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Home My WebLink AboutPermit Building 1997-8-15 " SPRINGFIELD ~I'~ Page 1 RESIDENTIAL PERMIT APPLICATION CITY OF SPRINGFIELD COMMUNITY SERVICES DIVISION BUILDING SAFETY Job Number: 971190 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location of Proposed Work: 4520 DAISY ST Assessors Map #: 17023243 Lot: Block: Tax Lot #: 04300 Subdivision: Owner: JASON BOLKAN Address: 4523 CAMELLIA STREET Phone #: 747-6771 City/State/Zip: SPRINGFIELD, OREGON 97478 Describe Work: FND FOR MOVED RES NEW Contractor Const. Contractor # Expires Phone General: 0047559 07/03/99 345-6305 MARQUARDT PO BOX 11764, EUGENE, ~ ~t \t\\O~ -- OFFICE USE -- ~~\f\~' - ~O\ ,,~ U~Ft..\\.~t ~~~\S ~O'\\\~~~&~~~-W~l(€ ~Q fO~ \~\S ~~ \i~Q \J~Q t:-.~t:-.~QO~ .~~O~\ - of(< \'0 To request an inspection, ct~\'b~~~C~ n~~.ecording at 726-3769. cO 01'-" l( All inspections requested be~~~~:oo a.m, will be made the same inspections requested after 7:00 a,m, will be made the following # OF BLDGS: 1 OCCY GROUP: R3 QUAD AREA: 3RSC # OF UNITS: 1 CONSTR. TYPE: VN working day, work day, REQUIRED INSPECTIONS --- FOOTING - After trenches are excavated. FOUNDATION - After forms are erected but prior to concrete placement. WATER LINE - Prior to filling trench. SANITARY SEWER LINE - Prior to filling trench, STORM SEWER LINE - Prior to filling trench. FINAL BUILDING - When all required inspections have been approved and the building is complete. Lot Faces: S Solar Approved: Y Total Height: 19 Lot Type: INTERIOR Setbacks S W E 20 8 33 Setbk From NPL: 49 N House 31 Item Main Total Value BUILDING PERMIT Square Feet x $/Square Feet Value 8,000.00 8,000,00 Building Permit Fee Surcharge/Admin 68.50 5.49 TOTAL FEE (A) 73.99 PLUMBING PERMIT Item Sanitary Sewer Water Storm Sewer 20 20 20 Fee 25.00 25,00 25,00 Plumbing Permit 75.00 l' Job Number: 971190 (Excluding Electrical) unless otherwise noted TOTAL AMOUNT DUE (A, B, C, D, and E combined) Page 2 6,00 (C) 81. 00 0.00 11.80 12,70 44,53 56.95 (E) 125.98 280.97 Surcharge/Admin TOTAL CHARGE MISCELLANEOUS PERMITS --- 'Surcharge/Admin Sidewalk Curb 'Cut PLAN REVIEW FEE SYSTEM DEVEL CHG TOTAL MISCELLANEOUS PERMITS 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 of Springfield, including the Development Code, regulating the construction and us.e of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Received By: Plans Reviewed By: DON MOORE Date: 08/14/97 Building Site Reviewed By: LISA HOPPER --- ADDITIONAL COMMENTS HOUSE MOVED FROM 6895 MAIN STREET, #970944 3 STREET' TREES REQUIRED By signature, I state and agree, that I have carefully examin~d 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. 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 rema~:e~~ times during construction. Signature - '/ () -- Date ..JUU j~U. C(7 / I '10 , ' ,ATIACHMENT A CITY OF SPRI NGFI ELD .SYSTEM~ DEVELL. lENT CHARGE WORKSHEET NAME OR COMPANY: J:<ON RDLKAAI LOCATION: ,45Zo DA/"SY' GT DEVELOPMENT TYPE~ , P.ELOCA ,go 'i2C510t':/'VcS- BUILDING SIZE~ LOT SIZE SO.' FE. 1, STORM DRAINAGE , (7) (l.NG....."" ~ "IV!.. '1' ) IMPERVious SQ. FT. 2.. 4-0 x $0.226 PER SO. FT. $ 54. z+ 2. SANITARY SEWER-CITY 11lA1V'SF6a.~O wlr~ J40..-s'-c, NO. OF PFU'S (See Reverse Side) X $46.86 PER PFU $ .0 3. " TRANSPORTATION TI2."'N~F~t) IJI Tit' J-Ie>IJSCT 'NO OF UNITS X TRIP RATE X COST PER TRIP x. X $472,49 $ '-e- , x X $472,49 $ x X $472.49 $ , , 4. SANITARY SEWER-M~JMC T'lA-N~FfS/1-t!.,:) ~I'T'# J.JOlJSlS NO. OF FEU'S , X PER FEU + $10 MWMC/ADM FEE $ -e- MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ TOTAL-MWMC SDC $ SUBTOTAL (ADD, ITEMS 1.2.3 & 4) $ S1-. 2..4 5, ADMINISTRATIVE FEES ., , BASE CHARGE (SUBTOTAL ABOVE) X .05 $ 2.7/ L9t Date: 8-7-Cf7 , SDC Coordi nator TOTAL SDC$ ,5-~. 95 (NOTE: For remodels, calculate (' , . ..,'\.. v. ,,_ vnu. \J_L\JU L_ . .Un.1 I r-\ULL... l\lumoer or l\lew r',,, ,";~,~s ^ Unit l:quivalent == Fixture.Units FIXTURE TYPE the NET additional fixturesl NUMBER OF , ... NEW FIXTURES Bathtu b.. .. ...... . .. . . . .. .. . .. . . . . . . . . . . . . . . . . . . . .. .. .. . . .. .. . . .. .. . . .. . . .. .. Drinking. Fountain...................,.............................,... Floor Drain.... ........ ....................... ...... ............... ......... Interceptors For Grease/Oil/SofidsiEtc... .............. Interceptors For Sand/Auto Wc:shiEtc.................. laundry Tub/Clotheswasher................................... Clotheswasher - 3 Or More.........................'............ Mobile Home Park Trap (1 Per Trailer).................. 'Receptor For Refrigerator/Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. -Shower, Single Stall................................... ..... ......... Shower, Gang................................ ........ .................. Sink: Bar, CommerCial, Residential Kitchen........................ Urinal, Stall/Wall.:..................................:.................. Wash BasiniLavatory, Single.......... ....................:... Toilet. Public Installation..................;.. ................... Toilet, Private.... ....................................... ............ Miscellaneous: TOTAL FIXTURE UNITS UNIT EaUIV ALENT 2 ... 1 2 3 6 2 6 6 1 3 2 i /Head 2 2 1 6 4 = FIXTURE UNITS CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. , Year Annexed Rate per $1,000 Assessed Value Year Annexed 1979 or before 1980 1981 1982 1983' 1984 1985 1986 $3.97 3.89 3.83 3.70 3;55 3.39 3.20 2.91 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 Credit for Parcel or Land Only If Applicable X $ (Rate X Assessed Value) X $ , (Rate X Assessed Value) Improvement (if after annexation date) = = CREDIT TOTAL = $ RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) , Residen tia!..,;....................... 0.4 Commerical............... .......... 0.9 Industrial............................ 05 Governmental...................... 0,5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT Rate per $1,000 Assessed Value $2.56 2.17 ".73 1.31 0.92 0.74 0.61 0.45 0.31 0.17 :! R:'i':;LD ~"!;Jrf/A't1J/~II". .){f::i1f~;Jj'4 ~~ .' 'I ' Job Number: 971190 --- VALIDATION Receipt Numbe" ~~D~_, Date Paid: p;.\~ ~ Amount Receivedt vA '&Dq-. Received BY'~~~_) Page 3