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Home My WebLink AboutPermit Building 2000-1-19 (2) \ - - ,I 225 North Fifth Street Springfield, OR 97477 . . Page 1 of 3 I Job# 99-01629-01 I I CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 99-01629-01 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 5780 FORSYTHIA ST Spr Assessors Map#: 18020411 Lot::1 Block: Addition:Replat Tax Lot #: 00119 Subdivision:Spring Oak Owner: Margaret Burdge 365 52nd Place Springfield, OR 97478 Value: $55,500 Address: Phone Number: 541-746-2377 City/State/Zip: New Scope Of Work: Manufactured Home on Private Lot First unit of two required units on this lot Contractor Type General Contr Electrical Contr Contractor Heirloom Constnuction Inc 1705 Minda Dr, Eugene, OR 97401 Margaret Burdge 365 52nd Place, Springfield, OR 97478 Registration # Expiration Date 104911 03/07/2001 Phone 541-343-5033 541-746-2377 To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be rnade the same working day, inspections requested after 7:00 a.m. will be made the following working day. Verify Ground Rod Foundation Final Building Pedestal Manufactured Home Service Manufactured Home Plumb Water Line Sanitary Sewer Line Stonn Sewer Line Manufactured Home Set Up Manufactured Home Final Required Inspections I Building I -Install ground rod at footing, and call for inspection in conjuction with footing andlor foundation -After forms are erected but prior to concrete placement. - When all required inspections have been approved and the building is complete. Electrical - Prior to cover. I Plumbing I -After home has been connected to water and sewer. - Prior to filling trench. - Prior to filling trench. - Prior to filling trench. I Manufactured Home - When all blocking is complete. -After all required inspections are approved and porches, skirting, decks, venting, house numb . I Job# 99-01629-01 I . Page 2 of 3 Required Inspections I Public Works I -After forms are ereceted but prior to placement of concrete. -After excavation is complete, forms and sub base material is in place. Street Improvement: Curb Cut?O Improvement Agr.?D San Sewer Depth (Ft): Storm Sewer Available? 0 Special Req.: Security Required: Bond Begin DateTime: 00/0010000 00:00 A Special Instructions: Other Utilities: Project Supervisor: Curbcut Sidewalk Sidewalk Type: Additional ROW? D Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: 0010010000 00:00 A Types Of Warning Devices Reqd. Zoning: MDR FloodPlain? D Wetlands? 0 Journal numbers 1:99-06-163 2: 3: Comments:private access easement recorded 1/10/2000 Overlay District: # of Street Trees: Land Use: Single Farnily Dwelling Pave Driveway? ~ Additional Requirements: Glenwood Area? 0 Required Attachments: Source Locn: Material: Planner: AI Ward Urban Growth Boundary70 Quantity Of Fill: Supplier: Drainage: Floodway FEMA: Construction Types Occupancy Groups: # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? D iArea (Sq. r "d) I Main: 1179 Accessory: Fee Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building Manufactured Home Service\Feeder State Surcharge For Electrical Permit Flood Plain FEMA: # Of Stories: 1 Current Units: Census Code:Does not apply Height (feet): 17 Proposed Units:1 Total:1179 Paid On Receipl# Building 01/19/2000 298 0111912000 298 01/19/2000 298 Value/Quantity Fee Amount 5,500 $56.50 $3.96 $1.70 $62.16 Electrical 01/19/2000 298 01/19/2000 298 2 $80.00 $5.60 . Job# 99-01629-01 . Page 3 of 3 Fee Paid On Receipl# ValuelQuantity Fee Amount Electrical Electric Administrative Fee 01/19/2000 298 $2.40 Total Electrical $88.00 Plumbing Minimum Plumbing Permit Fee 01/19/2000 298 $.00 State Surcharge For Plumbing Permit 01/19/2000 298 $7.35 Water Service Footage 01/19/2000 298 50 $25.00 Sanitary Sewer Footage 01/19/2000 298 20 $25.00 Storm Sewer Footage 01119/2000 298 70 $40.00 Manufactured Home Connection 01/19/2000 298 1 $15.00 Plumbing Adrninistrative Fee 01119/2000 298 $3.15 Total Plumbing $115.50 Manufactured Home Manufactured Home Setup Fee 01/19/2000 298 50,000 $105.00 Manufactured Home State Issuance 01/19/2000 298 1 $30.00 State Surcharge For Manufactured Hom 01/19/2000 298 $7.35 Manufactured Home Administrative Fee 01/19/2000 298 $3.15 Total Manufactured Home $145.50 Public Works New Sidewalk 01/19/2000 298 65 $60.00 New Curbcut 01/19/2000 298 , 1 $60.00 Total Public Works $120.00 System Development Manufactured Home - Storm 01/19/2000 298 3,036 $704.35 Sanitary Sewer 01/19/2000 298 20 $965.40 Residential Transportation 01/19/2000 298 1 $491.60 Residential Sanitary MWMC 01/19/2000 298 1 $242.76 Residential Improvement MWMC 01/19/2000 298 1 $22.05 MWMC Administrative Fee 01/19/2000 298 1 $10.00 SDC Administrative Fee 01/19/2000 298 $117.20 Property Annexed 1979 or Before' 01/19/2000 298 21 $-92.23 Total System Development $2,461.13 Willamalane SDC Manufactured Home - Willamalane 01119/2000 298 1 $1,000.00 Total Willamalane SDC $1,000.00 Grand Total $3,992.29 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 of any structure without permission of the Cornrnunity Services Division, Building Safety. I further certify that only contractors and ernployees who are in compliance with ORS 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 readable from the street, that the permit card is located at the front of the propery, and the approved set of plans will remain on the site at all times during construction. Signature Date DUPLICATE RECEIPT DUPLICATE RECEIPT ---------------------------------------- ---------------------------------------- CITY OF SPRINGFIELD 225 FIFTH STREET SPRINGFIELD, DR 97477 ( 541)726-3753 ....... -- --------------------- --------------.--- ---------------------------------------- HAPPY NEW YEAR!!!!! I!! ---------------------------------------- ------------ ----------------------.------ REG-RECEIPT:Dl-0000298 C:JAN 19 2000 CASHIER 10:059 10:35 am A:JAN 19 20gr. ------------------------------------. .~ i074-sDc/wILLAMALANE-----------$1~OOO~UO J08#:99-01629-01 1070 SDC/SToRM~ . JoB#:99-01629-01 lQ71 SDC/SANITARy'SEWERS JoB#:99-01629-o1 1072 SoC/TRANSP JoB#:99-o1629-01 1055 SoC/REGIoNAL SEWER JoB#:99-01629-01 1056 SDC/REGIoNAL SEWER JoB#:99-o1629-o1 1073 SDC/ADMIN JoB#:99-o1629-o1 1002 BUILDING PERMIT JoB#:99-01629-01 1099 STATE SURCHARGE(7X) JoB#:99-D1629-01 1098 ADMIN FEE(3X) JoB#:99-01629-01 1004 ELECTRICAL PERMIT JoB#:99-01629-01 1099 STATE SURCHARGE(7X) JoB#:99-01629-o1 1098 ADMIN FEE(3X) JoB#:99-o1629-01 1017 MOBILE HOME PERMIT JoB#:99-o1629-01 1089 MH ISSUANCE JoB#:99-01629-01 1099 STATE SURrHARGE(7X) JOBn:99-01629-01 109B ADMIN FEE(3X) JDB#:99-01629-01 1005 PLUMBING PERMIT JoB#:99-0J629-01 I 1099 STATE SURCHARGE(7X) JoB#:99-01629-01 109B ADMIN FEE(3X)/ JoB#:99-01629-01 1013 SIDEWALK PERMIT 'Aj- '~~"'--,:"...-. '-$704-;35 $965.....0 ! \.. $491.60 $172.58 $10.00 $117.20 $56.50 $3.95 $1.70 $80.00 $5.60 $2.40 $105.00 $30.00 $7.35 $3.15 $105.00 $7.35 $3.15 I , $60.00 I - - -~-.. ~ ~ 225 North Fifth Street Springfield, OR 97477 . . I Job# 99..(J1629..(J1 I CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 99-01629-01 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 578() Forsythia St Spr Assessors Map#: 18020411 Lot: 2 Block: Addition: Replat Owner: Tax Lot#: 00119 Subdivision: Spring Oak Margaret Burdge 365 52nd Place Phone Number: 541-746-2377 City/State/Zip: Springfield, OR 97478 New Value: $55,500 Address: Scope Of Work: Manufactured Home on Private Lot First unit of two required units on this lot Contractor Type General Contr Electrical Contr Contractor Heirloom Construction Inc 1705 Minda Dr, Eugene, OR 97401 Margaret Burdge 365 52nd Place, Springfield, OR 97478 Registration # 104911 Expiration Date 3/7/2001 Phone 541-343-5033 541-746-2377 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 working day. Verify Ground Rod Foundation Final Building Pedestal Manufactured Home Service Manufactured Home Plumb Water Line Sanitary Sewer Line Storm Sewer Line Manufactured Home Set Up Manufactured Home Final Required Inspections I Building I -Install ground rod at footing, and call for inspection in conjuction with footing andlor foundation i -After forms are erected but prior to concrete placernent. :::~:~::;"d ;"~~:::b~'''~~ ~"' ;~~~06 I P"m"", I ~ J -Prior to filling trench. -Prior to filling trench. - Prior to filling trench. I Manufactured Home - When all blocking is complete. ;;0 t::l ;;,:j I'T1::D::D -After all required inspections are approved and porches, skirting, decks, venting, hO~~ber C":J ~c:........ ::D ::DO ~IJ *2:1-' ::t: I ........C'Jt.N......o fT1::I:...o....oo ;;o::D-.o 0 ..:z:t\)f'\:IO om- ot\J ~r;';'!:il:5cg . I Job# 99-01629-01 I . Page 2 of 3 Curbcut Sidewalk Required Inspections I I'ublic Works I -After forms are ereceted but prior to placement of concrete. -After excavation is complete, forms and sub base material is in place. Street Improvement: Curb Cut?O Improvement Agr.?O San Sewer Depth (Ft): Storm Sewer Available? 0 Special Req.: Security Required: Bond Begin DateTime: 00/0010000 00:00 A Special Instructions: Other Utilities: Project Supervisor: Sidewalk Type: Additional ROW? 0 Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: 00/00/0000 00:00 A Types Of Warning Devices Reqd. Zoning: MDR FloodPlain? 0 Wetlands? D Journal numbers 1: 99-06-163 2: 3: Comments:prjvate access easement recorded 1/10/2000 Overlay District: # of Street Trees: Land Use: Single Family Dwelling Pave Driveway? 0 Planner: AI Ward Urban Growth Boundary?O Quantity Of Fill: Supplier: Drainage: Floodway FEMA: Additional Requirements: Glenwood Area? 0 Required Attachments: Source Locn: Material: Flood Plain FEMA: Construction Types: Occupancy Groups: # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? 0 rArea (Sq. Feet) Main: 1179 Accessory: # Of Stories: 1 Current Units: Census Code: Does not apply Height (feet): 17 Proposed Units:1 Total:1179 Fee Paid On Receipl# Building 01/18/2000 273 01/18/2000 273 01/18/2000 273 ValuelQuantity Fee Amount Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 5,500 $56.50 $3.96 $1.70 $62.16 Manufactured Home ServicelFeeder State Surcharge For Electrical Permit Electrical 01118/2000 273 01/18/2000 273 2 $80.00 $5.60 . ' , . . Job# 99-01629-01 I Paid On Receipl# Electrical 01/18/2000 273 . Fee Page 3 of 3 ValuelQuantity Fee Amount Electric Administrative Fee Total Electrical Minimum Plumbing Permit Fee State Surcharge For Plumbing Permit Water Service Footage Sanitary Sewer Footage Storm Sewer Footage Manufactured Home Connection Plumbing Administrative Fee Total Plumbing Plumbing 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 50 20 70 1 Manufactured Home Setup Fee Manufactured Home State Issuance State Surcharge For Manufactured Hom Manufactured Home Administrative Fee Total Manufactured Home Manufactured Home 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 50,000 1 New Sidewalk New Curbcut Total Public Works Public Works 01/18/2000 273 01/18/2000 273 65 1 Manufactured Home - Storm Sanitary Sewer Residential Transportation Residential Sanitary MWMC Residential Improvement MWMC MWMC Administrative Fee SDC Administrative Fee Property Annexed 1979 or Before Total System Development System Development 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 01/18/2000 273 21 3,036 20 1 1 1 1 Willamalane SDC 01/18/2000 273 Manufactured Home - Willamalane Total Willamalane SDC Grand Total 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 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 701.055 will be used on this project. 1 $2.40 $88.00 $.00 $7.35 $25.00 $25.00 . $40.00 $15.00 $3.15 $115.50 $105.00 $30.00 $7.35 $3.15 $145.50 $60.00 $60.00 $120.00 $704.35 $965.40 $491.60 $242.76 $22.05 $10.00 $117.20 $-92.23 $2,461.13 $1,000.00 $1,000.00 $3,992.29 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 perrnit card is located at the front of the propery, and the APpr d set of plans wi~ r~ain on the site at all times during construction. . r__ CO J ;t:,tw. / (- (K-(/.L Slg a u e ' Date