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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. ;f~ ~L"'-"<:''''' c::..-<:::t-~l Date ,~~ Signature --- VALIDATION Receipt Number: -::i?'7'J~ Date Paid: ~'""'3.~? Amount Received: t./ 7~2.~/ Received By: ~ , ,i " - . .. " ., ;" , ; ,', La~L"Ai1d "Dr.ai~~ge~'ALiration' Permit:- l , _., , P.!:Q~ ~ i- - ~ ~ w Q. Z 0 - I- ~ ~ LU I- ~ - ~ . Q"' Zl" ~ u.J <J ~ Z - ~ . ~ C C Z ~ ,...I 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. .. - - . ---- - - , 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 . ' ,Springfield, Oragon Tax Lot: oe~ ~ FDr EKc/W/htCII/" ~~~5 " ,. ./ ~~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 ~ 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. , o o o o '0 CROSS SECTIONS, SOILS & GEOLOGY PLAN, ~ < ,u ~ < iE 5 '" J II: -!l ~ w o in . .1 i: DRAINAGE, POLLUTION AND EROSION CONTROL PLAN REPLANTING PLAN . .. ~ . ,,; '. . ~ " .; - ,.. . " ADDITioNAL INFORM'ATION; ~ '. -. ., \.. .'> . " . '"... . 'J.'. . ., ' 'I . - >. , .' , ~., . i .'. " . . ., :. . If .. ~ 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 1-. - ~ ~ L.U 0., Z o - I- <C ~ L.U I- ....I <C C Z <C L.U ,<J <C Z - <C ~ C C Z <C -1 - o o o ,0 , Date: 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 $30.00 for each additional 10,000 cubic yards or fraction thereof. Estimated Volume: 3 ~L <.V , Plan Check Fee: -.. , Receipt: Date: Received By: Grading Permit fee: 72.. 0-0 Received by: /'" ~~. _~- -".~~ Date: Receipt?? ~_..,.y Date: Date: I I ~,~.c:;:~ ! , v VC;(/F-I/ -nMr ~ IS ~~ PALL ~/.i.l~1 7TH. A/~, MA-u' """.lJ)'-rfrP- -..,_ ~$I -k!'" 77/,l-,FW.Ifz<.,r"1' "f1M,;J.I'/"'-"~- .~~ #DT~ ::,t'1i:;':7?V /jJ~f;.~ _Au """ N_~.nw.u. 7'"_ 'fo!!u.1,os, {..~.v. IJurv. .LI4'-,.', C./htAJ.A.!l~. I , 1-f?ril:'2Lr/z- ~'f)o;(:> ~~~ r-f7r"J <:/IfjA.) (,..-,,q ".e(?!, L... r--:;';f') Y/Pt2./' :r r;:..=..a..) I'.LP 1/?//cK-' /...IZt!lf'l-mYr2.. L P~-RJ?/ <C :... r ";:'r.)~1? tf2J? ,y]///'.c- /-1 -r7;<: / 7/1?F?~r;; ~'!_ J::V=. t='C>/ICt=-, 'lJ.4r ..4.~ o>:"7'5.-r...Ld::E...P - ' ~,? t oF-_ r:::7DLJ/}~,/ P-Il ~ ;:?A.r:J Q I D/a~, 'f ' , / fZ}/ PlannlhP ~~ ~ o Engineerin~_ -.;f~?J..-Lt ~~, a-- Building: ~ ~..9:?AU \ ,. o Maintenance: Date: -r- - Q- 5, Date: 97-97 Date: W.2Ar"A '7 I Date Permit Number 971/7 7' Issued by: ~/"~ /'/V. Date: -='7..;:::9-'7:::: / 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'/