HomeMy WebLinkAboutPermit Building 2006-7-11
.
.ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/11/2006
APPLIED: 05/01/2006
EXPIRES: 01/1112007
VALUE: $ 373,344.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726.3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3600 Garden Av
ASSESSOR'S PARCEL NO,: 1802064202600
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Single family residence
Owner:
Address:
KNIGHTS DUANE A & SUSAN E
2258 33RD ST
SPRINGFIELD OR 97477
Phone Number:
OU \0
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I CONTRACTOR INFORMA TlON~If>-'" 9S'2..Cl5 'O~
" \~' \' <,," \ \ W n' \ ~ \u\e
r' \C . \eC, <ou" ~ \,\\e "e
Contractor \0\\0'1'1 '0(\0'" ()o\OI:;icenseO \e~pihl&jlln Date
DUANE KNIGHTS ~o\\'i{:;"'\~~'2.'OO\' 0'0\'0\<;1 c~~~" \,\\e ~\;'i\ca\\ \
BATEMAN ELECTRIC l~.c>f>-'" '{ou (\\a~ <;I\e\I~!~l\I0\\\\\~ ;"''''), 06/2112008
MARSHALLS INC 0090, , \,\\e ce e OZ57~~I.'~~'2.-'2. 12/23/2009
SHAD CHASAN SURRETT ca\l\:~\ \0\ \~< i51'5829'5 01/14/2008
BUILD1~G 'INFOl{MA TlON I
541-726-2960
Contractor Type
Geueral
Electrical
Mechanical
Plumbing
Phone
541-726.2960
541-998.7187
541-747-7445
541-741-3553
# of Units: I # of Stories: 2 Lot Size:
Primary Occupancy Group: R-3 Height of Structure 25,00 Sq Ft Ist Floor: 1,434
Secoudary Occupancy Group: U Type of Heat: Wall Heat Sq Ft 2nd Floor: 1,900
Primary Coustruction Type VN Water Type: Electric Sq Ft Basement:
Secondary Construction Type: Range Type: Electric Sq Ft GaragelCarport 1,794
# of Bedrooms: 3 Energy Path: Path I Sq Ft Other:
Sprinkled Building: nla Occupant Load:
1 DEVELOPMENT INFORMATION I
uc,REQi1'iRED PARKING
,,\~ " ,
O I D' U b F .."Ot Ir ..,,~ 'I'D' . 2
ver ay 1st: \('~. ' r an ,nnge t-J\11.ota: \
# Streeq~re1_ RiliI~t-J\I' SI-\f\\.~t\~'1-\1~7 ?tt\ t\)~~Ddicapped:',
Paved DriYf;Rq\l:- Il'C\) I.I~\) t\1',~9\\)G~ Compact:
% of Lot Co~e:i;a'gg Ct\) Ot\ IS 16,30
~Gt-J\t-J\t~ .~ ?'Ct\IO\." , .
\J . nr'\ n....
. ~. v . ~
I PUBLIC IMPROVEMENTS I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
20,00
20,00
20,00
12,00
32,50
Street Improvements:
Storm Sewer Available:
Special Instruction:
Gravel
No
Sidewalk Type:
Downspoutsmmins: Drywell . Provide
Drywell Engineering
Notes:
UGB Drywell and Septic
~\ '
Paee 1 of 4
Status
Issued
225 Fifth Street, Springfield, OR
541.726.3753 Phone
541-726.3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
V Wood Frame
Garaee
Dwellines
Garaee
Fee Description
Plan Review Residential '
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 8% State Surcbarge
3 Batbs One & Two Family
Addressing Assignment
Boiler/Comp Up To 100,000 btu
Building Permit
Dryer Vent
Fire SF Fee - Residential
Furnace - up to 100,000 btu
Gas Fireplace
Gas Outlets 1.4
Residence Wiriug 1000 Sq Ft
Residence Wiring Ea Addtl 500
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Storm Drainage Impervious Area
Temp Power 200 amps or less
UGB Plan Rev MjlMin - Planning
Veut Fan
Willamalane Single Family
Total Amount Paid
Initial Review
Initial Review
05/0212006
06/26/2006
.
~ITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/11/2006
APPLIED: 05/01/2006
EXPIRES: 01/11/2007
VALUE: $ 373,344.00
I Valuation DeseriDtion I
$ Per Sq Ft
or multiplier
$99,00
$26,00
Square Footage
or Bid Amount
3,300,00
1,794,00
Value
Date Calculated
$326,700,00
$46,644,00
$373,344.00
05/0112006
05/0112006
TQtal Value of Project
Fpp<. p.,irll
Amount Paid
$946.50
$10.00
$241.69
$172,97
$306,00
$31.00
$12,00
$1,456,15
$6,00
$254,70
$12.00
$15.00
$4,00
$106,00
$171.00
$29,39
$49,42
$805,70
$182,69
$587,86
$50,00
$268,00
$24,00
$ I ,000,00
$6,742,07
Date Paid
Receipt Number
1200600000000000570
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
5/1106
7/11106
7/11106
7/11106
7/11106
7/ll/06
7/11106
7/11106
7/11106
7/11106
7/11106
7/11106
7111106
7/11106
7/11106
7/11106
7/11106
7/ll/06
7/11106
7/11106
7/11106
7/11106
7/11106
7/11106
I Plan Reviews I
05/0212006
06/29/2006
APP LLH
APP LLH
Revised plans as requested by
Robert Castile
Paee 2 of 4
.ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/11/2006
APPLIED: 05/01/2006
EXPIRES: 01/11/2007
VALUE: $ 373,344.00
.
Status
Issued
225 Fifth Street, Springfield. OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannine Review
05/0212006
TAJ
OS/24/2006
APP
Public Works Review
05/0212006
APP
CAS
OS/25/2006
Structural Review
Structural Review
05/0212006
07/05/2006
RWC
RWC
OS/24/2006
07/07/2006
WE
APP
Setbacks based on the proposed
partition, This partition has not
been approved and no other single
family residential permits may be
approved until the partition is
platted and recorded,
7 street trees are required: 3 on
Laurel and 4 on Garden (Parcell
frontage),
Received info 5/9/06 planning review
until 5/24/06 Called for septic and
d rywell in fo 5/5/06
faxed to Mr, Knight 5/24/2006
Revised drawings
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.
Ueouire'Unsnections I
Erosion/Grading Inspection: Prior to ground disturbance and after erQsion measures are installed,
Drywell: EngineeredDrywell is Required, Provide the City with a copy of the DEQ application to keep on file,
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection,
Footing: After trenches are excavated,
Foundation: After forms are erected but prior to concrete placement,
Post and Beam: Prior to IlQQr insulatiQn or decking,
Floor Insulation: Prior to decking,
Shear Wall Nailing: Before covering sheathing with finish materials,
Framing Inspection: Prior to cover and after all rough in inspections have been approved,
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover,
Hold Downs Installed: Special Inspection performed prior to placement of concrete, Provide report to City
Bnilding Inspector,
Final Bnilding: After all required inspections have been reqnested and approved and the building is complete,
Perimeter Fonndation Drains: After gravel and filter cloth is installed bnt prior to backfill,
Underlloor Plumbing: Prior to insulation or decking,
Underlloor Drain: Prior to cover or placement of concrete,
Rough Plumbing: Prior to cover and including reqnired testing,
Paee3 of 4
.
, -=ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/1112006
APPLIED: 05/01/2006
EXPIRES: 01/1112007
VALUE: $ 373,344.00
Status
Issued
225 Fiftb Street, SpriDgfield, OR
541-726-3753 PboDe
541.726-3676 Fax
541-726-37691DspectioD LiDe
Sbower POD, Prior to coveriDg aDd iDclDdiDg reqDired testiDg.
Water LiDe: Prior to filliDg treDcb aDd iDclDdiDg reqDired testiDg,
SaDitary Sewer LiDe: Prior to filliDg treDcb aDd iDcludiDg required testiDg.
FiDal PlumbiDg: WbeD all plDmbiDg work is complete.
Rougb MecbaDical: Prior to Cover
Rougb Gas: After line is installed and required testiDg aDd capped if not attacbed to an appliaDce,
Undertloor MecbaDical, Prior to insulation or deckiDg aDd iDcluding required testiDg.
UndertlMr Gas: After IiDe is iDstalled aDd required testiDg and capped if not attacbed to aD appliance,
FiDal Gas: WbeD all gas work is complete,
Final MecbaDical: WbeD all mecbaDical work is complete,
Rougb Electric: Prior to Cover
FiDal Electric: WbeD all electrical work is complete,
Temporary Electric: Approval required prior to Utility CompaDY eDergizing pole,
By sigDature, I state aDd agree, tbat I bave carefully examiDed tbe completed applicatioD and do bereby certify tbat all
infQrmatioD bereoD is true aDd correct, and I furtber certify tbat aDY aDd all work performed sball be done iD accordaDce witb
tbe OrdiDaDces of tbe City of SpriDgfield aDd tbe Laws of tbe State of Oregon pertainiDg to tbe work described berein, aDd
tbat NO OCCUPANCY will be made ofaDY strocture witbout permission oftbe CommuDity Services DivisioD, BuildiDg Safety,
I furtber certify tbat only COD tractors aDd employees wbo are iD compliaDce witb ORS 701.005 will be used OD tbis project,
I furtber agree to enSDre tbat all required inspections are reqDested at tbe proper time, tbat eacb address is readable from tbe
street, tbat tbe permit card is located at tbe frQnt Qf tbe property, aDd tbe approved set of plans will remaiD OD tbe site at all
times during construction.
L___t
,H-/
:tjf 1/ ~~
Paee 4 of 4
CITY OF StltNGFIELD SYSTEMS DEVELOPMEN.ORKSHEET
JOURNAL OR JOB NUMBER: COM2006.00506
NAME OR COMPANY: Duane Knights
LOCATION: 3600 Garden
TAX LOT NUMBER: 1802064202600
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING U'IITS I BUILDING SIZE (SF' D LOT SIZE (SF):
. I STORM ORAINAGF,
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F, x I COST PER S,F, I I CHARGE I
0,00 I $0.323 = I $0,00
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S,F. I x I COST PER S,F, I x I DISCOUNT RATE I I
I 3640.00 I $0.323 I 50% ~ I
ITEM I TOTAL - STORM DRAINAGE SDC $587,86 ~
2, SANITARY S".wl'R. r:ITY
DISCOUNT
$587,86
I~
u
l>::
o ~
E-<
[/)
o
gj
$587,86 1070
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 0
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 0 $19,07
ITEM 2 TOTAL. CITY SANITARY SEWER SDC
COST PER DFU
$25,07
=,
$0,00
3, TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRIPRATE I x
I 9.57
B. IMPROVEMENT COST:
I ADTTRIPRATE I x
I 9,57 I
I NUMBER OF UNITS I x I
1 I I
COST PER TRIP
$19,09
x INEWTRlPFACTORI
I 100 I
1 NUMBER OF UNITS I x I
1 I I I
COST PER TRIP
$84,19
$988.39
x INEW TRIP F ACTORI
I 100 I
ITEM 3 TOTAL - TRANSPORTATION SDC ~ ,
4, SANITARY SEWER. MWMr:
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
I 0 I
ICOST PER FEU
I $82,03
B. IMPROVEMENT COST:
INUMBERO OF FEU's I x ICOST PER FEU
I $865,3 I
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =,
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ ,
S, AOMINISTRATIVE FEE,
I SUBTOTAL x I ADM, FEE RATE I~
I $1.576,25 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$0,00
$1,576,25
CHARGE
$78,81
Cheryl Slaymaker
PREPARED BY
5/2512006
TOTAL SDC CHARGES
DATE
-"
"-
$0,00
$0,00
$182,69
5805.70
=
$0,00
=
$0,00
$0.00
$0,00
1091
1092
1093
I
11094
I
1 IOS4
lOSS
IOS4
IOS6
-I
I
29.39 1079
$49.42
$1,655,06
11078
I
~-
/J
. .
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FlX1lJRE UNITS
(NOTE; FOR REMODELS, CAlClILA TE ONLY l1lE NET ADDmONAL FIXTURES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
rBATHTUB 0 0 3 = 0 -I
IDRlNKJNG FOUNTAIN 0 0 1 = 0 I
IFLOOR DRAIN 0 0 3 = 0 I
IINTERCEPTORS FOR GREASE 1 OIL 1 SOLIDS 1 ETe. 0 0 3 = 0 I
IINTERCEPTORS FOR SAND 1 AUTO WASH 1 ETe. 0 0 6 = 0 'I
ILAUNDRY TUB 0 0 2 = 0 I
ICLOTHESWASHER 1 MOP SINK 0 0 3 = 0 I
ICLOTHESWASHER.3 OR MORE (EA) 0 D 6 = 0 'I
MOBILE HOME PARK TRAP (I PER TRAILER) D D 12 = 0
RECEPTOR FOR REFRlG 1 WATER STATION 1 ETC. D 0 1 = 0
RECEPTOR FOR COM, SINK 1 DlSHW ASHER 1 ETC, 0 0 3 = D j'
SHOWER. SINGLE STALL 0 0 2 = 0
SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = D
ISINK: COMMERCiAuRESIDENTlAL KITCHEN 0 0 3 = 0
I SINK: COMMERCIAL BAR 0 D 2 = 0
ISINK: WASH BASINIDOUBLE LAVATORY 0 D 2 = 0
ISINK: SINGLE LA V ATORYIRESIDENTlAL BAR 0 0 1 = 0
iURINAL, STALL 1 WALL D 0 5 = 0
ITOILET, PUBLIC INSTALLATION D 0 6 = 0
ITOILET, PRIVATE INSTALLATION 0 0 3 = 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 0
~EDU (EQuivalent DwellinR Unit) is a discharge equivalent to a single family dwelling wlil (20 DFlfs) set at 167 gallons pet day __ _ .
_____u
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
r---- YEAR
I ANNEXED
iBEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
~
CREDlT RATE/$I,OOO
ASSESSED VALUE
$5,29
$5,29
$5,19
$5,12
$4.98
$4,80
$4,63
$4,40
$4,07
$3,67
$3,22
$2.73
$2.25
$1.80
$1,59
$1,45
$1.25
$1,09
$0,92
$0,72
$0,48
$0,28
$0,09
$0,05
l
I
IS LAND ELGlBLE FOR ANNEXATION CREDlT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX, CREDlT?
(Enter I fQT Yes, 2 for Nn)
BASE YEAR
2
2
1979
CREDlT FOR LAND (IF APPLICABLE)
VALUE 11000 CREDlT RATE
$0,00 x $5,29
~ ,
$0,00
CREDlT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE 11000 CREDlT RATE
$0,00 x $5.29
o
TOTAL MWMC CREDIT
$0,00
=
/"
'IS, TL I X -
(c, ,,'~
'f~ "
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1 A r.,r{..:-,. I
~ SEWAGE DISPOSAL SITE EVALUATION' .
S.I.#
o~9~ 9 /
Jbdivision:
,Job Location, '(.) V' '''.. c: i/
Written Directions ~ c.... " r e. ,/
o~
'\ ..,
I.... 0. \...{...,.. L
, G()../ i~< L-,
i~ e",,~,J "?
r {J"
........ 1,
Lot 1 Block L WATER SuppLy c.. P v: '-- G C.. -e {,.,,(
~PLlCANT'S NAME AND ADDRESS II u c~, (<. ~ _ '/"/ if..,... , ~hone "7.L Co 1. '1 Go c.)
NNERS'S NAME AND ADDRESS ~ L 'J- &' <. -\ y) c, f ) ,) Y , Phone 2. 2.. .s I "to c.
rRUCTURES NOW ON THE PFjOPERTY <; "^ -c..,{ ~ ' _ PROPOSED USE OF PROPERTY /UJ,' /. "h' >
ereby certify that the above statements are true and accurate, and that I have the following legal interest in the property ~ owner of record; contract purchaser: .
tentJal buyer: realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves of this action.
f' .~y/I, ,_
ST HOLES READY 1.-1 'l::. S Signature ,(Y1- _ _..///~ Date /.) - .L J ., 0 >
- , ./
. '* * * '* ",. * * '* * * '* '* * * * '* * * '* '* * * * * * * * * "Ii *, * * * * OFFICE USE ONLY BELOW THIS LINE * * * * * ~ * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* *
THIS REPORT IS NOT A PERMIT FOR SEWAGE SYSTEM INSTALLATION Y'IWVE- //r' ;':.1-:: F. J;.' ,
, ,,' /_ ,j){ r;~ ::["/7/( .T~'" /.((( ft>
e,areadescribe,dontheanachedPlotPlandated 1'-//-( is /fF?filPf-P ,fora ;"'r~/,-c /"(-/ '-'11 n-='/'r
,.. TA~"P/k P ~r: vA! system, //f/','_ (/J-", "C~'1:/I_
.. tW! TP'"f7:4t1.-!1,ft:?4' /"ch--j(J/'
m:.IONALCOMME~TS: 75"f'<.-'~ 7....._ In...n(?7S'RFt::UlifF,-P) '6//)(5J :';--;:;:;:::"';;;;7/;;5' RFC/,(/frf:V '
[5 /lI/./, "3(": /f."/4x T/7/::-A/r;/ Ol=F7Ji, .
. "...Y // p(j TFP C;?P,t-". . ~~U~/ RfY:/f/V..- '5///pC/I/l'k?"'1? 4 TT
ITE: ,.:;,?-, / t~' s J(E r;'IJ//5:PP ~E~11 .7...(:,~;r:;'f//-17/p.?- ?;=IC;,<?; T '
his report approves of a sand filter or pressurized distribution stem, detailed consfruction design J5]ans '
I be required with the installation permit application, ,/ fl~:'"
. ~r' ...............................
THIS IS A PRELIMINARY REPORT WHICH DOES NOT . WARNING: .
ENSURE THE ISSUANCE OF A FUTURE BUILDING . This Site Evaluation is a technical report to determine if a on.site .
PERMIT. ANY PLANS OR EXPENDITURES MADE IN system will function properly. It does not approve the proposed use of
RELIANCE UPON THIS REPORT ARE AT YOUR OWN . the parcel. This Site Evaluation may be converted to a construction per. .
RISK. IF SITE IS APPROVED, SEE REVERSE SIDE, . mit only if the parcel and use meet land use regulations in effect at the .
I' time of application, YOU ARE URGED TO CONTACT YOUR LOCAL
//',: /~ / . PLANNING OFFICE FOR LAND USE REVIEW, .
( ,/(' .A' 711'-/./ -:-. If:-~ I..-I.! - k .. . . .. . . .. . . . .. . . .. . . .. . . . . . .. . . .. . . .. . .
/ ,DEO AUTHORIZED AGENT DATE
NE COUNTY LAND MANAGEMENT. 125 EAST 8TH AVENUE, EUGENE, OREGON !l74n1 IIIR"_~7!<41
;
CITY OF SPRfNGFIELD, OREGON
.
1. :roCATION:a~~;:r11A770NJ!;.~~~:~
(l{~'='(!{'''' . ~~,,,''''-' -'" m",
~l ) ~:;.J;.:.jl;,,,,.~;<,~~~~"'';7~~'~~'';'i:;:-:::~'''l;:;~fi.~1.2jf/;....---t''''';;!'-..:~:.~~i1..v;?~,~
"BD~ () '-==l__~~'-=~
~~ ~f~e + ~rrQ ~:m=5~sq,aor C{ S19,OO \\\.00
Penults are ooo-traDSferab1e and expire ifwork Is Each Manufacl'd Home or
Dot started wlthlo 180 days of issuance or If work Is MOOuIar Dwelling Service or
Sospeoded for 180 days. Feeder
i~ ,,,__.",~=,=,",,,"'" .9",,# ,,;,'~'::W:;;:';'~'~'~~~"Wz~ ATTEW~~.,Q,W"~Jqw r~..,'_,,~ ,\g..;:"~.",-""";).-.,,,",,;;;,,,,,,,;,.~,~.,;,,
': CONTRACTOR'INSTALJ:iill~ON!ONI;'YG B. :!t~.:es;m~:i<.. .. ".= '. (Allentici,;s'or'Relocatioii:': 't!
2.:"";:;;;;'j:..:..,._~.......;;i>~"'''~j<'''-''''Wt!...~~~6_'ti.~.,...~, follov~r~~~-te " ~"" ~ET~;;,-"",;~~,":i;",,"'~'-'JDi""-'" ':'-"-j
-: - ..', "(1 'l :.LWT' 0. """' E '\,p "',.J.n./! ' iiat~on Center, Those ';ules are set forth' -- '.-...,
Electncal Contractor r';t"-/I f ~ It\. r~~~A~o~~6'6\mhrOugh OAR 9~., M1_ $63,00
()i..:\"'1?\ -r ",,' : l!.J/otlw,Y3~11~'d ~t1Wl&t~softher"'Mhy S75.00
Address \ I ,~ \ U V". "CO vI., . II' 4, o.t ' . ,ll!,600.AniDs the telephM~ SI25,oo
t,..t \''''S~:ltn~ lTl "lvI, \I',um: "
, -\\J'{\I'.l-i", 1','..J.u f'r,n.O _-1i~04mb,,~'~te!t,oe'b~itYNotifi"~tinnS S316375',OOOO
Cl~ _ L\ IV(\U ~,thone V'I~\!\ Llc. I oeerl~I~~2.2344).
R......,-....: Only S 50,00
3. W"roMPiEi'ii;J..WS€.H";'I)uiE1RRt:OW%:~""C
~..,,; ..~h,;:_-'~~,;:i;~'~~;~ ,.u<..,_._~~!U'..,.:.,;~~-
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54J)726-3753 . FAX: (54J)726-3Q19
ELECTRICALP~-#:PUCATION ~ '
City Job Number ~. aJlo Date \ - \ 1- 2 ~
S5O.00
Expiration Date
,!) DOlo S
ID-\-bL?
\~ \ q \ \
lD-2l- 09,
c, ~!eiir~~~:s.:~~~2!:i~~E:~~~r~~;g;~~fu~1i';J,,,'fr;~1231
Supervisor License Number
InstaDatioo. A ",,,:., , or ReIocatioo
200 Amps or less \
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or I 000 Volts see "B" above,
o '~.ij'~';~1?~:,;;:~~n:~'~'i!J~~~~:'f,:"'~)\;;(~~~._'i>1"ft;!r _f..::!;t,~:.";:;;,Xl~q
Signature of Supervising Electrician ' :L~~.:..,?ll}.~"'".&.1!T&J:,~~;:&-3\:;","',,:td.${1\"E['A'iS:U';;tfoli~611.!
-? / /'74 / New Alteratioo or ErteosIoo Per Panel
/ fl QL~ cr...::r_-< ./ One Circuit S 43,00
/ / Each Additional Circuit or with ' ,
- .. hYt {\ V. f\ ' (j:'r\ ~ Service or Feeder Permit S 3,00
~=N!Jam~_l''i e I \.. .' o{ CEE,~=-iI#~~~~"~W~~$'~jK~~,i~g@r;;~K'
'-'\ k\\~Y.f'=R1HiSPtRM\1'\~j'Ntf~-'. "_,!~c.,_",~"..,_.:,.,
--rL\ . \" ~\~\W~tionNDONEO FOR $ 50.00
COMM\:Nsfg\}&JiJih1 tiih'ung $ 50,00
FlNY ,80 Ci~&C&~lResidential $ ~.oo
The installation is being made on r' ... ....i I ~ which Limited Energy/c..~_.._- ..:.1 S 45,00
is not intended for sale, lease orrenL Mloimom E1eetr1e PermIt I.,., . .'" . Fee is $45.00 + Son:harges
Owners Signature: 4, i~it.~~~!t~YiI~>~i4Z1.~J~, ~q n.co
7% State Surcharge ~. \ ~
10"1.. Administrative Fee ' I
. .9>lp
Expiration Date
:f:I) .W
Constr, Contr, Number
S 50,00
S 69,00
SI00,OO
Ci
Iospectioo Reqoest: 726-3769
TOTAL
_ ~_ "' ~:_ _ ...__IC1_-..:....1 D_;. ......Iit-Minn 1-03..doc
225 Fifth lltreet
SprIngfield, Oregon 97477
541-726-3759 Phone
.~'~
c_r Springfield Official Receipt
~opment Services Department
Public Works Department
Job/Journal Number
COM2006.00506
COM2006.00506
COM2006-00506
COM2006.00506
COM2006.00506
COM2006.00506
COM2006-00506
COM2006.00506
COM2006.00506
COM2006.00506
COM2006-00506
COM2006-00506
COM2006.00506
COM2006-00506
COM2006.00506
COM2006.00506
COM'2006.00506
COM2006.00506
COM2006-00506
COM2006.00506
COM2006.00506
COM2006.00506
COM2006-00506
Payments:
Type of Payment
Cred itCard
cReceintl
RECEIPT #:
1200600000000001051
Date: 07/11/2006
Description
Addressing Assignment
Willamalane Single Family
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Fire SF Fee. Residential
UGB Plan Rev MjlMin - Planning
Storm Drainage Impervious Area
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC Sanitary/Storm Admin
SDC Transpo Admin
Building Permit
3 Baths One & Two Family
Furnace - up to 100,000 btu
Boiler/Comp Up To 100,000 btu
Vent Fan
Dryer Vent
Gas Outlets 1-4
-Mechanical Issuance Fee-
Gas Fireplace
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
SUSAN KNIGHTS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 319206 In Person
Payment Total:
Page I of I
1:16:40PM
Amount Due
31.00
1,000,00
106,00
171.00
50.00
254,70
268,00
587,86
182,69
805,70
29,39
49.42
1,456,15
306,00
12,00
12,00
24,00
6,00
4,00
10,00
15,00
172,97
241.69
$5,795,57
Amount Paid
$5,795.57
$5,795,57
711 1/2006
.
.ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/11/2006
APPLIED: 05/01/2006
EXPIRES: 01/1112007
VALUE: $ 373,344.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3600 Garden Av
ASSESSOR'S PARCEL NO.: 1802064202600
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Single family residence
Owner:
Address:
KNIGHTS DUANE A & SUSAN E
2258 33RD ST
SPRINGFIELD OR 97477
Phone Number:
OU \0
o.ul\e" ~ \.\\I\I\~
, _..1 ~e . .....('\(\ ~....rt\\
.......d..'.....t\\. ..,"'\ev'-;~es'O"" Q\"
I CONTRACTOR INFORMA TlON~If>-'" 9S'2.'Cl" 'O~
" \~. \' <,,, 1 \ w ,,\ \ ~ \u\e
r' \e . \eC, <ou" ~ \,\\e "e
Contractor \o\\o'l'l '0(\0,1' ()o\OI:;icenseO \e~pihl&jlln Date
DUANE KNIGHTS ~O\I'i{:;"'\~~'2.'oO\' 0'0\'0\<;1 c~~~" \,\\e ~\;'ilca\I'
BATEMAN ELECTRIC I~.c>f>-'" '{ou (\\a~ <;I\e\I~!~l\I.j\I\I\~ ;D.D.). 06/2112008
MARSHALLS INC 0090. , \,\\e ce e OZ57~~I_~~'2.-'2. 12/23/2009
SHAD CHASAN SURRETT ca\lI:~1 \01 \~< i"I'5829'5 01/14/2008
BUILD1~G 'INFOl{MA TlON I
541-726-2960
Contractor Type
Geueral
Electrical
Mechanical
Plumbing
Phone
541-726-2960
541-998-7187
541-747-7445
541-741-3553
# of Units: I # of Stories: 2 Lot Size:
Primary Occupancy Group: R-3 Height of Structure 25.00 Sq Ft Ist Floor: 1,434
Secoudary Occupancy Group: U Type of Heat: Wall Heat Sq Ft 2nd Floor: 1,900
Primary Coustruction Type VN Water Type: Electric Sq Ft Basement:
Secondary Construction Type: Range Type: Electric Sq Ft GaragelCarport 1,794
# of Bedrooms: 3 Energy Path: Path I Sq Ft Other:
Sprinkled Building: nla Occupant Load:
1 DEVELOPMENT INFORMATION I
uc.REQi1'iRED PARKING
'I\~ " .
O I D. U b F ..,'o\:. Ir ..,,~ 'I'D' . 2
ver ay 1st: \('~. . r an .nnge WlII.ota: \
# Streeq~re1_ RiliI~WlI' SI-\f\\.~t\~'1-\1~7 ?\:.t\ \:.\)~~Ddicapped:',
Paved DriYf;Rq\l:- Il'C.\) I.I~\) t\1',~9\\)G~ Compact:
% of Lot Co~e:i;a'gg C\:.\) Ot\ IS 16.30
~GWlWI\:.~ .~ ?'C.t\IO\." - .
\J . nr'\ n....
. ~. v . ~
I PUBLIC IMPROVEMENTS I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
20.00
20.00
20.00
12.00
32.50
Street Improvements:
Storm Sewer Available:
Special Instruction:
Gravel
No
Sidewalk Type:
Downspoutsillrains: Drywell - Provide
Drywell Engineering
Notes:
UGB Drywell and Septic
~\ '
Paee 1 of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
V Wood Frame
Garaee
Dwellines
Garaee
Fee Description
Plan Review Residential .
-Mechanical Issuance Fe....
+ 10% Administrative Fee
+ 8% State Surcharge
3 Baths One & Two Family
Addressing Assignment
BoilerlComp Up To 100,000 btu
Building Permit
Dryer Vent
Fire SF Fee - Residential
Furnace - up to 100,000 btu
Gas Fireplace
Gas Outlets 1-4
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
SDC SanitarylStorm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Storm Drainage Impervious Area
Temp Power 200 amps or less
UGB Plan Rev MjlMin - Planning
Vent Fan
Willamalane Single Family
Total Amount Paid
Initial Review
Initial Review
05/0212006
06/26/2006
.
~ITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/11/2006
APPLIED: 05/01/2006
EXPIRES: 01/11/2007
VALUE: $ 373,344.00
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$99.00
$26.00
Square Footage
or Bid Amount
3,300.00
1,794.00
Value
Date Calculated
$326,700.00
$46,644.00
$373,344.00
05/01/2006
05/01/2006
Total Value of Project
Fpp<, p.,irll
Amount Paid
$946.50
$10.00
$241.69
$172.97
$306.00
$31.00
$12.00
$1,456.15
$6.00
$254.70
$12.00
$15.00
$4.00
$106.00
$171.00
$29.39
$49.42
$805.70
$182.69
$587.86
$50.00
$268.00
$24.00
$1,000.00
$6,742.07
Date Paid
Receipt Number
1200600000000000570
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
1200600000000001051
5/1/06
7/11106
7/11/06
7/11/06
7/11/06
7111/06
7/11/06
7/11106
7/11106
7/11106
7/11106
7/11106
7/11/06
7/11/06
7/11106
7/11106
7/11/06
7111/06
7/11/06
7/11/06
7/11/06
7/11/06
7/11106
7/11/06
I Plan Reviews I
05/0212006
06/29/2006
APP LLH
APP LLH
Revised plans as requested by
Robert Castile
Paee 2 of 4
.ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/11/2006
APPLIED: 05/01/2006
EXPIRES: 01/11/2007
VALUE: $ 373,344.00
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannine Review
05/0212006
TAJ
05/24/2006
APP
Public Works Review
05/0212006
APP
CAS
05/25/2006
Structural Review
Structural Review
05/0212006
07/05/2006
RWC
RWC
05/24/2006
07/07/2006
WE
APP
Setbacks based on the proposed
partition. This partition has not
been approved and no otber single
family residential permits may be
approved until the partition is
platted and recorded.
7 street trees are required: 3 on
Laurel and 4 on Garden (Parcell
frontage).
Received info 5/9/06 planning review
until 5/24/06 Called for septic and
d rywell in fo 5/5106
faxed to Mr. Knight 5/24/2006
Revised drawings
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.
Ueouire'Unsnections I
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Drywell: Engineered Drywell is Required. Provide the City with a copy of the DEQ application to keep on file.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to Iloor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Final Building: After all required inspections have been requested and approved and the building is complete.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underlloor Plumbing: Prior to insulation or decking.
Underlloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Paee 3 of 4
.
. -=ITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00506
ISSUED: 07/1lI2006
APPLIED: 05/01/2006
EXPIRES: 01/1lI2007
VALUE: $ 373,344.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Sbower Pan. Prior to covering and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Rough Mechanical: Prior to Cover
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Undertloor Mechanical. Prior to insulation or decking and including required testing.
Undertloor Gas: After line is installed and required testing and capped if not attached to an appliance.
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
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 ofany 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.
L___t
.H/
:tjf 1/ ~~
Paee 4 of 4
CITY OF StltNGFIELD SYSTEMS DEVELOPMEN.ORKSHEET
JOURNAL OR JOB NUMBER: COM2006-00506
NAME OR COMPANY: Duane Knights
LOCATION: 3600 Garden
TAX LOT NUMBER: 1802064202600
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING U'IITS I BUILDING SIZE (SF' 0 LOT SIZE (SF):
. 1 STORM ORAINAGF,
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE I
0.00 I $0.323 = I $0.00
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I
I 3640.00 I $0.323 I 50% ~ I
ITEM 1 TOTAL - STORM DRAINAGE SDC $587.86 ~
2. SANITARY S"WI'R - r:ITY
DISCOUNT
$587.86
I~
u
l>::
o ~
E-<
[/)
o
gj
$587.86 1070
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 0
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 0 $19.07
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
COST PER DFU
$25.07
=,
$0.00
3, TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRIPRATE I x
I 9.57
B. IMPROVEMENT COST:
I ADTTRIPRATE I x
I 9.57 I
I NUMBER OF UNITS I x I
I I I
COST PER TRIP
$19.09
x INEWTRlPFACTORI
I 100 I
I NUMBER OF UNITS I x I
I I I I
COST PER TRIP
$84.19
$988.39
x INEW TRIP F ACTORI
I 100 I
ITEM 3 TOTAL - TRANSPORTATION SDC ~ ,
4, SANITARY SEWER - MWMr:
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
I 0 I
ICOST PER FEU
I $82.03
B. IMPROVEMENT COST:
INUMBERO OF FEU's I x ICOST PER FEU
I $865.31
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =,
SUBTOTAL (ADD ITEMS t, 2. 3, & 4) ~ ,
5, AOMINISTRATIVE FEE,
I SUBTOTAL x I ADM. FEE RATE I~
I $1.576.25 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$0.00
$1,576.25
CHARGE
$78.81
Cheryl Slaymaker
PREPARED BY
5/2512006
TOTAL SDC CHARGES
DATE
-"
"-
$0.00
$0.00
$t82.69
$805.70
=
$0.00
=
$0.00
$0.00
$0.00
1091
1092
1093
I
11094
I
I 1054
IOS5
1054
IOS6
-I
I
29.39 1079
$49.42
$1,655.06
11078
I
~-
/J
. .
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FlX1lJRE UNITS
(NOTE: FOR REMODELS, CAlClILA TE ONLY l1lE NET ADDmONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
rBATHTUB 0 0 3 = 0 -I
IDRlNKJNG FOUNTAIN 0 0 1 = 0 I
IFLOOR DRAIN 0 0 3 = 0 I
IINTERCEPTORS FOR GREASE I OIL I SOLIDS I ETe. 0 0 3 = 0 I
IINTERCEPTORS FOR SAND 1 AUTO WASH I ETC. 0 0 6 = 0 'I
ILAUNDRY TUB 0 0 2 = 0 I
ICLOTHESWASHER 1 MOP SINK 0 0 3 = 0 I
ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 'I
MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRlG I WATER STATION 1 ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK 1 DISHWASHER 1 ETC. 0 0 3 = 0 j'
SHOWER. SINGLE STALL 0 0 2 = 0
SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCiAuRESIDENTlAL KITCHEN 0 0 3 = 0
I SINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LA V ATORYIRESIDENTlAL BAR 0 0 1 = 0
iURINAL, STALL 1 WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 0 0 3 = 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 0
~EDU (EQuivalent DwellinR Unit) is a discharge equivalent to a single family dwelling wlil (20 DFlfs) set at 167 gallons pet day __ _ .
_____u
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
r---- YEAR
I ANNEXED
iBEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
~
CREDIT RATE/$I,OOO
ASSESSED VALUE
$5.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4.63
$4.40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
l
I
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE 11000 CREDIT RATE
$0.00 x $5.29
~ ,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE 11000 CREDIT RATE
$0.00 x $5.29
o
TOTAL MWMC CRED1T
$0.00
=
---
'IS, TL I X -
(c. ...~
'f~ "
(') \;':"':'';'''0 (.- L.{ 2.... M'c. ,
1 A r.,r{..:-,. I
~ SEWAGE DISPOSAL SITE EVALUATION' .
S.I.#
o~9~ 9 /
Jbdivision:
. Job Location, '(.) V' '''.. c: i/
Written Directions ~ c... " r e. ./
o~
.\ ...,
<o-\...{.......L
, G()../ i~< L-,
i~ ('.",,~,J ~
r {J"
........ 1,
Lot 1 Block L WATER SuppLy c.. P v: '-- G C.. -e {,.J
~PLlCANT'S NAME AND ADDRESS II u c~. (<. ~ _ '/"/ if.". . ~hone '7.L c. 1. '1 Go c.)
NNERS'S NAME AND ADDRESS ~ 2. 'J- &' <. -\ y) c, f ) ,) Y . Phone 2.. 2. .s I "to c..
rRUCTURES NOW ON THE PFjOPERTY <; "^ -c..,{ ~ ' _ PROPOSED USE OF PROPERTY /UJ.. /, "h' >
ereby certify that the above statements are true and accurate, and that I have the following legal interest in the property ~ owner of record; contract purchaser: .
tentJal buyer: realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves of this action.
f' ..~Y:../ I. ._
ST HOLES READY 1.-1 -.::. S Signature ,(Y1- _ _..///~ Date /.). L. J - 0 >
- , ./
. '* * * '* ",. * * '* * * '* '* * * * '* * * '* '* * * * * * * * * "Ii *, * * * * OFFICE USE ONLY BELOW THIS LINE * * * * * ~ * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* *
THIS REPORT IS NOT A PERMIT FOR SEWAGE SYSTEM INSTALLATION Y'IWVE- //r' ;":,1-:: F. J;.' ,
. ..' /.. .j) f r;~ :I/7/ ( .T..~'" /.(( ( f t>
e. areadescribe.d on the attached plot plan dated 1--// - (- is /I F?fil j/IP . for a :",.a-c /"(-/ '-'11 77.'=/'(
,.. TA~P/k P ~r: vA! system. /~fl'.'_ (/J- .--, - _~I..
. fW! TP"f7:4t1.-!1/':?...,' rCh~f}r
m:.IONALCOMME~TS: 75'f'<;,~ 7....._ ITi",n(?7S'RFt::!,-(J!ff:,P) 16//)(5J :';--;:;:;:::"';;;;7/;;5' RFCI.(/frf:V .
[5 /lI/./, '3(': /f.I4x T/7/=-.//rN OI=F7Ji. .
. .....Y // p(j TFP C;?A'/-",t-'. . /~U~/ Rf::[lf/V..- '5///pC/I/l'k?"'1? 4 TT
ITE: ,.:;,?-, / t~/ So J(E (;t'(//rPP ~E~11 .7..-c~;r:;'f//-17/p.t/ ?;=IC;,<?/ T .
his report approves of a sand filter or pressurized distribution stem, detailed coosfruction design J5]ans ..
I be required with the installation permit application. . / fl~:'-,
. ~r' ................*..............
THIS IS A PRELIMINARY REPORT WHICH DOES NOT . WARNING: .
ENSURE THE ISSUANCE OF A FUTURE BUILDING . This Site Evaluation is a technical report to determine if a on-site .
PERMIT. ANY PLANS OR EXPENDITURES MADE IN system will function properly. It does not approve the proposed use of
RELIANCE UPON THIS REPORT ARE AT YOUR OWN . the parcel. This Site Evaluation may be converted to a construction per- .
RISK. IF SITE IS APPROVED, SEE REVERSE SIDE. . mit only if the parcel and use meet land use regulations in effect at the .
I' time of application. YOU ARE URGED TO CONTACT YOUR LOCAL
//',: /~ / . PLANNING OFFICE FOR LAND USE REVIEW. .
( /.' .A' 711'-/./ -:-- .If:-~ I "-I.! - k .. . . .. . . .. . . . .. . . .. . . .. . .. . . .. .. . . .. . . .. . .
/ ,DEO AUTHORIZED AGENT DATE
NE COUNTY LAND MANAGEMENT. 125 EAST 8TH AVENUE. EUGENE. OREGON !l74n1 IIIR"_~7!<41
;
CITY OF SPRfNGFIELD, OREGON
.
1. :roCATION:a~~;:r11A770NJ!;.~~~:~
(l{~'='(!{-'" . ~~,,,."'-' .... m",
~l ) ~:;.J;.:.jl;,,,,.~;<,~~~~"'';7~~'~~'';'i:;:-:::~'''l;:;~fi.~1.2jf/;....---t''''';;!'-..:~:.~~i1..v;?~,~
"BD~ () '-==l__~~'-=~
~~ ~f~e + ~rrQ ~:m=5~sq.aor C{ 519.00 \\\.00
Penults are non-traDSferable and expire ifwork Is Each Manufact'd Home or
not started within 180 days of issuance or If work Is Modular Dwelling Service or
Snspended for 180 days. Feeder
i~ ,,,__."~='='>"'''' .9',. # "C' '~'::W:;;:';'~"~'~~~"Wz~ ATTEW~~"QJf'''~Jqw r~..'_._~ ,\g..;:"~.",.""";),..""";;;",,,,,;,,.~.~-,;,,
': CONTRACTOR'INSTALJ:iill~ON!'(JNI;YG B. :!t~.:es;m~:i<.. .. ".= '" (Allentici,;s'or'Relocatioii:': 't!
2.:"";:;;;;'j:..:..,._~.......;;i>~"'''~j<'''-''''Wt!...~~~6_'ti.~.,...~, follov~r~~~-te " ~"" ~ET~;;,-"",;~~,":i;",,"'~'-'JDi""-'" ':'-"-j
-: -' ... 11 'l :.LWT' 0. "'" E -\.p "'"J..n./! . iiat~on Center. Those ';ules are set forth' -- ""-.",,
Electncal Contractor r';In.:! f ~ It\. r~~~A~o~~6'6\mhrOugh OAR 9~., ""1.. $63.00
()i..:\'"1?\ -r ",,' : l(j/otlw.Y3~11~'d ~t1Wl&t~softher"'Mhy 575.00
Address \ I ,~ \ U V. ,.CO ~I..\ . II' 4. o.t . . ,ll!,600.AniDs the telephM~ 5125.00
t..t \,"'\~tn~ lTl "lvr. \\',um:"
. -\\J'{\I'.l-i", 1','.J.u f'r.n.O _-1i~04mb,,~'~te!t.oe'b~itYNotifi"~tinn5 5316375..0000
Cl~ ... L\ IV(\U ~.tbone \JI~\!\ Llc. I oeerl~I~~2-2344).
R_...____: Only 550.00
3. i!!'roMPiEi'ii;J..WS€.H";'I)uiE1RRt:OW%:~""'C
~..,,; ..~h,;:_-'~~,;:i;~'~~;~ ,.u<..,_._~~!U'..,.:.,;~~-
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54l)726-3753 . FAX: (541)726-JQ19
ELECTRICALP~-#:PUCATION ~ .
City Joh Number ~. aJlo Date \ - \ 1- 2 ~
550_00
Expiration Date
,!) DOlo S
ID-\-bL?
\~ \ q \ \
lD-2l- 09.
C. ~!eiir~~~:s.:~~~2!:i~~E:~~~r~~;g;~~fu~1i';J,,,'fr;~1231
Supervisor License Number
InstaDation,A..",:",orReIocatioo
200 Amps or less \
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or I 000 V oilS see "B" above.
o '~.ij'~';~1?~:,;;:~~n:~'~'i!J~~~~:'f,:"'~)\;;(~~~._'i>1"ft;!r _f..::!;t,~:.";:;;,Xl~q
Signature of Supervising Electrician - :L~~.:..,?ll}.~.,.".&.1!T&J:,~~;:&-3\:;","',,:td.${1\'E['A'is.:U';;tfoli~611.!
-? / /'74 ./ New Alteration or ErtensIoo Per Panel
/ fl QL~ cr...;:r_.< ../ One Circuit $ 43.00
/ / Each Additional Circuit or with . \
- . h,Yt {\ V. f\ ' (j:'r\ ~ Service or Feeder Permit $ 3.00
~=N!Jam~"'fi e I \.. .' o{ CEE.~=-iI#~~~~"~W~~$'~jK~~.i~g@r;;~K'
'-'\ k\\~Y.f'=R1HiSPtRM\1'\9-NtH.'-.' "..,!~c.,.""~"..._,:."
--rL\ . \'" ~\~\W~tionND()NtD FOR $ 50.00
CGMM\:Nsfg\}&.IiIih1 tiih'ung $ 50.00
PINY ,80 Ci~&C.&~lResidential $ ~.oo
The installation is being made on r' .... --.i I ~ which Limited Energy/c..~__._. .:.1 5 45.00
is not intended for sale, lease orrenL Mlnimnm Electric PermIt I.,., - .'" . Fee is $45.00 + Sorcharges
Owners Signature: 4. i~it.~~~!t~YiI~>~i4Z1.~J~, ~q .rJ.CO
7% State Surcharge ~. \ ~
10"A. Administrative Fee ' I
. .9>lp
Expiratinn Dale
:f:I) .W
Constr. Contr. Number
$ 50.00
$ 69.00
5100.00
Ci
Inspection Reqnest: 726-3769
TOTAL
_ ~_ "' ~:_ _ ...__IC1_-..:....1 D_;. ......Iit-Minn 1-03..doc
225 Fifth lltreet
SprIngfield, Oregon 97477
541-726-3759 Phone
.~.~
C_f Springfield Official Receipt
~opment Services Department
Public Works Department
Job/Journal Number
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM'2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
COM2006-00506
Payments:
Type of Payment
Cred itCard
cReceintl
RECEIPT #:
1200600000000001051
Date: 07/11/2006
Description
Addressing Assignment
Willamalane Single Family
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Fire SF Fee - Residential
UGB Plan Rev MjlMin - Planning
Storm Drainage Impervious Area
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC SanitarylStorm Admin
SDC Transpo Admin
Building Permit
3 Baths One & Two Family
Furnace - up to 100,000 btu
Boiler/Comp Up To 100,000 btu
Vent Fan
Dryer Vent
Gas Outlets 1-4
-Mechanical Issuance Fee-
Gas Fireplace
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
SUSAN KNIGHTS
(tern Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 319206 In Person
Payment Total:
Page I of I
1:16:40PM
Amount Due
31.00
1,000.00
106.00
171.00
50.00
254.70
268.00
587.86
182.69
805.70
29.39
49.42
1,456.15
306.00
12.00
12.00
24.00
6.00
4.00
10.00
15.00
172.97
241.69
$5,795.57
Amount Paid
$5,795.57
$5,795.57
711 112006