Loading...
HomeMy WebLinkAboutPermit Miscellaneous 2009-7-9 1~[E;g~[i~'!II:i;flii)~~j![~j!;tll Permit nO:eollU:-"O 'i' -o/bo.8- Date: 7- .,~ O't I 225 Fifth Street . Sorimdield. OR 97477 . PH(541)726-3753 . F A)((S41 )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_[~~~Jt![G~~BI(OO:~N1I1el!i&~~"qb:~I_1 I Zoning approval verified: 0 Yes 0 No I I Property is within flood plain: 0 Yes 0 No I I Sanitation approval verified: 0 Yes 0 No I 1i\!lI?~W"."'7'"?"-~~~~-'''''''''''~;=._-_.'''^,''''..'''-~''''~''%Y'''''''I 1.!ii'~~~~G~~'[~~q&>~Silj~!lt9.ill1S2tJ~If'~ 1 (g,Residential .1 0 Government 1 0 Commercial 1 1~Q..ml\!\5~~RM~jf~]J:[~~~tilll I Job site address: <f7r;o F"'I",kl,..., Bv, ~ N -2 , 1 City: IF \lOieNL County: LVvt I 1 State: 0 R ZIP: Cf7 ...,0 ! I 1 Subdivision: IF,,j.,.....l4.i.,le 1 Space/lot no.: tJ - 2 I Reference: /l29fO 31 ( 1 Taxlot: D"3 S-O n I ~).4i_lDEs'GRiemI0Nl!r01il"W0RK~!".''''11 ilil"''l\lJi!lIl;Jl!..~".#.Ji'+~_ "_.._,~.,_._..".._.-",_._.~..,,.._,...1,;~_~~_,1~1L 1 S'u...u" i<r<j2.I1c'U~I-I,,,,. 1-'>;'" U>I-,,),J,rkJ. I 1 S<f'A'€-. IN- Mob'/ L f"..k. I 1~.iIIR,gI~&i~E~1lfi'~W]]E-W~rlRl 1 Name: Ev'le..>e. M.b.l.. 1I,((A1e. _ll.C I I Address:L{7~L) F""",k{]oJ 1'3" I'or-F Ie\:''' I I City: f'Vi o->-e... 1 State: (!) r-z 1 ZIP:'!7'! 0 3 I . 1 Phone:s'""lI-74i Z Z, '7 I Fax:"'t -7'-/7 Z Z \'7 I 1 E-mail: -., ~AN4e~ to. e--!',v ,OF'<} 1 This instaifation is b~ing ~ad~ on residential ~r fann property owned by me or a member afmy immediate family, and is exempt from licensing requirements under OAR 918-515-0010. Signature: 1~:@N.tilli~~ill~BJ~~I[~IJ!~]rg~I"~1 1 Business name: .A -Ac.--t-tc,,", 1 IAddress:d57/& WJqgr'n<) 1 I City: Ven eJC-l .1 State: Dc 1 ZIP:G7 749 '11 1 Phone:,9-II-Q3"7 II 'i5 fp I Fax: . I I E-mail: I I CCB license no.: i 4 2 ~ 0"1 1 MDI license no.: /10 <J 1 1 Printname:( Jnl1hl'\j .-t. 0(tn:J~ 1 I Signature: lJ~1IC4 t JjaJ\ ~ I (j ( 440-2547,) (9/08/COM) .~!i\\!WJ.lll!1l!!~~~~'!l'~EE'"SGHEjjj1!1[tEm~~"':.~ili\Ill ,,,j~~~~~~,-,,,,,,,,,~,,^,~,;-,,,=,,,,,,,,~,,....~,~,0fI,.ifi~..~~El . Description I Qty.1 Cost each I Total , 1 (I) Manufactur.ed dwelling I (a) Placement (includes placement, a 1 electrical feeder, water/sewer. $397_00 $ /;? ~ ~ ; connection): . 7.......- (bi Reinspection (no. ofhrs. x fee per hr.): $58.00 $ -- I Placement permit can only be obtained by homeowner or Oregon- I lic~nseq. manufactured dwelling installer. I (2) Recreational-park trailer I (a) Installation (includes stand and lot preparation; support blocking; anchoring; temporary steps; plumbing, mechanical, and electrical): . $397.00 $ (b) Reinspection (no. ofhrs. x fee per hr.): (c) Each additional inspection: (1) $58_00 $ $58.00 $ Electrical service permit to be obtainedonly by homeowner performing work or signing supervisor of Oregon-licensed electrical contractor performing work ~_...l'!"~,!;1!:!;F.EEl!SGBEjjj(!JIl!E2~~~~ ~~~~~dt~"-''''''_''''.~'0,.J"",_,~~,c~~y~~~~~..,~~j4 rcj (3) Surcharge, 12%(.IZxtotal,equalto I orzj: $ 1./7::> (4) State administrative fee for manufactured dwelling (item I) only, OAR 918-500-0105(5): I (5) Technology Fee, 5% I 1 TOTAL fees and surcharges (3 + 4+5): 1 $ $30.00 $3000 :?U, ,~ $ I ';155" 1 ~?'f ~ . I ~~1giti!:f~'j.tu;~~tlirn~i';;t-};~T~;i~J~:;1:;I~1i:I;:~<;'~'j~Jf~,t. _~. ?R,N G71~Li::I .:'::::::":.~:...:::__~ ::.~f:{;\~~,~S~fiF~~:~18~~~~_C:~~J~~~~~ci-;~~1~~~~~~~t~'t+~;~;~~;t;~~_ ;l~~~~~~~~~~~~;~:~:;;~i~ PH:(541)726-3753 . FAX: (541)726-3:8~, ~i~~::~~~}!l-~ City Job Number C~vv1 ?-c>C:>-7- 0 I OO~ Date ~ ~O q 1. . LOCATION OF INSTALrATI()N . 47 r-o ~....\c..f.:"7S1v'.L LEGAL DESCRIPTION I <OOSO] ( ( JOB DESCRIPTION 0] SaO 1#/1- !:Ltx- T<L \.G.A-L Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is S~spended for 180 days. .. CONrRACTORINSTAJfLIl.nol-li6NLY. 2. .." <.. '.. _... ..__ ..,...... Electrical Contractor Rn,NW1/cf'i I3krJ-r/( . Address ~ II ,..- (.J --1..wd ~ ~ City ;:::'" t:: ,,--,,_0- . ; Phone3(t~.7.:2.77 Supervisor License Number ~ J.L) - 5- Expir~iion Date /rl / I l..2-o/a Constr. COntr. Number ) '7 2.5" 2.. Expiration Date :LI""1 /07 Signature of Supervising Electrician /J~~:~ ~Name .eutl-:S'I c:::>GC- Address" b 20 i' II 6fV\-1 wo be city ---r;J c~,v Phone kl OWNER INST ALLA TIQN The installation is being made on property I Dvm which is nor intended for saie_ lease or rent. ~ Dwners,Signarure: ~~ ~~ '^S~ . ~'l~1 C"(';. ~\'liO\\ ;f \ ,\'11: Inspection Request: 726-3i69 3. NZ- COIvIPLETE FEESCFIf.prJLE BELQW A. New Residcn~ar- ~'i,ri.g~~.:'?'~'_:~:i~ul~~'F~~~}y '~er 'd~~;:~!:~~~g:.'~ni:i:~:" Service Included 1000 sq. ft. or less . . Each additional 500 sq_ ft_ or portion ther~of Each Manufac!' d Horne or. Modular Dwelling Service or Feeder $106.00 $ 19.00 I roo B. Scn-i~~s,'o~ F~~:~~i~;2!:rii'~f~!J#4~:4~'~4i';~f~:ti~,~s;'?~::~~~*.~~~fB\2;~~~:: 200 Amps or less. 20J Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 . $375.00 $ 50.00 . -':-i:'.,....,.,.... C. Temporary S.eryic~s~;o_r:."t~ed~r:s:. Insrnlla[ion. Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 i Amps to 600 Amps S 50.00 S 69.00 $100_00 Over 600 Arnpsor 1000 Volts .'e: "B" above_ D. Branch. Circuits . . . . . New Alteration or Extension Per Panel One Circuit. $ 43.00 Each Additional Circuit or with Service or Feeder Permit $ 3.00 (J:)((.Q~us (Se;;'i'ceif~edc~ not'included) -Ea'ch"Jnstul1arion Pumpar irrigation $ 50.00 Sign/Outline LJghting $ 50.00 Limited Energy/Residential S 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is S45.00 -i- Surcharges ~. SUBTOrlL OF _WOVE 3% State Surcharge i O%..":"dministrative Fee TOTAL Shared Drive(T:VBuildinl5 formSlEl~crricd Permit Appiic:::nion : -06.co CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01008 ISSUED: 07/09/2009 APPLIED: 07/09/2009 EXPIRES: 01109/2010 VALUE: __~,~~~~~;~I;~~':'~JI,'J~,II,~ll,~," l: .. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4750 FRANKLIN BLVD SPACE N2 ASSESSOR'S PARCEL NO.: 1803031103500 Springfield TYPE OF WORK: Manufactured Home in Park PROJECT DESCRIPTION: Manufactured home in park TYPE OF USE: New Rcsidential Owner: OGG ERNEST Address:. 6208 N CAMINO DE COROZAL TUCSON AZ 85704 Contractor Type Electrical Manuf Home Inst I CONTRACTOR INFORMATION I Contractor License NEW REYNOLDS ELECTRIC INC 184921 A ACTION MOBILE HOME MOVING & DElY142807 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: . # of Stories: uires yOU to R-3 ENTION. <!:leiglif'Jt'-St,rSgur.~on Utility A;T rules ~cl:YiPe'~f.He\''1tl~~ ~are set torth . tVB~W hon ceM\a1,,;rlJ9R~,tgh OAR 952-00'- ~o~~~ 952-00Rli'IIj~TY}~ies ot the rules by In090. '{ou me:~iif~In:'x.a~~.i: the telephOne o aIling the (SPri1fkl~~I~\Y!lI.t'lg:lotltlCatlO~/a c J:_..4-hpOreQ ~_ .....",11"\ nUI1D'i~Eoo'PM~.!{iNFORMA TION , Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: IPUBLIC IMPROV~MENTS I Street Improvements: Storm Sewer Available: Special Instruction: Expiration Date 01/01/2011 05/05/2010 Phone 541-343-7297 541-935-1786 Lot Size: Sq Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: . Compact: Sidewalk Type: Downspouts/Drains: NOTICE: PIRE IF lHE WORK lHIS PERMli SHf\LL ~\SPERMli IS NOl AU1HORIZED UND\~ ABANDONED FOR COMMENCED OR ANY 180 DAY PERIOD. Notes: Page I of 3 " CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01008 ISSUED: 07/0912009 APPLIED: 07/0912009 EXPIRES: 01/09/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line I Y~luation Descrintion I Descriotion Tvne of Construction $ Per Sq Ft or mnltiplier Sqnare Footage or Bid Amount Value Date Calculated Total Value of Project Fppli', P<::aiA ~ l-i!JIliIIoI Fee Description + 12% State Surcharge + 5% Technology Fee Manuf Home State Issuance Manufactured Home Placement . Amount Paid Date Paid Receipt Number $47.64 $19.85 $30.00 $397.00 719/09 7/9/U9 7/9/09 7/9/09 1200900000000000791 1200900000UUUOOU791 1200900000000000791 1200900000000000791 Total Amount Paid $494.49 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. ~lIirpdln~wtion~ , Manuf Home Set Up: When installation of all piers or stands is complete. Manuf Home PluJ.1lbing: After home has been connected to water and sewer. MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. 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. Paee 2 of 3 _~~};~~I'l!I~~',9L'1,',\1,1,~,I)ll,~,;i' .,\1 Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01008 ISSUED: 07/09/2009 APPLIED: 07/0912009. EXPIRES: 0110912010 VALUE: 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 Springtield 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 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 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. ~ ------ -, Owner or Contractors Signature Paee 3 of 3 71th? Date , OWNER NAME: PHONE # ADDRESS: ~ - __~__ _u_ _ _ _ _ . __"...__._ '___ '---'~'-- --.,---- - ~ SITE PLAN SUBMITTAL FORM Map and Taxlot #: Scale: r:: eP u- c-} f? (. -:; III ::~ I APPLICANT NAME: PHONE # ADDRESS: . I 1 Q, ~ :;. 5' -. CD Co ..... (") -. ::r~o .. " ~, :l~lD III -. '" .., (j) < ..,-~ o - -. '" 0 0 <;+~ ~ ~' -:.-'(. ~- ~ 'n ] C 'J " ~ ~ is:: ~ ~ ~ ~ - '" ~ ] t;, :~. ;:,. .k; '-'" ~ :'-,' ......'<-::; ,'':" --:, - ~ '" <<: ~_.~ .. , j~~. ..:' ;~~.;. .?\., ~~.p~Ylf; . o kl - '" ~ ~' 'f, ;:: .~ ;::;-, , '-- .~J. "C 1:~ - ]:~ $: IfM~ ,~ 'l~\(\~\~' -e, 225 Fifth Street Springfield, Oregon 97477 541-726-'3759 Phone Job/Journal Number COM2009-0 I 008 COM2009-0 I 008 COM2009-0 I 008 COM2009-0 I 008 Payments: Type of Payment Check cReceintl RECEIPT #: a..'1"'NQFIELD~._"" .. :-J^ T ., .. tIIi:., . City of Springficld Official Receipt Developmcnt Services Department Public Works Department 1200900000000000791 Date: 07/09/2009 Description Manufactured Home Placement Manuf Home State Issuance + 5% Technology Fee + 12% State Surcharge Paid By EUGENE MOBILE VILLAGE Item Total: Check Number Authorization Received By Batch Number Number How Received djb 2286 In Person Payment Total: Page I of I 10:39:27AM Amount Due 397.00 30.00 19.85 47.64 $494.49 Amount Paid $494.49 $494.49 7/9/2009