HomeMy WebLinkAboutPermit Building 2018-11-295PRINGfIELD
t,
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-7 26- 3? 53ORIGO
web Address: www.springfield-or.9ov
Building Permit
Residential Manufactured Dwelling
Permit Number: 81 1 -18402754-MO
IVR Number: 81 102127341 1
Email Address perm tcenter@sprinqneld or.gov
Permit lssued: November 29. 20'18
TYPE OF WORK
Category of Construction; Manufactured Dwelling Type ot Work: New
Submitted Job Value: $0.00
Description of Work: Placement of new manufactured home on existing private lot.
JOB SITE INFORMATION
Worksite addroas
5660 DAISY ST SPC 24
Springfield, OR 97478
Parcel
17 02334401402
BESSETT LUCKY
LIMITED LIABILITY
COMPANY
254 SPYGLASS DR
EUGENE. OR 97401
Owner:
Address
LICENSED PROFESSIONAL INFORMATION
Business name
SEE PROPERTY OWNER
INFORMATION - Primary
License
Owner (Property)
License number
OWNER
Phone
lnapection
5999 Final Manufactured Dwelling
5300 MH Setup
5100 Site lnspection
5240 Footing
lnspection group
Mfd Dwelling
Mfd Dwelling
Mfd Dwelling
Mfd Dwelling
lnspection status
Pending
Pending
Pending
Pending
SCHEDULING INSPECTIONS
Varaous inspections are minimally .equired on each project and often dependent on the scope of work. Contact the issurng
jurisdiction indicated on the permit lo determine required inspections for this project.
Schedule or track inspections at www.buildingpermits oregon.gov
Schedule by phone call 1-888-299-2821 use IVR number: 811021273411
Schedule using the Oregon ePermitting lnspection App, search "epermitting" in the app store
Permits must bc posted in clear view on the worksite. Permit6 erpire if work is not started within 180 Days of issuance or if work is
suspended for 180 Days or lon96r depending on the issuing agency's policy.
All provisions of laws and ordinanc6s governing thi6 type o, work will be complied wilh whether specitied h6rein ornot- Granting of
a permit does not prcsume to giv6 authority to violate or cancel the paovisions of any olher state or local law 169ulating construction
or the peatormance of construciion,
ATTENTION - CALL BEFORE YOU DIG: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those tules are s€t forth in OAR 952{01{010 through OAR 952-O0l-0090. You may obtain copies of the rules by calling the Center at
(877) 668-4001 or dial 8'11.
All peEons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Struclural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010{20 (Plumbing).
Pinled on: 11/29/'18 Page 1ol2 std,BuildingPerm(_pr
tNs,FC
Permit Number: 8'l'l -1 8-002754-MD Page 2 ol2
Fee Description
Manufactured dwelling placement permit
State manufactured dwelling fee
State of Oregon Surcharge - 14FD (12olo of applicable fees)
Quantity
Total Fees:
Fee Amount
$5 3 7.00
$30.00
$64.44
$63t.44
1
1
Pnnied on 11/29/18 Page 2 ol 2 std EuildingPermit_pr
PERMIT FEES
SPRINGFIELD
OR€GON
www-springfi eld-or. gov
Worksite addressi 5660 DAISY ST, SPC# 24, Springfield, OR 97478
Patcel 1702334401402
Transaction Receipt
81 1-18-002754-MD
Receipt Number: 468713
Receipt Date: 11/29/18
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
54\-7 26-37 53
permitcenter@springfield-or. gov
Fees Paid
Transaction date
11t29t18
1't t29t18
11t29t18
Units
1.00 Ea
'1.00 Ea
1.00 Ea
Account code
224 -OOOO0 - 42 5602 - 1 030
821-00000-215009-0000
821-00000-21 5004-0000
Paid amount
$537.00
$30.00
$64.44
Description
Manufactured dwelling placement permit
State manufactured dwelling fee
State of Oregon Surcharge - MFD (12% of
applicable fees)
Fee amount
$537.00
$30.00
$64.44
Payment Method Credit card authorization
719243
Payer: lonny basset Payment Amount:$631.44
Cash er: Katrina Anderson Receipt Total:$631.44
Prinled 11/29l1E 3 38 pm FIN_TransactionRec€ipt_pr
Crrv or Smnvcrrrr.n, OnrcoN
:-,"i-,]225 Fifth Stie€t . Sorirsfield. oR 97477 . PH( 541.|726-3 7s3 . FAXr54l )726-3689
Man ufactured Dwelling/Recreation al-Park Trailer
Placement Permit Application
This permit is issued under OARs 918-500-0105 and 91&525-0370. Permits expire if work is not started withitr 180 days of
issuance or if work is suspended for 180 days.
FEE SCHEDULE
Description Qty Cost each Total
(1) Mrnufactured dwe[itrg
(a) Placement (includes placement,
electrical feeder, water/sewer
connection):
$537.00 S
(b) Reinspection (no. ofhrs. x fee per hr.)s9s.00 S
Placement permit can only be obtained by homeowner or Oregon-
licensed manufactured dwelling installer.
(2) Recreational-park trailer
(a) lnstallatioo (includes stand and
lot preparation; support blocking;
anchoring; temporar1r steps; plumbirg.
mechaiical, and eiectrical):
$537.00 s
599.00 s
s99.00 S
Electrical service permit to be obtained only by homeowner petforming
work or sighing supe ,iso; of OregonJicensed electical contractor
performing \|orh
(3) Surcharge, 12% (.12 x total, equal 1o I or 2)
(4) State administrative fee for
manufactured dwelling (item 1)
only, OAR 9l 8-500-0105(5):
$30.00 l $30.00
(5) Technology Fee, 5%S
I
I
TOTAL fees and surcharges (3 + 4+5):o.3i.+'
""..1
olL 5ap,!e
PEr- Fl.5r6 tl={Y.
oa rt/z>f6
t/
DEPARTMENT USE ONLY
Permit no.: l?-@fl ^\
'"'"' ll /L1 lra
LOCAL GOVERNMENT APPROVALS
Zoning approval verifi ed ! Yes ENo
Properry is within flood plain: E yes E No
Sanitation approval verified: I Yes n No
CATEGORY OF CONSTRUCTION
I Residential E Govemment ! Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: SLb O SD X"4 Do$vt
city gtuoll Covrrty, ) A)
'o.r ztP: q7q'lZ
Space/lot rc.: )QSubdivision:77; ,..,7
Re
PTIDESC
Ta-xlot o'L-
OF WORK
Year Mxufactwed: )Q /S
value: </$ o3-9# Bedrooms: 5 sq.Fts l2EO
PROPERTY OWNER
L
Address ?c
cit}: €i t.' State: f17 ztP:q'77D1
ptone5l-lLqt4. Oed Fax
E-mail
This installation is being made on residential or farm property ovred by
immediate family, and is exempt fiom liceosing
Si Fi->-4/'l
me or a membbr
918-515-0010
TOR INSTALLATION
Sr-"tr
State ZIPcitv
Fax:
E-mail
I MDI license no.: l9U1 -CCB iicense no.: L, A9{t
Print name: /\
Signa
last edired 5/5/2017 BJones
-/l-.r.}rlE BF.E6tTf
lAddress:
State:
Name:
(b) ReiDspection (no. ofhrs. x fee per hr.):
(c) Each additional inspection: (1)
FEE SCHEDULE
l$
'CoNTR/
Business name: -t
Phone:
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the foilowing statement before a buiiding permit can be
issued. (ORS 701.325 (2\l
This statement is required for residentiai building, electrical, mechanical. and plumbing permits,
Ljcensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement. This statement will be filed with the oermit.
Please cneck the approoriate box.
I own, reside in, or will resioe in the compleled structure and my general contractor is
Expiratior: Date
I will in{orm my general ccntractor that all subcontractors who work on the structure must be
licensed with the Construction Contractorc Board.
or
Narne
K I will be performing work on property I own, a residence that I reside in, or a resldence lhat I will
reside in. lf I hire subcontractors, lwill hire only subcontractors licensed with the Construction
Conti'actors Board. lf I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the coritractor to the ofnce
issuing this Building Permit.
I have read and understand the lnformation Notice to Homeowners About Construction Respoosibilities,
and I hereby certify that the inrormation on this homeowner statement ls true and accurate.
Lo Itrtsel*
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RE: contact i-nfo - SiteA4ail _ A4sg
(Oliver Technologies, OR.jpeg)
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OU1ER TECTINOLOGIES, NC,
467 Swsxl Ai,eouE
P.O. Bor 9
Hobeowal4 TN 38462
Re: OIivE T€cbtrologi.q lac AII S.3--1 Fortrdaliotr SlEtcnL Moricl I 100 'V" S.ries
Dcer Mr. i,ower:
Wc bEve reviefled lhe Moiel i I 00 'qr''" nccl bi"cilg riysleE tbat i6 dlsigned to be iDselled wirl,
ed to su@eot s coEvatioDEl p3d Eod pier or poured co xetc EsnxfarlE-ed dwelliug s€{-up.-t{e coocrr vith 3or.E co_eiae<i[g od testiEg thsl yorE Mode] I 100 'V", wbed iDrtslled
according to your iuellation instsuctiolrs l,ill sdisry o[E ,equir.oo6ts for resistiEg y,iod fo!.6
ia I(JD W_md Zooe I. A-lI otbE rca.uir@.dls of the sct-up 6tsEd in Oregon's MEnufttturcd
DweUiDt ald Pat Spei8lty Cod. - 300? Eiition tEEst b. rqsl
wc the* you for the @poltuniry tio obs€ve ),orr Foduct aDd fo! dl the inforEt,liou you
providcd DA. If you havc any conmeotr, questiou or coocems plesse fecl fiee to aoDBct !!e at
(503) 37&2306.
Chief of M2IlufscE!_ed StruclurEs & Parks
From: "Father & Sons', <fatherandsons@hughes.net> - RE: contblct info
Lttnc'/Arrehmair cenrrrn'rinkoffice.net/sitemaiyread email-phdrtd=27gg0&folder-rnbox&pri...4/191?,018
RE: contact nfo - Site\4ail - Msg
From:
To:
5u bject:
"FEther & Sons" <fatherandsons@hughes. net>
<prproduction @qwestofflce. net>
RE: contact info
Page 1 of5
Sent: Thu t9/O4/18 6:50 PN
Priority: Nbrmal
Hello,
fr4ike said you didn't receive these that Isent on April5th. I am fe-sending.
Thank you,
Shirley CIark
Father and Sons of Oregon, lnc.
From: prproduction@qwestoffice.net <prproduction@qvrestoffice.net>
Sent: Wednesday, April 18, 2018 2:26 PM
To: fatherandsons@hughes.net
Suhject: contact info
Thanks
Lonny
Kymberly
Office Manager
' Portable Rock Production Co.
547-7 47 -O790
541-7 46-87 23 fax
L4-. //,r,^Lqo_I ^--f,.-rin LnfGne ner/sitemaiVreademail.php?id=27880&folder-Inbox&pri,.. 4l 19 /2018
RE: contact fufo - SiteMail - \4sg
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Sraxt ytrd se!!ack shall be 15 ie:z mini;run, :xcept:ll !2rE_.isand carpcrls t3kii9 aca:ss on th? frcnt oi the prcp:r:y sln)l beset ia:;i 20 i'9er- Siid yrl.a sh.li b: ltndac:rred al1d tui,:r;inel.Si/i7erd sri5a.i::nterjor siJe y:rd 5 feEfAll:, siCe yard 5 fe.t5ire:t s: de yerJi-. (except ',h6i garagis }iir'; be set back' 2C fe2.) I0 feetStredi side reverEe cgrfler 15 ieet
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