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Home My WebLink AboutPermit Building 2004-1-29 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01206 ISSUED: 01129/2004 APPLIED: 12/03/2003 EXPIRES: 07/29/2004 VALUE: $ 221,322.00 SITE ADDRESS: 6652 Jacob Lane ASSESSOR'S PARCEL NO.: 1702341109900 PROJECT DESCRIPTION: SFR Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential Owner: IO'DEAN THOMAS K TE Address: 3762 W 11TH AVE EUGENE OR 97402 1 CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone General GORDON BRET EVANS 102721 10/20/2004 541-746-4803 KARL STONER 541-687-6817 Electrical LYNNS ELECTRIC 102316 1011412007 541-726-1895 Mechanical HOME COMFORT HEATING & AIR 84164 06/25/2007 541-345-2838 Plumbing DON CLEWIS 33076 06/10/2005 541-688-1931 I DEVELOPMENTlNFORMATION I SETBACKS ' ORK Front yard Sett<<~l\C~'. tlp.,\.l\:.O{!,/-PIRE If 1~~'~'\1l@ist: Side I Setback:1t1IS PERt-/l11 ~Nd~I'!OItlIS PERt4)1,tFf&t Trees Rqd: Side 2 Setback: p..1j1t10RIIED iSO~ep.,NDONea;~rive Rqd: Rearyard setba<$Ot-/lt-/lENC~~ ~~~Q). % of Lot Coverage: Solar Setbacks: p..N'{ 180 D "114.50 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Street Improvements: Storm Sewer Available: Special Instruction: Notes: BUILDING INFORMATION I I R-3 U-I VN # of Stories: 2 Height of Structure 28.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Electric Energy Path: Path I 441 3 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 1,384 943 Floodplain 2 REQUIRED PARKING Total: 2 Handicapped: Compact: Yes 18.00 I PUBLIC IMPROVEMENTS' Fully Improved Sidewalk Type:you to Curbside 5' No ^""""ENTION:oregonm.~J~~~~:;gr.;"'dlity Curb and Gutter "II dbytntjv'..Y"........ follow rules adopte ose rules are set lort' .Iotification Cemer. Th hroU hOAR 952-00 1 OAR 952.001.-00~ 9~, . , :.9. ~ f th'e rules l obtam Copies 0 . \l090. YO~ ryJay .(Note: the telephone call1ng,the center. Utility Notification number~~::~~i~~~~~~_332_2344). Paee I of4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Description DwelIin!!s Gara!!e Tvpe of Construction V Wood Frame Gara!!e Fee Description Plan Review Residential -Mechanical Issuance Fee-- + 10% Administrative Fee + 10% Administrative Fee + 7% State Surcharge + 7% State Surcharge 3 Baths One & Two Family Addressing Assignment Annexed 2000 Appliance Vent Building Permit Curhcut Permit Dryer Vent Exhaust Hoods Furnace - up to 100,000 btu Gas Fireplace Gas Outlets 1-4 Plan Review - Planning Plan Review Residential Plan ReviewlResidential Hourly PW Mult Disc - 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less . . CITY OF ~rKll'1(ul'1J!,LD Building/Combination Permit PERMIT NO: COM2003-01206 ISSUED: 01/29/2004 APPLIED: 12/03/2003 EXPIRES: 07/29/2004 VALUE: $ 221,322.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $90.60 $23.80 Amount Paid $583.15 $10.00 $5.00 $152.62 $3.50 $106.83 $306.00 $8.00 $-3.28 $12.00 $962.15 $75.00 $6.00 $9.00 $12.00 $15.00 $4.00 $59.00 $42.25 $135.00 $-30.00 $106.00 $76.00 $447.46 $588.64 $10.00 $214.23 $314.63 $108.28 $53.47 $727.42 $164.89 $75.00 $770.97 $50.00 Square Footage or Bid Amount 2,327.00 441.00 Value Date Calculated $210,826.20 $10,495.80 $221,322.00 12124/2003 12/241200~ Total Value of Project Fpp< P~ilIJ Date Paid Receipt Number 12/3/03 1129104 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1129/04 1200200000000002531 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 1200400000000000135 Pa!!e 2 of 4 . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2003-01206 ISSUED: 01129/2004 APPLIED: 12/03/2003 EXPIRES: 07/29/2004 VALUE: $ 221,322.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Vent Fan WlIIamalane Single Family $18.00 $1,000.00 1129/04 1129/04 Total Amount Paid $7,198.21 Plan Reviews I Initial Review 12/04/2003 12/0512003 APP LLH Plan nine Review 12105/2003 WE EMM Plannine Review 12110/2003 APP EMM 12/10/2003 Public Works Review 1211212003 APP VRJ 12/3112003 Structural Review 12105/2003 WE DLM 12123/2003 Structural Review 12130/2003 0112312004 WE DLM Structural Review 01128/2004 01129/2004 APP DLM 1200400000000000135 1200400000000000135 Electrical permit not included. Applicant left a question mark by the electricians name so I did not contact the electrician for permission to use electrical permit form. Left message for contractor regarding submittal of LDAP. Also measurements on plot plan add up to extend beyond easement line. Dlfffers from structural plan. Which is correct? Needs to submit LDAP. Requirments of the no build line and 5' easement apply on rear and west side of property. Pw's fees have been added. Building Permit given to Ken Vogeney for review and approval. 12/31103- Plan reviewed and approved. KJV Plan review is complete except for lateral engineering for front building walls, requested from applicant. dIm Engineering calculations and drawings submitted for review 1213012003 dim Lateral engineering for front garage wallis missing from submitted information. Called owner and engineer for additional info. dim Received additional engineering for garage from applicant 1128/2004 dIm 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. IRpm~ 25 Site Inspection: To be made after excavation but prior to setting forms. 27 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. Paee 3 of 4 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2003-01206 ISSUED: 01/29/2004 APPLIED: 12/03/2003 EXPIRES: 07/29/2004 VALUE: $ 221,322.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 4 Final Mechanical: When all mechanical work is complete. 17 Rough Electric: Prior to Cover 9 Electric Service: Approval required prior to utility company energizing service. 2 Final Electric: When all electrical work is complete. 24 Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 7 Curbcut - Standard: After forms are erected but prior to placement of concrete. 33 Temporary Electric: Approval required prior to Utility Company energizing pole. 11 Footing: After trenches are excavated. 12 Foundation: After forms are erected but prior to concrete placement. 16 Post and Beam: Prior to Ooor insulation or decking. 10 Floor Insulation: Prior to decking. 22 Shear Wall Nailing: Before covering sheathing with finish materials. 13 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 31 Wall Insulation: Prior to cover. 6 Ceiling Insulation: Prior to cover. 8 Drywall: Prior to taping. 15 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 1 Final Building: After all required inspections have been requested and approved and the building is complete. 30 UnderOoor Plumbing: Prior to insulation or decking. 28 UnderOoor Drain: Prior to cover or placement of concrete. 20 Rough Plumbing: Prior to cover and including required testing. 23 Shower Pan. Prior to covering and including required testing. 32 Water Line: Prior to filling trench and including required testing. 21 Sanitary Sewer Line: Prior to mling trench and including required testing. 26 Storm Sewer Line: Prior to filling trench. 5 Final Plumbing: When all plumbing work is complete. 29 UnderOoor Mechanical. Prior to insulation or decking and including required testing. 18 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 14 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 19 Rough Mechanical: Prior to Cover 3 Final Gas: When all gas work is complete. 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 701.005 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. -!~ ~/ /-- J..}'-o 1" Date Owner or Contractors Signature , Pal!e 4 of 4 225 Fifth Si'i'eet Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1206 COM2003-0 1206 COM2003-01206 COM2003-01206 COM2003-01206 COM2003-01206 COM2003-01206 COM2003-01206 COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 COM2003-01206 COM2003-0 1206 COM2003-01206 COM2003-01206 COM2003-01206 COM2003-01206 COM2003-01206 COM2003-01206 C0M2003-01206 COM2003-01206 COM2003-0 1206 C0M2003-0 1206 COM2003-01206 COM2003-01206 COM2003-01206 .. COM2003-0 1206 COM2003-0 1206 COM2003-0 1206 C0M2003-0 1206 j? -;:-~.I IE"".""...=......,....,'"..,' ~ " . ,c" I ":--A!:', j WIlft" j '.. "_" _ .~. _ _ . ,i B",,",~" ."c- Receipt #: 1200400000000000135 Description Addressing Assignment Willamalane Single Family Plan Review - Planning Vent Fan Gas Fireplace Dryer Vent -Mechanical Issuance F ee- + 7% State Surcharge Residence Wiring Ea Addtl 500 Residence Wiring 1000 Sq Ft Appliance Vent + 10% Administrative Fee Gas Outlets 1-4 3 Baths One & Two Family Furnace - up to 100,000 btu Exhaust Hoods Building Permit SDC Transpo Admin SDC SanitarylStorm Admin SDC MWMC Administration SDC MWMC Reimbursement SDC Transpo Improvement SDC Transpo Reimbursement Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Improvement Storm Drainage Impervious Area PW Mult Disc - 2nd Permit Curbcut Permit Annexed 2000 Sidewalk Permit Plan Review Residential Plan ReviewlResidential Hourly + 7% State Surcharge + 10% Administrative Fee Temp Power 200 amps or less 7' City of Springfield Official R~ceipt Development Services Department Public Works Department Date: 01129/2004 2:17:54Pl\1 Amount Paid Item Total: 8.00 1,000.00 59.00 18.00 15.00 6.00 10.00 106.83 76.00 106.00 12.00 152.62 4.00 306.00 12.00 9.00 962.15 53.47 108.28 10.00 314.63 727.42 164.89 447.46 588.64 214.23 770.97 (30.00) 75.00 (3.28) 75.00 42.25 135.00 3.50 5.00 50.00 $6,615.06 . . 225 Fifth Street <,' Springfield, Oregon 97477 541-726-3759 Phone Payments: Type of Payment Check CreditCard Paid By WASHINGTON MUTUAL GORDON BRET EVANS Uit-,fj,';~~M. ""'0,." i " .i . .: ~'_",'~.' -, 'c,! Receipt #: 1200400000000000135 Check Number Batch Number Authorization Number Received By djb djb 66870530 000287 342532 City of Springfield Official Receipt Development Services Department Public Works Department Date: 01/29/2004 2:17:54Pl\1 How Received In Person In Person Payment Total: Amount Paid $6,556.56 $58.50 $6,615.06 . . r_ : "'. ' . CITy.OFSPRrNGF~I~I"D,:qREG~~.,. . . 215'FIYfH STREET. SPRINGFIELD, OR 97477 . PH:(S4J:,726-3753 . FA-X: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number Ctl!LI2L:tJ ~ -OL.~ Dale ~.ct V~ 3. ~:gg'~~~~M::~~gt~?~?~~~~~~g~~~\~~1~!~~~; 'O.:'~-~~':O:"_'lr"'~ 't<~..-"'r..n:, '~~'~:_;>'Il'"':>'_....~., ..;-.. ',:~~:":'<;'~''1':!:;/,', ";'jI;j'>," 1. "!&.,CMJON .OF.'JNSTM;JfATION/,;ity:$;;t/ 'I. . ... .,' _ ,-~_" _ ,_, .. , ' ..' ", ...... ",., I "', . ,.,.. ..., ~~..,"'~.~ "'~III:><.;'4Ci'O~llw~.~, .......,..~~,,,','.~, .,~4~.,~~,...~:.l.,.#'":Jr "52. JAc~~) LEGAL DESCRIPTION /702- 3+/1 I'Y7'7>tJO JOB DESCRIPTION" 'f),0- ~ J w,iL1rf: U'~~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work Is Suspended for 180 days. :~, ~)f~~~~rG~?tf.':'a.\jlID~,,;"-.!!i'~~iW~~;IS'~~~~,i 2. ;;h<i!t~~~~~.~~-m.,.~~i;,,,n~~)?g.mf;~ , ' Electrical Contractor .Ly.u-N;$ tlf.ctR'r...: Address f.(), 'M it City f"t.-\ \ ~~ Phone "'7Vr1etf)"" Expiration Date :1.35'1-5 10/0110'-/ , Supervisor License Number Constr. Cona-. Number 10 ';I.. :s I <0 10/01 J Of Expiration Date inspection Request: n 5-3769 ::',~f;' ",t!'~:0~""1:'r :,,'t"',~ "1::':>:'~,;1"',!it~;.,. :':\l>'('?";';,"~:.i'.. ,<I \~,',,':;<';'';;!f'''_;~ !\'!~:i I' ,,;r.(,''I:l~<1':;::~~'r~','\\ "'''!'''~',- ;w,,' " A. ,'~N",,~ReSickiiti81 :::,SingJe:or,]\llliti~Fariin:' 'er,dwellin "uJiit':,;~r~ ;,,~...:., iJ-'~..~;,,~'~"'<!i~'.' ....p.I;."",: :....~_..;;.'f;'.'>~.,,:.::.::... . .', .~.';,;....~.r P,...,~".;.~.....,~.,.,~~\,=.;...,~ ..-..t.<;~ Service Induded 1000 ;q. ft. or less Each,dditional 500 sq. ft. or portion thereof Each ~;anufact' d Home or Modul" DweUin8 Service or Feeder ..J.L:.. _ $106.00 j IJ In ~ . ~ $19.00 ~ $5'; 00 l~. 1~1~i~~t~1t~~~~t~rt~;I~fll.~~:(~ti~~~'~\~t~i~~~~ ~'~:;{:!..:A.1;;.'~;:'.\~~i.IlJj:::'ljli;.:j::~':7d~\liQEih~';:ci:{i ~~;~1~1ci/;. .;:.i.:~ '\"~~S:M.i)1t~.~;::~l 2 00 Amps or less 20 I Amps to 400 Amps 41'1 Amps to 600 Amps 6l,1 Amps to 1000 Amps Over 1000 AmpsIVollS R<connect Only $ ,;3.,'0 $ 15.lX; $J 25.00 $1<,3.('0 __ $375.(10 $ 50.0') "W", ..~..'''...~~' ";""-',"0''''', ,"_.....f~, J,-, " "',.~, ' ~,. .7'" ~.,<.."""0&1 \i '" >'!'~"~~I'Y~~I'" . .:~:v:....-€.~~.;. ..;.f"~~ ~. ..:-. ,!:.';" 1~ . .'- l~~.M"j:; .. C, ~.lI~_~~f.'t.. ~ J~~S~.2S;f:,,~~~~t:,~~ :~,: - :;l'~. ;It':~ > ~ "'!~~:l.~:.' \ 7% Statt' Surcharge 10% Adn:lnistrative Fee TOTAL Sha,.:-d Drivc(T:)lBuih1iIl8 Fonns.'Elcc:ncnl Pcnnit A)XlI. nltOn I.03.doc - . 1..,-:: .;.<':-','.,"_ '\. C'I~T 'F'S.,...on:TGFIEL'D :'b.REG'ON"c -:' ,:; ',.;:. f. 'he"'-: J - t .,; ,\:;, ':l;7I~ . ,; L.I\...li'il _ ; \.:J }.,"'i 'U ~"".....' ':.... !Jl'!, '~1; "'~.~ -. ::~~-:.:.-' ~ .::., .t. !!:~.~ ;. ': "-;''':.{'::. - "':. \ '., . ~"#'J'-. .~.:.: f ..J{,~r... : .:~.:. ~'rii7i-. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726.3 ELECTRICAL PERMIT APPLICATION City Job Number ;)O{)3 -()j d 6 h """<'i:("J~,r,~~-' ""~'~':;"~"'~ ,," ""'~~'R~q. ,....~~'" C. ~~ TemporarYjSer";ces:or;Feeilsr.~.:,":~~" "'~~.! .J:~~~r.~t'~({,~, ~,- _'M-<....1t~>... ... ~~ ~ ". ~Q"'~.~~j..,.-",i.~~..;::...iif.~~::';': ~""" Installation, ;W.~M~~\1!~1tion -0 ~ 20~~~~: ?'t.\l.\tI\ ~I:)\l. I $ 50.00 S ~n"\~ 't:.~\tI\'i8i ~?>i~\? ~~\) $ 69.00 \\\\S? ~SLt.4l>)J ~l\!bt Amps $100.00 Expiration Date t\\\~ ~~ ~~' Signature of Supervising Electrician c~~~~ ~\~~ch'Gi.rr~~~,~~~"~;I~~;~'~~i:~~~~;,':~::i~: ~;ii, :l,~~.~o1 . ~ New Alteration or Extension Per Pan~O - One Circuit tas'IOU.\*! $ 43.00 . ,Each Additional Cir&iQ 6~~igo{l \J" ,~{\ ~ d rJJ .55 C' Service or6~a1#~eW\\tIe Ot eta "e\ ..uV $ 3.00 ~;:r:~:?~bh;J 1f~)5e~:;:L73( ~;~~~~~~5!:?~\~t~f~l~~~I~t~~ City r;-e~l I J Phone /1 J, - (J..,:) I" ~o\i\\tl~~'2!'~~ga~~\l.i{l c O\a'. \~a W:~liC\l.\\f$-50.00 ,.,. {I orsf'=,n,,~'lL,~hlJl\g\~ U\i\\\'j ," $ 50.00 " n!'I ""!0'7 Cefl< (J.~~, '2.'3~ .1 OWNER INSTALLATION " \)()"'r::~'E'&r~~'j!Lp'~_'3~'2.' $ 25.00 The installation is being made on property I own which ~!'l(i~~~;gYIC6irirrfercial $ 45.00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Date I. Wl!OCATWN'OF:INSTAL'TfA11.0N.' ~';'J"i,J;jr 6' 6 YX""i)A~"8B5""i~KJ"'-"""="'''''''c' Mi. ;;1.\1;3 LEGAL DESCRIPTION 1702 -s.YII 07 :?e>c) JOB DESCRIPTION -rbtA r? i5f-(...~ <<-- L '-- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. , W'CONf~Ct8ft1NSTAEH:tri6&bNEf,:71 2. ~~~'~~:;..~""....' :.;.......,,~.:.:.l''''!.:s:.i'k~~c,.;k'''':.., &i.'.:;,~,~:::'l , Electrical Contractor Ly A/ J/IS EL~1i1P. Address City fE.!.! r 1<___ Phone Supervisor License Number Expiration Date Constr. Contr. Number Owners Signature: ~~fi ~ Inspection Request: 726-3769 . ~o 0)66'0 ~. '\'0\)\\\\\~~~ ~'0 ,0\,0\ I - d. 9- tfJ l/ - 1J'5.J~.,...OIlO ~",... ,. r.'.\'"'fno-:'!...... ,_ '... ,'" _.. ~"~ -"'t;.! 'V'.';'~~1'" -0~:..~~~,."'~~~$'".>l....:.-...-~ 3. . \ COM,n..1:.H:,'EEE'S EDULE n>Wi"" ~~'''',",."~.",,~:;.~,,, ~~,-$=-~"':.,l;."~':"~""ft.""':"~.5lt.!:':.4..r::.!$~ ':)~. ,,^ ~~~1E.:..r:::\.UW~~t.~JE . .. 9'1.)"" IO-e....v asfl aU\ A. . ~i~~i~}{~i~~2Mi~~f~iiirti~\~~Ki~lii~W:~i{~~~;fa~miW~~Xi~~;fj~ ~";:"-':!I':""~~'.J...~,,' ~_.O . ,....,..> ....,.:!!',...~.~..'" ~. !?..........:h ....;.);i...._~'.ui"w.-,....-;:'C~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereo f Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. ~,)\~~!&~~~~r\F~~di~V'~I~~~~Yliti~~;?Arfl~t~~gf!R~I~t~ti~~;'~'-l ....~."'.'l'".-"-.,..'.....,'~,.._'':''''<.e:,._.... ..:):1"_ ......,t- ~ '<".-r~.~'.3,~--~~."":o',,~1_Jr.~'F" It"U''~.:~,,r.u.'~'':ir' -. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 };f;:l~:"T.;,:..bS',.: -_.K,,:', :..t.!.\,,:;.J' .,:~...,~:~;,~! 4, ~-Sr.lBTOTAL'OFABOVE)< ~;'F ';." ,.:;"', ";"';;.1 ;:-. '~~X"'Y.~""_":_' "-'_~::;::":;.,,_T"""":""i~~.;""--;:- -L'r...:.,f:::...., !!:o..~-;.~"rf/';~[~ .~Joi",...---, .~i!o>"'~...""l\.~.~..=".,_,,;.-'...,,.....-......-,~__,T\_, 5"D 3;0 7% State Surcharge 10% Administrative Fee I $ ,-otj S c-Q ~c ::>u_ TOTAL Shared Drive(T:)lBuilding FonnslElectrical Permit Application 1-03.doc - . I"'""~"'''''''<'V'''' ''C3\.~ ,?t'm.\,1i;~1.":ti:;;;~1,, j.~"~':::;~ (54ij726-37Sf3 FAX(541)726.3676 Estimated Base Flood Ele.vation & Disclaimer For property located at ~tD~1L ~ Cfi, {\ 0-, Springfield OR The calculated Base Flood Elevation (BFE) for lot# , Levi Landing - Second Addition is feet above mean sea level, based on the CUlTent FEMA datum information. The floor level of the residence to be placed on the lot must be certified at least one foot above the Base Flood Elevation as indicated above. (Please note - the City's surveyed benchmark datum information and the FEMA benchmark datum are not the same for this area. Add O.30ft to the City's benchmarks to adjust to the FEMA benchmark elevations.) The estimated base flood elevations in this area are based on interpretation of scientific and engineering evaluations known to the city at this time. Larger floods can and will occur on rare occasions. Flood heights may be increased by human-made or natural causes. The City's estimation of a base flood elevation does not imply that land within this area will be Ji'ee from flooding or flood damages or that conformance with the requirements of.the City will protect the property .from flooding or flood damages. The City, its officers, agents .and employees shall not be liable for any flood damage that may result Ji'om estimation of base flood elevation or any other administrative decision made regarding administration of the City's Floodplain Development Code. The developer of this property may elect to perform additional scientific and engineering studies for consideration by the City to further refine the estimated base flood elevation for this property. The developer of this property may also elect to undertake additional development and construction measures in addition to those required in article 27 of the Springfield Development Code designed to avoid or 'minimize the potential for flood hazards and damage. Such additional measures are subject to City approval. Acknowledgment: I hereby acknowledge receipt of a copy of this document: ". . h..t:t Name (print) G ORd () IV 31< Et EI/ 11 NoS Signature A~.J-.. ~r ~ Date /-~;;-Of/ ~This copy to be signed by Owner's authorized agent and retained in City address file) " . . . . CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: Com2003-01206 NAME OR COMPANY: Dean Thomas LOCATION: 6652 Jacob Lane TAx LOT NUMBER: 17023411 tl9900 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. " COST PER S.F. I I CHARGE I 2658.50 I $0.290 = I $770.97 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS , IMPERVIOUS S.F. I " COST PER S.F. I' 1 DISCOUNT RATE I I DISCOUNT I 0.00 I $0.290 I 50% I = , $0.00 ITEM I TOTAL - STORM DRAINAGE SDC $770.97 I 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: , NUMBER OF DFU's I " COST PER DFU , 26 I I $22.64 B. IMPROVEMENT COST: I NUMBER OF DFU's I , I 26 I CIJ ~ o o U P'i ~ 18 ~ o LOT SIZE (SF): 10803 $770.97 1070 $588.64 1091 , ' COST PER DFU , . $17.21 $447.46 11092 I ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $1,036.10 3, TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIPRATE I , I NUMBER OF UNITS I ' I , 9.57 'I I x I COST PER TRIP $17.23 x INEWTRIPFACTOR' I 1.00 , $164.89 1093 B. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBERIOF UNITS I , 9.57 , ITEM 3 TOTAL - TRANSPORT A nON SDC COST PER TRIP $76.01 $892.31 x INEW TRIP FACTOR I I 1.00 , $727.42 1094 4, SANITARY SEWER - MWMC _I = , A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU 1 , $314.63 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I , $214.23 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD( = , SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , 5, ADMINISTRATIVE FEE.. 'SUBTOTAL I x , ADM. FEE RATE 1= I $3.234.96 I 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: = $314.63 11054 Virginia Jurasevich PREPARED BY 12/26/2003 DATE . . .' . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE, FOR REMODELS, CALCULATE ONLY TIlE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IsA THTUB 2 0 3 = 6 IDRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = '0 ICLOTHESW ASHER / MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRIG / WATER STATION / ETC. . 0 0 1 = 0 IRECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER, SINGLE STALL 0 0 2 = 0 ISHOWER. GANG (!'lUMBER OF HEADSt 0 0 2 = 0 ISINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LAVATORY 2 0 2 = 4 ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 IURlNAL. STALL! WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EOll'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 26 -EDU (Equivalent DwellinK Unit) is a discharge equivalent to a sin.ide family dwel1in~ unit (20 DAYs) set al 167 Jt8l1ons per day_ MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$I,OOO ANNEXED ASSESSED V AWE IS LAND ELGIBLE FOR ANNEXATION CREDIT! BEFORE 1979 $5.04 (Enter I for Yes, 2 for No) 1979 $5.04 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT! 0 1980 $4.95 (Enter I for Yes, 2 for No) 1981 $4.88 BASE YEAR 2000 1982 $4.75 1983 $4.58 CREDIT FOR LAND (IF APPLICABLE) 1984 $4.41 VALUE /\000 CREDIT RATE 1985 $4.20 $36.43 x $0.09 ~ , $3.28 1986 $3,88 1987 $3.50 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $3.07 V AWE /\000 CREDIT RATE 1989 $2.60 $0.00 x $0.09 ~ I 0 '1 1990 $2.14 I 1991 SUI 1992 $1.52 TOTAL MWMC CREDIT = $3.28 1993 $1.38 1994 $1.19 1995 $1.03 1996 $0.87 1997 $0,68 1998 $0.46 1999 50.27 I 2000 $0.09 L 2001 $0,04