HomeMy WebLinkAboutPermit Miscellaneous 1992-2-11
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SPRlalELD I I
DEVELOPMENT SERVICES
PUBUC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726-3753
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield
that with the approval of the attached
manufactured homes will be placed at
Springfield, Oregon, City Job Number
Development Code, I understand and agree
perm(~'cS9;\~~c{~Pc\Wt~ ~n
~ \D,'L\ .
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
'~1 fiC-O
~faiure "
Z'.~/~
v-
c9-i(-9 U
Date
,Lot faces. .~.. Lot Type.
lot sq. ftg. Interior I P.L.
IN
Lot coverage Corne r Is
Topography Panhandlo Lw
Total height Cul-de-sac IE
.. "'"
., THE PROPOSED WORK IN THE
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
h
.....
Setbacks
HSE GAR Accl
I
BUILDING PERMIT
ITEM sa. FT.
X S/SO. FT. ~ .VALUE"
,Qr}~~.
Main
Garage
Carport
I I
I.'
J APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall. In all respects, conform to the Ordinance
adopted by the City 01 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 ordinances.
7240, Plan Check Fee:
~ Date Paid:
Total Value
Receipt Numb""'"
Building Permit Fee j' ~ Received By:
Slate Surcharge
Total Fee (A) 8D11R Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDCI _
(B) ,1,9,-Q, - ~.
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
c<):=)
e~
A6
Sanitary Sewer
FT.
FT.
FT.
Water
Slorm Sewer
Mobile Home
Plumbing Permit
'lb.0U
G.'!)
YJ~.15
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhau," Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryor Vent
Mechanical Per:nlt
Issuance
State Surcharge
H
Total Permit
(D)
MISCE1.LANEOUS PERMITS
Mobile Home
mas
]5.1s
.....P) .6)"5
c:mQ
State Issuance
State Surcharge
Sldewal ( q 4
ft
II
Curbcul
Demolition
State Surch~rge
Total Mlscel.anecus Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)"'78B,(:0
(A, B. C. 0, and E Combined)
Systems Deve/opmenl Charge 1.5 due on all undeveloped
properties within the City limits which are, being Improved.
, ADDITIONAL COMMENTS
By slgnalure. 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 nurther certify
that any and all work perlormed 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 Building Safely Division.
I further certify thaI only contractors and employees who
are In compliance with OAS 701.055 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 readabla
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.
Signature ~ ~....k~.~
Oat.,
VALIDATION: ~~ (
RECEIPT NUMBER. 0 L (J
DATE PAID ,Q . ! \. '~
AMOUNTRECEIV~D -.1TfY)/'iPJ . I 0 J
RECEIVED BY '"f1\T~-' - .
\
,
;;'I~..y~ ~.
ASSESSORS MAP:
.
SPRINGFIELD
\ RESIDENTIAL
\PERMIT APPLICATION
'Inspections: 726.3769
OHice: 726.3759
LOCATION OF PROPOSED WORK:
N/A
-;:t:J
BLOCI"
LOT:
OWNER'
Lochaven Partners
ADORE"'"
1199 N. Terry St.
Eugene
STAT'"
OR
CITY'
JOB NUMBER
q l()l1..L
225 Flflh Street
Springfield, Oregon 97477
r 1Jq,1? T
. TAX LOT: N/A
.
fj)(o?-CD
SUBDIVISION'
Lochaven
PHON'"
688-~123 ~it.~
ZIP: 974~
t ~
NEW
x
stringers - Accessorv Value $J1'1D~
OTHER M.H. Value $ ,'2)Pjf)'&'S .
DESCRIBE WORK' Mobile Home set UP
.- Concrete
REMODEL
ADDITION
DEMOLISH'
, .
CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR'
GENERAl' Ernie & Son's 87922 LaPorte Dr.. Eug. 41497
PLUMBING' Harrison Construction 1441 N. Hwv. 99 20-236PB
MECHANICA" Ernie & Son's 87922 LaPorte Dr.. Eug. 41/,97
. ,
ELECTRICA" Heritage Electric 855 ,~. 24th 20-280C/63j17
OUAD AREA:
\R t\hlj
\
\~~
\
- OFFICE USE -
\ \ '7-D
\
LAND USE:
. OF UNITS:
. OF SLOGS:
OCCY GROUP:
CONSTR. Type.
f;-
HEAT SOURCE:
. OF STORIES'
WATER HEATER: _T
RANG'"
EXPIRES
2/2/92
PHONE
484-6505
689-7762
484-6505
144-1500
2/2/92
FLOOD PLAIN:
ZONING CODE: _ ( 1 )'i-
. OF BDRMS' ~
SECONDARY HEAr.
SOUARE FOOTAGE:'
. \
To request 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 requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanlcol - Prior to
cover. '
o Site Inspection - To be made
after excavation, but prior to
setting forms.
f-7(';lderslab Plum ngl Electrlcal/
~'~chanlcal - Prlo ver.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
@ootlng - After trenches are
r excavated.
o Masonry - Steel location, bond
beams, grouting.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
D Foundation - After forms are
erected but prIor to concrete
placement.
o Wall/Celllng Insulation - Prior to'
cover.
D Underground Plumbing - Prior
to filling trench.
o Orywall - Prior 10 taping.
o Underlloor Plumblng/Mechanlcal
- Prior to Insulation or decking.
o Wood Stove - After Installatlo~.
o Post Bnd Beam - Prior to floor
InsulatIon or decking.
o Insert - After fireplace approval
and Installation of unit.
o Floor Insulation - Prior to
decking.
~anltary Sewer - Prior to filling
Lf-llrench.
~torm Sewer - Prl.or to filling
! trench.
.-.<?water Line - Prior to filling
t:t:J ;rench. '
o Curbcut &.Approach - After
. forms are erected but prior to
placement of concrete.
~Idewalk &.Orlveway - After
~ .:xcavatlon Is complete, forms
.and sub-base materIal In place.
o Fence - When completed.
. '.
o Rough Plumbing - Prior to
cover.
o Street Trees - When..all required
trees are .planted. .,
o Flnsl Plumbing - When all
plumbing work Is complete.
o Final Electrlc.al - When ~II
electrical work Is complete..
o Final Mechanical - When all
mechanIcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building ,.
completed.
o Other
MOBILE HOME INSPECTIONS
~IOCklng and Set.Up - When all
( ~IOCklng Is complete.
~IUmblng Connections - When
home has been connected to
water and sewer. .
(1ectrlcBI Connection - When
locking. set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
~al - After all required
. nspectlon.s ore approved and .
porches. skirting, decks".and
venting have been Installed.
.
.
Fi:nure Unit Calculatio:l Table: ::uc,tH cr ne'.' fi:-:tures r,ultiplied by \!:1it
equivalents. NOTE: For r~models, calc~!Bte only the ~ET additional fixt~res.
Fb:ture Type
of Unit
F xtures Equivalents
Fi:\ture
l'ni t s
3athtub........................,......... .
Drinking fountain........ .,.. .............
Floor drain...............................
Interceptors for grease/oil/solics/etc....
Interceptors for sand/auto .ash/~:c.......
Laundry tub/clothes ,asher.. ..............
Clothes .asher (3 or more).....,....,.....
Xobile home park trap (1 per !~.~.)........
Receptor for refrig/~ater static~/~tc.....
Receptor for Coc~er sink/dish~s~:/etc.....
Shover, single stall......... ,........,...
Sho~er, gang (per head)........ ...........
Sink, bar, com~,ercial.....................
Sink, commercial/industrial/etc....,......
Urnial, stall/~all..............,....,....
Vash basin/lavatory, si~gle. ,.............
Vater closet, public installatic~.........
Vater closet, private........ ,....,.......
Miscellaneous: ..........
2
1
2
3
6
2
6
6
1
o
...
2
1
2
3
2
1
6-
4
..........
..........
Total Units:
Total fixture units
h $13.25 each = Total Charge: $
Credit Calculation Table: 3ased en total value of property at time of permit
application.
Year "]...:nne:.:S:d
to the city
Credit per $1,000
~ssessed ",alee
19'=4
1979
1950
1981
1982
1983
1924
1985
1986
1987
1988
1989
1990
$2.65
$2.64'
$2.53
$2.41
$2.19
$2.04
$1. 69
$1.35
$1.15
$0.92
$0.59
$0.23
r:ate
x S IO}:,I...O
;'.sse:s~ed Vali..:e
= s
Credit
Total Credit
Metropolitan
Wastewater .
Managernent
Commission
.
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........, .... ..,... ..
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i'ii'iH A:'iD A SiREEiS - ~i';:.i:':GF:::LD CiiY ;-:;LL - oi';::i';Gi'iELD. C;:,EGC!J ';;7"77 ELEr;-:C,:,E (:,:;j 7"7."::,
!".iMC CO!'liECTION CHARGE
Building Address: 1t:1 SB M. Q. T Wlf,h, C!.;J\Iff-t
Refere8umbe:: 110 32. ~ , ~ " Tax Lot Number: 0" 3 d)
O..ner: D0AJOJ) r n. i /\In A+.,ruf.~')
Address: \ \C\ C\ ,{\ '\~>r~ \: . Phone Number: lo~'K-Ct\23
City: fA')0tO J1SL State: CC)J~ 1)~BY\ Zip: q f\4ry2---
~ Residential Fee ($222.00)
$r9Q~ ~
___ Commercial Fee (new non-residential deve1opment/
remodel)
Total fixture unit charge (see reverse of this form) $
Credit Due (see reverse of this form)
SUBTOTAL $
<$ '-of) 4-:)
>
TOTAL MVMC CHARGE
s
l C\4 CS~
Date Received: ~ . t t .q~
Receipt Number: z~f) { ( (J
Received
By: rAr/V) )
Building Job Number: Cj 10'72/
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1.
UY{~E~~~;t)
Permits are non-transfe a e and expire
if work is not started wi thin 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
City
EUQene
Phone 344-1500
Supervisor License Number 9455
Expiration Date
10/1/
Constr Contr. Number 63137
Expiration Date
12/27/
Signature of Supervising Electrician
ilePv uJ ~ rtf..5'5
, ..
Owners Name
Address
City Phone
OYNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
DATE: _=-~;!;r ( l .-g~:-----:-.:---
RECEIt'r 11: . ~.+-A-.- <..-J'-IJ.Jlu
RECEIVED BY: \/ ~,I ){ ~ ./
, -
SPIIINGFIELO
City Job Number
Ne esidential-Single or
lti-Family per dwelling
Service Included:
q (()12J
"".*
Items Cost Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling c!J ~O
Service or Feeder $ 40.00
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
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D. Branch Circuits
$ 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
$ 2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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