ 69.00
$100.00
Expiration Date
_ Si~arure of St:pervising E~~uiciaI!.-_,
~: :; ;:1.. '..'..... ....~...:., ': .. j .
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Owners Name C~ /;'?f'~IA_ \ A.-Lk......
Addres.~ '::> t:b r ~l ~y .5 ;-
City ~-=?I;::;~ Phone c; i-<t - 8tP ~
S 43.00
$ 3.00
.3
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E. .)t1is~el1,ap.~qlls.<~enif~1~dtr not Includeil) -EacblnstaUatlon "
........ ......__..J... ..... ...... .,
OWNER L"'STALLATIO~
Pump or inigation S 50.00 , .
Sign,~{!Jlir\e)!!ghtillg l r.X.p.h~E. IF ltS'O.ob'Oh"
Limited\~ernfF2,' ~l~ilie~~~l D 11\\C D~R~$.Ii%.~ NU I
, ,. II \ _~'~rn \\f\\IJr.n \0 ~' _ ~.cD
I Lunlt~dEnelr.~y/IQbnlmerl:'lal ,\ I"' ^ ",n!lN~'JS-:lJJen
/"\U" _ r:Q !Iii \S 1"'1,)""- -
.MInimum F0~'ctlit:!P..J'r!fuii Insp,ectioltfee i!i $45.00 + Surchllr::es
,,", . ~~,'~:':rPlOD~'( Pf::K\U," "",
4. ,St.~,Tt~,r1t:.gf~9~~;, '.' . -:;3- I/~;
. l-:'{., . .Ca ,/2
7% Stale Surcharge - 0
10% Administrative Fe:: "5'~ J I ~
6Z6l1_((: -
TOTAL ~
Sha.'1:d Drive(T:)l!luilding Fomu/EICl:I';CAI P~J":llil '''pplie;liun ! -OJ.doc I} 5:72
The installation is heing made or. property I own which
is nor intcndcd for sale, leas.: or rent.
Owners Signature:
ATTENTION: Oregon law requires you. ~o
- . I J --,.~.... ""y-the Or~g,nn 1111hty
TOIlOW ru \:1::1 Cl v",.QtT1;I
Notification Center. Those rules are set forth
"'~ftiRc@~~fDj~jftr9>ugh OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the tel~~ho~e
number for the Oregon Utility NotifIcation
Center is 1-800-332-2344).