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Home My WebLink AboutPermit Building 2002-12-18 . Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2534 MAlA LP ASSESSOR'S PARCEL NO.: 1703251404700 a- CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2002-01331 ISSUED: 12/18/2002 APPLIED: 12/02/2002 EXPIRES: 06/18/2003 VALUE: $ 10,340.00 Springfield TYPE OF Manufactured Home w GaragelCarport on Private Nelv Residential PROJECT DESCRIPTION: MH on private lot with garage TYPE OF USE: Owner: IMA BROADDUS Address: 85321 NESTLE WAY PLEASANT HILL OR 97455 Phone Number: 541-744-7963 Phone Number: 541-744-7963 Phone Number: 541-687-3258 Phone Number: 541-744-7963 I eONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone General HARRISON JACOBSON INC 66447 05/07/2004 541-689-7762 Electrical RALPH W BROWN 63137 02/1512004 541-729-1500 Manuf Home Inst HARRISON JACOBSON INC 66447 05/07/2004 541-689-7762 Owner IMA BROADDUS 541-744-7963 Plumbing HARRISON JACOBSON INC 66447 05/0712004 541-689-7762 # of Buildings: Primary Occupancy Group: Secondary Occupancy fFrimary Construction Type Secondary Construction # of Bedrnnms: 1 R-3 U-l VNSpr SETBACKS Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 123.00 109.00 70.00 16.00 0.00 Street Storm Sewer Available: Special Instruction: 2 BUILDING INFORMATION' ~,?--'f.. # of Stories: ",v..~ ~@t Size: Height of ~,~ 1'6.~,S 'Sq Ft 1st Floor: Type of Heat: ,.ort~'2iI'~'~ ~I::l~q Ft 2nd Floor: Wa~~ Type: ~\.\. ...:~'S, ~ Sq Ft Basement: ~ T~e'P~~I::l<i:.'?-- ~~ ectric Sq Ft Garage/Carport \\\)ill.l~Pa~~ ,S ~ Sq Ft Other: "\\\~v..I::l~':..~~I::lI::l~'\:..~I::lI::l. Impervious Surface Area: .;..~ \..!'. -1;~ I DEVEL:OPME"N;t:\INFORMATION, ~W' ,'C,,\~REQUlRED PARKING ~pr.;.. ,~..,' \'\1 Overlay Dist: ,I,IJ1!side"n1'\ U .;. \!.otal: # Street Trees __\'8" ,."3' ~Sr;;\ H, aIidicapped: 1)\ 'i\e- '(}'C: n ,,...... Paved Drive Rqd: .O~f?-fo ,,,,,,\~ .,.et ',..,g,,'Compact: O~. '"v"_e~v' D~" \j.W" % of Lot,Go~~}age;(lo'il'; ~'(\o~ ol?iOO ,,\:,C ~ 'roo--;.e I'-' \;~U"'''Ge\"l\e ~\C)\"\"I' -ci~eSO .rJ;:'<::. ~'i).O{\ .-.\\0 ,o.n'(\ ..4...('S ......cO" ,':\G \:. _'~\~\C'(). IPUBLle lMiROVEMENJSI o'Q~~~'~~~'\)\~\'\:';I~~b,l' .~'"' ~uv Ce'<i- -0.0 ,.,f)--' \ ()9iC)' . 0.\'(16 ~e(Si}le'talk'Type: ~ ~\\\"I. \oI~ ",:0 C -<\'Oe~ r:;\e' Downspouts/Drains {\U'" 0' 400 5,267 1,283 Private infrastructure Notes: I of 3 , -;-III:~J..~_~ -~.,,-'" ... . I , . , . e CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2002-01331 ISSUED: 12/18/2002 APPLIED: 12/02/2002 EXPIRES: 06/18/2003 VALUE: $ 10,340.00 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Description Type of Construction Foundation Only Use Bid Amount Garaee Garaee Manuf Home Manufactured Home $ Per Sq Ft $1.00 $19.60 $1.00 Square Footage 2,500.00 400.00 40,000.00 Value $2,500.00 $7,840.00 $40,000.00 $50,340.00 , Date Calculated 12/02/2002 12/02/2002 12/0512002 Total Value of Project ~ Fee Description Amount Paid Date Receipt N urn ber Plan Review Residential $74.88 12/2/02 1200200000000000318 + 5% San & Storm Admin Fee $124.94 12/18/02 1200200000000000425 + 50/0 Transportation Admin Fee $47.97 12/18/02 1200200000000000425 Add, Alter, Extend Circ Ea Add $3.00 12/18/02 1200200000000000425 Addressing Assignment $8.00 12/18/02 1200200000000000425 Annexed 1979 or Before $-146.69 12/18/02 1200200000000000425 Building Permit $115.20 12/18/02 1200200000000000425 Manuf Home State Issuance $30.00 12/18/02 1200200000000000425 Manufactured Home Connection $45.00 12/18/02 1200200000000000425 Manufactured Home Feeder $50.00 12/18/02 1200200000000000425 Manufactured Home Placement $160.00 12/18/02 1200200000000000425 Manufactured Home Service $50.00 12/18/02 1200200000000000425 Plan Review - Planning $55.00 12/18/02 1200200000000000425 Plan Review Residential $74.88 12/18/02 1200200000000000425 Sanitary Sewer - Ist 50 Feet $45.00 12/18/02 1200200000000000425 Sanitary Sewer - Improvement $319.01 12/18/02 1200200000000000425 Sanitary Sewer - Reimbursement $419.71 12/18/02 1200200000000000425 SDC MWMC Administration $10.00 12/18/02 1200200000000000425 SDC MWMC Improvement $34.83 12/18/02 1200200000000000425 SDC MWMC Reimbursement $332.86 12/18/02 1200200000000000425 SDC Transpo Improvement $709.81 12/18/02 1200200000000000425 SDC Transpo Reimbursement $160.87 12/18/02 1200200000000000425 Storm Drainage Impervious Area $658.47 12/18/02 1200200000000000425 Storm Sewer - Ist 50 Feet $45.00 12/18/02 1200200000000000425 Water Line - Ist 50 Feet $45.00 12/18/02 1200200000000000425 WilIamalane Manuf Home Private $1,000.00 12/18/02 1200200000000000425 Total Amount $4,472.74 I Plan Reviews , Initial Review Plannine Review 12/03/2002 12/0312002 12/05/2002 12/0312002 APP LLH APP AID Garage height not to exceed primary structure height Private infrastructure Public Works Review 12/05/2002 12/10/2002 APP DPE 2 of 3 . e CITY OF SPRINGFIELD Building/Combination Permit Status: Issued PERMIT NO: cOM2002-01331 ISSUED: 12/18/2002 APPLIED: 12/02/2002 EXPIRES: 06/18/2003 VALUE: $ 10,340.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 12/05/2002 12/1812002 APP DLM 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. I Reouired Insnections I I Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 2 Footing: After trenches are excavated. 3 Foundation: After forms are erected but prior to concrete placement. 4 Shear Wall Nailing: Before covering sheathing with finish materials. 5 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 6 Firewall: Located and constructed according to plans. 7 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 8 Manuf Home Set Up: When installation nf all piers or stands is complete. 9 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. 10 Final Building: After all required inspections have been requested and approved and the building is complete. 11 Underfloor Drain: Prior to cover or pJacement of concrete. 12 Water Line: Prior to filling trench and including required testing. \3 Sanitary Sewer Line: Prior to filling trench and including required testing. 14 Storm Sewer Line: Prior to filling trench. 15 Manuf Home Plumbing: After home has been connected to water and sewer. 16 MH Service: Approval required prior to utility company energizing service. 17 MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. 18 Final Electric: When all electrical work is complete. 19 Rough Electric: Prior to Cover By signature, I state and agree, that I have carefully examined the completed 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 wiil 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 ti"};'s du~ing construction. ~~ Iz/(8-0Z- Owner or Contractors Signature Date 3 of 3 I , , ! , J 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Line Items: Job/Journal Number eOM2002-0 1331 eOM2002-0 1331 eOM2002-0 1331 COM2002-0 1331 eOM2002-0 1331 eOM2002-0133I COM2002-01331 COM2002-0133 1 COM2002-0133 1 eOM2002-0 1331 eOM2002-0 1331 eOM2002-0 1331 eOM2002-0 1331 eOM2002-0 1331 eOM2002-0 1331 i' - City of Springfield Development Services Department Public Works Department Official Receipt Receipt #: 1200200000000000425 Date: 12/18/2002 . Amount Paid 55.00 8.00 1,000.00 50.00 50.00 3.00 658.47 419.71 . 319.01 160.87 709.81 332.86 34.83 (146.69) 10.00 Description Plan Review - Planning Addressing Assignment Willamalane ManufHome Private Manufactured Home Feeder Manufactured Home Service Add, Alter, Extend eirc Ea Add Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - l...p.v."uent SDe Transpo Reimbursement SDe Transpo Improvement SDe MWMe Reimbursement SDe MWMe Improvement Annexed 1979 or Before SDe MWMe Administration Page I of2 cReceipt.rpl 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone COM2002-0 1331 eOM2002-0 1331 eOM2002-0 1331 eOM2002-0 1331 eOM2002-0133 I eOM2002-0 1331 eOM2002-0133 I eOM2002-0133 I eOM2002-0 1331 eOM2002-0 1331 Payments: Type ofPaymeot eheck Paid By Receipt #: 1200200000000000425 Date: 12/18/2002 + 5% San & Storm Admin Fee + 5% Transportation Admin Fee Plan Review Residential Building Permit Manufactured Home Placement Manuf Home State Issuance Sanitary Sewer - 1st 50 Feet Water Line - 1st 50 Feel Storm Sewer - 1st 50 Feet Manufactured Home Connection Received By Check Number Confi rm No GOODEN HARRISON djb Page 2 of2 City of Springfield Development Services Department Public Works Department Official Receipt 124.94 47.97 74.88 115.20 160.00 30.00 45.00 45.00 45.00 45.00 Line Item Total: $4,397.86 How Received Amount Paid In Person 4,397.86 $4,397.86 Pavment Total: . . cReceipLrpt ~.. ~- ,',- '-.-~225 FIFTH STREET ',' e., ':"'. '"-' 'i,#.f;;-.::~t:; ELAneAL PERMIT APPLICATION." . .(.~ "':SPRlNGFIELD. OREGON 974'17 ;,\;",ij~;~, ' ",' ': ;~":~(\~A'r\M)'" '':2~I:'::: ';:.;' .:. .;.::- ,.:.~ lNSPEeTlOl'!REQl!EST:;72~;3?'~~ 'l " . '(). ~oh ~u~;~c;:~\~UJvc:.c)hiQ',::: ' ,_'~"', t'''-OFFICE' 726',37-9',l~"\ f..,), ",,,,,o~.,,,,,. ,,\' .. >., ,., " "t,.-- _,!-,-,'h r ':. . - ,:J -i~;.;,~.." .~.. ~!-'0'b{~; ~\ {~: "o.;.'~...-'i'C~:>~~':;~"'~'\' ,;~:,,:,; .:-\~~,,-;._.:,>... ~ >".~; ~,,-' ~;i..; ;:. ':,: 't'j.i:~ ~'-"',o.;.~t~,;"" lie, ., c. 3".. OMPLE:rEFEE SCHED.ULE BELOW."'." ,:c~,~;f.-;' ~ ."~,'i- '1':'_4,..~ >.', '- ~~~('i.. ",', ')'~5i""""'/' .-~,..;C" ~..., ,.;:.-?"'......:...~r... <.~......':t--:<t. ~.r.,. ,.~. :;~:I'~F ~:~ ~~I~ '\ \ \l ~Qj~5~ t1~~~~-' ~~~e;;~~'~dent;:;~~'(~;i:$;;t;~t~'~J~~';~;s'2:::~:';;i ;;:J-;;~ ~ /. f'IJ<:' Multi-Family per dwelling unit. LEGAkDE~c;.RlPTlO~~;,,"00 cb' '" Sm'ice Included. \ lU'?I.Q..7,~ (" ~~ Items Cost ~.... ~l\RE~~ft, 1O{9~__....J. ~~ 1000 sq.ft. or less ~ ~ Each additional 500 sq. ft or portion Permits arc lion-transferable and expIre thereof ;:. if work is not'started within ISO da);s Each Manufd Home or ,:':: " ~~~s:~,~~.~cc or if work is suspended for ~~~l;~~r ~;~~~~; i?'L.:& $ 50.00 . 'roo.W 2 eONT~i~OR INST ALLA TION ONLY B Sen'iccs or Feeders.{{M;l~';SL;; . ' ..~}. . , . . '. ."-'~ 'h"');,,, ':<'-,,'1;'. t:...:,.", .~'!'.:'". , '''9/ ~ InstallatIOn, AlteratIons or . .~: ' '. ,,-. " . '^,:o'. Electrical C~nl~acto~ ~(~.A.-- ~ Relocation: _.~;\",;;'~d~~ 1'.~'~':.~.~:- "~l:i,,~~~-.. ':~,.f~:, ,;." l~'~ r,.lo- '''~.I~....( .' ,'1--,''', 'Aol>'T~ t";. 'Ie.' "1; ';v':~~ ~:.'r f~i"'i:\ ~"'~',,, 1.1: ~;>~ ;t:;:;~!.. ....',. \ . ~ '7 \, 'to ""~. ' ,. J'::ct ];1'" '," - '" ..."7 ,,', ' ~,...~ 'oj,;,,;: Arldless. ,C/' '-""" '. ,;':'Y'J" 200 amps or less'ci..:.,";,. \~~..;'::'~'$~3.00 '-. . ~,..~,-':.~.'.,,:':., ~.~ .:: ~.; . .. ::" '7 a(:~s5~cio:: 'j ~-" 20J amps10400amPY~~.l' J;4-J~~'~~~T5,Q'Q . :/_:,:r~ _ ., ... r"7 L--i.,~""}Ii.;>-' ..1.:.,~1' ~'> '>, .. .."- ~ "r, ,~ ~ . ~ <", City . __ .". Phone f .~__>,~ ','o)i~Y''''<':$' 40Iampsto,600an)ps;...,.:.-",:~$12.).0.0~., //'~. ~ _ '_, ~ ;r'.~~" ~. -l'>~' t". J ~- .' .. .... '0 ~-, . ~ ~n '-.. -'C/ ..;--...; '5":' ~. ""'5'" ,Fc;;,r-.::::.:;,;,',,>"'; 601 amps to 1000all1ps'~. ,"-~'l,', < "\.$163.00 :'" ' ,'. .' . ".- /'/' '~D.t~' ":)~\'~.,'I; .... ," ~.~ .-:,. "",.~ "". - -,.... \- Supervisor License'Number ";, ~I.:. . '-t-. ..*~j...q'Z,,~~:';')j;- (t1\~\Over 1000 amps/voltS :~~:.~~1"7{~,.}:~~:'..'~ _;.,,:$375.00 '., ll; . ,~,~.~,.,,-.,^~:,,::::'.',~:',"'~"!i'l.;.,I;..:,',,:~.',~.,',~>',~,.,..~,~,.',...'.:' ;" ':, '''. ".. ,; , :, ' :;:;.... ',,:_,>~~1~1'.~:V;';..;~:; ". Reconnect b~IY: ',)/: ~,':".i"',):;:,~ $:'5'0.60 -----:;,::- .:~"~ I ,,".l'-"",I.''';. '~'Zo.;"/')..)."i-' .:. ,-.;;.J:' "".{:"r'c':-l';",,'..x: ," u " -",<k";:,'I"~~',"""----;;- _I. .-;---"" Expiration Date ' -:' (( r{.-v~.r. \_';':V ";:r ;i~ ..."'"~ f.i-:..~'''..' - "i'c ~ . .:- ~;l"'l.. '~., :'i .~; 'tw~: ,~~J~':t^~\O::-;1~~":'~~"fw ,1'I,\,~;.. .. " ;-- I'" ' 't "; r~ ":"'.' ~. ,'.:.'. '; r .t ;- 'r", ""'\l:..I..~"\4Q 'ttl~l~t?'...t.' ".".~;.: f" ,-,: ':, -:.' :., .:.. ,'- - ~,..:. i ~SI:.<:!-G.,.~TeI1lPOran Sernces or Feedc'~I.''':'''' U'!}\.\, ., -, "," ,.......,. .'JfVi<<} tCOJ1~t; C~ntr. Nu~{(;tr~6'315rl\:::: ;~.'?.. !if~t,;..~h~ -"'~"installatiori;Altehiiiofi:'b~M~lricat'i~:i\~f'll,l~ ~~>;:;"f~'} ~:~~f~ f'!',~v_., '. J...l.<:"? Fr..\~~ '......~\~, "'", ';1/:<1:","1<\ 1,'3 ~:. :,1\~:';"'~~~~~~\\)}~ ~'Y"~~'''\~~i:rS't:'2}\,.~~:~\,;:r~,'';.o:.';",~:~ ,,,~,"",. ' ",-,v' l--"0' ---.;' ,(1 '7'~" ',"',p ,,' '~~'i- 'ilO.t. ~\'~ 1.', ~,t)" ~- V'l-1C . ~ }n}t..~: ',,~ .'.\;',"1-., ~'.-JJ.-' i:ri/\1.:;'':'~'~'!~l '~I~~'~; .' '. ,-,\""I;~ ....\~" \\:~_ /''''d:gtS :}'x"'.J,"""""","~~,.~2" ,~;j:.,:ii.H\",Expiratian Dote f 'f,':-."'-' .",;' -":c''-~', ~;,:., ., ;3" .'200ifI1lpS\0r;less., ,'-l<",;,M0l1\.~....:.....ciS~50.QO '..,. > .<< ,....:~,.<:0f,{:-:J:<; ~, " ~l~~~~~:;t>:}::~J~;i"~o\<oibi.~ps(tO'~ob~affips\~~'r'p:i:A\~~,~'~Y~$69.00:; \;..-':,: . ,.":....).\...'.\-.. .- , -.;;.::~...;.t ' " "'.o:i\Ut' '",...-i r'\.,)\r~ -'J.'.'f\,'e\$y:r."",,"'R~'''''''''--:-::' i' ;~ ~ ~':'\:\,.:\:<~~; ',Signatnrc of SUl'erv;,ing Electrician ' ~\()\\'Over401~to 600 amps~Q...".. ':::*:,a~,$~OO.OO'~'_'"".:f' ',. ''":.'of.'~';'')'''' ...... \'1 ,:r::I'\;;\. L.,' ,~'n-\f'L-.... .......~,\\,.,...t "~\\I~\.~~' ...:. .! ..- f:."\:~\~;j~.,"""'*": .,,: ' .' "- ~ . .'f"\O.0ver600(nmpsorlOOO..t;voltssee.ti'-e"-\........p;..-i\'#~~,"~."'':'j,jo.<.1j ,':"'U"" .,....~. ",. ,,, ",",u" \\1el........,.,\\\\\\'(',., "'".",.,,."," .""", ':;:,i..-...,'.c',. .. ,-.,. ,.,', W OO<;!B':aboveece "O\........,",..'^Ai/".".,,~.:.:...,".:.;'~. ;:;;;,,;'l.o'~.-r':(~',' ._ . ';:'J,''''~ ~ tt''f''\Q"(\t\ ate.., l'1i'l2...i~ ~~~\"~'?6,,')":\...;.:,.J( "',;;-~",1',~"" - .,lZ',.." ca\ll""'''''o-\ne oQO'"'''' ,\";';~....isl?",,.~.:,:..::,. :"." ~.'i>.'t-.,..N.~,." -.' '4,. 'o'r'-\\ 'c'\"o 1..."t<.~"o-;"'.\-""':'~"";",, ~,;::.\,.;::,g;"t:.>q-"l:' -~' , ~,~. ~ '~''-'''~)'' OO~." OJ D. Branoh;Gircuits"'\e\\.... . ..~.: ;,';..:t;;(({.-y~;..<f.i _ol..t;-., ,\"~--~;:::rr(t~y.\;j' ..-- ""\,It ~ , "... J'O\J~t. .7-::j.l'...,\...~...r~"..f"\.~"*.J-.:.' ;t-:":::;\~,.t/~ Owners Name. ' ~, - II New Alteration or Extension Per Panel -; .~~' ,".,~,,:,. _l- ,.... ("r'o;: -"'h~ ',.;\~:.;' '.~-"'" '<,'t. , \. '-;i .... ~', ~ A" ,- " ~,~. ,h'" " f ~: . -, ~;- ~ '.:~, ' ~.,:' +'~;;""\-:" -"t',.. . ..~~'t ' .".~:::~".-',~:'i >^" - n c::.:~n'I...t\.:j'tli':\ ~ ., '.', c' .:.., ~.._.:" ~',.', ." c'''' '- , { )1.;:~~, Add',:ess -r::,' 'cJul:o\ \ ,~li One eircuil. .j,~ ,.\~ $43.00 .; >. ,"{, ".;"';1"","''r\L\'; ,.....-, ~'1,::4',-n'." ',c '.-, ,,~t.'l'-~O\:''''~''!'''''' :.' " :.'~{. ~..; e;{~ V ~ \ ',~'. . Phone'rt"'T n, Eaci, Add'iiiOI\il\i~~~\'i~h~<<lceL~r< ,!l 00 .,.' ':"':: . . ", .'. .'_0:1 82ff3 t:..orFeede.r~f.\i;11t,-\\<;;'?t: ~\)'{~~$.3.00.~ .. ' OWNER INSTALLATION .~e:. C\,,\'\;l,.' ~\\ 'O~ ~'i' \" ~\)\J~ ". " .- . ,'. 'The installation isbei~g made on.' ~E(\S''i'~i~bllli'\5':~eder not included) ., ' ': .' property I own wInch IS not mtended "'\ ~'U"'\ ~\)W..t~1J . .' ",. for sale, lease or rent. .: , .::' . \>I \)~~ R oation . $50.00 . ' . . . . c, l'( utline Lighting $50.00 ,Owners Signature. I>-~ Limited EnergylRes $25.00 Limited Energy/Comm' $-15.00R ,~ .. ;' ;.~\:;~_:: '~.:~iB; ~(:~~ 0.'... .',' . ~- "i, "'j:,-, :....' :,X"'. ~ ',',' :~;; : g~;.;: Sum(,' 'c.~~~~r:,;; $106.00 . ":~:".~: $ 19.00 .'.'.','-' :'/ _.~t. , .~~'\'~~f . ....' l\IinimuIll Elcctric Permit Inspcction Fcc is S'-l5.0n + S;:;2)'lJ'gCS 4. SUBTOTAL OF ABO~E~~ I O~'72 . \ 7% State Surcharge l3'b P> .I)~ 8% AIIministrat;rc Fee I~ ll~ AS , ' ;~,~ .' TOTAL . , SPRI'ELD DEVELOPMENT SERVICES DEPARTMENT 225 FIFTH STREET SPRINGFIELD, OR 97477 , . (541}726-3753 ' FAX (541) 726-3689 MANUFAeTURED HOME LAND USE AGREEMENT As required by the eity of Springfield Development eode, I agree that with the approval of the attached permits, one of the following manufactured homes will be placed at 2-<S ~ 4-, ~.t4 4P Springfield, Oregon, eity Job Number C01n./z;2 -tY~. ~ 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 in height for each 12 feet in width, that has no bare metal siding' or roofing, and that has been certified by the manufacturer to have an exterior thennal envelope meeting perfonnance standards which reduce heat loss to levels equivalent to the perfonnance standards required of single family dwellings constructed under the State Specialty eodes: _ Type II Manufactured Home. A unit of not less than 12 feet in width with an enclosed floor area of not less than 500 square feet, that has a nominal roof pitch of2 feet in height for each 12 feet in width and that has no bare metal siding or roof mg. The manufactured home shall be placed on an excavated and back-filled foundation not to exceed 6 percent slope within 10 feet of the perimeter enclosure. The perimeter foundation wall surrounding the home shall be constructed of stone, brick or other masonry materials, and with no more than 24 inches of the enclosing material exposed above grade. 1 further agree to meet all land use and eity eode requirements of the above mentioned parcel within 60 days of the date of Issuance of the manufactured home set up penni!. These requirements may include, but are not limited to the items listed below. Specific land use requirements regarding your parcel are noted on your approved set up plans and/or permit and your partition approval if applicable: . Street Trees . Paving Driveway . Minimum 32 square foot storage structure . Completion of partition approval . Removal of any existing structures as noted on your partition approval . Signing and recording of any required partition, easement, improveQlent agreements, etc. ' . Fmallot grading , . City Sidewalk and curbcut mstallation . Any outside agency approval as required i.e., Division of State Land approval. By my signature below, I agree to complete the above mentioned land use requirements. Owner Signature ~IIC/A~~' eontractor Signature Date I z,- I 8 - 0 '- Date i"-. . CITY OF SPRlNGFIE&YSTEMS DEVELOPMENT c~ORKSHEET JOURNAL OR JOB NUMBER: eOM2002-0133I NAME OR eOMPANY: Ima Broaddus LOeA TION: 2534 Maia Loop TAX LOT NUMBER: 1.70325E+l2 DEVELOPMENT TYPE. SINGLE FAMILY RESIDENeE I NEW DWELLING UNITS: I BUILDING SIZE. 1680 SF LOT SIZE. 5267 1. STORM DRAINAGE DIREeT RUNOFF TO elTY STORM SYSTEM IIMPERVIOUSS.F'I,I COSTPERS.F. I 2335.00 $0.282 RUNOFF ROUTED TO DRYWELL DESIGNED AND eONSTRUCTED TO eITY STANDARDS I IMPERVIOUS S.F. I xl eOST PER S.F. I xl DISeOUNT RATE 1 0.00 $0.282 50% 1 I ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - elTY A. REIMBURSEMENT eOST: I NUMBER OF DFU's I 'I eOST PER DFU 19 $22.09 B. IMPROVEMENT eOST: I NUMBER OF DFU's I ,I eOST PER DFU 19 L $16.79 I ITEM 2 TOTAL - eITY SANITARY SEWER SDe 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS 1 x I eOST PER TRIP 1 x I NEW TRIP F AeTOR I 9.57 I I $16.81 1 1.00 ~I B. IMPROVEMENT eOST: I ADT~~~RATE HNUMBE\OFUNITSH eos;7:EI~TRIP I ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMe A. REIMBURSEMENT eOST: I NUMBER OF FEU's I 'I eOST PER FEU I $332.86 B. IMPROVEMENT eOST: I NUMBER OF FEU's I 'I eOST PER FEU I $34.83 MWMe eREDIT IF APPUeABLE (SEE REVERSE) SUBTOTAL OF MWMC REIMBURSEMENT, IMPROVEMENT & eREDlT MWMC ADMINISTRATIVE FEE lITEM 4 TOTAL - MWMC SANITARY SEWER SDe I SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5. ADMINISTRATIVE FEE: 1 SUBTOTAL I ^ I ADM. FEE RATE I $2,498.87 5% 1 xl NEW TRIP FAeTOR I 1 1.00 =1 =r =1 TOTAL SANITARY ADMINISTRATION FEE: 1 TOTAL TRANSPORTATION ADMINISTRATION FEE: I SF =1 $658.47 =1 =1 $0.00 $658.47 =1 $419.71 =1 =1 $319.01 1 $738.721 I -, $160.87 $709.81 $870.68 =1 $332.86 =1 =1 =1 =1 =1 =1 $2,498.87 I , , '- $231.00 ----L I , $34.83 ($146.69) $221.00 $10.00 $124.94 76.97 $47.97 Siw<- 1~ SDC COORDINATOR DATE TOTAL SDc CHARGES =1 $2,623.81 12/1012002 I I 1079 ll078 r:/1 P-l Cl o U ~ P-l E--< r:/1 ...... o ~ II I 11070 1091 1092 1093 1094 1055 1056 ;,- ;;. . .. e 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 # NEW # OLD x EQUIVALENT = (I 0) x 3 (0 0) x I (0 0) x 3 (0 0) x 3 (0 0) x 6 (0 0) x 2 (I 0) x 3 (0 0) x 6 (0 0) x 12 (0 0) x I (0 0) x 3 (I 0) x 2 (0 0) x 2 (I 0) x 3 (0 0) x 2 (0 0) x I (0 0) x 2 (2 0) x I (0 0) x 5 (0 0) x 6 (2 0) x 3 II FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETe. INTERCEPTORS FOR SAND I AUTO WASH I ETe. LAUNDRY TUB eLOTHESW ASHER I MOP SINK eLOTHESW ASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIG I WATER STATION I ETe. REeEPTOR FOR eOM. SINK I DISHWASHER I ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK eOMMERelALIRESIDENTIAL KITeHEN SINK eOMMERelAL BAR SINK. DOMESTIe BAR WASH BASIN LAVATORY URINAL, STALL I WALL TOILET, PUBLle INSTALLATION TOILET, PRIV ATE INST ALLA TION MISCELLANEOUS DFU TYPE NUMBER OF EDU's' FIXTURE UNITS 3 o o o o o 3 o o o o 2 o 3 o o o 2 o o 6 (0 0) x 20 0 TOTAL DRAINAGE FIXTURE UNITS =1 19 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFV's) set at 167 gallons per day MWMc CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE IF IMPROVEMENTS OeeURRED AFTER ANNEXA TION DATE, CALCULATE CREDIT SEPARATELY l YEAR eREDIT RATE PER $1,000 II YEAR CREDIT RATE PER $1,000 ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE 1979 Or\. DC;:;:;;Jf" $4.92 1990 $2.06 1980 $4,83 1991 $1.64 1981 $4,77 1992 $1.45 1982 $4,64 1993 $1.31 1983 $4.47 1994 $1.13 1984 $4.30 1995 $0.97 1985 $4.09 1996 $0.82 1986 $3.78 1997 $0.63 1987 $3.41 1998 $0.41 1988 $2.98 1999 $0.22 1989 $2.52 2000 $0,04 VALUE 11000 CREDIT RATE 29.816 X $4.92 =1 0.000 X $4.92 =1 TOTAL MWMC CREDIT =1 eREDlT FOR LAND (IF APPLICABLE) I eREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) $146.69 $0.00 $146.69 . e CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2002-01331 ISSUED: 12/18/2002 APPLIED: 12/02/2002 EXPIRES: 06/18/2003 VALUE: $ 10,340.00 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2534 MAlA LP ASSESSOR'S PARCEL NO.: 1703251404700 Springfield TYPE OF Manufactured Home w Garage/Carport on Private TYPE OF USE: New Residential PROJECT DESCRIPTION: MH on private lot with garage Owner: IMA BROADDUS Address: 85321 NESTLE WAY PLEASANT HILL OR 97455 Phone Number: 541-744-7963 Phone Number: 541-744-7963 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone General HARRISONJACOBSONINC 66447 05/07/2004 541-689-7762 Electrical RALPH W BROWN 63137 02115/2004 541-729-1500 Manuf Home Inst HARRISON JACOBSON INC 66447 05/07/2004 541-689-7762 Owner IMA BROADDUS 541-744-7963 Plumbing HARRISONJACOBSONINe 66447 05/07/2004 541-689-7762 # of Buildings: Primary Occupancy Group: Secondary Occupancy P'rimary Construction Type Secondary Construction # of Bedrooms: SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Stree t Storm Sewer Available: Special Instruction: Notes: BUILDING INFORMATION I 1 R-3 U-l VNSpr # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: I 16.00 "orced Air Electric Electric Electric 2 Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: 1m pervious Surface Area: 5,267 1,283 400 I DEVELOPMENT INFORMATION I REQUIRED PARKING 123.00 Overlay Dist: 109.00 # Street Trees 70.00 Paved Drive Rqd: ':(.,. 16.00 %OfLotc;;rtr~t~~\ 9.00 O.OQ . ~'f...?\~ ol'J'l\\ \S 'IO~:? . o,.\r.~. .. ~\.\D.\.\. ',\'f'- pi'<-, ,('\Q.....tas. . ...'H.\'l \,\\1' ?t.W~-- m 'L~ . = \ 1>!'1\"'~ g.o" - \0<'" i\\\S , ~'i \ ~")8 TS_I . .\.o~e~o;~~\~a?::0-\as~~O'O'" ~\}i\\~i~Ct.\) ~~\O\)' :~~"'i\CSidewalk-Typ.e: ~I},.e Op..~ 9~ ~aS '0':1 COWl \0.1\ \)t>.'1 ? ~ ..1 ~1}\eD:~~P.< ~~~~~,~. O~ '<!,\"Z ~~o'(la . .. ..\" ull ~\O". vV' 0-'''' ,\0" ~e"\ . 0(\ Private inll'<\structure \0.,. ,;a.\.I0'll nO"'\) \\~ CO~ . \'{\e\a :'-\C0-\\ . ~O\\\\ 9~7;'v 0'0\'0' ~~\e. . " ~O\ll . \'11 Op..~ 'l01} ~a.~e~~e~' ~O\\ IJ'(\~~,?>AA" O'O'90'~X\\\';J}"\Ie..\"\IeO\e ~\)a!;,':, .. Cll: :oe~\O' 1\S'I- '(Il}t<I Ce'llW- Hillside 3 Total: Handicapped: Compact: 1 of 3 - -lfi~~"'~ l \',. T <_ t.;nj"" . e CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2002-01331 ISSUED: 12/18/2002 APPLIED: 12/02/2002 EXPIRES: 06/18/2003 VALUE: $ 10,340.00 Status: Issued 225 Fifth Street, Springfield, OR . 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Desc ription Type of Construction Foundation Only Use Bid Amount Garaee Garaee Manuf Home Manufactured Home $ Per Sq Ft $1.00 $19.60 $1.00 Square Footaee 2,500.00 400.00 40,000.00 Value $2,500.00 $7,840.00 $40,000.00 $50,340.00 Date Calculated 12/0212002 12/02/2002 1210512002 Total Value of Project Fee.. tlWU Fee Description Amount Paid Date Receipt Number Plan Review Residential $74.88 1212102 1200200000000000318 + 5% San & Storm Admin Fee $124.94 12/18/02 1200200000000000425 + 5% Transportation Admin Fee $47.97 12/18/02 1200200000000000425 Add, Alter, Extend Circ Ea Add $3.00 12/18/02 1200200000000000425 Addressing Assignment $8.00 12118/02 1200200000000000425 Annexed 1979 or Before $-146.69 12/18/02 1200200000000000425 Building Permit $115.20 12118/02 1200200000000000425 Manuf Home State Issuance $30.00 12118/02 1200200000000000425 Manufactured Home Connection $45.00 12/18/02 1200200000000000425 Manufactured Home Feeder $50.00 12/18/02 1200200000000000425 Manufactured Home Placement $160.00 12118/02 1200200000000000425 Manufactured Home Service $50.00 12118/02 1200200000000000425 Plan Review - Planning $55.00 12118/02 1200200000000000425 Plan Review Residential $74.88 12118/02 1200200000000000425 Sanitary Sewer - Ist 50 Feet $45.00 12118/02 1200200000000000425 Sanitary Sewer - Improvement $319.01 12/18/02 1200200000000000425 Sanitary Sewer - Reimbursement $419.71 12118/02 1200200000000000425 SDC MWMC Administration $10.00 12118/02 1200200000000000425 SDC MWMC Improvement $34.83 12/18/02 1200200000000000425 SDC MWMC Reimbursement $332.86 12118/02 1200200000000000425 SDC Transpo Improvement $709.81 12118/02 1200200000000000425 SDC Transpo Reimbursement $160.87 12/18/02 1200200000000000425 Storm Drainage Impervious Area $658.47 12/18/02 1200200000000000425 Storm Sewer - Ist 50 Feet $45.00 12/18/02 1200200000000000425 Water Line - 1st 50 Feet $45.00 12118/02 1200200000000000425 Willamalane Manuf Home Private $1,000.00 12/18/02 1200200000000000425 + 7% State Surcharge $39.07 12/24/02 1200200000000000456 + 8% Administrative Fee $44.66 12/24/02 1200200000000000456 Total Amount $4,556.47 Plan Reviews I Initial Review 12103/2002 12105/2002 APP LLH 2 of 3 . e CITY OF SPRINGFIELD Building/Combination Permit Status: Issued PERMIT NO: cOM2002-01331 ISSUED: 12/18/2002 APPLIED: 12/02/2002 EXPIRES: 06/18/2003 VALUE: $ 10,340.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plannine Review 12103/2002 12/03/2002 APP AJD Garage height not to exceed primary structure height Private infrastructure Public Works Review Structural Review 12105/2002 12105/2002 12/10/2002 12/1812002 APP APP DPE DLM 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. I Relluir..rl lnsn..di"ns I I Ufer Electrical Ground: Install ground rod at footing and call for inspectinn in conjunction with footing and/or foundation inspection. 2 Footing: After trenches are excavated. 3 Foundation: After forms are erected but prior to concrete placement. 4 Shear Wall Nailing: Before covering sheathing with finish materials. 5 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 6 Firewall: Located and constructed according to plans. 7 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 8 Manuf Home Set Up: When installation of all piers or stands is complete. 9 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. 10 Final Building: After all required inspections have been requested and approved and the building is complete. 11 Undernoor Drain: Prior to cover or placement of concrete. 12 Water Line: Prior to filling trench and including required testing. 13 Sanitary Sewer Line: Prior to filling trench and including required testing. 14 Storm Sewer Line: Prior to filling trench. 15 ManufHome Plumbing: After home has been connected to water and sewer. 16 MH Service: Approval required prior to ntility company energizing service. 17 MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. 18 Final Electric: When all electrical work is complete. 19 Rough Electric: Prior to Cover By signature, 1 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 ofthe 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 wiD 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 3 of 3 .u;:" ~ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Line Items: Job/Journal Number eOM2002-0133I eOM2002-0 1331 Payments: eheck Type of Payment Paid By Descriotion + 7% State Surcharge + 8% Administrative Fee GOODEN HARRISON Receipt #: 1200200000000000456 Date: 12/24/2002 Received By Check Number Confinn No djb Page I of I 12/24/2002, 9:28:39AM " City of Springfield Development Services Department Public Works Department Official Receipt . Amount Paid 39.07 44.66 Line Item Total: $83.73 How Received Amount Paid In Person 83.73 $83.73 Pavment Total: . cReceipt.rpt