HomeMy WebLinkAboutPermit Building 2003-02-18OF
Buildin g/C ombination Permit
Status: Pending
225 Fifth Street Springfield, OR
541:726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-00087
ISSUED:
APPLIEDz 0211812003
E)GIRES:
VALUE:
SITE ADDRESS: 157 l2TH ST SPACE 2
ASSESSOR'S PARCEL NO.: 1703354100201
PROJECT DESCRIPTION: MH replacement in park
Owner: SpRINGLANE MOBILE VILLAGE
Address: 15712TH ST SPRINGFIELD OR 97477
Springfield TYPE OF
TYPE OF USE:
License
63137
66750
Manufactured Home in
Park
Alteration Residential
Phone Number: S4l-747-3557
Contractor Type
Electrical
Manuf Home Inst
Owner
Plumbing
Contractor
RALPH W BROWN
EMERALD LIFE STYLE HOMES INC
SPRING LANE MOBILE VILLAGE
EMERALD LIFESTYLE HOMES INC
Expiration Date
02n5t2004
05/18/2003
0s/18/2003
Phone
541-729-1s00
541463-2022
541-747-3557
541463-2022667s0
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Frimary Construction Type
Secondary Construction
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Arailabte:
Special Instruction:
Notes:
# of Stories:
Height of
Type of Heat:
Water Tlpe:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees
Paved Ihive Rqd:
oh of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport:
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARIflNG
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutVDrains
UAY I
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Status: Pending
225 Fifth Street, Springfield, OR
541:126-3753 Phone
541-726-3676 Fax
54l.7 26-37 69 Inspection Line
Buildin g/C ombin ation Permit
PERMIT NO: COM2003-00087
ISSUED:
APPLIED: 0211812003
E)OIRES:
VALT]E:
Description Tvpe of Construction $ Per Sq Ft Square Footage
Total Value of Project
Fee Description
+ l0oh Administrative Fee
+ 77o State Surcharge
Manuf Home State Issuance
Manufactured Home Connection
Manufactured Home Feeder
Manufactured Home Placement
Amount Paid Date
Total Amount $328.3s
Value Date Calculated
$2s.s0
$17.85
$30.00
$4s.00
$s0.00
$160.00
2t20t03
2t20t03
2t20t03
2t20t03
2120103
2t20t03
Receipt Number
1200200000000000729
1200200000000000729
1200200000000000729
1200200000000000729
1200200000000000729
1200200000000000729
PIan Reviews
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same \ryorking day, inspections requested after 7:00 a.m. will be made the following work
day.
1 Manuf Home Set Up: When installation of all piers or stands is complete.
2 Final Manuf Home Set Up: After all required inspections are requested and approved and porches, skirting, decks,
venting, street address numbers, trees, driveway, etc. have been installed.
3 MH Service: Approval required prior to utility company energizing service.
4 Manuf Home Plumbing: After home has been connected to water and sewer.
2of3
Valuation Description I
h ees rard I
t(eourreo InsDectrons I
OF
Status: Pending
225 Fifth Sfteet, SpringfieH, OR
541:726-3753 Phone
541-726-3676 Bax
541:726-37 69 Inspection Line
Buildin g/C ombination Permit
PERMIT NO: COM2003-00087
ISSUED:APPLED: 0211812003
E)GIRES:
VALI]E:
By signature, I state and agree, that I have carefully examined the completed application and do hereby certi$ 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
hereirl and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division,
Building Safety. I further certiff 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 hcated at the front of the property, and the approved set of plans will remain on the site
at all times
or Contractors
3 of 3
2/2012003
l:40:22PM
City of Springfield
Development Services Department
Public Works l)epartment
Official Receipt
225 Fifth Street
Springfield, Oregon 97 47 7
541-726-3759 Phone
Receipt #: 12002000000000 007 29
Date: 0212012003
Line ltems:
Job/Journal Number Description Amount Paid
coM2003-00087
coM2003-00087
coM2003-00087
coM2003-00087
coM2003-00087
coM2003-00087
Manufactured Home Placement
Manuf Home State Issuance
Manufactured Home Connection
Manufactured Home Feeder
+ 7%o State Surcharge
+ l0%o Administrative Fee
Payments:
160.00
30.00
45.00
50.00
17.85
25.50
Line Item Total:$328.3s
Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid
Check EMERALD LIFESTYLES HOME IKW 381 l7 In Person 328.35
Total:$328.3s
Page I of I cReceipt.rpt
apttlxIIFuu*n
Citl'
ELE..I-) :aAL
Job
Multi-Famill' per drvelling unit.
Sen'ice Inclutled:LEGAL oozt,Iterns Cost
JOB DESCRTPTION
Pernrits are
if u'ork is IIot stnrted
of issuance
180 days.
2. CONTRACTOR
Electrical
Address
or less
500
portion
Each Manufd Horne or
Ivlodular Duelling
Scn.ice or Feeder
B. Serviccs or Feedcrs
Instirllation,
Rclocation:
200 anrps or less
201 aurps to 400
401 anrps to 600
1 amps
Over
"B" abol'e
D. Brrrnch Circuits
Neu Alteration
One Circuit
Each Additional
or Feeder Permit
$ r 06.00
$ 19.00
tO,, +^
Cxz4"hqr)
or
or Extension
Circuit or ri'ith
ALLATION
is being rnade on
property I orvn lhich is not
for sale, lease or rent.
Orvncrs Signitture:
-Each installation
Pump or irrigation
Sign/Outline Lighting
Liniited Euergl'/Res
Liurited EnergviConint
J. SUBTOTALOFABOVE
7%o State Surchirrgc
8%o Administrltivc Fcc
$50.00
s50.00
s2-5.00 _
$+5.00
intended
l\Iinimunt Electric Pernrit Insltcction Fec is Sl5'0{) * Strrchrrrgcs
<oo
TOTAL satc-
225 FiFTH STREET
SPRINGFIELD, OREGON - ,.I77
INSPECTION REQUEST : 7 26-37 69
OFFICE: 726-3759 :.
l.OF5
al./
3. COMPLETE FEE SCI{EDULE BELOW
A. Nerr' Rc.sidcntirrl-Singlc or
I t- -'/ sso.oo 5.-
pt o,r" /Z / -/5oo
Supen'isor License Nunrber
Expiration
Constr Contr.
Expiration
Signaturc of Supcn'ising Electrician
Orvners
Address
$ 63.00
$ 75.00
$125.00 _
sr63.00
--$375.00 _
$ 50.00
$loo.00 _
s43.00