HomeMy WebLinkAboutPermit Building 1997-9-9
SPRINGFIELD
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 971179
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of propoee~ Work: 6862 FORSYTHIA ST
Assessors Map #: 18020311
Lot: 15 Block: 4
Tax Lot #: 00200
Subdivision: CASCADE HGHTS 1
OWner: TIM/LISA PATTERSON
Address: 735 LAKSONEN LOOP
Phone #: 744-9250
City/State/Zip: SPRINGFIELD, OREGON 97478
Describe Work: S.F, RESIDENCE
NEW
Contractor
Const.
Contractor #
Expires
Phone
General:
OWNER
QUAD AREA: 4RSE
# OF UNITS: 1
CONSTR. TYPE: VN
WATER HEATER: E
SQ FOOTAGE: 3291
OFFICE USE --
LAND USE: 1111
ZONING CODE: LOR
# OF BDRMS: 3
RANGE: E
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: FE
INSUL PATH: PI
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 ---
SITE - To be made after excavation but prior to setting forms.
FOOTING - After trenches are excavated.
FOUNDATION - After forms are erected but prior to concrete placement,
ROUGH GAS - after line is installed and capped if not attached to an
appliance
UNDERFLOOR PLUMBING - Prior to insulation or decking.
UNDERFLOOR MECHANICAL - Prior to insulation or decking.
POST AND BEAM - Prior to floor insulation or decking.
INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover
WATER LINE - Prior to filling trench.
SANITARY SEWER LINE - Prior to filling trench,
STORM SEWER 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,
SHEAR WALL NAILING - Before covering sheathing with finish materials.
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 MECHANICAL - When all mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is complete.
PRE BACKFILL: To verify site ie clean of debris prior to final grading
and backfill.
SPRINGFIELD
Job Number: 971179
Page 2
GAS SERVICE - After line is installed and line has been connected to a
minimum of one appliance. Pressure test done at this point.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Faces: S
Topography: 10
Solar Approved: Y
Lot Sq. Ft.: 9787
Total Height: 30
Lot Type: INTERIOR
Setbacks
S W E
30 7
28 10
N
House 37
Garage
Item
Main
Garagel
BONUS RM.
RAISED DECK
Total Value
BUILDING PERMIT
Square Feet x
2100
840
350
276
Building Permit Fee
Surcharge/Admin
TOTAL FEE
PLUMBING PERMIT ---
Item
Residential Bath(s)
3
Plumbing Permit
Surcharge/Admin
TOTAL CHARGE
-- - MECHANICAL PERMIT ---
Furnace
Exhaust Hood
Vent Fan
Dryer Vent
GAS LINE & F,P.
4
Mechanical Permit
Issuance
Surcharge/Admin
TOTAL PERMIT
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
Sidewalk
Curb Cut
WILLAMALANE SDC
CITY SDC
LAND ALT/DRAINAGE
TOTAL MISCELLANEOUS PERMITS
Lot Coverage: 23.5 %
Setbk From NPL: 53
$/Square Feet
64,66
16,27
51
8
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, 0, and E combined)
(A)
= Value
135,796.00
13,667.00
17,850.00
2,208.00
169,511,00
590,50
47,25
637.75
Fee
192,50
192,50
15,41
207.91
12.00
4,50
12,00
3.00
6,50
38.00
10,00
3,04
51. 04
0,00
22.75
15.40
1,000.00
2,785.16
72.00
3.895,31
4.792.01
(C)
(D)
(E)
SPRINQFIELD
Job Number: 971179
Page 3
--- 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.
Plan Check Fee:
Received By:
Plans Reviewed By: DON
Building Site Reviewed
379,44
Date Paid: 08/04/97
Receipt Number: 26953
MOORE Date: 09/08/97
By: LISA HOPPER
--- ADDITIONAL COMMENTS ---
MAXIMUM HEIGHT OF RESIDENCE CANNOT EXCEED 30 FEET
PATH 1; SEPARATE ELECTRICAL PERMIT IS REQUIRED.
SPECIAL WASHERS ON ANCHOR BOLTS.
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.
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Date
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Signature
--- VALIDATION
Receipt Number: -::i?'7'J~
Date Paid: ~'""'3.~?
Amount Received: t./ 7~2.~/
Received By: ~
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;" , ; ,', La~L"Ai1d "Dr.ai~~ge~'ALiration' Permit:-
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City of Springfield
22S Fifth Street, Springfield, Oregon 97477. Development services
Date o( Application ~/20/5'7 Expiration Date:
Property Owner 7i~ h/Ak;,'))( J
Address: 7'2 <::" / __... 4 ,,,,,,,) /./1.
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Phone: 744 -92.)""0
City 99/-'1" State:~IP~ ~
Site Address: ~~ 2. FFwC:;w 77f7A-
o UGB Tax Map No: /~rl:;;z. I/?)' 7: / I
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,Springfield, Oragon
Tax Lot: oe~
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~~uantity 'J.,/) I.AJ/itJr ,r-~'l?rc~a~orr:..1"::7'AL .$3~ a.'1 r"/;'f'~
~Plier~.r I-ARiNI+-7:z"16'1.. ,Material ~ tv. ' ,
~GRADING,QUantity~ '~.,;/AA:wI ~~~
o EXCAVATION, Quantlt~~~"If;: ~^"I.. :;:JV "-Y-fll-
Suppller:'J)4tIF-r {,..JJI"" , Project Supervisor J<.::r: BratJVI ixtAv'",nrJ
Address " Phone
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SITE PLAN Required Data:Quantlty of material, Property lines and descriptions, Tex map and
lot number, Site address, Existing contour lines, Proposed contour lines, Existing drainage
ways, Proposed drainage ways, Significant trees and follalle, Ground cover, Soli types,
Buildings, Septic systems, Sewers, Areas subject to flooding, Utilities, Areas subject to land
slides, Proposed site improvements. ,
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CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
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DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
REPLANTING PLAN
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ADDITioNAL INFORM'ATION;
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COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
, PHONE
CITY
STATE
, PHONE
CITY
STATE
CONTRACTOR NAME:
PROJECT SUPERVISOR:
Registration Number:
ADDRESS:
STATE: , ZIP:
MOBILE PHONE:
PHONE
" Expiration Date:
, CITY:
OFFICE PHONE FAX
, EMERGENCY PHONE:
,
By signature. I state and agree. that I have carefully examined the completed application and do hereby certify that all
information herein 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. applicablo City Standard specifications and Drawings, and the laws of the State ot
Oregon pertaining to the work described herein, I further certify that only contractors and employees who are In compliance
with ORS 701.055 will be used on this projecl.
The City may inspect the work site described In this permit a't any time during 8 one year period fOllowing the receipt by the
City of notice of completion of the described work and specify', tit the City', ,ole desecration, any additional restoration work
required to return the site to a standard acceptable to the City. The permlnee will be notified In writing of any work required
and will have thirty (30) days from the date of the notice to complete the work. Work not completed at the end of the thirty
days will be performed by tho City and the costs will be billed to the permittee.
It further agree to ensure thtlt all required Insp'ections are requested at the proper time, that project address is reedable from
the street, and the approved let of plans Will remain on the site at all times during construction.
Signature
Date
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DRAINAGE,
o Storm, 0 Ditch, 0 Culvert, 0 Natural
WETLANDS, Description
FLOOD PLAIN, Zone:
, FEMA Community Panel No,:
FLOODWAY, FEMA Community Panel No,:
. PLAN CHEC,K FEES:
UP TO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
1,001 TO 10,000 CUBIC YARDS
10,000 TO 100,000 CUBIC YARDS
100,001 TO 200,000
200,001 CUBIC YARDS OR MORE
GRADING PERMIT FEES:
UP TO 100 CUBIC YARDS
101 TO 1,00.0 CUBIC YARDS
1,001 TO. 10,000 cualc YAROS
10,000 TO 100,000 CUBIC YARDS
100,001 TO 20,0,000
$20,00
, $30,00
$40.00
$40,00 For the first 10,000:cublc yards. plus
$20,00 for each additional 10,000 cubic yards or fraction theraof,
$220,00 For thellrat 100.001 cubic yards, plus.
$20.00 for each additional 10,000 cubic yards or fraction thereof,
' . ' $340 For the first 200.001 cubic yards, plus
$6.00 for each additional 10,000 cubic yards or fraction thereof,
$30.00 .'
$30.00 For tha first 100 cubic yards, plus
$14.00 for each edditional.100 cubic yards or fraction thereof.
$156.00 For,thit first 1,000 cubic yards, plus '
$12.00 for each additional 1,000 cubic yards or fraction thereof.
$264,00 For the first 10,000 cubic yards, plus
$54,00 for each additional 10,000 cubic yards or fraction theraof,
8750,00 For the first 100,001 cubic yards, plus
$30.00 for each additional 10,000 cubic yards or fraction thereof.
Estimated Volume:
3 ~L <.V
,
Plan Check Fee:
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, Receipt:
Date:
Received By:
Grading Permit fee: 72.. 0-0
Received by: /'" ~~. _~-
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Date:
Receipt?? ~_..,.y Date:
Date:
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o Engineerin~_ -.;f~?J..-Lt ~~,
a-- Building: ~ ~..9:?AU
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o Maintenance:
Date: -r- - Q- 5,
Date: 97-97
Date: W.2Ar"A '7
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Date
Permit Number 971/7 7'
Issued by: ~/"~
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Date:
-='7..;:::9-'7::::
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Final Inspectlong.
Planning:
Date
Engineering:
,Date
Building:
Date
Maintenance:
Date:
, , ,_ JOB NO. <]7//79
, . ,ATTACHMENT A .
CITY OF SPRINGFIELD SYSTEMSDEVEiJ)PMENT CHARGE
WORKSHEET '
NAME OR COMPANY: 0 H -e J J "'.4 ~ // i::-IC.SO~
LOCATION:
;.:; R ~ F;,g, ." Y:' rJ-l/A
...; 1= fL-
DEVELOPMENT TYPE' '
BUILDING SIZE:
LOT SIZE
50, Ft.
1. STORM DRATNAGF
IMPERVIOUS SQ. FT. ' .~.z. Ao
,
X $0.226 PER SO. FT. $ 74 , ' 2 ~
2, ' SANTTARY q:l,.JER-rTTY
NO. OF PFU'S 27
(See Reverse Side)
X $46.86 PER PFU
$ /, 2fc'r, 2.:2-
3. ' IBANSPORTATiON
'NO OF UNITS X TRIP RATE X COST PER TRIP
...
I X' I. 0 I X $472.49 $ , 477,2-/
-
, X X $472.49 $
X X $472.49 $
4. ~TTARY SFWFR-MWMr;
Du Du
NO. OF-Fftt'S I ,x 277.7b PER fftj + $10 MWMC/ADM FEE $ Zn,76
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$ 1/8094-
TOTAl -MWMC Sill: $ I,,::, R , !l2..
SUBTOTAL (ADD ITEMS 1.2,3 & 4) $ 2" (nS2-.:53
5. ADMTNTSTRATTVF FFFS'
; ,
BASE 'CHARGE (SUBTOTAL ABOVE) X ,05
!)t,
'$ 132,<::'3
Date: 8-8-q7
',SDC Coordinator
TOTAL SO($ Z:7R5.ICD
.' '^. VI~~ un.. I v/""\&...vULJ-\. IV"'" . J-\U,L.L:.. l'aumoer or 1.\leW I-lxtures ^ Unit equivalent"= Fixture.Units .
,HIlOTE: For remodels, calculate onl.' NET additional fixtures), .' ' , ' " " :'
, , ' . , ,". , NUMBER OF UNIT, FIXTURE ' '
FIXTURE TYPE, NEW FIXTURES EQUIVALENT UNITS
, ,
Bathtub......,...."."........".."...,.,...;..,.",...,...."............ ..
Drinking. Fountain..........". ';."......,........",:,....,...., ,.....
'Floor Drain.....:.:......,...., ."..., ,..... ........:.,...,.,........,...,.
Interceptors For Grease/Oil/Solids/Etc................. ,
Interceptors For Sand/Auto WashiEtc................',', , .'
Laundry,Tub/Clottleswasher,..:",.,.......,.......,...., :':..,
Clotheswasher - 3 Or More..........:........;....;,......,....
, Mobile Home Park Trap (1 Per Trailerl.............-..:.:,
, Receptor,For Refrigerator/Water Station/Etc...:....
,Receptor For Commercial' Sink/Dishwasher/Etc.. '
'Shower. Single Stall..........~.... ....... ..............:..:.........
, Shower, Gang."........".."",.,.,..,....." :.....,....... ,'.',:."...,..'
Sink: Bar, Commercial, Residential Kitch.en'....,.......:...........
Urinai, Stall/Wall......,....".;........."......... ,:.........., .......
Wash Basin/Lavatory, Single............:.................:...
, Toilet, Public Installation..................:..........:..........
Toilet, Private............:..........""................,...........'
Miscellaneous:
Z-
'2
3
.."
TOTAL FIXTURE UNITS'
2
.1
2
3
'6
2
6
6
1
3
2
l/Head
2
2
1
6
4
=
4-
4-
:z..
"",'
3
1'2-
2.'7
CREDIT CALCULATION TABLE: Based on assessed value, If improvements occ~rred after a(lnexation date in table,
calculate credits separates.
"
, Year,
Annexed ..
/1iJi:q or bAfore
1980:
1981
1982
1983'
1,984
1985
1986
Year
Annexed
Rate per $1,000
Assessed Value '
$3,9V'
3,89
3.83
3.70
,3;55
3,39
3,20
2,91
1987
1988,
1989
1990 '
1991
1992
1993
1994
1'995
1996
IlfL9+
.'
Credit for Parcel or Land Only'lf Applicable
.3 "Q7 X $ z1,9~o
(Rate X Assessed Value)
X $
, '(Rate X Assessed Value)
',. ",. '.'.
Improvement (if, after annexation date)
=
=
Rate per $1.000 " I:
,"Assessed Value
$2.56
, 2.17
'1.73
, 1.31
0.92,
,0.74
0.61
0.4,5
0:31
0.17
CREDIT TOTAL = $ _'IR ,qt
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
Resideniiai.,:.;..;...,.;...,......,... 0.4
Commerical...:...........:......... 0;9,
,'ndustrial............................ 0 5
Governmental.'"..,......,.,.,.,... 0,5
IMPERVIOUS AREA';' TOTAL LOT SIZE X RUNOFF COEFFICIENT
, '.
.
Job. No.
t\f\\\~
SYSTEM DEVELOPMENT CHARGE
- WHRKSHEET . ,
NAME:\\N\\--\~_ l ~\\f~ PHONE: 144.G\~~
ADDRESS:\a~ } STATE: (JiLZIP: J. J11<j{
.\
LOCATION OF PROPOSED BUILDING SITE:. #":..l->
Street Address: ~ ~o'L ~\S\.! ~lI.lOOA
Plat Name: ~,~I~~ t Number: 1IDOO ~\ \ OfflIfJ
1. DEVELOPMENT TYPE (CheCk~prOPriate dwelling(s). sac calculations and dwelling t
ype definitions are on the back.)
\,
-
A. Sinale-FBmilv Detached,
l Single Family home
NO. OF UNITS (
Manufactured home not in a park CO
X $1,000 per unit = $ \ DOO I .
B. Rinqle'-FBmilv Attached
NO. OF UNITS
X $924 per unit = $
C. lIIulti-FBmilv Aoartment
NO. OF UNITS
X $692 per unit = $
D. ,Manufactured Home PBrk,
NO. OF UNITS
X $699 per unit = $
$ \tfJ)~
pf
$ \C)m~
$
WILLAMALANE SDC
2. SDC CREDIT (if applicable) SaC-payer must furnish proof of
Willamalane Credit approval. See SDC Credit Worksheet.
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SOC reduced for Credit)
D~~~art:'",
City of Springfield
?
Date
1 9 /9'/