HomeMy WebLinkAboutPermit Building 2020-01-15SPRINGFIELDM1
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OREGON
Web Address: www.springfield-or.gov
Permit Issued: January 15, 2020
Building Permit
Residential Manufactured Dwelling
Permit Number: 811 -19 -002798 -MD
IVR Number: 811092821134
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
Email Address: permitcenter@springfield-or.gov
TYPE OF WORK
Category of Construction: Manufactured Dwelling Type of Work: New
Submitted Job Value: $0.00
Description of Work: New manufactured home placement 3bed/2bath (private lot)
JOB SITE INFORMATION
Worksite Address Parcel Owner: MILLIGAN LESLIE M
662 53RD PL 1702331303600 Address: 654 53RD PL
Springfield, OR 97478 SPRINGFIELD, OR 97478
Owner: MILLIGAN LESLIE M
Address: 654 53RD PL
SPRINGFIELD, OR 97478
LICENSED PROFESSIONAL INFORMATION
Business Name License License Number Phone
LEISURELAND HOMES INC - CCB 23333 541-928-1555
Primary
PENDING INSPECTIONS
Inspection Inspection Group Inspection Status
5999 Final Manufactured Dwelling Mfd Dwelling Pending
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811092821134
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
Permits expire if work is not started within 180 Days of issuance or if work is suspended for 180 Days or longer depending on
the Issuing agency's policy.
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not.
Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at (503)
232-1987.
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Structural/ Mechanical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing).
Printed on: 1/15/20 Page 1 of 2 C\myReports/reports//production/01 STANDARD
Permit Number: 811 -19 -002798 -MD Page 2 of 2
PERMIT FEES
Fee Description
Quantity
Fee Amount
Technology Fee
$15.25
Manufactured dwelling placement permit
1
$553.00
State manufactured dwelling fee
1
$30.00
Plan Review - Major, City
1
$251.00
Address assignment - each new or change requested externally, per each
1
$54.00
SDC: Improvement - Transportation SDC
3611.72
$3,611.72
SDC: Improvement Cost - MWMC Regional Wastewater SDC
1620.85
$1,620.85
SDC: Compliance Cost - MWMC Regional Wastewater SDC
22.82
$22.82
SDC: Administrative Fee - MWMC Regional Wastewater SDC
10
$10.00
SDC: Total Storm Administration Fee
108.34
$108.34
SDC: Total Sewer Administration Fee
305.39
$305.39
SDC: Total Transportation Administration Fee
190.09
$190.09
SDC: Total MWMC Administration Fee - Local
89.48
$89.48
SDC: Reimbursement - Transportation SDC
190.06
$190.06
SDC: Improvement Cost - Local Wastewater
2015.76
$2,015.76
SDC: Reimbursement Cost - Local Wastewater
4092
$4,092.00
SDC: Improvement Cost - Storm Drainage
1283.03
$1,283.03
SDC. Reimbursement Cost - Storm Drainage
883.74
$883.74
SDC: Reimbursement Cost - MWMC Regional Wastewater SDC
135.93
$135.93
Fire SDC - New Res Construction Sq Ft fee - enter sq ftg
1600
$96.00
Willamalane fees - Single Family Detached, per unit
1
$3,805.00
State of Oregon Surcharge - MFD (12% of applicable fees)
$66.36
Total Fees:
$19,429.82
Printed on: 1/15/20 Page 2 of 2 C:\myReports/reports//production/01 STANDARD
SPRINGFIELD`j
ti OREGON
Transaction Receipt
811 -19 -002798 -MD
IVR Number: 811092821134
Receipt Number: 473560
Receipt Date: 1/15120
www-sp ringfield-or.g ov
Worksite address: 662 53RD PL, Springfield, OR 97478
Parcel: 1702331303600
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
permitcenter@springfield-or.gov
Fee amount
Paid amount
Fees Paid
Transaction
Units
Description
Account code
date
1/15/20
1.00 Ea
Manufactured dwelling placement
224-00000-425602-1030
permit
1/15/20
1.00 Ea
State manufactured dwelling fee
821-00000-215009-0000
1/15/20
1.00 Ea
State of Oregon Surcharge - MFD
821-00000-215004-0000
(12% of applicable fees)
1/15/20
1.00 Ea
Address assignment - each new or
224-00000-425602-0000
change requested externally, per each
1/15/20
883.74 Amount
SDC: Reimbursement Cost - Storm
617-00000-448029-8800
i
Drainage
1/15/20
1,283.03 Amoun
SDC: Improvement Cost - Storm
617-00000-448028-8800
Drainage
1/15/20
4,092.00 Amoun
SDC: Reimbursement Cost - Local
611-00000-448024-8800
Wastewater
1/15/20
2,015.76 Amoun
SDC: Improvement Cost - Local
611-00000-448025-8800
Wastewater
1/15/20
190.06 Amount
SDC: Reimbursement - Transportation
434-00000-448026-8800
SDC
1/15/20
3,611.72 Amoun
SDC: Improvement - Transportation
434-00000-448027-8800
SDC
1/15/20
135.93 Amount
SDC: Reimbursement Cost - MWMC
433-00000-448024-8810
Regional Wastewater SDC
1/15/20
1,620.85 Amoun
SDC: Improvement Cost - MWMC
433-00000-448025-8810
Regional Wastewater SDC
1/15/20
22.82 Amount
SDC: Compliance Cost - MWMC
433-00000-426607-8810
Regional Wastewater SDC
1/15/20
10.00 Amount
SDC: Administrative Fee - MWMC
611-00000-426604-8800
Regional Wastewater SDC
Printed: 1/15/20 3:36 pm
Page 1 of 2
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
permitcenter@springfield-or.gov
Fee amount
Paid amount
$553.00
$553.00
$30.00
$30.00
$66.36
$66.36
$54.00 $54.00
$883.74 $883.74
$1,283.03 $1,283.03
$4,092.00 $4,092.00
$2,015.76 $2,015.76
$190.06 $190.06
$3,611.72 $3,611.72
$135.93 $135.93
$1,620.85 $1,620.85
$22.82 $22.82
$10.00 $10.00
FI N_Tra nsaction Receipt_pr
Transaction Receipt
811 -19 -002798 -MD
Receipt number: 473560
Fees Paid
Transaction Units
Description
Account code
Fee amount
Paid amount
date
1/15/20 108.34 Amount
SDC: Total Storm Administration Fee
719-00000-426604-8800
$108.34
$108.34
1/15/20 305.39 Amount
SDC: Total Sewer Administration Fee
719-00000-426604-8800
$305.39
$305.39
1/15/20 190.09 Amount
SDC: Total Transportation
719-00000-426604-8800
$190.09
$190.09
Administration Fee
1/15/20 89.48 Amount
SDC: Total MWMC Administration Fee
719-00000-426604-8800
$89.48
$89.48
— Local
1/15/20 1.00 Ea
Plan Review- Major, City
100-00000-425002-1039
$251.00
$251.00
1/15/20 1.00 Automatic
Technology Fee
204-00000-425605-0000
$15.25
$15.25
1115/20 1,600.00 SgFt
Fire SDC - New Res Construction Sq
100-00000-424005-1091
$96.00
$96.00
Ft fee - enter sq ftg
1/15/20 1.00 Qty
VUillamalane fees - Single Family
821-00000-215023-0000
$3,805.00
$3,805.00
Detached, per unit
Payment Method: Check number:
Payer: US Bank
Payment Amount:
$19,429.82
3976512868
Transaction Comment: 662 53rd PI
Cashier: Katrina Anderson
Receipt Total:
$19,429.82
Printed: 1115/20 3:36 pm Page 2 of 2 FIN_TransactionReceipt_pr
225 Fifth Street ♦ Snrinefield. OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689
Manufactured Dwelling/Recreational-Park Trailer
Placement Permit Application
DEPARTMENT USE ONLY
6PpINQF16LLf
Permit no.:
Date: Le
This permit is issued under OARS 918-500-0105 and 918-525-0370. Permits expire if work is not started within 180 days of
issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVALS
Zoning approval verified:
❑ Yes ❑ No
Property is within flood plain:
❑ Yes SNo
Sanitation approval verified:
❑ Yes ❑ No
CATEGORY OF
CONSTRUCTION
esidential
❑ Government ❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: in (Q -)-
— L
City: i.eLA I County:
State: A/ ZIP: ri"
Subdivision: Space/lot no.:
Reference: 11 0 D. 1331 3 Taxlot: f (�
DESCRIPTION OF WORK
Year Manufactured:
{ # Bedrooms: 3 Sq. Ftg: /<-y
Value:t0i
PROPERTY OWNER
Name: D
Address: 6-574 53 4kJGe
City: S' State: OIL ZIP:4 Z IN
Phone:y-%( -(pt�- gyp: [Fax: - -
E-mail: pyurni 0$af'} `d0. Ca""`
This installation is being made on residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under OAR 918-55�1.5-00010.
Signature: l� V r7
CONTRACTbIR INSTALLATION
Business name:
E Address:
City:
State: ZIP:
Phone: - -
Fax: - -
E-mail:
CCB license no.:,2 3 3 3 MDI license no.:
Print name:
Signature:
fast edited 51512017 Wones
FEE SCHEDULE
Description
Qty.
Cost each
Total
(1) Manufactured dwelling
(a) Placement (includes placement,
electrical feeder, water/sewer
connection):
&55
$5 $
(b) Reinspection (no. of hrs. x fee per hr.):
$99.00 $
Placement permit can only be obtained by homeowner or Oregon -
licensed manufactured dwelling installer.
(2) Recreational -park trailer
(a) Installation (includes stand and
lot preparation; support blocking;
anchoring; temporary steps; plumbing,
mechanical, and electrical):
$537.00
$
(b) Reinspection (no. of hrs. x fee per hr.):
$99.00
$
(c) Each additional inspection: (1)
$99.00
$
Electrical service permit to be obtained only by homeowner performing
work or signing supervisor of Oregon -licensed electrical contractor
. performing work.
FEE SCHEDULE
(3) Surcharge, 12% (.12 x total, equal to I or 2):
$
(4) State administrative fee for
manufactured dwelling (item 1)
only, OAR 918-500-0105(5):
$30.00
1
$30.00
(5) Technology Fee, 5%
$
TOTAL fees and surcharges (3 + 4+5): $
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER:
811 -19 -002798 -MD
NAME OR COMPANY:
SDC
LOCATION:
662 53rd Place
TAX LOT NUMBER:
1702331303600
DEVELOPMENT TYPE:
Single Family Residence
NEW DWELLING UNITS
1 BUILDING SIZE (SF): 0 LOT SIZE (SF) 0
IMPERVIOUS AREA
MAX 45% 0 MAX 35%1 0
1. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
ADT TRIP RATE x NUMBER OF UNITS
x COST PER TRIP x NEW TRIP FACTOR
9.57 I
19.86 1.00 —
A. REIMBURSEMENT COST
1093
B. IMPROVEMENT COST:
AREA DRAINING TO
ADT TRIP RATE x NUMBER OF UNITS
IMPERVIOUS S.F. x
COST PER S.F.
9.57 1
DRYWELL
$3,611.72
CHARGE
ITEM 3 TOTAL - TRANSPORTATION SDC
2936.00
$0.301
=
0
$883.74
B. IMPROVEMENT
COST
NUMBER OF FEU 's x COST PER FEU
IMPERVIOUS S.F. x
1 $135.93
COST PER S.F.
$135.93
CHARGE
B. IMPROVEMENT COST:
2936.00
$0.437
= 0
$1,283.03
ITEM 1 TOTAL - STORM DRAINAGE SDC
$2,166.77
=
2. SANITARY SEWER - CITY
1055
C. COMPLIANCE COST:
A. REIMBURSEMENT COST:
NUMBER OF FEU's x COST PER FEU
NUMBER OF DFU`
x
=
COST PER DFU
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
_
24
1054
MWMC ADMINISTRATIVE FEE
$170.50
$10.00
1056
B. IMPROVEMENT COST:
= $1,789.60
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4)
NUMBER OF DF[Ps
x
COST PER DFU
5. ADMINLSTRATIVEJBE
24
SUBTOTAL x I ADM. FEE RATE
$83.99
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
= $6,107.76
$883.74
$1,283.03
1091
= 1 $2.015.76 II 1092
3. TRANSI'OR I A 1-10N
A. REIMBURSEMENT COST:
ADT TRIP RATE x NUMBER OF UNITS
x COST PER TRIP x NEW TRIP FACTOR
9.57 I
19.86 1.00 —
$190.06
1093
B. IMPROVEMENT COST:
ADT TRIP RATE x NUMBER OF UNITS
x COST PER TRIP x NEW TRIP FACTOR
9.57 1
$377.40 1.00 =
$3,611.72
1094
ITEM 3 TOTAL - TRANSPORTATION SDC
= $3,801.78
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
NUMBER OF FEU 's x COST PER FEU
1 $135.93
=
$135.93
1054
B. IMPROVEMENT COST:
NUMBER OF FEVs x COST PER FEU
1 $1,620.85
=
$1,620.85
1055
C. COMPLIANCE COST:
NUMBER OF FEU's x COST PER FEU
] $22.82
=
$22.82
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
_
$0.1111
1054
MWMC ADMINISTRATIVE FEE
_
$10.00
1056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
= $1,789.60
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4)
_ $13,865.91
5. ADMINLSTRATIVEJBE
SUBTOTAL x I ADM. FEE RATE
= CHARGE
$13,865.91 1 5%
$693.30
TOTAL STORM ADMINISTRATION FEE
5108.34
TOTAL SEWER ADMINISTRATION FEE:
305.39
1079
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$190.09
1077
TOTAL MWMC ADMINISTRATION FEE - LOCAL
$89.48
1078
TOTAL SDC CHARGES =
$14,559.21
PREPARED BY Steven Petersen DATE
12/16/2019
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)
FIXTURE TYPE
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
NEW OLD EQUIVALENT UNITS
BATHTUB
1 0 3 =
3
DRINKING FOUNTAIN
0 0 1 =
0
FLOOR DRAIN
0 0 3 =
0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.
0 0 3 =
0
INTERCEPTORS FOR SAND / AUTO WASH / ETC.
0 0 6 =
0
LAUNDRY TUB
0 0 2 =
0
CLOTHESWASHER / MOP SINK
1 0 3 =
3
CLOTHESWASHER - 3 OR MORE (EA)
0 0 6 =
0
MOBILE HOME PARK TRAP 1 PER TRAILER)
0 0 12 =
0
RECEPTOR FOR REFRIG / WATER STATION / ETC.
0 0 1 =
0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC.
1 0 3 =
3
SHOWER SINGLE STALL
2 0 2 =
4
SHOWER, GANG NUMBER OF HEADS)
0 0 2 =
0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN
1 0 3 =
3
SINK: COMMERCIAL BAR
0 0 2 =
0
SINK: WASH BASIN/DOUBLE LAVATORY
1 0 2 =
2
SINK: SINGLE LAVATORY/RESIDENTIAL BAR
0 1 0 1 =
0
URINAL, STALL / WALL
0 0 5 =
0
TOILET, PUBLIC INSTALLATION
0 0 6 =
0
TOILET. PRIVATE INSTALLATION
2 0 3 =
6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 =
TOTAL DRAINAGE FIXTURE UNITS
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit 20 DFU's set at 167 gallons 'r da
0
24
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
CREDIT RATE/$1,000
ASSESSED VALUE
$5.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4.63
$4.40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
IS LAND ELGIBLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
CREDIT FOR LAND i IF APPLICABLE)
VALUE/ 1000 CREDIT RATE
$0.00 x $5.29 =
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29 =
TOTAL MWMC CREDIT =
0
0
1979
$0.00
0
$0.00
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
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225 FIFTH STREET • SPRINGFIELD, OR 97477 • PH:(541)726-3753 • FAX: (541)726-3689
ADDRESS REQUEST
Property Owner: • Q
Mailing Address:
0
SPRINOFIS0
City: ��(LJ'�7��' ; State: Zip:
H / (/
Person or Agency requesting address if other than owner:
Phone number where you can be
contacted between 1:00pm and 5:00pm:
Assessor Map #: �' �� ., ?� j Tax Lot #: Co () Q
Properties are generally assigned addresses when application is made for a permit to
improve the property. Please explain specifically why you need an address assigned
prior to the property being improved:
Proposed Address:
Property Owners Signature:
OFFICE USE
Date: /a' —A
Date Received: 1 �e`�C1 Received By:
Fee: S� • (90 Receipt #: aa Amount Paid:
Reference Numb Q�- �( '�_ Tax Lot #: (D 3 Ce 00
Approved
If approved, new address is:
Reviewed By
(G)
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