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Home My WebLink AboutPermit Building 2003-08-19Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2003-00670ISSUED: 0811912003APPLIED: 0712512003EXPIRES: 05/0412004VALUE: $ 47,553.00 SITE ADDRESS: 1218 38TH ST ASSESSOR'SPARCELNO.: 1702304303201 Springfield TYPE OF WORK: Manufactured Home on TYPE OF USE: PROJECT DESCRIPTION: MH on private lot. Add carport to plans for review 10122/03.D8 ROGER CRABTREE 4028 CAMELLIA ST SPRINGFIELD OR 97478 PhoneNumber: 541-747-3549 Private Lot New Residential Owner: Address: Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License Expiration Date Phone CONTRACTOR INFORMATION G INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 1 R-3 u-1 VN 1 Heat Pump 20.00 14.00 10.00 7 No 28.00 REQUIRED PARKING Total: 2 Handicapped: Compact: 35.00 0.00 Partially Improved No spdfltlgguction: Nlit$ PERMIT SHALI FXptRE l[:Tt,i !,,i/UTHORIZED Ui,IDI,R I'HIS PERMII ;i ; IOMMENCED OR IS A5ANDONEO TJ* ANY 180 DAY PERIOD Sidewalk Type: Downspouts/Drains: Drywell - Provide Drywell Engineering DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Page I of4 ffi- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-00670ISSUED: 0811912003 APPLIEDz 0712512003 EXPIRES: 05/0412004VALUE: $ 47,553.00 Description Tyne of Construction Carport Carport Foundation Onlv Use Bid Amount Manuf Home Manufactured Home $ Per Sq Ft or multiplier $16.30 $1.00 $1.00 Square Footage or Bid Amount 310.00 2,500.00 40,000.00 Value $5,053.00 $2,5oo.oo $40,000.00 $47,553.00 Date Calculated 10t22t2003 07t25t2003 08/19/2003 Amount Paid Total Value of Project Date Paid Fee Description PIan Review Residential -Mechanical Issuance Fee- + l0o Administrative Fee + 7%o State Surcharge Foundation Permit Heat Pump Manuf Home State lssuance Manufactured Home Connection Manufactured Home Feeder Manufactured Home Placement Manufactured Home Service Minimum/Adj ustment Mechanical PIan Review - Planning Plan Review Residential Refund - SDC Storm Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Plan Review Residential + l0o/o Administrative Fee + 7o/o State Surcharge Garage/Carport Total Amount Paid Receipt Number 1200200000000001821 1200200000000001983 1200200000000001983 r200200000000001983 120020000000000r983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 r200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000002357 2200200000000001725 2200200000000001725 2200200000000001725 $59.67 $10.00 $44.78 $31.3s $s2.80 $12.00 $30.00 $4s.00 $50.00 $160.00 $s0.00 $33.00 $s9.00 $-25.35 $-203.58 $51.63 $67.92 $16.16 $407.16 $45.00 $49.s3 $7.62 $5.33 $76.20 7t25t03 8/19/03 8/19/03 8/19/03 8n9t03 8/r9103 8/19/03 8n9t03 8n9t03 8n9103 8/19t03 8/19/03 8/19/03 8n9t03 8n9t03 8n9103 8/19/03 8n9t03 8/19/03 8/19/03 10t22t03 tu5t03 tu5l03 1 1/5/03 $1,135.22 Fees Paid Plan Reviews Initial Review Planning Review 07t28t2003 07t28t2003 07128t2003 08tr4t2003 APP APP RJB TAJ Pase2 of 4 I t}- Valuation Descrintion I Status Issued 225Fitth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00670ISSUED: 08/19/2003APPLIED: 0712512003 EXPIRES: 05/0412004VALUE: $ 47,553.00 Public Works Review Structural Review Structural Review Structural Review Structural Review 08/18/2003 10t22t2003 07t28t2003 08/01/2003 APP VRJ 07t28t2003 0811412003 wE DLM 08/18/2003 IO DLM Site plan does not show storm drainage, contacted Mr. Crabtree 81112003. Mr. Crabtree requested splash blocks for storm drainage, splash blocks are not allowed as per Plumbing Code Chapter 38, Section 3801. Copy ofcode attached to building permit. RLID(SCS) soil type, 76-Malabon Urban Land Complex. Perk Test is required from a licenced geologist for drywell. Drywell must meet City specifications, see notice and specs included in building permit. PERK TEST, DRYWELL SIZE AND CALCULATIONS MUST BE APPROVED BY PUBLIC WORKS PRIOR TO FINAL OCCUPANCY. SDC credit for old MH burned ll-27-02, as per document from Oregon State Office of Fire Marshall. Credit included impervious surface for 728 sq ft., plumbing fixtures (l tub, 2 toilets, 2 lav., I kit. sink, I clothes washer), Transportation and MWMC fees. Permit includes a carport, but no carport plans were submitted. I talked to owner's son-in-law. He will submit two copies of the required drawings as soon as they are prepared. Talked to owner about carport drawings required. He has decided to delay the carport permit in order to expedite the M.H. permit. The carport permit will be added or renewed at a later date. Carport permit deleted from application. Now M.H. only CARPORT - Roof drains from carport to connect to house drains to drywell. 08n912003 Ly04t2003 APP DLM APP DLM To Request an inspection call the24 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 3 of4 t:r- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-00670ISSUED: 08/19/2003APPLIED: 0712512003EXPIRES: 05/0412004VALUE: $ 47,553.00 1 ) 3 4 5 6 7 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Foundation: After forms are erected but prior to concrete placement. 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. Manuf Home Plumbing: After home has been connected to water and sewer. Final Mechanical: When all mechanical work is complete. MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. MH Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Rough Electric: Prior to Cover Footing: After trenches are excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. 8 9 10 11 t2 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 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. #*5-o 7 Owner or Contractors Signature Date Pase 4 of 4 Required hspections I 225Fift}a Street Springfield, Oregon 97 477 541-726-3759 Phone n City of Springfield dfiiciat Receipt Development Services Department Public Works Department Receipt #:22002 172s Date: 1110512003 3:00:08PM coM2003-00670 coM2003-00670 coM2003-00670 Garage/Carport + 7o/o State Surcharge + ljYo Administrative Fee 76.20 5.33 1.62 Item Total:$89.1s Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check ROGERCRABTREE DLM 839 In Person Payment Total: $89.15 $89.15 Building/Combination Permit Status Issued 225 Fifth Street, Spring{ield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00670ISSUED: 08/19/2003 APPLIEDz 0712512003 EXPIRESz 0211912004VALUE: $ 2,500.00 SITE ADDRESS: 1218 38TH ST ASSESSOR'S PARCELNO.: 1702304303201 PROJECT DESCRIPTION: MH on private lot Owner: ROGER CRABTREE Address: 4028 CAMELLIA ST SPRINGFIELD OR 97478 Springfield TYPE OF WORI(: Manufactured Home on Private Lot TYPE OF USE: New Residential Phone Number: 541-747-3549 License Expiration Date PhoneContractor Type General Electrical Mechanical Plumbing Contractor owt[ER owt[ER OWNER OWI\ER CONTRACTOR INFORMATION ; INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Vo ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: I R-3 u-1 VN I Heat Pump 20.00 r4.00 10.00 3s.00 0.00 2 No REQUIRED PARKING Total: 2 Handicapped: Compact: 28.00 Street Improvements: partially Improved Storm Sewer A".rild[kr I u i\ : u r e g o n I aw req u ilBsJi,t l?,Special Instr$ffi rules adopted by the no** xtl'jg;*ifffil;r"J'lut""'x""J i)090' Vo"' "V obtain-copies of the rules L catt in g"the-cente r' (Note: the telephone n urntre'r ;;; il; O"gon U-tility N otif ication 'ocnto, is 1 -8h0-33 2 -2344)' Sidewalk Type: Downspouts/Drains: Drywell - Provide N'IICE: Drywell Engineering i'nii'iEin,rlT sHALL EXPIRE l! 11E.y9RK i'uiHdiliiD u r'rorn THI s PERMIT-Is^N 0T ffi'llilil{cEo on rs ABANDoNED FoR nNV teo oAY PERI0D' DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Pase 1 of4 Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00670ISSUED: 0811912003APPLIEDz 0712512003 EXPIRESz 0211912004VALUE: $ 2,500.00 Description Type of Construction Foundation Only Use Bid Amount Manuf Home Manufactured Home $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 2,500.00 40,000.00 7t25t03 8/19/03 8n9103 8n9t03 8fl9t03 8/19/03 8t19t03 8n9t03 8n9t03 8/19/03 8fi9t03 8n9t03 8/19/03 8/19/03 8n9t03 8fl9t03 8fi9t03 8n9t03 8/19/03 8/19/03 Value $2,500.00 $40,000.00 $42,500.00 Date Calculated 07t25t2003 08/19/2003 Amount Paid Total Value of Project Date Paid Fee Description PIan Review Residential -Mechanical Issuance Fee- * l0o/o Administrative Fee + 7o/o State Surcharge Foundation Permit Heat Pump Manuf Home State Issuance Manufactured Home Connection Manufactured Home Feeder Manufactured Home Placement Manufactured Home Service Minimum/Adj ustment Mechanical Plan Review - Planning Plan Review Residential Refund - SDC Storm Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Total Amount Paid Receipt Number 1200200000000001821 1200200000000001983 r200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200d00000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 1200200000000001983 $s9.67 $10.00 $44.78 $31.35 $s2.80 $12.00 $30.00 $4s.00 $50.00 $160.00 $s0.00 $33.00 $s9.00 $-25.35 $-203.s8 $51.63 $67.92 $16.16 $407.16 $4s.00 $996.54 Plan Reviews Initial Review Planning Review 07t28t2003 07t2812003 07t28t2003 08fl4t2003 APP APP RJB TAJ Paee2 of 4 Valuation Description I Fees raro Building/Combination Permit Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 54l-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00670ISSUED: 08/19/2003APPLIEDz 0712512003 EXPIRESz 0211912004VALUE: $ 2,500.00 Public Works Review Structural Review Structural Review Structural Review 07t2812003 08/01/2003 APP VRJ 07t28t2003 08n412003 wE DLM 08/18/2003 IO DLM 08/18/2003 08/19/2003 APP DLM Site plan does not show storm drainage, contacted Mr. Crabtree 81112003. Mr. Crabtree requested splash blocks for storm drainage, splash blocks are not allowed as per Plumbing Code Chapter 38, Section 3801. Copy ofcode attached to building permit. RLID(SCS) soil type, 76-Malabon Urban Land Complex. Perk Test is required from a licenced geologist for drywell. Drywetl must meet City specifications, see notice and specs included in building permit. PERK TEST, DRYWELL SIZE AND CALCULATIONS MUST BE APPROVED BY PUBLIC WORKS PRIOR TO FINAL OCCUPANCY. SDC credit for old MH burned ll-27-02, as per document from Oregon State Office of Fire Marshall. Creditincluded impervious surface for 728 sq ft., plumbing fixtures (1 tub, 2 toilets, 2 lav., I kit. sink, 1 clothes washer), Transportation and MWMC fees. Permit includes a carport, but no carport plans were submitted. I talked to owner's son-in-law. He will submit two copies of the required drawings as soon as they are prepared. Talked to owner about carport drawings required. He has decided to delay the carport permit in order to expedite the M.H. permit. The carport permit will be added or renewed at a later date. Carport permit deleted from application. Now M.H. only To Request an inspection call the24 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. wiII be made the following work day. I Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 2 Foundation: After forms are erected but prior to concrete placement. Page 3 of4 Reouired fnsnecfions E LL\ LDrF Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00670ISSUED: 08/19/2003APPLIEDz 0712512003 EXPIRESz 0211912004VALUE: $ 2,500.00 3 4 5 6 7 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. Manuf Home Plumbing: After home has been connected to water and sewer. Final Mechanical: When all mechanical work is complete. MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. MH Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Rough Electric: Prior to Cover 8 9 10 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 atl 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. ?-(z-63 Owner or Contractors Signature Date Page 4 of 4 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541)726-3689 E LE CT RI CAL P E RM IT AI' P LI CATOAT Date | 16 tollowing prolect as submitted has the tollowing ,,g and does not require specitic land useCity Job Number 1.LOCA'I'ION OT,' LEGAL DESCRIPTION 3 CO]IIPLET'E F'EE A. New Date or CO,\fffa4CfOI{ IArS?XI,I-ATIOItr Otr,rll}' B. Sen,ices or Feeders - Instatrlati*n, Alterations or Relocation: Electrical Contractor $ 63.00 $ 7s.00 s 12s.00 $ 163.00 s375.00 $ s0.00 Address Superwisor License C. Temporarl Services or Feeders City JOB DESCRIPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2 Phone Expiration Date Consff Number Date Signature of Supervising Electrician Owners Name Address o/ 1no Yn "" 7/-V 3s4/ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $ 106.00 $ 19.00 Z $so.oo /OO 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with Service or Feeder Permit D. liranch {-'ircuits City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: E. $'Iiscellaneous (servicelfeeder not irrcluded) --Eactr lnstallatiolr Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 4. sLrBrorALoFABovE /g "ffi4 7V6 State Surcharge * $ 50.00 $ s0.00 $ 2s.00 $ 45.00 l0% Administrative Fee / Or3rorAl ffiqo@ Shared Drive(T:)/Building Fonns/Electrical Pennit Applicat ion I -Ol.ao!. / / ' Inspection Request: 726-3769 rewwsffi #ffi€ffi per unit. I \,;.1 NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS LOT SIZE (SF):65340 l)tRNAL 0R l0B NWBER: Com200i-00670 SINGLE FAMILY RESIDENCE BUILDING SIZE (SF, O Crabtree 1218 38th Street 17023043 tl 3201 COST PER S.F s0.290 CHARGE $0.00 IMPERVIOUS S.F 1404.00 COST PER S.F $0.290 DISCOUNT RATE 50% $203.s8 DISCOUNT ITEM 1 TOTAL. STORM DRAINAGE SDC xx DESIGNED AND CONSTRUCTED DIRECT RUNOFF TO CITY STORM SYSTEM TO CIry STANDARDS $67.92 $51 NUMBER OF DFU's 3 COST PER DFU $22.64 NUMBER OP DFU's 3 COST PER DFU sl'7.21 $l19.5s B. IMPROVEMENT COST: ITEM 2 TOTAL - CITY SANITARY SEWER SDC x x A. REIMBURSEMENT COST: $0.00 ADT TRIP RATE 9.57 NUMBER OF UNITS 0 COST PER TRIP $17.23 NEW TRIP FACTOR 1.00 ADT TRIP RATE 9.57 NUMBER OF UNITS 0 COST PER TRIP s76.01 NEW TRIP FACTOR 1.00 $0.00 A. REIMBURSEMENT COST: B. IMPROVEMENT COST: ITEM 3 TOTAL - TRANSPORTATION SDC xxx xx NUMBER OF FEU's 0 NUMBER OF FEU'S 0 COST PER FEU $34.83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD( =$0.00 COST PER FEU $332.86 B. IMPROVEMENT COST: x x = I $0.00 : | $o.oo A. REIMBURSEMENT COST: SUBTOTAL (ADD ITEMS 1,2,3, & 4)$323.r SUBTOTAL s323.13 ADM. FEE RATE 5% CHARGE s 16. 16 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: 5. ADMINISTRATIVE FEE: x I so.oo Virginia Jurasevich 81412003 TOTAL SDC CHARGES PREPARED BY DATF CITY OF SPR'NGF'EID S YSTEMS DEVELOPMENI WORKSHEET v)HooO & E]Fari E]& 1070 1091 1092 1093 1094 1055 1 054 1056 079 078 S.F. x x DRAINAGE FIXTURE UNIT CALCULATION TABLED!'U NUMBER OF NEW FXTURES X TINIT EQUIVAIENT = DRAINAGE FXTURE L,]NITS DRAINAGE FIXTURE UNITS NO. OF FIXTURES NEWFIXTURE ryPE OLD (NOTE: FORREMODELS,CAICULATE ONLY THE NET ADDITIONAL FXTURES) UNIT EQUIVALENT 3I03BATHTUB 1 000DRINKING FOUNTAIN 0 3 00FLOOR DRAIN 0003INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 6 00INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 2 0LAUNDRY TUB 0003CLOTHESWASHER / MOP SINK 6 000CLoTHESWASHER - 3 OR MORE (EA) 0 12 0MOBILE HOME PARK TRAP (1 PER TRAILER)0 0001RECEPTOR FOR REFRIG / WATER STATION / ETC. 3 000RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 2 0SHOWER, SINGLE STALL 0002SHOWER, GANG (NUMBER OF HEADS) 0 3 0SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 0 2 0SINK: COMMERCIAL BAR 0002SINK: WASH BASIN/DOUBLE LAVATORY 0 1 0SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 0 5 0URINAL, STALL / WALL 6 000TOILET, PUBLIC INSTALLATION 0 3 0TOILET, PRIVATE INSTALLATION 0 toa set at 167 0 unit MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS *EDU ls a MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 0 0 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1OOO s0.00 CREDITRATE s4.92x I so.oo CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/ IOOO CREDITRATE $0.00 x 94.92 TOTAL MWMC CREDIT I so.oo BEFORE I 979 $4.92 1979 s4.92 l 980 $4.83 l98l $4.77 1982 $4.64 1983 s4.47 1984 $4.30 l 985 $4.09 I 986 $3.78 l 987 s3.41 I 988 $2.98 I 989 $2.52 1990 $2.06 1991 $1.64 1992 $1.45 1993 $r.31 1994 $ l.l3 1995 s0.97 1996 s0.82 1997 s0.63 1998 $0.41 1999 s0.22 2000 s0.04 20 l-d- CITY OF OREGO'V SPh.d<GFIELD DEV ELO P M ENT SE RV I C ES D E PARTM ENT %225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 www. ci. s p i n gf i e ld. o r. u s / As required by the Ciry of Springfield Development Code, I understand and agree that with the ap_proval of - -theattachedpermits,oneoftheiollowingmanufacturedhomesu,illbeplaced at /Z/2' 39C 5 /' Springfield, Oregon, City Job Number a I I 2a43 -@ A 7A 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 thermal envelope meeting performance standards which reduce heat loss to levels equivalent to standards required for single family dwellings at the time of construction.initials Type Il Manufactured Home: A unit of not less than 12 feet in width enclosing a minimum floor area of 500 square feet, that has a nominal roof pitch of 2 feet in height for each 12 feet in width, that has no bare metal siding or roofing, and that has blen certified by the manufacturer to have an exterior thermal envelope meeting performance standards which reduce heat loss to levels equivalent to the performance standards required for single family dwellings at the 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, Sffeet 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 than24 inches of the enclosing material exposed above grade. ?-( 7 *03 MANUFACTURED HOME SET-UP AGREEMENT Date - Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:ryb4,1!gl4 fi>"G70& Permit #: Address: Issued by:Date: ,x Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensedwith the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), neednot submit this statement. This statementwill befiledwith thepermit. Fill in the appropriate blanks and initial boxes I and2, and either box 3A or 38: ,[f- l. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the stnrcture must be licensed with the Construction Contractors Board. OR 21 38. I will be my own general contractor. If I hire subcontactors,I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general confactor, I will contact with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. -4 /- (Signature of permit applicant) @ate) (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 03/ I I /03 1.'i , Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY CIWNER$ ABOUT CONSTRUCTION RE$POr.{$IBILITIES NOIE: This ln{armation Nctice ta Propefty Ovvners about Canstruclion Responsibfffies was developed by the Conslrucilb* Contractors Board in accardance with ORS 7A1.A55{5J, passed by the 198g Oregon L,egistature. If you are acting as your or!'n contractor to constnrct a new home or make a substantial improvement to an existing skucture, you can prevent many problems by being aware of the follorving responsibilities and concerns. Employer Responsibilities You will, in most instances, be nrled to be an "employer" and the contractors you contract with will be "employees" if you use conkact*rs not licenssd with the Construction Contractors Board to do labor in constructing or to assist in the conskuction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withhalding Tax Law: As an employer, you must withhold income taxes ltom employee wages at the time; employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For a State Business ID number, cali the Business Information Center at 503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax fqrr unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Ernployrnent Department at 503-947,1488. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' oompensatiorl insurance, you could be subject to penalties and be liabie for all claim costs if one of your employees is injured on thejob. For more information, call the Vy'orkers' Compensation Division at the Department of Consumer and Business Services at 503-947-781 5. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage fnsurance: Contact your insurance agent to see if you have adequate insurance coveragefor ageidents and omissrons such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. Time: Make $ure y.ou have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notiS building officials as the appropriate times so they can perform the required inspections. If you hav-e additional questions call the Construction Contractors Board {503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Properfy_owner.doc 03i I ll03 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #:1983 Date:08/19/2003 1:55:0lPM coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 coM2003-00670 Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Refund - SDC Storm Plan Review - Planning Manufactured Home Placement Manuf Home State Issuance Manufactured Home Connection Heat Pump Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- Manufactured Home Feeder Manufactured Home Service Foundation Permit Plan Review Residential Storm Sewer - lst 50 Feet + 7o/o State Surcharge + lloh Administrative Fee 407.16 67.92 51.63 16.16 (203.58) 59.00 160.00 30.00 45.00 12.00 33.00 10.00 s0.00 50.00 52.80 (2s.3s) 45.00 3 1.35 44.78 $936.87Item Total: Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check ROPGER CRABTREE dlm 749 In Person Payment Total: $936.87 $936.87 '.i c)11 t{t.- l DErtsri@irc- F.dd srA?;E ot oescut ofin v $arE E1EE uLsetl ILT A ffir'r RESOXmrcsf,srEM GO{tr{TYD'STRICTOF OTITERTTPEOA 2C & &notcd,.ddftc t/PGdGGl FOT'ND: DISTRICT'.zoNE 4 3 ( () Ot{esrll{cDerr OGAilcEroREFosf, 'c.l.lo. D'r+?etAIIt, a UP 3 a 14U (t(*k^ fifffro-o?72 L1(^ ({rr. 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ASEd !o Ooool Erc 3 O AFd Aodd t{o. 8...i f iIc 4OSJst$agD@god J a t{o ltc.& & SoGo(OiSin SOltoSJ,6h:ktt OOn .stutlibrlha*qsa I B Opcarcd & Coooltcd/Eaiqll Frc 2 O Opcacd & lla CoollErdry Erc 3 O Shontd hrsOPcatcdlD&t llc 4 tl S)@ Ilrc cdlErToo S@'X SOliloESfuiERmdortF! OOFc6oicllEtPorcd !. OSP ,. O6crSccalAGsYa. IncelED6hcdfil. 6A,I tc<- lrYES,WEOfrII.L TITVESTIGA:rErgEool() UP qISER. _a)__ MAICE{C t}TORMATION &,ooarordncctl? .YES' NO'todue ecWesildzycitSTI]DY:rl'krtqlceOSFMSPECIAL3 rsrarls.tndcscribc ,w.#l Jw-dl2 Jw.f3 .lw.#4 Asc Gcodcr 2O{}rO(R2OOO' ..- -:...:,-l : . t..t 253 MOB I LE rIOME AP.PRA I SAL Code No /Z:4- Situs Acct No Ili I l t -e Home Acct. No raisal dat tit V. D. No \,, No.........--...-......'....--....'--ExP Date -19-State---Tr iP Permit No /tvgo-,-o # $ 500 7fiv- t9 VAI,UE SIJIIMARY Mobile Home D.R.C. ' Accessory ImP. D.R.C (See Acct. No Appraised VaIue Appraised bY QG? ----<'.eT-la=D-4 '' "'{nnxs-t INFoRMATIoN Yr Mfe. 19- -Brand - Model Pur Pr ice $-Dat e--l9--lnc : Fur ns Sk i r t i ng$-Awn i ng$-Deck$-St eps $- lfoving Charge $ .....---Set-uP Charge Trm of Sale: Cash Cont Trd DnPmt Ask Pr ice $_----Da te:--19-Shn BY:Own Ten a3? 0/ P , rri-^ce. AIIOr RSON J I fi ti Ut Vt2lu I,t 38Tij SrSPRIhGFILLO CK 9t4tll7 i,2 )1, 4 ) 1_l2tl - 4A5b2)3 MOBILE HOME YALUE ADJUSTITIE\T t Adjustment Adjusted T.C'V' Year Adjusted Bf s 19- _19- -19---_19- -19- $$ t4 x DESCR IPTI ON {7 AND VALUATION/7A,4q FT. X$U -BASEFACMR= ': _'i/i I LiTc t,ACrOR S0Or tsqiclAss LMNG AREA--I3--sQ BASE COST ADJUSTNTEI{T FACTORS + Piers I'lasonrY \\D SUPP0RTS: l{al I Bm Post l{J ;i MtIF00TlNG: Prmtr \ld SK tal iube les lerII CONST: lld Mrl covm r{d .-l[tl &DR Fbr gi EXTTRIOR CN Fla n6tr Mrl I oist ed Car Hwd RsInt COVER Hbd PIv Comp Kit D00RS & TRIM: L.C Nled Cood PARTITIONS lv il .B rm Ha INTERIOR COMPONENTS BUIi,T. INS: APPL I ANCES Kit Elect B- uril Gas Chest P':1i1 Raige Pl ain Cooktop Ave EI ab BI Oven -IIo-o! & Fan' Exh Fan FueIfEI ecr ttl i Ave I Few Ave SERVICE:Mncp I 0n-Site llt r Sewer age I -aTo l{t rPLI,T,IBI NG HEATING. COOLING ftEct Oil EIectSYSTDI: COOLING F.A.Duct Ref r ig Unit Evap Floor [aI i Bsbd FUU, FIlU-: Cas GasF.A . Duct STEPS PORCH DECK A\\NING D(TTRIOR COMPONENTS A&I. TOTALS NgT ADJ -_-t+:A,a/* {I I/7I) ORE. DEPT. OF REVcouNTY fORM 303'012 (A&A'A-12) i q FOUNDATION FI ,F'T:TR I CAI , I}IPROY E'$ENTS D IAGRA'il DESCRIPTION AND VALUATION-ACCf,SSORY IMPROVEMENTS CONSTRUCT ION DEPREC IATED REPL. COST AREA S EASE ADJ. BASE REPL. COST S ADJ. TOTAL QUALITY L, C. U. ii MDFR. .L 7, PHYS USE GOOD !ALLS YISC DIXINS IONS FOUNO FLOOR ROOF NO TYPE i - -44- -2-- E)C<)*d .<35{ ADJ. REPL COST * i/ 2 ll 6 1 8 9 s-_=.- z-. ACCESSoRy rMpRoyEMENrs D.R...li8+:tfi6.to: YALUE SUMMARY 0R 4 t$t:r ,] I t t. i DemolishedBuilding/NlanufacturedStructureForm This is to certify the DEMOLISHMENT of the following: f 62 53 /7'Account # Map # Date structure(s) removed: Commercial Owner of ProPertY: Address of ''l Date Signature Phone +{'/i // Address + Pubtic Service Hours : Manufactured'Struct "" 7/UJ-'k' )l'o nu Other ,.'?;nn11;l"1i1"-""'J$:,';'":'il.:5::?,eorx-number,andseriarnumber) i tL,, ','/ / 'f! 1t t c t'/ Z I hereby su)ear or aftirm that theforegoing affidavit is true and accurate' Pleasebeadvlsedthat,according-tooRS308.21o(1},ifthestructureisinexistenceasof January 1, of the assessment year, iti" Li.ure toi ttrat year. The account wi' be re-appraised i"i tn" iollowing assessment year' Mail or deliver to: Lane CountY O.p""meniof Assessment & Taxation Attn: APPraisalSection 125 East Sth Avenue Eugene OR 9740t-2968 MondaY through FridaY Telephone & Informaiion Hours: 9:00 am to 4:00 pm ^ -'-'-Puy*ent Counter: 9:00 am to 4:00 pm- (s4t)682-4321 H:\WPDATA\Forms Others\DEMOBLDG doc/July I8' 2000/' n I / IMPRO\IEMENT DATA 1.00 App!aiser,/Date 4056253 Construction Property Class: 109 1218 3BTH ST,SPRINGETELD,OR, 9?4l8,USA Finished Base Area Eloor Area Sq FtPHYSICAI CIIARACIERI STICS structure Vafue 0 style: 11 manufactured occupancy: single familY story Height: 1 Einished Area: 0 Attic: None Basement: None ROOFINGMaterial: Comp shingrle medir:m Type: Gable Framing: St-d for class Pitch: Not- available FLOORING EXTERIOR COVER INTERIOR FINISE ACCOMMODATIONS TIEATING AI.ID AIR CONDITIONINGLower Fu11 Part ,/Bsmt 1 Upper Upper PLUMBING # TOTAL O REMODELING AI{D MODERNIZATIONAnount Daf,e 0 Crawl TOTAL BASE Row Type Adjtrstment- SUB-TOTAI 0 Interior Finish 0 Ext Lvg Units 0 Basement Fini.sh Eireplace (s) Heating Air Condition Erame/s i dj-ng/Roof No Plumbingf 16310 0.00? 16370 ) 0 0 0 0 0 0 0 0 Exteri,or Features Description Value SUB-TOTA-L ONE UNTT SUB-TOTA], O UNITS Garages 0 Integral 0 Att carage 0 Att Carports 0 Bsmt Garage Ext Features 16370 16370 0 0 0 0 0 SPECIAI EE,ATI'RES Description Value \i M MHOME stry Consf- Year Eff Use Hqt Type Grade Const Year Cond SI'MMARY OE IMPROVEMENTS Base Rate Feat- ures SUB-TOTAI Quality Cfass/Grade GRADE AD.]USTED VAIUE Adj Size or Computed PhysObso.lMarket t Rate Area Value Depr Depr Adj Comp 163?0 4 ID VaIrte 22700 10404 79'13 t9'13 AV 22.49 N 30 100 64 87 100 100 Neighbortrood Neiqh 0 AV ) Data col1ccto!/Date 968 suppl@enta]. cilds IOIAI, I}TPROVEMENII VATI'E 104 0 74x 52 4056253 ADMINI STR,ATIVE INFORL'ATION ANDERSON JAMES H & BEVERLY J OWNERSIIIP ANDERSON JAMES H & BEVERLY J 1218 3 STH ST,SPRINGFIELD, OR,97 47 8,USA IaxID 7702304303201 Printed 01/ll/2003 card No TR.AI,{SFER OE. OWNERSIIIP Date 109 1 "f1PARCEI NUMBER 4056253 Parent Parcel Number 1218 N 38TH ST,SPRTNGETELD,OR, 97477lUSA SPRTNGFTELD/ OR 91411 ],eqal on FileProperty Address 1218 38TH ST,SPRTNGFTEI,D,OR, 97418,USA Neighborhood 0 Property Class 109 109 Res conforming mhone TAXING DISTRICT INEORMAT]ON ,furisdict-ion 020 Area 001 RESIDENTIAL VAIUATION RECORD Assessmenf- Year Reason for Chanqe fi/ al/ 1998 01-/0L/L999 Reassess 01./ 0L/ 2000 Trend 0t/at/2001. Trend 07/at/2002 01,/01,/2a0:0L / 0!/ 2003 ReassessTrendTren( VALUATlON Market vafue L B T 0 12670 126!0 0 12610 L2670 0 13240 13240 0 77250 11250 0 9340 9340 0 B B7O I 870 0 1040 1040site Descriptj-on Topography: Public Utilities: Street or Road: Neiqhborhood: zoninq: Legal Acres: 0.0000 IJAI.ID DATA AND CAI,CUI,ATIONS FacLor Land Type Rating Measured soil ID Acreage -or- -or-Actua] Effective Frontaqe Frontage Table Prod Effective Depth _or_ Depth Eactor_or_ Square Eeet Base Rate Adj usted Extended Vafue Inffuence Factor Value Ts'-$S 199: sLat Cfass see real- prop account 0116051 CBo4: CaI1 back 2004 to see if removed NPyr: 2003-mim value per site review REQR: 2oo3-Request for Review'Taxation requested review for abandoned MS Recevj-ed Demo form said removed 9-15-02 appraiser there in oct still there. see notes 96e 1O/14/A2--MS not livable est value at 91000 for 2003 if not destroyed and removed from property FARMLAND COMPUTATIONS Parcef Acreage 81 Legal Drain NV t-l 82 Pub1ic Roads NV t-l 83 UT Towers NV t-l 9 Homesite(s) t-l TOTAI ACRES FARMTAND TRUE TAX VA],UE Measured Acreaqe Average True Tax Val,ue,/Acre TRUE TAX VA],UE FARMLAND Classified Land Totaf Homesite (s) Va.Iue (+) Supplemental Cards TOTAI I,A}ID \r}I,UE