HomeMy WebLinkAboutPermit Encroachment 1998-4-7
t. SPRINGFIELD
~*'
Page 1
COMMERCIAL/INDUSTRIAL PERMIT APPLICATION
CITY OF SPRINGFIELD Job Number: 980405
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 3680 JASPER RD
Assessors Map #: 18020612
Tax Lot #: 02700
Owner: SPFLD SCHOOL DISTRIC
Address: 1890 42ND STREET
Phone #: 744-6375
City/State/Zip: SPRINGFIELD, OREGON 97478
Description Of Work: CONNECT TO SAN SEWER
NEW
Value:
17,448.00
PLUMBING
NO.
Fee
Charge
85.00
Sanitary Sewer
383
ft.
TOTAL PERMIT
85.00
QUAD AREA: 3CSC
-- OFFICE USE --
LAND USE: 6800
Item
Square Feet
x
$/Square Feet
Value
TOTAL VALUE OF PROJECT
0.00
Surcharge/Admin
MECHANICAL
Surcharge/Admin
PLUMBING
Surcharge/Admin
SEWER CONNECTION INS
CITY SDC FEES
SUBTOTAL PERMITS
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
0.00
0.00
0.00
85.00
6.80
5.00
27,481. 24
27,578.04
TOTAL PERMIT FEES EXCLUDING ELECTRICAL
27,578.04
REQUIRED INSPECTIONS
It is ~the responsibility of the permit holder to see that all inspections are
made at the proper time. To request an inspection, call 726-3769
(recorder), state your City designated job number, job address, type of
inspection requested and when you will be ready for inspection. Requests
received before 7:00 a.m. will be made the same working day, requests made after
7:00 a.m will be made the following work day.
Special Inspections: In accordance with
a special inspector shall be employed by
construction of any following "*" work.
shall be furnished to Building Safety.
Section 306 of the State Specialty Code
the Owner/Contractor during
A copy of the special testing reports
In addition to the inspections specified, the Building Official may make or
require other inspections of any construction work to ensure compliance with
the Building, City or Development Code.
Job Number: 980405
Page 2
SANITARY SEWER LINE - Prior to filling trench.
SANITARY SEWER CAP - Capped within five feet of the property line and
capped with an approved material as UPC requires.
--- ADDITIONAL COMMENTS ---
BREAK HOLES IN THE BOTTOM OF THE SEPTIC TANK AND PUMP COMPARTMENT SO THEY CANNOT
FILL WITH WATER.
Plans Reviewed By: LORNE PLEGER Date: 05/14/98
Building Site Reviewed By: LISA HOPPER
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 project address is readable from the street, that the
permit card is located at the front of the property, and the approved set
Si1. e ~
D:ff-'/9r
'-.../
- u VALIDATION
Date Paid:
_I) ~ C;~q J
S/ZC/lf
J- 7- I 5-7 Y;. 0'-/
CJl tJ cJJ /
Receipt Number:
Amount Received:
Received By:
226 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
OFFICE TELEPHONE (5031 728.3753
~
ENCROACHMENT PERMIT
NUMBER:
PERMIT NUMBER: 9~~
INSPECTION LINE SEE INSPECTIONS ON BACK SIDE .
APPLICATION DATE: "'tl-7..9A
"
DATE ISSUED:
,LOCATION OF WORK
APPLICANT ""PP'~h ~~ V..;c;.7;.'/9
SITE ADDRESS: ?~~O I"M..,--...-~ . M.
CITY: hp~ sTATE;~.' ZIP:
r
SUBDIVISION:
OWNER: '...sL#~L ~",,"h 74/.c>- #- /49
ADDRESS: .J~4...-:;) ~?;.ns':.pr; CITY; ~Lo
CONTRACTOR: ADDRESS:
CONTRACTOR REGISTRRATIONO~:
PROJECT SUPERVISOR' _' _ .
'/ -
REQUESTED PER,nnITS' .
,.,'
D ENCROACHMENT PERMIT NO: ............................... n
VALl) FOR IlXTV 1101 DAYS fROM DATI 0' IlSUANCI
o CUT STREET, 0 BORE 0 OTHER
o DUST CONTROL (TYPE OF CONTROU
,PHONE 7.~t./. ~ ~~
,TAX MAP: /4!i!~~./.2..
<9?~ TAXLOT:~2~
,PHONE:
"STATE: ~. I
ZIP: ':::;::::>7"::_ ....
PHONE:
,
, EXPIRATION.DATE:
PHONE: .2iV-c J7:S
lNSP!cnoNS RlQUUWh
AI'l'UCATlON '"' DDOSIT
ACCOUNT NO:
n
.
Q 020.00 I
Q.
o CONSTRUCTION, STORAGE. STAGING n Q .
o OTHER Q NOTICEQ .
o ASPHALT OEPOSIT......:........................................................................."..............'I'IttS'1'ERMa&1'../_:. :,:PIRe If TI Ie 'A'0....:r.
TVPF OF SECURITY DEPOSIT AUTHORIZ~ UNDER THIS PERMIT IS NOT
Q BLANKET SURETY BOND Q SURIITY BOND Q CASH I CHECK C ,
OMMENC un I':> "'C"'''UUI~I:U run
o CURB CUT PERMIT NO: ................;... FT. Q~O DAilFt:W&a.+ ..161FT.
IN..Pltl'!TlnN. CUAB, APPROACH AFnR FORMS AlII weno BUT hilV" IU POURlNQ CONCR!T!.
, VAI.IlI'OR 110 DAY, FROM DATI 0' BSUANC!.
Q SEcOND DRIVEWAY lSEE SEl'ARA TE APPUCA nON!
Cl SIDEWALK PERMIT NO:.................... FT.
VALIDPQR '80 DAVI FROM OATlO'ISSUAHCI.
o NEW 0 REMOVE I REPAIR 0 PAVE Pl.ANT STRIP
O'SETBACK 0 CUR8SIOE 0 LENGTH
IN!Il.Ht"TlnN. IIttDlWAlIl: J DRIVEWAY FOR AU. CONCRfTI ,,,VIHQ WITHIN TH! mElT RIGHT 0' WAY. TO BE
MADa AFTEA AU lXCAVAT\NQ IS COMPLnI. AND FORM WORK AND 'UB-BAlI MATIIUAL 18 IN PLACE.
iI SANITARY SewER CONNECTION PERMIT: ................ n
VALl) FOR IlXTY 1801 DAva FROM OAT! QIi ISSUAHCI
.iI TO STUB 0 MAIN UNE IEASEMENT.R/WJ 0 OTHER
o STORM SewER CONNECTION PERMIT: ....................(1
VALl) 'OR IlXTV 180J DAva FROM DATI 011 ISSUAHCI
o CATCH BASIN I BUBBLER 0 STUB 0 MAINUNE
PROOF 01: ''''''''RANCE' .600,000 MINIMUM
. 0 ATTACHED 0 REQUIRED AMOUNT
n
Q .'0.00",..161FT.
~ $5.do I .
~~
Q .5.00 I
TOTAL DUEi-.
TOTAL DUE WITH PERMIT.
?:--~
DESCRIPTION OF PROJECT:
PERIOD OF USE OR TIME OF CONSTRUCTION:
, 0 PLANS (TWO SETS) ATTACHED
AREA: LENGTH:
TYPE OF WORK: CUT:
OTHER:
EXISTING SURFACE MATERIAL:
BACKFILL MATERIAL TO BE UTILIZED:
SURFACE REPLACEM'ENT MATERIALS TO BE UTILIZED:
TYPE OF DUST CONTROL TO BE UTI~IZED:
NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT:
WARNING DEVICES TO BE UTILIZED:
Advanc. .5gnIng Ind work Ion. .protectlon to b, In complllncl ~~, ~. M.nuar on Uniform TreUlc Control C.vlc.. CMUTeDI.
FROM DATE:
TO OA TE:
WIDTH:
. DEPTH:
TIME:
. TIME:
HEIGHT:
BORE:
BACKFILL MATERIAL:
DESCRIPTION:
~
WORK SHALL COMPLY WITH CHAPTER X ARTICLE Ii OF THE CITY CODIt CONTRACTOR TO COMPLY WITH MUTCD .
REVISIONS 8/24181 FORM , 111 '
,
1
"'
PLAN REVIEW COMMENTS I SPE. INSTRUCTIONS: . .
Dflt~I>>;B~~~~r~AW~~,BM~ft~C'E't'JW, EXISTING CITY CODES AND YdbMPUANCE WITH CURRENT
001 BackllD WIth '" minus rock. - 018 M1numum 4' cl..r.nc. .t.ny point, .wlng..w.y.
. .
. 002 Comp.ct .v.ry 18" 100.. d.pth. . 020 Concr.to minimum 4. d.pth, 3.000p.1.
. 003 R.qulro. compaction with. 11111 rolllar. 021 Tronch to b. "T" out.
. 004 A.C.to m.tch tho gro.tll ol.x1l1lng d.pth or 4". j 022" Nlld. St.t.1 Counli' p.rmlt,
. 0015 AD cut. ...ted tor fln.i InlplotIon. . 023 No .bov. ground ."clollng. In .Idlw.lk or hlndlclP rlmp..
. 008. Tlmponry pitch mlY b, ulld It the .nd 0' the day. . 024 DIamond cut A.C,lConcrttl v.lue box.. to grad..
. 007 Signing .nd Zon~ prot.ctlon to oomply with MUTCO . 026 Fro.h 011 .Ign.' Grod.d.
. 008 Cut concretl onty on Icor. IIn.. O( cold Joint.. . 026 Comply with Amlrle.ns with DI.abllltles Act.
. 008 SId.w.lko .nd drIV.w.y. mln. 3.000p.~ . 027 Coner.t. al.b.. 72hro. curing tlm.. 4600p.l.
. 010 Curbing mln 3.S00pall No pllchwork I.u th.n 3'. . 028 Concrttlll.b. roqulro lolntolll mat.ri.l.
. 011 Mi.t min. roqulrom.nto on curb out.. Spld. cod.. 028 Oriv.way ,.qulrt. dow.l. .v.ry 18..
012 R.II"" pltnt.d.II.... Spld. cod. 208.3.06 ri 030 Subml.trolllo control pl.n prior to 1X0.vatlon.
. -
. 013 Spec..o 80,.1 J.ck I No A.C. out.. . . 031 Notify T,.Wo DlYltlon beforo .xcavaUpn.
. 014 M.chanlcal comp.ctlng roqu~.d. . 032 Coro drill main IIn.. Ina.rt tll. 21lo min. grad..
_ 016 No patchwork .now.d. 8 933 Mu.t comply with tho provlalon. 01 ORS 767.641 to 767.671.
_ Ot8 Lat.rol out. to have control d'MIty fill. 343 S. CIrcular hol.1H2().V.c.
017 Cut. to be poiym.rtz.d crack ..al.d fo,'lnalln.p.ctlon.
: ' 018 Mlnlnum 2- eN_hid rock'- minus.
.\ -
."
Commenll:
."
YOU ARE REQUIRED TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S
"ONE CALL NUMBER" 1-800-332-2344
48 HOURS 8EFORE DIGGING
INSPECTIONS:
'Q CURB CUT AND"SIDEWALK iNSPECTtONS CAll 72603769IRECORDER) STATE YOUR DESIGINATED CITY JOB
NUMBERlPERMIT.NUMBER,.JOB ADDRESS. TYPE OF INSPECTION REQUESTED, AND WHEN YOU WILL BE READY FOR
INSPECTION, CONTRACTOR'S OR OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 A.M. WILL BE
MADE THE SAME' DAY, REQUESTS AFTER 7:00 A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE
CALLED IN AFTER' EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE BUT PRIOR TO POURING CONCRETE.
. ,j"',!',. .
13
SANITARY SEWER, STORM SEWER, ENCROACHMENT PERMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT
72603761.
SIGNATURE:
AMOUNT RECEIVED: S. tJU
RECEIPT NO: /J 'Z- q 11' 1
;
DATE PAID:
RECEIVED BY:
5"1 U /7'i /:'
. J //1/-.1/
By signature, I alate and agree6 thet I have cere fully exeml[led lhe completed eppllcation end do hereby certify that allln/ormetion
here n la 1r\le end correct, and further certify thaI eny end ell work performed shell be dpne In accordence With the Ordinances of the
" CitY of Springfield, applicable ItY Slendard spaclflcallons and Drawlngshand the laws of the State of OreJl.on pertaining to the work
dascribed herein. I further certify thaI only conlractors end employees w 0 ere In compliance with ORS 701.055 will be used on this
. project. . .
The City mey Inspect the work slle described In this Ilermlt et 'any time during a one year period following lhe re"ceipt Ily the City of
nollce Qf.complellon of the described work end specify, alth, CltY's .ole deseresslon, e[lY eddltlonel rsstoretion work re~ulred to
. return thr ,Ite 10 a slenderd accepleble 10 the CIl'(. Tlie psrmltte, will be notified In writing of eny work required end will heve thirty
. daYS (30 from the daf' of the notice to complele the work. Work not completed at the enCl of the thirty deys" will be performed by the
CItY end tha OOSIl wll be billed 10 the permittee.
" I furthor egree to ensure thaI ell rrqulred Inlpectlo[ls are re'lu&led et the proper time, thaI project eddress II reldeble from the street,
end the epproved set of plens wll remeln on the site at ell times during construction.
",' .
Slgneture
Dete
VALIDATION:
CJ TRAFFIC REVIEWED BY:
CJ ENGINEERING REVIEWED BY:
. CJ MAINTENANCE:
CJ PERMIT ISSUED BY:
DATE:
DATE:
DATE:
DATE:
: FOR SIDEWALK AND CURB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRA WER.
. INSPECTION:
:" INSPECTION:
WORK IN PROGRESS
. '
AT TIME OF COMPLETION:
ELEVENTH MONTH:
DEPOSIT RETURNED:
.DATE:
DATE:
DATE:
DAT~:
DATE:
DATE:
"
"
...
,
,
. .OB ~O. . '18CWao
ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE'
WORKSHEET
NAME OR COMPANY: ~v;h.~t;.,&.r.J~A"; 13h~// 5,,"~j
LOCATION: . 3(, 80 -J.,..,~,.f..J. '
OEVELOPMENT TYPE: C#/iM..a- 0l.?."~~ ,7~/-t, 5.i:-.b........... 9""'::d..::'
tJ -/
BUILDING SIZE:~v 8.z!,,'1ZJO LOT SIZE SQ. Ft.
1. STORM DRAINAGF -A/o~y
IMPERVIOUS SQ. FT. X $0.226 P,ER SQ. FT. $ ~.
2.SAtilIARY SFWER-ClTY
..
NO. OF PFU' S . ;1 '1'8 ' .
(See "Reverse Side).
3. TRANSPORTATION ~ d ~
NO OF UNITS X TRIP RATE X COST PER TRIP
X $46.86 PER PFU
.. ;:18.
$ /.G. <~n-
x
X $472.49
$ -&"
x
X $472.49
X $472.49
$
x
$
4. sAtllIARY SFWER-MWMc;,
. . .
. "
NO~ OF FEU'S ~"t..5'X .In ~ER FEU + $10 MWMClAl)M FEE $';?"(9,.2S-~
.. I .
. 6:Z
. MWMC .CREDIT IF APPLICABLE (SEE REVERSE) .,$/_~. {).57. .
IQIAL-MWMC sac 0'fl~~. ,..
. ~""(;~, ~
SUBTOTAL (ADD ITEMS 1.2,3 & 4) . $ ,2~) /7.1- .
5, ~INIST~ATIVF FFFS"
. .
BASE CHARGE (SUBTOTAL ABOVE) X .05
. {.3
'. $/, .7Db,....-
~S~dinator .'.
.Date:_y4/9A'.
/A2~
. MAl Silt: 1.27y(ZL .
,
..
.
. FIXTURE UNIT CALCULAlON TABLE: Number of New Fixt. X Unit Equivalent = Fixture \Jnits ,.,
(NOTE: ~ remodels, calculate only. t,!il additional fixtures) .
r,roJ-. ~If~d ,:C;<tX NUMBER OF UNIT FIXTURE
"FIXTURE TYPE NEW FIXTURES EaUIVALENT UNITS
Bathtub.................:...;............................................... .
Drinking. Fountain....... ~.............................................
Floor oraio:.....:............................;".......:.................... "
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc................:.
Laundry Tub/Clotheswasher........ :...... .... ................
Clothes washer . 3 Or More.:....................................
Mobile Home Park Trsp (1 Per Trailer)...................
Receptor For RefrigeratorlWater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stsl!................ .................................
Shower, Gang............,.............................................
. Sink: Bar, Commercial, Residential Kitchen.........................
Urinal, StalllWall..... ...... .............. ..".... .,.. ..... ,........,......
Wash Basin/Lavatory, Single..................................
Toilet, Public Installation.:......................................
Toilet, Private. ..... .....................:....... ......... ...... .....
Miscellaneous:
.',q
. -'"
2
1
2
3
6
2
'6
6
1
3
2
. 1/Head
2
2
1
6
4
/
.fq
hZ
-,
7".7
TOTAL FIXTURE UNITS
=
"103 .
d
./6
--......<
:<
711
~9'
J;t;(
CREolT"CALCULATION TABLE: Based on assessed value. If improvements occurred sfter annexation date in table,
calculate credits separates.
I
.I
Year
Annexed
---"
Cll?~ or be~
19t1U
1981
.1982
1983'
1984
1985
1986
1987
1988
1989
1990
1991
1992.
1993
1994
1995
1996.
Rate per $1,000
" Assessed Value
Year
Annexed
$3.97
3.89
3.83
3.70
3.55
3.39
3.20
2.91
Credit for Parcel or Land "Only If Applicable
.'
Improvement (if after annexation date)
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Onlyl
.Residential...:..,................;... OA
Commerical.....".................... 0.9
Industria!............................ 05
Governmental...................... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
Rate "per $1,000
Assessed Value
II
$2.56
2.17
1.73
1.31
0.92
0.74
" 0.61
0.45
0.31
0.17
j!
,I'
.J ., ·
,\p""'.09--98 07: 35A B _ H_P
54&45 5303
P_Ol
B(J~h;Jer & lIuUard Eng;neerJ
Mf:CHANICAL, ELECTRICAL, CIVIL CONSULTANTS
FACSIMILE TRANSMITTAL
975 LINCOLN ST, EUGENE. OR 97401
PO BOX 10347. EUGENE. OR 97440
(541) 686-8478 (phone) I (541) 345-5303 (fax)
TO
COMPANY
FAX NO.
FROM
SUBJECT
Lorne Pleger
City of Springfield Development Services
726-3689
Mikael Shields
Douglas Gardens Elementary School
Sanitary Sewer Connection
April 9, 1998
PAGES: 2 (including this sheet)
Attached is the fixture unit calculation table for determining SDC's for the referenced project. Please
call if you require any additional information.
~_fMj oa:09A a.H.E.
FIXTURE UNIT CALCULA TION TABLE: Number of New FiKtyres X unit EQUivalent -
(NOTE: 'or r.modeIS. Clllculat" only ttul liEI ad[iitional fixtures.
. NUM8ER OF
NEW FIXTUf'lf5
Apr.-09-9S
04/08/98
07:35A B.H.E~
15:Z7 FAX 541744UJ74
FIXTURE TYPE
8athtub....... ................. .............................. .....
Drinking. Founui".......,...o..... ... ..-.. .... ... ...............
Aoo' O'aln_..............~.......... ........... .......-........
,""lIrce.pton For Gre...IOIIJSoIidIJEtc..- ..... ..... ....
tntere.PIOtI For Sand/Auto w.sh/Etc.....--...........
l.~ndry TublClofh..washer,,".. ..............."'"..". ......
Cloth....,.shef - '3 Or More.....................................
MObIle nom. Park Tr.g (1 Per Ttail~rl.............-....
Rae.ptor For Refrlgerafor/Water Stafion~tc..."....
JIlec_ptc:ar For C01'T'Vn8re,ial Sink/Dlsnwaaher/Etc..
Sr.awer. Sil'lglc 5.all... .."..........."."...............
Sno"".f, Gang....... ............... ..... ........... --...............---
Sink.~ Bar. Comn"etciaJ. Residential Kitchel"'--..-.-.................
Urinal. St.urN.II............" ...................................."
Wash Basin/Lavatory. Single..... ........-.--.................
Toil.t. Public In.t.lIation...... ... ... ..........-.... .........-...
Toder . Pr'lvlrc.. ......... ...... ............... ............~.. ........
Mi.cellaneout: A,.,.,." \E1....5.
\lD-rWA<~ 1JI..6
51'S
.
541 345
1IA1Nn:l'CAl'H;t;
5303
.
'.
p'~ 02
1lJ0UZ
P.05
fixture Vntts
F1XTtJRE
UNITS
2
,1'"1
:?
"2
,Po.
.,)'i
"(
6L~ d..
af
p>
348
541 345 5303
UNIT
EQUIVALENT
""J
--" -
-.
2
1
2
3
6
2
6
e
I
3
2
IIHead
2
l
1
6
+
Based on asseaed value. It improvements. occurred after annexation d.te in tlbl..
aIEDIT CALCUULTION TASLE:
clllc"alte credits seDarate..
r -' .--.-"-- - -"""
Year
Ann...d
R... po< ".000
A.-s.....d Value
'979 ot before
1$80
1981
'982
1983
1984
1985
19B!!
n.S7
3.89
3.83
3.10
3.115
3.38
3.20
2."
Cr.dit tor Parcel or land Only If App6ceble
Imgrov.""enr (if litter .nn.x~lion date)
I
-fq
~
.a..
------' ...
TOTAL AXTURi UNITS
.- ., ..... "1
V.... Rat. por 11.000
A"ne.mt Asso...d Value
1981 fZ.!Itl
1988 2.17
1989 1.13
1990 1.31
1991 0.92
t992 0.14
19&3 " 0.81
1994 O.4~
19915 0.31
J_ 1996 0.17 _J
x ,
(flate X As..pod V.I...,
X .
IRate X Jl,s..ued VoIuel
~
CREOIT TOTAL _s
AUNOF~ COEFFICIENTS FOR STO"M ORA.INAGI!
IPo, Eatim.tlng Pw1i_s Onlyl
ResIdenti.L..........................O.4
Cotnrnerical........ ._h ............. 0.9
Ind..sui.1..u"....................... 0 II
Gov.rnm.ntal-........... .....--... 0.5
IMPERVIOIlS AREA = TOTAL lOT SIZE X RUNOFF COEFFICIENT
04/08/98 08: 14
TX/RX NO.US8
P.OOS
.