The URL can be used to link to this page

Home My WebLink AboutPermit Building 2009-12-22 225 Fifth Street. Sorimmeld. OR 97477 . PH(541)726-3753 . FAXI541l726-3689 . Manufactured DwellinglRecreational-Park Trailer Placement Permit Application I'i;~~~~~~~~~~li I D~te: IZ -zz-D 7 I 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. . J ';i:;:,rJ::;r;;:;~;;f\!S:~}"<~i;1nr;ki~Y:;.~.~,E::.~:~H'~p~ R~,:,:.::ri.,f::flf~}:f:ii:~::;~t:;~r~m~}~~el I Description " I Qty.1 Cost each I Total I (1) Manufactured dwelling (a) Placement (includes placement, electrical feeder, water/sewer connectio'n): I (b) Reinspection (no, oflITs. x fee per hr.): $58.00 $. I Place~en~ permit can only be obtained by homeowner or Or,egon- licerised manufactured dwelling installer." . " I (2)'Recr~ati~nal-pa~~'trailer. (a) Installation (includes stand and lot preparation;' support blocking; "~choring; temporary steps; plumbing, Subdivision: Space/lot no.: <5 7 mechanical, and electrical): Reference: (70335'-(\ TOllol: 00 zo I I (b) Reinspection(no: oflITs. xfeepe~lIT.): $58,00 $ I )/.f';i:DE:S(;RIRti6N;bt:WpR~r'Y?:h':}? (c) Eac~ditional inspection: (I) $58.00 $ . I aa oj ~rvice pe1'mlt to be obtained only by homeowner performing I Year Manufactured: /-q? 1- ~. 0'e9~~ ~'ff~e t ~~;{~~e~lSOr o!oregOn:llcensed elec~'c,al con:~ct~r .", I · Ok.".,.. 2. I ,,<. "" ~__'l...", .'FEE 'S.CHED~'E..". "", .. ,.,. I.. ~'cel\\~" \tIIO". , , , ,: ,PROPERTYt . :\0 , ,. ~ a 2% (.12 x total, equal to 1 or 2): $ , n . "0\\ gO ~,,3, ", Name: I!:,,,A-,of; -1--/ #-e("'E2~~tCll3t l~0\8'l\t'" administrative fee for I Add . '~.' ~ ~Oig, ' ~ufactured dwelling (item I) $30.00 ress'1J'L7.:2 azA-c.4r;.~'Vr... only, OAR 918-500-0105(5): I City: I I!!...v I ;V -e.- I State: C~ 0 ~ I (5) T,chnology Fee, 5% I Phone:'74<1 UlJ-1) ~:J</}d I Fax: - - II ..,~"."";".''''TOTALfeesandsurcharges(3+4+5): $ E-mail: .~' I' 1:;t,E:';::'J,:.QcALJ;,'GQV!O~:N.riligNt,iAjjJU'~Q:i.A~~?:j~);~~,;,;1 I Zoning approval verified: DYes D No ' I I Property is within flood plain: DYes D No I I Sanitation approval verified: DYes D No I ' 1;;;,~b;;:m';;~AtEG9R:{::Q'F;:<;qri~J:~:l:i9,fIQN:;E!~0i<;'i,:::1 IIX'! R~sidential I D Government I D Commercial I 1';;;:~~QB.$,(fE:i&FQ~riIi~f[9~:;t\~6.::~9qJi.fl9.N];~SI ' I Job site address: /5 7 Ai. I d jj, s..--I. I ICity:~f"-"'!JCIe..I.-l. 'ICounty:LILAN_ I I State: 0 I?.. , I ZIP: q 7 If 77 $397.00 $ I I $397,00 $ $30.00 $ This installation is being made on residential or fann property owned by me or a member of my immediate family, and is exempt from licensing requirements under OAR 918-515-0010. .,.".'. . , I i~:qi,:?-'" Signature: ~!My p~,/ ))'JLZ/~ ..;>"..,;>);:,~t'~":c-'~Ov.'{. , I; ". CONTR,l\Ct'OR, INSTALLA'nOr(': . . -, I . ,-,.,.,., ~,v.t \~~~ \~ ~Q't I Busmessname: QUI1-J, ';/ /J1,:,h,/", J.?,mp S",,~,~" ~\S"t>-\.\.~,,'S\'t.~t.~~Qv., I Address: dL?/S?/ J'J7oa.J,.<Lo.I) /J'M' Or ~r\\% 1't.~~t.~ U~\)~~ f>.,~\I.~\)Q " ..,~ I City: j2, -P dJ. I State: CY.e r ZIP:'J 77;.,{ \\\ ,Q\'\ ":t.\) Q~ ,(\~. ~R . J . T- ~t.~v ?t.\,\,v I Phone, .':,--zf/ /'::1 R.:J _:>,..-, Fax. - r,C)~i "\~I.) \l~ () . E-rnali:. \I.~. ~ \d:J ~. '" CCB license no,: > ? 1(,3 I MDllicense no.: I ~' k' . I Print name: I I Signature: "- . . I ....~' . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01824 ISSUED: 12/22/2009 APPLIED: 12/22/2009 EXPIRES: 06/22/2010 VALUE: ~RINGI'Il'tbD,.,- _"";" ,~""",f.-J.""-_""",,~,, _,.ffiE',,_,'n i: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 157 12TH ST SPACE 37 ASSESSOR'S PARCEL NO.: 1703354100201 Springfield. TYPE OF WORK: Manufactured Home in Park PROJECT DESCRIPTION: Manufactured home pIacement.in park TYPE OF USE: New Residential I PU,~LIC IMPROVEMENTS I . .-,,",,,.,,, : . ".,,:,*:ii.1Sid!'.lllt1k ,Type: ..~"-,.",-,..._~~,,~,, ':v,{:r;:"""~~ ~#)s/Drains: .' , "",t" ....~ ~ ,.;" ,,' '~\.\. ~~~ Vt"''''D'lf::)''' }::: ~O\\ct~~~ ~~~~~'" ~~ ~~~f::)~'?" ".,' , liE ~i -rJ' '\. 'f, ~'O ' I~~r,*,~w~e~~~'n I vry'\'i'>l.i . $ ~i;q Ft 'Square Footage o.r multiplier or Bid Amount Owner: Address: BRIAN L FITTERER INC (MSD410) 19772 MACARTHUR BLVD STE 200 IRVINE CA 92612 I ~~NTRACTOR INFORMATION I Contractor Type Manuf Home 1nst License 39913 BUILDING INFORMATION I Contractor GARY M LARSEN # of Units: Primary Occupancy Group: Secondary Occupancy Group: "R-3 Front yard Setback: Side 1 Setback: Side 2 Setback; Rearyard Setback: Solar Setbacks: ' Street Improvements; Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction i . \,;.. ' Expiration Date 04/05/2010 Phone 541.389-8227 II/a Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: . Occupant Load: REQUIRED PARKING Total: Handicapped: Compaci: Value Date Calculated , r,;' .:!,. \~ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0I824 ISSUED: 12/22/2009 APPLIED: 12/22/2009 EXPIRES: 06/22/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project F~es Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Manufactured Home Placernent. Amount Paid Date Paid Receipt Number $47.64 $19,85 ,. $397.00 12/22/09 12/22/09 12/22109 2200900000000001417 2200900000000001417 2200900000000001417 Total Amount Paid $464.49 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. Reouired InsnectionsJ Manuf Home Set Up: When installation of all piers or stands is complete. 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. Manuf Home Plumbing: After home has been connected to water and sewer, MH Electric: When blocking, setup and plumb,ing i~spections have been approved and the home is connected to the panel. By signature, 1 state and agree, that 1 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 thc.Ordinances of the City of Springlield 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 en.sure 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. dte..., O!~ /;2, - ..2.;Z - 09 Owner or Contractors ~nature Date Page 2 of2 City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 541-726~3759 Phone' Job/Journal Number COM2009-0 1824 COM2009-0 1824 COM2009-0 1824 Payments: Type of Payment Check cReceintl RECEIPT #: 2200900000000001417 10:23:34AM Date: 12/22/2009 Description Manufactured Home Placement + 5% Technology Fee + 12% State Surcharge Amoun(Due 397.00 19.85 47,64 $464,49 Paid By SPRING LANE MOBILE VILLAGE Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb In Person $464.49 ]998 Payment Total: $464.49 . ;, 1....1''; , ~, >' Page 1 of I 12/22/2009 :J -.-,.' ;\ 38' >-I I... OfLrEC. -., "- /... . ILl I :P SfWE~ f. . fR';SH WA'Tlrt< '-, ;;-' \ ,,~r , 5t t- I..u \..u 5 d <::c \- If) \ \ ,( \ 1-, /fI. 5' 60' -- ,-- 51f?ffZ7 ." .5 PRlrJGLANE (v/8L.V1'LLAGf 157 /~t+l5/. tf~7 SPR:INGF'I,; to; 6 R q1l77 DRAW:fN G NOT TO SeA L E.