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HomeMy WebLinkAboutPermit Miscellaneous 1992-4-15 . DEVELOPMENT SERVICES PUBUC WORKS METROPOUTAN WASTEWATER MANAGEMENT 225 FIFTH STREET SPRINGFIELD. OR 97477 (503) 726-3753 MANUFACTURED HOME SET-UP AGREEMENT As required by the City of Springfield Development Code, I understand and agree that with the approval of -the attached permit~~~of rY\~follOwing'_h manufactured homes will be placed at I I~ -rn 1 ")/ l"'l \ ) Springfield, Oregon, City Job Number ~'n . - - - . o Class A Manufactured Home. A manufactured home of not less than 24 feet in width and 16% (not less than 2:12) roof pitch, with exterior dimensions enclosing a space of at least 960 square feet, with roofing and siding materials that are commonly used or compatible with site built homes. / o Class B Manufactured Home. A manufactured home of not less than 12 feet in width and 16% roof pitch, with exterior dimensions enclosing a space of not less than 500 square feet, with roofing and siding materials that are commonly used or compatible with site built homes. I further state, by my signature below, that I have been provided with the following information: - Mobile home blocking - Sanitary sewer connection - Yater line connection - Electrical connection - Street tree standards -- Minimum requirements for permanent steps f\ (l (fin l j (1 Yf/Yt Y 'Jigna ture cr -. - - 4_:J.l- q J. Date \ ~~ LOCATION OF PROPOSED WORK: f7 '-/9' rn.!:......[J;//IC; h N/A \'1D2>~ I~ . . '7,' - BLOCK' ,'L ... ~ i18SIDENTIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726-3759 ASSESSORS MAP' LOT' OWNER' ADDRESS' CITY' Lochaven Partners ll99 N. Terry St. Eugene DESCRIBE WORK' Mobile Home set UP NEW x REMODEL ADDITION CONTRACTOR'S NAME Ernie & Son's GENERAl' PLUMBING' Harrison Construction SPRINGFIELD ,. STATF' OR ....., JOB NUMBER..3J..Q1'lll~ 225 FllIh Street Springfield. Oregon 97477 r /JC{(( T TAX LOT: -1!/ A 0 ( tf)JXJ SUBDIVISION' Lochaven PHON~' 688-9123~ ~ y " ZIP' 97402 -- Concrete strinQ.ers - Accessorv Value $17'/0- . OTHER M.H. Value $,-~RJ()::t -, DEMOLISH CON ST. CONTRACTOR . EXPIRES PHONE EUI!. 41497 212/92 484-6505 20-236PB 689-7762 EuQ.. 41/.97 2/2/92 484-6505 20-280C/63137 344-1500 ADDRESS 87922 LaPorte Dr.. 1441 N. Hwv. 99 MECHANICAl' Ernie & Son's 87922 LaPorte Dr.. HeritaQ.e Electric 855 W. 24th ELECTRICAl' QUAD AREA: ~,Q \\)\.0 - OFFICE USE - LAND USE: \\Y-n FLOOD PLAIN' . OF BLDGS' ~ \ . OF UNITS: \ I ZONING CODE: U)IL OCCY GROUP' K..'==J CONSTR. TYP~' vrv . OF BDRMS' ~ \ ~E.. --' . OF STORIES' HEAT SOURCE: SECONDARY HEAT: WATER HEATER:_9 ) RANGE: 9. SOUARE FOOTAGE: JJ ~ : - To requesl an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be made the same working day, Inspections requesled aller 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS D Temporary Electric D SlIe Inspection - To be made after excavation, but prior to setting forms. -- /1 '-- \ mnderslab Plumblngt lectrlcal/ ~echanlcal - Prior cover flA. Footing - Aller trenches are ~ excavated. D Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. D Underfloor Plumbing/Mechanical - Prior to Insulation or decking. D Post and Beam - PrIor to floor InsulatIon or decking. D Floor Insulation - Prior to decking. Ef Sanitary Sewer - Prior to filling trench. ater LIne - Prior to filling rench. . , D Rough Plumbing - Prior to cover. D Rough Mechanical - Prior to cover. . D Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. D Framing - Prior to cover. D Wail/Ceiling Insulation - Prior to' cover. D Drywall - Prior to taping. D Wood Stove - After Installation. D Insert - After fireplace approval and Installation of unit. D Curbcut & Approach - After forms are erected but prior to placement of concrete. ~'dewalk &.Orlveway - After ~xcavatlon Is complete. forms .and sub.base material In place. D Fence - When completed. D Street nees ~.When all required trees are planted. . D Final Plumbing - When all plumbing work Is complete. D Final Electrical - When all electrical work Is complete.' o Final Mechanical - When all mechanical work Is complete. D Final Building - When all required Inspections have been approved and building Is completed. DOther MOBILE HOME INSPECTIONS ast(BloCklng and Set.Up - When all ~ blocking Is complete. ~Plumblng Connections - When home has been connected to water and sewer. . ~ElectrJcal Connection - When blocking. set.up. and plumbing Inspections have been approved and the home Is connected to the service panel. PFfnal - Alter all required ,Inspections are approved and. . porches, skirting, decks: and venting have been Installed. 'Lot faces~ r Lot Type . l.:ot'Sq. Itg. Lol coverage Interior Setbacks HSE GAR ACC . THE PROPOSED WORK IN.J.t\E" ~. HISTORICAL DISTRICT, OR oFl THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance. Topography Total height . ,. . Panhandle I P.L. IN Is Iw IE I I APPROVED: Corner Cul-de.sac Main X $/SO. FT. ~ VALU()fE , ,'?AI , ~ ~ . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition thai the said construction shall, In all respects, conlorm 10 Ihe Ordinance adopted by the Clly of Springfield, Including the Development Code, regulating the construction and usa of buildings, and may be suspended or revoked at any time upon violation of any prOVisions of said ordln:mcos. BUILDING PERMIT ITEM SO. FT. Garage Carport 2R <6L\4 ~~- Plan Check Fee' Date Paid: Tolal Value J~ Recelpl Number' Building Permll Fee Received By: State Surcharge (~ . . Total Fee (A) Plans Reviewed By Dato L~ SYSTEMS DEVELOPMENT CHAR~).Sp,~~. : (B) ~~ Syslems Development Charge I,s due on all undeveloped properlles wlthl,n the City limits which are. being Improvod. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures Resldenllal Bath(s) Sanitary Sewer N' Waler FT. CIS A~ ;:J,e::... FT. Slorm Sewer FT. Mobile Home Tolal Charge (C) '7 S pO ~ 0, 'lS !) X, 15 Plumbing Permit Slate Surcharge MECHANICAL PERMIT Furnace Venl fan N' By signature, I state and agree, that I have carefully examined Ihe compleled appllcallon and do hereby certify that all In(ormallon hereon Is Irue and correcl, and I furlher cerllfy Ihat 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 perlalnlng 10 the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I furlher certify thai only contractors and employees who are In compliance with ORS 701.055 will be used on Ihls project. Exhaur.t Hood Wood Stove/Insert/Fireplace Unit Dryor Venl Mechanical pe..:nll Issuance Slale Surctjarge Tolal Permit (0) ~ .t"Y1 f)~ from the sireet, Ihat the permit card Is located at the front a:L.C1J....) . of the property, and the approved set of plans will remain _I :So '1-"'. \ ~ on the slle a'j1l tlme.s dUring. cO"(lctlon. . -5. a~ .~ure (JJjj (nte.mJe / /1.C).rO..~ Date 4-1:\ -QJ- CS I furlher agree 10 ensure that all required Inspections are requesled at the proper lime. Ihal each address Is readable MISCEl.LANEOUS PERMITS Mobile Home Slale Issuance State Surcharge .tJ.5' Sldewal (,-) It Curbcul It Demollllon TOTAL AMOUNT VUE (excluding electrical) (A, B, C, 0, a~d E Combined) B.'~l) Pfr VALIDATION: RECEIPT NUMBJR . 4:)..2.5 "" "'0 q-. \;mt AMOUNTREC~ -, .~1 RECEIVED BY I.:!)t Slale Surch2rge Total Mlscel,anecus Permits (E) . . Fixture Unit Calculatio;, Tabl~; ::'"~'~~l' cf ne'_' fi:-:t\ll'es r.'Jltiplied by \!nit equivalents. "OTS: For n",od~ls, calCJbte c.nly the ::ST aedi tional fi:-:t.:res. Fh:ture Type or Unit F xtures Squi~al~nts Fixture l'ni ts 3a t h t \I b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drinking foun tain. . . . . . . . . . . . . .. .... . . .. . . Flool: drain............................... Interceptors for grease/oil/solics/e!c.... Inteiceptors for sand/auto ~ash/E:c........ Laundry tub/clothes ~asher........... ..... Clothes ~asher (3 01: more)................ Hobile home park !iap (1 per H.3.).. ...... ~eceptor for refrig/~ater static~/etc..... Receptor for Coc~er sink/dish~5~::etc..... Sho,'er, single stalL..................... Shover, gang (per head).. .... .......... ... Sink, bar, com~ercial......... ............ Sink, commercial/industrial/etc........... Urnial, stall/vall........................ ~ash basin/lavatory, si~gle............... Vater closet, public installation......... Vater closet, private........ ............. Hiscellaneous: .......... 2 1 2 3 6 '_2 6 6 1 3 2 1 2 3 2 1 6- 4 .......... .......... Total Units: Total fixture units x 513.25 each = Total Charge: $ Credit Calculation Table: 3ased on total value or property at time of permit applica tion. Year J..nJie:.:e:d to tl-!e city Credit per $1,000 assessed value i ':'(04- 19?9 1980 1981 1982 1983 1924 1985 1906 1987 198a 1989 1990 $2.66 $2.64' $2.53 $2.41 $2.19 $2.04 $1. 69 $1. 35 $1.15 $0.92 $0.59 $0.23 Rate x S 10/3?.O r.ss€:ssed Valt:e = s Credit Total Credit Metropolitan . Wastewater Managen"\ent Commission . C.',",' ::-:', ',';.' ~:: C:.:~ ~~"~::-r~.~:.:. C:".';": '!:' F.:r,i- CI~:'..-h;t:,t ~'! =.!::l!f' t".: s:: . ~:;~:.: -:-.-~;' -';',f': ~c, :t:''i~i:' i:.~ C',':; ~i '!: '.- ~;-;. ;"~ : .~: ~.: ::.'::", C~:.~ "}:;~";~~~~~~:"~'~~'::~:l ~~:::;~;~.~:.~~ t.~,:i. \':u:;i:';;-::.;;t.;~ Li, :.~: '!~~ ~.::' .! FiFTH A:'~D A SiREE7$ - Sr;:,::<GF:~LD Cny !-:;'.LL - ~:=R::,Gr:ELD, Cr:,EGC!J 97.:.77 TELEr-:-:C:...E i':C.2) 7':7.':::1 Jr,'JJ,c C(lliNECTION CHARGE Building Address: /ct4C1 Me!.. T<UJ\~ ~~W'I-t Refere~jUmber: 1'7032.'7/3 .' Tax Lot Number: 0&100 o\:ner:DnbOJ) r n . i_ /~()Af~~J1.f-"~) Address: \ \ C\ C\ .\\ '\,-~>0f\ \:- Phone Number: l o~<iS - q \23 City: fAJ(l60 JIJL State: (()~.D~BY\..ZiP: Qf\4('YZ-- .~ Residential Fee ($222.00) $J-0Q ~ r;P ___ Commercial Fee (new non-residential development/ remodel) Total fixture unit charge (see reverse of this form) $ SUBTOTAL $ Credit Due (see reverse of this form) <$ ~1) 4t=) > TO!.L.L I".'JJ,C CHARGE $ \C\L\ .h..~ Date Received: 4/\~.q~ ~.ao' Recei ved By:~/ffi) ~ . Receipt Number: Building Job Number: q Ie 1 '2 "Z- SP'IINCt'=IELO . 8fO!! ~r,!'''9. Oij~,*" iO;ijlrri SIIij &6.'% ~ ,,~,,~:1I9clJb ELECTRICAL PERMIT APPLICATION io1'l{, 1i!~"'lltiJtJili14 S"/~"'~ Job Number - "lIa8 ~ LETE FEE SCHEDULE BELOY """.~ Cost' 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726- OFFICE: 726-3759 ~~ ....$. 4 'fJ.? 1. LO~Aa.o~~ I~~~r\.1")\ ~_ \ -tl~~~t\\~N [)\ ol\CYJ I: ro~ DEn~e~ ~ L Permi ts are - non-transfe~ and expire if work is not started within 180 days of issuance or if work is suspended for '180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Heritaqe Elect Address 855 West 24th Avenue Ci ty Euoene Phone 344-1500 Supervisor License Number 9455 Expiration Date 101l/ Constr Contr. Number 63137 Expiration Date 12127/ Signature of Supervising Electrician ~ cJ. ~ 11/5-5 Owners N~~O(l1J(JJ ff) ~ Address~ . T~ CityC{YliJ\ Q ~ Phone~~1dJfl v...t.l\ :tJSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE: _ ~--zt:-\ S .C{~....... _ ..- ---- RECEIn 11: f ft' ~ ,'"1\'T,~~, RECEIVED BY: / j )Lfi.. ./ -. Items Sum 1000 sq.ft. or less S 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular Dwelling c9 AD Service or Feeder $ 40.00 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 Branch Circuits $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation B. Services or Feeders Installation, Alterations or Relocation: 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 $ 40.00 $ 55.00 $ 80.00 volts see "B" above New, Alteration or Extension Per Panel Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lightin~ Limited Energy/Res Limited Energy/Comm One Circuit Each Additional Circuit or with Service or Feeder Permit E. 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL $ 35.00 S 2.00 not included) $ $ $ $ p/)CD , <i ex) '7""'fq,fiJ 40.00 40.00 20.00 36.00 . ...~ INFOF&TION NOTICE TO PROPERTY O_ERS ABOUT CONSTRUCTION RESPONSIBILITIES .",,",- .~~ NOfE;- .'. This Inform,ation Notice ,to Property Owners About Construction Responsibilities was devefoped by"'the Construction Contractors Board in accordance with ORS 701.055(5), . ,. passed-by 11;'6"1989 Oregon Legislature. . ,\\\~~ . . ..:":: -. :~.....,,~, -, "-If you are. acting as your own contractor to construct !l new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do lab.or in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an "employer" and the people you hire will be "employees". As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from 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 more information, call the Oregon Department of Revenue at 378-3390. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment.Division DHR at 378-3224. - --:::... 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' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. 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 more information, call the Internal Revenue Service" at 221-3960. . OTHER RESPONSIBILITIES AND AREAS OF CONCERN: ---' Code Compliance: As the permit holder for this project, you are respo.nsible for resolving any failure to meet code requirements that may be tJrought to your allent,ion through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and ,finish trades, and to notify building officials at the -appropriate times so they can perform the required inspections. ' ,- _J , J -..-'. - -:-- If you have additional questions, write to: Construction Contractors Board 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89 ~..., . . . (J/A"'>-;7.., __ //L//":--':-- .<- ~_' ,.s. Permit No: ~~' Address: ~.:j'7,4f?C T/12//,r /'f Issued by: 4X~ Date: #2- FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required .for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: 1 . J:::><:::r I own, reside in, or will reside in the completed structure. 2..c:.- -, I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. A.I 1 My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B.~ I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify 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 understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 'XC ~ A / - Signature of Permit Applicant $/l-9'L Date CONSTRUCTION CONTRAClDRS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COpy TO APPLICANT ..' _____:.:" '4 . . SPRINGFIELD FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 Job Location: ,qL/q ;.AcTi#//<" {!b!...r..e-r- * I?P-::' '2- (' /3 A...",,, "p I, ~ or 3 f E/~". S T" Lot I, 067"'"" ..: Owner: j. ()ch J,,wf:vt jJ M:r,.,)C(L<> / DtfJ,J,J e./~ Address: Phone #: City: State: Zip: Value of Fence: CI__~~ - 7t-)l) Fence Permit is $5.00 Address: DOIJ,J l"<lor . .4A.CTfkJi~"- SP/2..~ ij t: d~ F1IFR ~"~ Phone #: Contractor/Installer: City: State: ~ & 83-Jl/7h Zip: 97'f,/7 Construction Contractors Registration #: Expires: By signing this permit/application, I agree to call for an inspection once my fence has been constructed (726-3769). I also state that all information on this application/permit is correct and that I was provided with the Springfield Development Code requirements for fence standards. G,?~k</),f~ 5'- b -'1 2- Uate . FOR OFF ICE USE ~ , ~,..,~ --, Date of Appl ication: '5/7/92..... ( I Receipt #: -{.5f!'// Issued By: - ,ro Total Amount Collected: tJ '7/ (../ / e=. """- Job #: ~~---r-::r ~ Checked for Delinquencies: c..--- Checked for Historical Status: