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HomeMy WebLinkAboutPermit Plumbing 2013-5-30 • SPRINGFIELD 225 Fifth St `' CITY OF SPRINGFIELD Springfield,OR 97477 i Phone: 541-726-3753 , OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01024 www.springfield-or.gov permitcenter@springfield-ar.gov PROJECT STATUS: Issued ISSUED: 05/30/2013 EXPIRES: 11/25/2013 STATUS DATE: 05/30/2013 . APPLIED: 05/22/2013 SITE ADDRESS: 827 S 57TH ST,Springfield,OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1802041400100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Residential hook up to city sewer/septic abandonment OWNER: HORTON DONALD M&LAUREN E Phone Number: 541-517-3059 ADDRESS: 775 S 57TH ST SPRINGFIELD OR 97478 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED II Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 7170 Septic Tank Abandonment 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 or 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. —� I Owner or Contractor Contractor Signature Date • follow rules adopted by the requires regon Utility • NOTICE: Notification Center. Those rules are setforth In OAR 952 001 0010 through OAR 952-001' THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the teleph 3 OMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification Center is 1-800.332-2344). NY 180 DAY PERIOD. Springfield Building Permit - 5/30/2013 8:37:33AM Page 1 of 1 . • • • SPRINGFIELD APPLICATION TO PAY SYSTEM DEVELOPMENT CHARGES(SDC) IN INSTALLMENTS AND CONSENT TO ASSESS LIEN The owners of the property shown below hereby apply to the City of Springfield to pay the system development charges of • $ ,due on • ,in twenty(20)semi-annual installments,plus interest and late fees if applicable. The owners hereby apply for and consent to the voluntary imposition of a lien for the full amount of the system development charges,plus a one-time administrative fee of$50,plus interest accrued upon the following described land in the City of Springfield,Lane County,Oregon: • MAP AND TAX LOT ^I(8 Z o { -\ -001 0° SITE ADDRESS 80,7 Se S7 tti stre BILLING NAME .y�o/n�-� r'- - R–co tt\ BILLING ADDRESS tT BC) So u-'c\ 5-1 Tt-F Skre tt CITY Sfrn v13-&e�c� STATE Ore 6r ' ZIP °\–PA�T SDC CHARGE $ 563. ADMINISTRATIVE FEE 50.00 • In TOTAL PRINCIPAL $ 3/ C 13. if INTEREST RATE • !o We are all of the legal owners of the described land or all of the contract purchasers of record of the described land to which these system development charges are applicable. We waive any and all irregularities or defects,jurisdictional,or otherwise, in any proceedings to impose,calculate and collect these system development charges,and in the imposition and collection of the lien consented to in this application. We promise to pay these system development charges,plus a one-time administrative fee of$50,in twenty(20)equal semi-annual installments commencing on . In addition to each of those principal installments,we promise to pay interest on the unpaid principal balance accrued to the date of payment at the designated interest rate. The interest rate at the time of signing the contract shall be calculated at the rate of the previous month's average interest earned on the City of Springfield's investments,plus 2.0%. If, at some future time,the City finances the balance of the receivable by selling bonds,then the interest rate will change to the rate paid on that bond,plus 1.5%.If the principal and interest billed semi-annually has not been paid in full by the subsequent billing,then a 10%late fee based on the delinquent installment amount will be imposed. The charges may be paid in full at any time without penalty. We understand that if there is a subsequent failure to pay any installment,plus interest and late • fees,the City shall have the right to enforce payment of the amount due in any manner provided by the general law of the State of Oregon or by the Springfield Municipal Code. In the event of any proceeding to enforce collection or to foreclose, the entire unpaid balance,accrued interest,and any fees shall be considered delinquent and due. We also agree to pay the city's cost of collection or foreclosure and any attorney fees necessary for such collection or foreclosure • e.- 0 In, Wt. *V—tUtk1> y`—�'�— m ' { k c72,1 13 Ccli05'73059 Print Name of Owner Signature of Owner Li ate Phone# - Print Name of Owner Signature of Owner Date Phone# Print Name of Owner Signature of Owner Date Phone# Print Name of Owner Signature of Owner Date Phone# W�f'R�P OFFICIAL SEAL ' KATHRYN E REEDER STATE OF OREGON ) • NOTARY PUBLIC-OREGON ss. COMMISSION NO. 443126 County of Lane ) MY COMMISSION EXPIRES OCT 4,2013 The foregoing instrument w ex uted before me this 2 ron day of ti�GA 1 A , 2O\ co • issioI - , `D l-'e .4t Notary 'ub Orego - v:\common\accnting\assessmt\SDCcontract.doc • • CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: SPR2013-01024 NAME OR COMPANY: Don Horton LOCATION: 827 S.57th m at TAX LOT NUMBER: 1802041400100 0 DEVELOPMENT TYPE: II Single Family Residence U , u NEW DWELLING UNITS 1 UBUILDING SIZE(SF): u b U LOT SIZE(SF)L 0 F I.STORM DRAINAGE o • DIRECT RUNOFF TO CITY STORM SYSTEM z A.REIMBURSEMENT COST AREA DRAINING TO IMPERVIOUS S.F. x COST PER S.F. DRYWELL CHARGE 0.00 50.244 = 0 $0.00 I $0.00 B.IMPROVEMENT COST IMPERVIOUS S.F. x COST PER S.F. CHARGE 0.00 $0355 = 0 $0.00 ( $0.00 1070 ITEM I TOTAL-STORM DRAINAGE SDC $0.00 2.SANITARY SEWER-CITY A.REIMBURSEMENT COST: NUMBER OF DFU4 x COST PER DFU 18 $138.93 = I 51,25038 1091 B.IMPROVEMENT COST: NUMBER OF DFU's x COST PER DFU 18 $67.81 = I $610.27 1092 ITEM 2 TOTAL-CITY SANITARY SEWER SDC = $1,860.65 3.TRANSPORTATION A.REIMBURSEMENT COST: ADT TRIP RATE x NUMBER OF UNITS x COST PER TRIP x NEW TRIP FACTOR 9.57 1 54.78 1.00 = ( $0.00 1093 B.IMPROVEMENT COST: ADT TRIP RATE x NUMBER OF UNITS x COST PER TRIP x NEW TRIP FACTOR 9.57 1 $199.65 1.00 = I $0.00 1094 ITEM 3 TOTAL-TRANSPORTATION SDC = $0.00 4.SANITARY SEWER-MWMC A REIMBURSEMENT COST: . NUMBER OF FEUs x COST PER FEU 1 $108.14 = $108.14 1054 B.IMPROVEMENT COST: NUMBER OF FEUs x COST PER FEU 1 $1392.04 = I $1.392.04 1055 C.COMPLIANCE COST: NUMBER OF FEIPs x COST PER FEU . 1 $22.61 = $22.61 MWMC CREDIT IF APPLICABLE(SEE REVERSE) = 50.00 1054 MWMC ADMINISTRATIVE FEE = $10.00 1056 ITEM 4 TOTAL-MWMC SANITARY SEWER SDC = 51,532.79 SUBTOTAL(ADD ITEMS 1,2,3,&4) = $3,393.44 J 5.ADMINISTRATIVE FEE: SUBTOTAL x ADM.FEE RATE = CHARGE $3,393.44 5% $169.67 TOTAL STORM ADMINISTRATION FEE $0.00 TOTAL MWMC ADMINISTRATION FEE-LOCAL $76.64 TOTAL SEWER ADMINISTRATION FEE: d ( 93.03 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE: I $0.00 1078 Kaye Wilson 522/20/3 TOTAL SDC CHARGES = I $3,563.11 PREPARED BY DATE Plumbing Permit Application DEPARTMENT USE ONLY `.;f SPRINGFIELD aT�Ts - _. '` r* Vglk.% `. " :, . t t - Permit no.: 373 -010Z11 CIT OF SPRINGE EL-DZOREGON , , br L , e F y_ . _ 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: //3 This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. LOCAL':GOVERNMENT AP,PROVAL,t f l'a"h WA P F'`,',`aclti Ag;I:. .'1: , FEE','SCHEDULE , 7 Zoning approval verified. Ill ❑No ':' xr ~nt ` " T a * ` Cost :'Descrl tlon%<- 1+ - Qty ,> 4 ,;m.- db. R 61,4.r149n41111: (li i:. 4- 3:ea •,acog 15 Sanitation approval verified? ❑ Yes ❑No New residential ;CATEGORY, OF`CONSTRUCTION it`^ ' ';:= I bathroom/1 kitchen(includes:first 100 feet of water/sewer lines,hose %Residential ❑Government ❑Commercial bibs, ice maker, underfloor low-point $262.00 $ JOB;SITE•;INFORMATION,AND LOCATION; ,,!• ,w,;`„ drains and rain-drain packages) Job site address: 8'�92-1 , -6-7 .04 - 1 2 bathrooms/1 kitchen $411.00 $ City: I„ a State: oil ZIP:97'i 1P 3 bathrooms/] kitchen $483.00 $ Each additional bathroom(over 3 ((// ( 3) $104.50 $ Reference: 0 Z OCe(y Taxlot.: OO f 00 Each additional kitchen I over ( ) $104.50 $ a ±` .1^x,11'. +;:DESCRIPTION' OF WORKka + srr`4a '. , Residential fire sprinklers(includes plan review) 1IL u^ .-r C f C,t,7e 0 to 2,000 square feet $80.00 $ up _1 2,001 to 3,600 square feet $128.00 $ r 3, a a§=, iri, ' PROPERTY4 OWNER I "Y 3,601 to 7,200 square feet $192.00 $ �,� T^l�� 7,201 square feet and greater $255.00 $ Name: ,, A-. on - I or-. _ _ . Manufactured dwelling or pre-fab(circle one) Address: 'MO S., 45 7 ftf 51 Connections to building sewer and $80.00 $ water supply City: ;- ;.-t••ry State: 0,2_ ZIP:e"]t.17�j Commercial,industrial,and dwellings other than one-or Phone 5 f 6-11 13o 59 Fax: - - two-family E-mail: Minimum fee $80.00 $ r�o', W% rtn el G w.r}=,l w� This installation is being made on residential or farm property Each fixture $21.00 $ owned by me or a member of my immediate family, and is Miscellaneou es a exempt from licensing requirements un er OAR 918-695-0020. 100' storm sew ,water line / $83.50 $ 83 Signature:- �Yt-� ✓11 :— .— Each fixture,appurtenance,and piping. $21.00 $ w,% ,, ,.%CONTRACTOW1NSTALL"ATION �'" . , 'r. Storm water retention/detention facility ty $21.00 $ Business name: v' tA//I/� Irrigation systems $21.00 $ Piping or private storm drainage $21,00 $ Address: systems exceeding the first 100 feet City: State: ZIP; Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone: - - Fax: - - Special requested inspections(no.of E-mail: hrs.x fee per hr.) n� $80.00 $ CCB license no.: BCD license no.: Each additional inspection ) P" / $80.00 $ KO Plumbing license no 132ed¢sl gas plpmgdtdk' `c ift( „a ) Minimum fee $ Print name: n Enter value of installation and equipment$ , Enter fee based on installation and equipment value. $ Signature: — a � AWA1P LICANTaUSEr ' Pi nta I (A) Enter subtotal of above fees $ /b//J p 2,--1.31 i (Minimum Permit Fee$80.00) 1 b5 (B)Investigative fee(equal to[A]) $ 2' (C)Enter 12%surcharge(.12 x[A+B]) $ ?XL- 3 vv�tc,r w (D)Technology Fee(5%of[A]) $ 8 WV,1,t 'S TOTAL fees and surcharges(A through D): $ ' 9/ a o 440-2500-1(4/1/2013/COM) g L -4-ir\. ( I L' LL- i; L [�St?A tv.9 _ L.-,...\--' IFI6 to( .7 SPRINGFIELD CITY OF SPRINGFIELD -6s .,�„O t ORE TRANSACTION RECEIPT Springf 225 Fifth StR97477 541-726-3753 811-S PR2013-01024 www.springfield-ocgov 827 S 57TH ST permitcenter©springfield-ocgov • RECEIPT NO: 2013001059 RECORD NO:811-SPR2013-01024 DATE:05/30/2013 (DESCRIPTION______ ___i__,.:.y _ ._ _- .,_ __:.. T ACCOUNT CODE/TRANS CODE__T, AMOUNT DUE in lieu of Assessment 409-00000-448051 1153 7,502.72 Sanitary sewer 224-00000-425603 1005 83.50 Sewer cap/septic tank demolition 224-00000-425603 1005 80.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 19.62 Technology fee(5%of permit total) 100-00000-425605 2099 8.18 TOTAL DUE: 7,694.02 L;PAYMENT TYPE PAYOR: -CASHIER KWILSON` COMMENTS AMOUNT PAID J Check DMH Enterprises Plumbing &Sewer in Lieu for 7,694.02 1055 sewer connection TOTAL PAID: 7,694.02 — S 2_7 5, s7 Sf- I25°•5u 410. 27 DLI I I DO (OY. I t /?i 4n c •O# d 02 1 l 3 9 z. 01-. O 0 .lob AC- . 4 i 0 x , 603.35F toaco h ° 144, x &- 32¢ i g 3.C° 'C___---ZZ(o la.S SF f4t1 r#- -AA1 414,05.is : • w ,c) ° 7411; o_ i - t %„ Of L9 • G 2, • • • SPRINGFIELD CITY OF SPRINGFIELD :1- 225 Fifth St TRANSACTION RECEIPT Springfield,OR97417 ',OREGON TRANSACTION 811-S PR2013-01024 www.springfield-or.gov 827 S 57TH ST permitcenter©springfield-or.gov RECEIPT NO: 2013001065 RECORD NO:811-SPR2013-01024 DATE:05/30/2013 ,DESCRIPTION , 11. - - - ACCOUNT_CODEITRANS CODE. - , AMOUNT.D.UE_ SDC:Administrative Fee-MWMC Regional Wastewater SDC 611-00000-426604 1189 10.00 SDC: Compliance Cost-MWMC Regional Wastewater SDC 444-00000-426607 1113 22.61 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 610.27 SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 1,392.04 SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 1,250.38 SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 108.14 SDC:Total MWMC Administration Fee-Local 719-00000-426604 1121 76.64 SDC:Total Sewer Administration Fee 719-00000-426604 1175 93.03 --- -�-v-� �- T---�-- — TOTAL DUE: 3,563.11 L_PAYMENT�TYPE �;,rPAYOR_ °cnSwER:RwILSON " ,;:;� COMMENTS ' • AMOUNT PAID Internal Transfer DMH Enterprises Emergency Sewer connection 3,563.11 SDC's Deferred TOTAL PAID: 3,563.11 •