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CITY OF SPRINGFIELD ·
Building/Combination Permit
PERMIT NO: COM2007-01254
ISSUED: 10/15/2007
APPLIED: 08/23/2007
EXPIRES: 06/28/2008
VALUE: $ 43,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541 -726-3769 Inspection Line
SITE ADDRESS: 4569 CAMELLIA ST Springfield TYPE OF WORK: Manufactured Home on
ASSESSOR'S PARCEL NO.: 1702324304500 Private Lot
TYPE OF USE: New Residential
PROJECT DESCRIPTION: Manufactured home on private lot.Existing Residence to be Demolished within 20 days
of occupancy of Manufactured Home. See COM2007-01253 for demolition permit
Owner: RUST ELLIS W & PAULINE L
Address: 4569 CAMELIA ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMA nON I
Contractor Type
General
Electrical
Manuf Home Inst
Plumbing
Contractor
ROY HAROLD HAUGLAND
EUGENE ELECTRIC SERVICE INC
JERRY PAUL OTT
ROBINSON PLUMBING INC
License
138110
90200
69455
107124
BUILDING INFORMA nON I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I
R-3
# of Stories: I
Height of Structure
Type of Heat: orced Air Electric
Water Type: Electric
Range Type: Electric
Energy Path:
Sprinkled Building n/a
VB
3
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
22.70
5.00
67.00
34.00
0.00
Overlay Dist:
# Street Trees Rqd: 3
Paved Drive Rqd:
% of Lot Coverage: 12.30
Phone Number: 541-746-2132
Expiration Date
10/18/2007
03/17/2009
09/26/2008
07/13/2009
Phone
541-343-9030
541-344-3561
541-935-2696
541-345-6909
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
9,996
1,232
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
1-\1 I l:1\I I IUI\I; uregon raw reqt...o,) J'OU to
I PUBLIC IMPROVEMENTS Ifollow rules adopted by the Oregon Utility
NotifiSfii~DMrWe: Those rules are set forth
Fully Improved in OAR 952-001-0010 .through OAR 952-001.
Y es 0090.DmlPHUty~mlii\1~pies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Street Improvements:
Stor~~9rs:t..~ ~ailable:
spe<!iaY~ctlOn:
THIS PERMIT SHAll_~
NotWTH~1lft)3fJNt1tIf rHn~ Ifo thI~\MOflf4 curb.
COMMENCED OR IS ABA~rio~~~1T IS NOT
ANY 180 DAY PERIOD. FOR
Pa2e I of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Type of Construction
Foundation Only Use Bid Amount
ManufHome Manufactured Home
Fee Description
Plan Review Residential
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Fire SF Fee - Residential
Foundation Permit
Manuf Home State Issuance
Manufactured Home Conn - Plmb
Manufactured Home Feeder
Manufactured Home Placement
Manufactured Home Service
Plan Review Minor - Planning
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Storm Sewer - 1st 50 Feet
Water Line - 1st 50 Feet
+ 5% Technology Fee
Sidewalk Repair Permit
Total Amount Paid
Plannin2 Review
Public Works Review
Structural Review
09/10/2007
09/10/2007
09/10/2007
Initial Review
08/24/2007
Public Works Review
08/24/2007
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01254
ISSUED: 10/15/2007
APPLIED: 08/23/2007
EXPIRES: 06/28/2008
VALUE: $ 43,000.00
I Valuation Description I
$ Per Sq Ft
or multiplier
$1.00
$1.00
Square Footage
or Bid Amount
5,000.00
38,000.00
Value
Date Calculated
$5,000.00
$38,000.00
$43,000.00
08/23/2007
08/24/2007
Total Value of Project
~
Amount Paid
$49.23
$56.01
$33.09
$43.66
$14.40
$75.74
$30.00
$50.00
$55.00
$160.00
$55.00
$116.00
$50.00
$142.83
$187.83
$23.09
$131.14
$50.00
$50.00
$0.75
$15.00
$1,388.77
Date Paid
Receipt Number
8/23/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
10/15/07
2/8/08
218/08
1200700000000001079
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
1200700000000001307
2200800000000000168
2200800000000000168
I Plan Reviews I
08/24/2007
08/30/2007
APP LLH
APP BRC
Stormwater to be directed to weep
hole in curb.
Pa2e 2 of 4
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01254
ISSUED: 10/15/2007
APPLIED: 08/23/2007
EXPIRES: 06/28/2008
VALUE: $ 43,000.00
. '
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Initial Review
09/10/2007
09/10/2007
APP LLH
Public Works Review
09/14/2007
09/14/2007
OK LKW
Plannin2 Review
08/24/2007
10/05/2007
APP T AJ
Structural Review
08/24/2007
10/11/2007
APP DJB
Owner has submitted new floor plan
and requested plans to be routed.
Plans have been removed from
withdrawn status and routed to pw,
planning, and structural again toda)'
(9/10/07).
This is a new submitted set of plans
Per sign and notarized agreement b)'
Ellis Rust, the house needs to be
completely demolished and the
utilities capped within 20 days of
occupancy of the MH. Please
contact Tara (736-1003) in Planning
when this is done.
Street trees are required only if
there are not trees now.
32 sf of enclosed outside storage is
required unless it is already there.
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
UeouiredJnsnections'
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
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.
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.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Pa2e 3 of 4
, ,
CITY OF SPRINGFIELD'
Status
Issued
Building/Combination Permit
PERMIT NO: COM2007-01254
ISSUED: 10/15/2007
APPLIED: 08/23/2007
EXPIRES: 0612812008
VALUE: $ 43,000.00
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 herem, and
that NO OCCUPANCY will be made ofany 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
Pa2e 4 of 4
Gil!J 0/ Uprillg/ie/d '
DRIVEWAY/SIDEWALK PERMIT APPLICATION
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
OFFICE TELEPHONE (503) 726-3753
~
PERMIT NUMBER' ~:J..fb 1-- 0/ d--!::'-If
DATE ISSUED.
APPLICATION DATE
SITE INFORMATION'
LOCATION OF WORK 1-/<;- [J 7 C IC/-n1...fi U I v....-
APPLICANT ,if d;v ~/ ~ / jA-~ D
ADDRESS l.f \"(0 "i t" otvv7 ~ L l.- J k
PHONE
1')3- g-~ ~ '1
TAX MAP
CITY
S/~~
STATE
DiL
ZIP.
TAX LOT
SUBDIVISION
OWNER
ADDRESS
PHONE
CITY,
STATE.
ZIP
REQUESTED PERMITS.
o SIDEWALK ..
AMOUNT OF SIDEWALK IN EXCESS OF 90FT
/."
o SIDEWALK REPAIR ...."".. ,,, . . .... .. . . ........ .
o CURB CUT/DRIVEWAY. NUMBER OF DRIVEWAYS
"" .".".. .. ".$ 8500 .. "". ...... ", = $
@$O 08 SF = $
""....... " $15.00... "" .." . .. . = $
x
.. $ 85 00 1 st Cut = $
o MULTIPLE PERMIT DISCOUNT EA . ., (MAX 2) .....,,, $3000
(MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION ~
APPLIES TO 2nd AND 3rd PERMWgNLY NOT SIDEWALK REPAIR).
ia 5% Technology Fee $ D, '-t.::> TOTAL DUE WITH PERMIT $
o PROOF OF INSURANCE. ,$500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
,. ,
CONTRACTOR INFORMATION:
2nd Cut =$j-
=$
r
CONTRACTOR
~l\ M t:
1-<;-"3')
..A~
~'N~
PHONE
ADDRESS'
CONTRACTOR REGISTRATION NO
"
EXPIRA nON DATE
PROJECT SUPERVISOR
PHONE
i
INSPECTIONS'
AN INSPECTION REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FO RMED AND MADE READY TO
POUR CURB CUT AND SIDEWALK INSPECTIONS CALL 726-3769 (RECORDER) STATE YOUR DESIGINATED CITY JOB
NUMBER/PERMIT NUMBER, JOB ADDRESS, TYPE OF INSPECTION REQUESTED, AND WHEN YOU WILL BE READY FOR INS PECTION, CONTRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER REQUeSTS RECEIVED BEFORE 7 00 A M WILL BE MADE THE
SAME DAY, REQUESTS AFTER 7 00 A M WILL BE MADE THE NEXT WORKING DAY INSPECTIONS ARE TO BE CALLED IN
AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE BUT PRIOR TO POURING CONCRETE
_ YOU ARE REOUIRED TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S
1l0NE CALL NUMBER" 1-800-332-2344
48 HOURS BEFORE DIGGING
SIGNATURE:
I
AMOUNT RECEIVED
RECEIPT NO
}S-. IS."'"
DATE PAID. t-/~/ () g'
RECEIVED BY' AIl~
By signature, I slate and agreel that I have carefully examined the completed appllcalloo and do he reby cerllly lhat alllnformalion heretn is true
and correct and I further cerllfY thai any and all work performed shall bl! done In accordance with the Ordinances of
the City of Springfield. appllcalJle City Standard specilicatlons and DraWIngs, and the laws of the Stdte of Oregon pertaining to the work descnbed herein. I further
cerMy fhat only contractors and employees who are In comphance With ORS 701 055 Will be used
on thiS project
The City may Inspect the work site described In thiS permit at any lime dunng a ooe year penod fo lIowing the racelpt by the City of notice of com~etloo of the
deSCribed work and speclly, at the City's sole discretion, any addltlooal restoration work required 10 return Ihe site to a standard accep.table to the C. The
permlflee Will be noli fled In wntlng of any work required and Will have thlr!Y days (30) from the date of the nollce to complete the work Work not com eted at the end
of the thirty days Will be performea by ttie City and the costs Will be billed to ttie permittee
I further agree to ensure that all required Inspections are requested at the proper lime, that prol act address IS readable from the
street, and the approved set 01 p'an74S. III r main on the site at all limes dUring construcllon ,
Signature Il /'-- .A ~ Date <Z - Fs --- 0 ~
I-I II -r~-
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007 -0] 254
COM2007-0]254
Payments:
Type of Payment
Cash
cRecelOll
RECEIPT #:
Description
Sidewalk Repair Permit
+ 5% Technology Fee
Paid By
ROY HAUGLAND
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000000168
Date: 02/08/2008
Item Total:
Check Number AuthorizatIOn
Received By Batch Number Number How Received
mas
]n Person
Payment Total:
Page ] of]
8:05:13AM
Amount Due
]500
075
$15.75
Amount Paid
$]575
$15.75
2/8/2008