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Job# 00-00357-01
Page 1 of 4
TRANS#:01-0001056
DATE:NAR.272000
AHT RECD:2 $ 20299.41
CHANGE:
CASHIER: 059
SPRINGFIELD
-w.:~
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00357-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3963 Cherokee Dr Spr
Assessors Map#: 18020613
Lot: 54 Block: Addition:
Tax Lot #: 01900
Subdivision:Jasper Park
Owner:
Address:
Hayden Enterprises Inc
806 Hazelnut Lane
Phone Number: 541-744-6966
City/State/Zip: Springfield, OR 97478
New Value: $77,533
Scope Of Work: Single Family Residence
Contractor Type Contractor Registration # Expiration Date . Phone
General Contr Hayden Enterprises Inc 92208 7/29/1999 541-744-6966
806 Hazelnut Lane, Springfield, OR
97478
Electrical Contr Philips Electric Inc 54438 9/19/1999 541-688-6121
1298 Bethel Dr, Eugene, OR 97402-2003
Mechanical Contr
Efficient Heat & Air
Quad Area:
# Of Units:
Constr, Type:
Water Heater:
3RSC
1
(VN) Wood Frame
Electric
NOTICE:
BMC Plumbing 1 0357bH/S PERMiIT'8~1)l1l EXP/ 541-895-3758
648 W Oregon Ave, Creswell, OR 97426 . AUTHORIZEDUND RE IF THE WORk
('1-., ,. ,,_. ER TI-iIQ Or-"" v-
, . ..n;{"'''LoI:U OR IS -. """ 'i:) IVUT
Office Use ,{Ny 180 DA ABANDONED FOR
Land Use: Single Family Dwelling YPi~PB>uildings: 1
Zoning Code: LDR Occupancy, Group: Dwelling
Bedrooms: 3 Heat Source: Wall Heat
Range: Electric Sq. Footage: 1008
x, x, X
Plumbing Contr
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..requeste~ ~W>olt:,OO.;a,m,lWill(l'J'eli\1~de the following
working day. r\llt:.I\iIlV1, t dbytheoregonUtllllY,
follow rules adop eTh e rules are set fort, ,
R~AAiiietl1ia!;~\'iI~ t~~ougnu,,;:'Y';': '2':"
. I Inu 2~01', copies ofthe rules by
Verify Ground Rod -Install ground rod at fo '\i!\~(h~ l!minstIMc:tIeht\Wd8h7~~!lr~With fooling and/or foundation i
Footing -After trenches are excavS Jiq;erforthe Oregon Utility !'lO~I Ie "'
Foundation. -After forms are erected'il~\'/:li'lot'g,.f,8n~et€"'Placement14.. .
Post and Beam -Prior to fioor insulation or decking.
Floor Insulation -Prior to decking.
Ceiling Insulation - Prior to coveL
Shear Wall Nailing - Before covering sheathing with finish materials.
Framing - Prior to cover.
,
"
-it'
Wall Insulation
Drywall
Final Building
Temporary Power
Rough Electrical.
Electrical Service
Final Electrical
Underfloor Plumbing
Underfloor Drain
Rough Plumbing
Water Line
Sanitary Sewer Line
Storm Sewer Line
Final Plumbing
Underfloor Mechanical
Rough Mechanical
Final Mechanical
Curbcut
Sidewalk
1 Job# 00-00357-01 1
Required Inspections
Building
Page 2 of 4
- Prior to Cover
- Prior to taping.
-When all required inspections have been approved and the building is complete.
1 Electrical 1
-Approval required prior to SUB energizing pole.
-Prior to cover.
-Must be approved to obtain permanent power.
. -When all electrical work is complete.
I Plumbinq
- Prior to insulation or decking.
. - Prior to cover or placement of concrete.
- Prior to coveL
- Prior to filling trench.
- Prior to filling trench..
- Prior to filling trench.
-When all plumbing work is complete.
1 Mechanical -I
- Prior to insulation or decking.
- Prior to cover.
- When all mechanical work is complete.
I Public Works I
-After forms are ereceted but prior to placement of concrete.
Sidewalk Type: Curbside - 5'
Additional ROW? D'
Size Of Line (in): 8
Downspouts/Drains: To Curb and Gutter
Enchroachment Permit:
Street Improvement: Fully Improved.
Curb Cut?0 Improvement Agr,?D
San Sewer Depth (Ft): 6 4
Storm Sewer Available? 0
Special Req,: .
Security Required:
Bond Begin DateTime: 00/00/000000:00 AM
Special Instructions:
Other Utilities:
Project Supervisor:
San Sewer Tee (in):
Bond End DateTime:
6
00100/0000 00:00 AM
Types Of Warning Devices Reqd,
,
(
'.-
Zoning: LDR
FloodPlain? D Wetlands? D
Journal numbers
1: 2: 3:
Comments2 paved 9x18 off-street parking spaces arefequired
I Job# 00-00357-01 1
Overlay District:
# of Street Trees: 2
Page 3 of4
Land Use: Single Family Dwelling
Pave Driveway? 0
Planner: AI Ward
Urban Growth Boundary?D
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA: n/a
Additional Requirements:
Glenwo.od Area? D Required Attachments:
Source Locn:
Material:
Flood Plain FEMA: n/a
Construction Types:(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings: 1
# Of Bedrooms: 3
Handicap Access? D
,Area (Sq, r ..1)
I Main: 1008 AccessoryflOO
Accessory Structure
# Of Stories: 1 Height (feet): 17
Current Units: Proposed Units:1
Census Code: New SF - detached
Total:1408
. Fee
Paid On Receipt#
Plan Check
03107/2000 856
Value/Quantity
Fee Amount
Hourly Plan Review
Total Plan Check
2
$80.00
$80.00
. I
Building
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
77,533
$367.00
$25.69
$11.01
$403,70
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
1
Electrical
03/27/2000 1056
03/27/2000 1056
03/27/2000 ( 1056
03/27/2000 1056
03/27/2000 1056
1
1
1
$85.00
$15.00
$40.00
$9.80
$4.20
$154,00
Wiring Footage 1,000 Sq ft or Less
Wiring Footage Each Add'l 500 Sq Ft
Temporary: 200 Amps or Less
State Surcharge For Electrical Permit
Electric Administrative Fee
Total Electrical
Minimum Plumbing Permit Fee
Two Bathrooms'
State Surcharge For Plumbing Permit
Plumbing Administrative fee
Total Plumbing
Plumbing
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
$.00
$160.00
$11.20
$4.80
$176,00
Hood and Exhaust
Minimum Mechanical Permit
Mechanical Administrative Fee
Vent Fan to One Duct
Dryer Vent
Mechanical Issuance
Mechanical
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
1
$4.50
$1.50
$.45
$6.00
$300
$10.00
2
1
,
, .,-
..'
Job# 00-00357-01
Page 4 of 4
Fee
Paid On Receipt#
Mechanical
03/27/2000 1056
Value/Quantity
State Surcharge For Mechanical Permit
Total Mechanical
New Sidewalk
New Curbcut
Total Public Works
Public Works '
03/27/2000 1056
03/27/2000 1056
50
1
Residential- Single Family - 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
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056
03/27/2000 1056.
15
2,264
18
1
1
1
1
SF Residence - Willamalane .
Total Willamalane SDC
Grand Total
Willamalane SDC
03/27/2000 1056
1
Plan Check Type
Initial Review-Res
Engineering-Res
PlanningcRes
Structural-Res
Checked By
Lisa Hopper
Steve Templin
AlWard
Wendy Stanley
Date Completed
03/08/2000
03/14/2000
03/15/2000
03/16/2000
Fee Amount
$105
$26,50
$60.00
$60.00
$120.00
$52525
$868.86
$491.60
$242.76
$22.05
$10.00
$104.67
$-67.05
$2,198,14
$1,000.00
$1,000,00
$4,158,34
'.' By signature, I stil,te and agree, that I have carefully examined the completed application and do
hereby certify that all information hereon is true and correct, and' 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 rea,dable from the street, that the permit card is located at the front of the property, a3lz, d, t : )
approvprl opl of plans will remain on the site at all times during construction.. .
~.~ . _ 1l?O
, ...... . I
Signature . . Date
S. .""'GFIELD
. .
zo~;n~, oa~~gd~~o~e~~~s su~mjtted h.B.s the following
approval. reqUIre specIfic land Use
Zoning LDrZ
1~;)7~OD
1)W
Date
225 FIFTH STREET Authorized Signal
SPRINGFIELD, OREGON 97477 Uffi
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
L01- 1154-, 3Cf '=:,3 (1.hr"rnb:-:f" nrivc:.
LEGAL DESCRIPTION
\~0).-6(q\ "> DIe; oD
JOB ,DESCRIPTION
r.tol') hOMe.
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if 'work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Elec trical Con trac torFl'/l'h~'l.s Ape for Inc.
I - "/ .
Address /c29R .J3deJ l\r;ve
CitYCUrrr",flP . Phone bf'?-tJ:21
Supervisor License Number ,:( 1/9:s
Expiration Date /O/O//LJ/
Constr Contr. Number ~()-J79c..
Expiration Date ./%/IoD
Signature of Supervising Electrician .
C, _~.
. ~ 1 I
Owners NameJ.Jn.vdef\ l--loMe S
I .
Addressf1Dt. f.lcrzjC".J~tff. COYle
Ci ty ':s{)riMj-P,'p/J Phone 7</<1-.-09(;,4
I U
OIINER. INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Owners Signature:
DATE:
RECEI'PT I:
RECEIVED BY:
~~d-l-00
\~
aill3
ELECTRICAL PERMIT APPLICATION
City Job Number oO-cn357-0J
3.
,
COMPLETE FEE SCHEDULE BELOY
A. New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
1000 sQ.ft. or less I
Each additional 500
sq. ft or portion
thereof I
Each Manuf'd Bome, or
Modular.Dwelling
Service or Feeder
.B.
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less ~
201 amps to 400 amps
401 amps to 600 amps
601 amps to. 1000 amps
Over 1000 amps/volts
Reconnect Only
unit.
Cost Sum
. tX)
$ 85.00 J'S
$ 15.00 .l2.:.- ~
.$ 40.00
$ 50.00 -;;;:-:- ."~ '-
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
/ $ 40.00 ~o
.$ 55.00
$ 80.00
volts see "B" above
D.
Branch Circuits
"
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
5. SUBTOTAL OF ABOVE
7% State Surcharge
37. Administrative Fee
TOTAL
$ 35.00
$ 2.00
no t included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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/0 FT. 7 FT.
I P.U.E. S 000 00' 45" E. ! P.U.E. 7/3.27 (5)*
. ~ - ? ~
96.94 - 25.13 f 25./3 r ,... - ---25.02 --r - ,- - ---20J
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1m R/{W lKiI ~ ~
6578 SO FT 7209 SO FT ~ 6618 SO
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96,91 I C\J I 101.99
I .25.00_ 25,00
Q 0 II ~
697~ FT I~, '~llJ ~I @ ~ ~
I ~ I: I "I 7690 so FT . :
I 1,> ~ I;', I N 00012'06" E
I Cl ': :"'1 108.95
I 1 '-- 7 FT. P.UE.
~ col & SIDEWAL'K" Q
I~ ~I' EASEMENT ~
69/7 SO FT /'" .
. I II 8217 so FT
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96.9/
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96.98
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103.77
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6570
NOoo/2
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1-- 0
7894 SO FT '! ~
. m 6574 i
~ N 370/5'2T E co
~. 23.76 00
-1 84.56~ t - -~- - 70.00
8480 SO FT
N 000/2'06" E
1/4.40
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ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER 00-00357-01
NAME OR COMPANY: HAYDEN ENT
LOCATION: 3963 CHEROKEE DRIVE
TAX LOT NUMBER 18-02-06-13-01900
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
DWELLING UNITS:
BUILDING SIZE:
1408
LOT SIZE:
7690
1. STORM DRAINAGE
IMPERVIOUS SQ. FT
2264.00
x
$0.232 PER SQ. FT.
$525.25 1
2. SANITARY SEWER-CITY
NUMBER OF PFU's
(SEE REVERSE SIDE)
18
x
$48.27 PER PFU
$868.86 I
3. TRANSPORTATION
NUMBER OF TRIPS x TRIP RATE x COST PER PM PEAK HOUR TRIP
TOTAL TRANSPORTATION SDC
$491.60 I
$0.00
$491.60 I
x
x
1.01
x $486.73 PER TRIP
x $486.73 PER TRIP
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
NUMBER OF FEU's
x
$242.76
PER FEU
$242.76 1
B. IMPROVEMENT COST:
NUMBER OF FEU's
x
$22.05
PER FEU
$22.05 1
($6705)1
$10.001
$207.76 1
$2,093.47 I
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
TOTAL MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
5. ADMINISTRATIVE FEES:
BASE CHARGE (SUBTOTAL ABOVE)
x
0.05
$104.67 I
~j;;, '
SDC COORDINNrOR
~ t'f /7A>oO
dATI:!
TOTAL SDC CHARGES I $2,198.141
PLUMBING FIXTURE UNIT (PFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = PLUMBING FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET AODlTlONAI FIXTURES)
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN
INTERCEPTORS FOR GREASE/OILlSOLIDS/ETC
INTERCEPTORS FOR SAND/AUTO W ASH/ETC
LAUNDRY TUB/CLOTHESW ASHER/MOP SINK
CLOTHESW ASHER - 3 OR MORE
MOBILE HOME PARK TRAP (I PER TRAILER)
RECEPTOR FOR REFRIGERA TORIW A TER ST A TION/ETC
RECEPTOR FOR COMMERCIAL SINK! DISHW ASHER/ETC
SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)
SINK: BAR, COMMERCIAL, RESIDENTIAL KITCHEN
URINAL, ST ALL/W ALL
WASH BASIN/LAVATORY, SINGLE OR DOUBLE
TOILET, PUBLIC INSTALLATION
TOILET, PRIVATE INSTALLATION
MISCELLANEOUS:
FIXTURES
NEW OLD
2
UNIT
EQUIVALENT
2
I
2
3
6
2
6
6
I
3
2
I
2
2
I
6
4
PLUMBING
FIXTURE
UNITS
4
o
o
o
o
2
o
o
o
o
o
o
2
o
2
o
8
o
o
o
TOTAL PLUMBING FIXTURE UNITS=I 18
2
2
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATEL
L YEAR
ANNEXED
1979 or before
1980
1981
1982
1983
1984
1985
1986
1987
1988
RATE PER $1,000
ASSESSED VALUE
$4.47
$4.38
$4.32
$4.20
$4.03
$3.88
$3.68
$3.38
$3.03
$2.62
YEAR
ANNEXED
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE $4.470 .x'
IMPROVEMENT (IF AFTER ANNEXATION DATE) x'
RATE PER $1,000
ASSESSED VALUE
$2.18
$ 1.75
$1.35
$ Ll7
$ 1.03
$0.86
$0.71
$0.57
$0.39
$0.18
15.000
CREDIT TOTAL
$67.05,
$0.00
$67.05
~Ati .
.. "'I'... Wi llama lane
'"t, ""'!' Park & Recreation District
,..., SYSTEM DEVELOPMENT CHARGE
WORKSHEET
) Q f\ ff\:b
'\0 ~~f\J. 3 STATE: ~'P:C\.141K
LOCATION OF PROPOSED BUILDAN~ ~ITE..:..
Street Address: ~C\\o ~ ~ \Q11) ~ 'tJt\ \1Q.J
:VC't}. t .:fax Lot Number: \ <6()~Dto 130\QcO
.,};
Job. No.CO.OO'3S~'OI
NAME.
PHONE:\k1 \o4\:{o
ADDRESS:
1. DEVELO. .ENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. Sinolp.-F8milv Dp.t8r~hp.1
l Single Family home
NO. OF UNITS
----
Manufactured home not in a park
l X $1,000 per unit = $ l ()(y"). cO
B. Sinolp.-F8milv Attached
, .
NO. OF UNITS
X $924 perunit = $
C. Multi-Familv Aom1ment
NO. OF UNITS
X $692 per unit = $
. D. M8nuf8ctumn Homp. Parl\
NO. OF UNITS
X $699 per unit = $
$ \OOO.@
r>>
$ (CXJO_dJ
$
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SOc-payer must furnish proof of
Willarnalane Credit approval. See sac Credit Worksheet.
3. TOTAL WILLAMALANE NET SDe ASSESSED
\ (if SOCjire uced for Credit)
- l\ '.:\
~\JU 3 I
Deveiopme t elVicrs-~epartment Date
City of Springfield .
~l I
in
~