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SPRINGFIELD
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Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 950769
225 North Fifth Street
Springfield, OR 97477
Location of Proposed Work: 3742 DOUGLAS DR.!
Assessors Map #: 18020621
Lot: 99,/ Block:
Office: 726-3759
Inspection Line: 726-3769
Owner: HAYDEN ENTERPRISES
Address: 899 SOUTH 32ND STREET
Tax Lot #: 00000 /f1_
Subdivision: HAYDEN gLYalft ~
Phone #: 744,6966
City/State/Zip: SPRINGFIELD, OREGON 97478
Describe Work: S.F. RESIDENCE NEW
Const.
Contractor Contractor # Expires Phone
General: HAYDEN ENTERPRI 0092208 07/29/ C(1 923-6607
1511 SW 33rd Redmond OR 977560000
Plumbing: EMERALD VALLEY 0051737 09/19/tj1 683-5116
2727 N 20th Springfield OR 97477000
Mechanical: HAYDEN ENTERPRI 0092208 07/29/ ({1 923'6607
1511 SW 33rd Redmond OR 977560000 n-r /47
Electrical: ALLEN ELECTRIC 0000968 475,2139
201 N 3rd Madras OR 977410000
QUAD AREA: 3RSC
# OF UNITS: 1
CONSTR. TYPE: VN
WATER HEATER: E
SQ FOOTAGE: 1693
OFFICE USE --
LAND USE: 1111
ZONING CODE: LDR
# OF BDRMS: 3
RANGE: E
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: WH
INSUL PATH: P1
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 work day.
REQUIRED INSPECTIONS ---
FOOTING - After trenches are excavated.
FOUNDATION - After forms are erected but prior to concrete placement.
UNDERFLOOR PLUMBING - Prior to insulation or decking.
POST AND BEAM - Prior to floor insulation or decking.
INSULATION - Floor; prior to decking Wall/ceiling; Prior to cover
SANITARY SEWER LINE - Prior to filling trench,
STORM SEWER LINE, Prior to filling trench.
WATER LINE - Prior to filling trench,
ROUGH PLUMBING - Prior to cover,
ROUGH MECHANICAL - Prior to cover.
ROUGH ELECTRICAL - Prior to cover.
ELECTRICAL SERVICE - Must be approved to obtain permanent power,
FRAMING - Prior to cover.
INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover
DRYWALL - Prior to taping,
CURBCUT - After forms are erected but prior to placement of concrete.
SIDEWALK - After excavation is complete, forms and sub-base material
in place.
FINAL PLUMBING - When all plumbing work is complete.
FINAL ELECTRICAL - When all electrical work is complete,
FINAL MECHANICAL - When all mechanical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
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SPRINQFIELD
Job Number: 950769
Page 2
Total Height: 15
Lot Type: INTERIOR
Setbk From NPL, 65
Solar Approved: Y
Item
Main
Garage
Total Value
BUILDING PERMIT ---
Square Feet x
1133
560
$/Square Feet
56.20
14.10
Value
63,675.00
7,896.00
71,571.00
Building Permit Fee
Surcharge/Admin
349.00
27.92
TOTAL FEE
(A)
376.92
--- SYSTEMS DEVELOPMENT CHARGE (SDC) ---
(B) 1,588.05
Systems Development Charge is due on all undeveloped properties within the City
limits and the Citys Urban Growth Boundry which are being improved,
PLUMBING PERMIT ---
Item
Residential Bath(s)
2
Fee
160.00
Plumbing Permit
Surcharge/Admin
160,00
12.80
TOTAL CHARGE
(C)
172.80
- - - MECHANICAL PERMIT - - -
Exhaust Hood
Dryer Vent
4,50
3,00
Mechanical Permit
Issuance
Surcharge/Admin
16,50
10,00
1. 33
TOTAL PERMIT
(D)
27.83
--- MISCELLANEOUS PERMITS ---
SurCharge/Admin
Sidewalk
Curb Cut
ELECTRICAL PERMIT
PLAN REVIEW FEE
0,00
20,50
14,80
124,20
40.00
TOTAL MISCELLANEOUS PERMITS
(E)
199.50
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, D, and E combined)
2,365.10
~(gOO 5.oJ _
1J I. jJ '6'10. I D
--- 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
use of buildings, and may be suspended or revoked at any time upon violation
of any provisions of said ordinances.
...olIlIIIIII
SPRINGFIELD
Job Number: 950769
Page 3
Received By:
Plans Reviewed By: DON MOORE Date: 07/03/95
Building Site Reviewed By: LISA HOPPER
--- ADDITIONAL COMMENTS ---
DRIVEWAY REQUIRED TO BE PAVED
2 STREET TREES REQUIRED
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,
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.
Signatur;-l (lJJ lD~~
~1l-trq{
Date
Date Paid:
--- VALIDATION
'&~\~
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Receipt Number:
Amount Received:
Received By:
.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
(RESIDENTIAL)
Name or Company: HAYDEN ENTERPRISES
Location: 3742 DOUGLAS DR
Developement Type: R Building Size:
Job No,: 950769
Lot Size: 0
1. STORM DRAINAGE
Impervious Sq Ft 0 X 0,209 Per Sq Ft =
2. SANITARY SEWER - CITY
Number Of PFUs 18 X 43.26 Per PFU
(see Page 2)
3. TRANSPORTATION
Number Of Units
1 X
X Trip Rate
1. 010 X
X
Cost Per Trip
436,19
$440,55
Transportation Total
4. SANITARY SEWER - MWMC
Number Of PFUs
18
Per PFU +
17,190 +
MWMC Admin Fee
10,00
X
X
MWMC CREDIT If Applicable (see Page 2)
TOTAL ' MWMC SDC
SUBTOTAL - (Add Items 1, 2, 3 & 4)
5. ADMINISTRATIVE FEES
Base Charge (Subtotal Above) X
0.50
TOTAL SDC
Reviewed By: KIP BURDICK
Date: 07/03/95
Page 1
Sq Ft
$0,00
$778.68
$440,55
=
$319.42
$26.23
$293.19
$1,512.43
$75.6~
$1,588.05
SPAINOFIELD
Job Number: 950769
Page 2
FIXTURE UNIT CALCULATION TABLE
Fixture Type
Bathtub
Drinking Fountain
Floor Drain
Interceptors For Grease/Oil/Solids/Etc
Inteceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher
Clotheswasher - 3 Or More
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 Basin/Lavatory, Single
Water Closet, Public Installation
Water Closet, Private
Miscellaneous
TOTAL FIXTURE UNITS =
Number of
New Fixture
Unit
Equivalent
Fixture
Units
2
o
o
o
o
1
o
o
o
o
o
1
o
2
o
2
o
2
1
2
3
6
2
6
1
3
2
4
o
o
o
o
2
o
o
o
o
o
2
o
2
o
8
o
2
2
1
6
4
18
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1000)
Year Annexed: 1960
Credit For Parcel Or Land Only If Applicable:
Improvement (if after annexation date) :
7,580
X
3.46
26.23
o
X
3.46
0.00
CREDIT TOTAL =
$26.23
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)