HomeMy WebLinkAboutPermit Miscellaneous 2009-2-4
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CITY OF SPRINGFIELD
Building/Combination Permit
Status ~ ~~
225 Fifth Street, Springtield, OR ,
541-726-3753 Phone
541-726-3676 Fax ,
, 541"726-3769 Inspection Line
PERMIT NO: COM2009-00169
ISSUED:
APPLIED:
EXPIRES:
VALUE:
02/04/2009
08/04/2009
SITE ADDRESS: 1625 HENDERSON AVE SPACE BI Eugene
ASSESSOR'S PARCEL NO.: 1703344313302
TYPE OF WORK: Manufactured Home in Park
TYPE OF USE: Move
PROJECT DESCRIPTION: Manufactured dwelling placement space blO (Moved from Eugene)
Residential
Owner: JERALDINE LECKRONE
Address: 1625 HENDERSON AVE SPACE BI0
EUGENE OR 97403
Contractor Type
Contractor
^T..ldTlf""\td, t"'\~,~;-~~ l~... requires you to
I. CONTRACT.ORJNRORMATION '.lle Oregon Utility
Notification Center, Tllose rules are set forth
In OAR 952'001,cIa\c~e"'~!;ugll ~,~p'iJ;;tJig!llDate Phone
0090, You may obtain copies of tile rules by
BUILDING~iNFORMATrON IfI~Ole:.'ne telepnone
l/,., .,' '_ on Utility Notification
# fS . Center is 1,800,332,2344). S'
o tones: Lot Ize:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
~ ate,' Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
# of Units:
Primary Occupancy Group: R-3
Secondary Occupancy Group:
Primary Construction Type VB
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT_INF.ORM(\n~l'i I
. .,.., -,!. .-- _.,,'IRE IF T~E WtRIE~UIRED PARKING
NJT!lORIZED UNDER THIS PERMIT IS ~IOT
Ove'j~~\,9,iWf\lCED OR IS ABANDONED FOR Total:.
# St~erP:rees ~qd: PERIOD HandIcapped:
Pavel! DrM'Rq\l! Y. Compact:
% of Lot Coverage:
! PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
, Special Instruction:
Sidewalk Type:
DownspoutsfDrains:
Notes:
I V aluation Descri~tion :1
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calc~,lated
Paee I of 2
CITY OF SPRINGFIELD
i
Building/Combination p,ermit
Status Pending
225 Fifth Street, Springfield, OR
,541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2009-00169
ISSUED:
APPLIED:
EXPIRES:
VALUE:
02/04/2009
08/04/2009
Total Value of Project
Fees Paid I
Total Amount Paid
$0.00
Date Paid Receipt Number
f/t-( j) ...fJI'1lf ~'i BY ~c .:tf'1)./,)
;11MZ4-~ ~~t4L
C--\'IL-- ~C(I/'i <1
Ii
Fee Description
Amount Paid
I Plan Reviews I
,To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 ~,erl"!~ed I nsnectio":s ,
Manuf Home Set Up: When installatiou of all piers or stands is complete.
Final Manuf Home Set Up: After aiL required inspections are requested and approved and porches, skirting,
decks, venting, street address numbers, trees, driveway, etc. have been installed.
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 ofany structure without permission ofthe 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 fr~m 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.
"N\.().I~\ (11.'~~ ~A
~.:;.: l\i]::ontractors Signature
r;~, (j
J ;:)6n9
,Date
Paee 2,of 2
, 1'l!I~.g~~l!lM[~1t~ID~g!i:ltil
!Permitno,C'1-/(';'7 I
I Date: .2-/'1) 0'1 I
225 Fifth Street. Sorine:field. OR 97477 . PH(54l)n6-3753 . FAX(54J)726-3689
Manufactured DwellinglRecreational-Park Trailer
Placement Permit Application
,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.
~1!0€lA~GeVERNMENi1i1lEi'AegRe~l!s~@#0~1!1
1~",~E~'d,,,,,,,,,,,;.L.,,,<"*~__,,-.._.~~d,,",,,~,,,,~;A:~,,,,,,,,,,,,~~
I Zoning approval verified: 0 Yes 0 No I
I Property is within flood plain:, 0 Yes 0 No I
Sanitation approval verified: 0 Yes 0 No I
~~~llis,Q:~iYIWI,gg~~l~jlf1?1ll~~~.fjl
IIiZf Residential I 0 Government I 0 Commercial
1~~l[~t';!F,,~~M.~]m~~:~~~~i1t~~.
I JObsiteaddress:lf, ;;",- I~V.~~YJ 40& ~
I City: >//.t? I'J ~_ County: } IV i;)~
I State: '-h l' , , ZIP: ~'? Ij n::. ,I
I Subdivision: Space/lot no,: 'J?) n I
I Reference: TaXlot:'--' I
1~~0ESGRI8iiijWNi0ij<tW@RK~,I:?'~~~1
. ~~j_""_,,<_~__~~,"~""'I<1:",,,_,~....-,_._..._,~,.~.3?tf~-i.__~;J?,_S~
I ,- I
I I
Name: ~I D;J"'1
I Address: '7t.JD '7
City:l.t.xL" iJ [)
Phone:
I E-mail:
This installation is being made on residential or farm property owned by
me Of a member of my immediate family, and is exempt from licensing'
requirements under OAR 918-515-0010,
(v\>'\/Ju /2...
St.J r A QD I NVl-L. W'll Sm-/~
I State: Dl1- I ZIP:q??-2-'! I
I Fa: I
I
r~~'i.Eg:~1,~&jK[1~=~-1
I (I) Manufaetur'ed dwelling
(a) Placement (includes placement,
electrical feeder, water/sewer ($397.00 ,$ 3'17
connection):
I (b) Reinspeetion (no, ofhrs, x fee per hr,): $58,00 '$
I Placement permit 'can only be obtained by homeowner or Oregon-
licensed manufactured dwelling installer.
I (2) Recreational-park trailer
(a) Installation (includes stand and
lot preparation; support blocking; $397.00 "$
anchoring; temporary steps; plumbing,
mechanical, and electrical):
I (b) Relnspeetion (no, ofhrs, x fee per hr.): $58,00 1;$
I (c) Each additional inspection: (I) $58,00 1$
Electrical service permit to be obtained only by homeowner perjorming
work or signing supervisor aJOregon-licensed electrical contractor
performing work. "
I (3) Surcharge,12% (,12 x total, equal to I or 2):
(4) State administrative fee for
manufactured dwelling (item I) $30,00
only, OAR 918.500.0105(5):
I (5) Technology Fee, 5%
I TOTAL fees and surcharges (3 + 4-i-5): I
':$'i'1"'~
, $30,00
$ rq'6>1
$ t/'i'4fL
Signature:
1"~~~.'~cEiNmR;6;G-m0RljNsffiP)l!i!AmI0N~'ll1~~",
~~,>""""",_';AG<h"."0'~'~_"/I'~."""",-",,,,4___,;;:,;!;-;,",":""'=W,;,~??;:~~,..;~
I Business name: A - 1 nIT M Of!;J:U;;:-, f../-O/i1E 5'J3Te/{P
I Address: I
I City: I State: I ZIP: I
I Phon8H)q?f:j 7j;q A I Fax: I
I E-mail: I
I CCB license no,: I MDI license no,: I
I Print name: ~F:l2.. '12Y} 11"" I
I Signature: I
440.2547,) (9/08/COM)
;';'
'}"
'Each 'Plot Plan Needs to
Have the Following Items
i
~
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:# ,-<;
,$>~ ~.#', (
Jl #' #~.
'<<" .....
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"
... .
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-----
-,
1. Mobile Home Park name
2, Mobile Home Park space numbers
3. Names of Park streets
4, All plans need to be drawn to scale
5. Indicate actual dimensions In brackets
EXAMPLE
,
" STREET NAME
"
.'
PARK NAME:
,M',dwAy-f' Al'/:Q~
Space No, R - J{)
/ I
Lot size "'-It) x.7 C;
w/...-
>
EACH SQUARE EQUALS 10 FEET
(Vartlcal'ly, horizontallY.. Of.. dl~gQ_nall:) ,
,
-::::....;."".. Dc.k.... _<KI ~""'" ~
:t'
Home Information
Manufacturer:
Model:
Manufacture Year:
Date of Sale:
Square Footage:
Roofing Material:
Siding Type:
Heating Type:
Cooling Type:
Section
Information
Site
Information
Owner
Information '
If
Status of Manufactured Structure Ownership
State of Oregon
Department of Consumer & Business Services
Building Codes Division
1535 EdgewaterNW, PO Box 14470
Salem, OR 97309.0404
(503) 373.1309, Fax (503) 378-4101, TTY (503) 373-1358
231947
SHELBY
UNKNOWN
1979
10/28/2008
938
RUBBERIZED
LAP CEMENT COMPOSITION
ELECTRIC
HEAT PUMP
Purchase Price:' $ 0
No, of Bathrooms: 2
Manufacturer 10 Number
PS8777
DANELAND MOBILE HOME
PARK, EUGENE
1199 N TERRY ST SP 262
EUGENE, OR 97402
Owner Name(s)
LECKRONE, GERALDINE
BARBER, MARGE I
Print Date/Time:
02/03/2009 10:02 am
Includes land: NO
No, of Bedrooms: 2
HUD Number
LANE COUNTY
Owner Contact Address:
1199 TERRY
SPC 262
EUGENE, OR 97402
NOTES: ' OWNERS RIGHT OF SURVIVORSHIP
, - - -
* * * * *
Owner(s) Removed 11/05/2008:
LECKRONE, GERALDINE JANE
* * * * *
:1-0
.,
..l'
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number.
COM2009-00169
COM2009.00169
COM2009.00169
COM2009-00169
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Desc~iption
Manufactured Home Placement
Manuf Home State Issuance
+ 5% Technology Fee
+ 12% State Surcharge'
Paid By
MARGE BARBER
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000132
Date: 02/04/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
In Person
Payment Total:
9265
Page I of I
1:01:45PM
Amount Due
397,00
30,00
19,85
47,64
$494.49
Amount Paid
$494.49
$494.49
2/4/2009