HomeMy WebLinkAboutPermit Building 2000-5-24
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I Job# 00-00783-01 I
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Page 1 of2
TRANS#:01-0001878
DATE:MAY 24 2000
AMT RECD:2 $ 384.98
CHANGE:
CASHIER: 059
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CITY OF SPRINGFIELD~ OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00783-01
225 North Fifth Street '
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 6866 Glacier Dr Spr
Assessors Map#: 18020311
Lot: Block: Addition:
Tax Lot#: 02100
Subdivision:
Owner:
Gerald Thomas
6866 Glacier Dr
Phone Number: 747-165-6
City/State/Zip: Springfield, OR 97478
Alteration Value: $5,000
Address:
Scope Of Work: Interior
Finish of bonus room, the plumbing was roughed in at building, Now they will be insulating, and
finil'hinn NOT'I
Office I:J$(;~:
IH~p -
Land uS~'J" ERMITSH~LL # Of Buildings:
Zoning C~CJ€!ORIZEDUND t:XP/Rt:/F70f;:CUDancy Group:
( 'nM ER T, , Ie: l!)/I)O"
Bedrooms: MENCED OR HIS PER",lJpat ~ource:
Range:'Wy 180D"\-" /S~B~NDON,..~Sq~q:ootage:
'" 0<=",_, ..., 'C-n_
-. "VLJ wi I
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
working day,
Quad Area:
# Of Units:
Constr, Type:
Water Heater:
Required Inspections
Building
Wall Insulation
Drywall
Final Building
Rough Electrical
Final Electrical
- Prior to Cover
- Prior to taping_
- When all required, inspections have been approved and the building is complete,
... 1c..1\j'n..n..........,,'j<-:...
fo/'ow rUles EI' ctr" I I
Notif;' ,e Ica '~' ~~: " ~,
- Prior to cover, ,~a;,'on ~entel, Those, '
IJIV~M:.,t:;'''tlr: 0;- ":....
. When all electricalwork'is complete'). 'q I
vvov, YOu may Obti'li ' '~~, " '"
cal/rng the cP'lumbih~o."'''~ 'JI'"
-When all pl'JllIBliigrw-orl<-,is COmp.llit'e~I"I':t'" 1'-"'"/-1':'
C -.-.:..;.....'ull. N 'f'
pnt~,..:_.. C'f'l, .. / Oll ICBi
I Mechanical ';'''''>,-'1'
Final Plumbing
Rough Mechanical
Final Mechanical
- Prior to cover.
-When all mechanical work is complete,
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Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
iArea (Sq. Feet)
I Main: Accessory:
Fee
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
Miscellaneous Electrical
State Surcharge For Electrical Permit
Electric Administrative Fee
Total Electrical
Minimum Plumbing Permit Fee
Number of Fixtures
State Surcharge For Plumbing Permit
Plumbing Administrative Fee
Total Plumbing
Minimum Mechanical Permit
Mechanical Administrative Fee
Vent Fan to One Duct
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
Sanitary Sewer
SDC Administrative Fee
Total System Development
Grand Total
I Job# 00-00783-01 I
# Of Stories:
Current Units:
Census Code: Does not apply
Total:
Paid On Receipt#
Building
OS/24/2000 1863
OS/24/2000 1863
OS/24/2000 1863
Electrical
OS/24/2000 1863
OS/24/2000 1863
OS/24/2000 1863
Plumbing
OS/24/2000 1863
OS/24/2000 1863
OS/24/2000 1863
OS/24/2000 1863
Mechanical
OS/24/2000 1863
OS/24/2000 1863
OS/24/2000 1863
OS/24/2000 1863
OS/24/2000 1863
System Development
OS/24/2000 1863
OS/24/2000 1863
.
Height (feet):
Proposed Units:
Page 2 of2
Value/Quantity
I
Fee Amount
5,000
$50,50
$3,54
$1,52
$55,56
15
$15,00
$1,05
$.45
$16.50
3
$,00
$30,00
$2,10
$,90
$33,00
1
$12,00
$.45
$3.00
$10,00
$1.05
$26.50
5
$241,35
$12.07
$253,42
$384,98
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 and the Laws of
the State of Oregon, I further state 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 the project 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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Signature
S- - ;JJ1 ,-cp
Date
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ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER
DEVELOPMENT TYPE:
DWELLING UNITS:
1. STORM DRAINAGE
IMPERVIOUS SQ, FT,
_-":"'7 - ("'lr> --.~ '3 -0 I
, THOMAS
6866 GLACIER
18-02-03-11-02100
BATHROOM ADDITION
BUILDING SIZE:
LOT SIZE:
0,00
$0,232 PER SQ, FT,
x
2, SANITARY SEWER-CITY
NUMBER OF PFU's
(SEE REVERSE SIDE)
5
$48,27 PER PFU
x
3, TRANSPORTATION
o
NUMBER OF TRIPS x TRIP RATE x COST PER PM PEAK HOUR TRIP
1.01
x $486.73 PER TRIP
x $486,73 PER TRIP
TOTAL TRANSPORTATION SDC
x
x
4. SANITARY SEWER - MWMC
A, REIMBURSEMENT COST:
NUMBER OF FEU's
B. IMPROVEMENT COST:
NUMBER OF FEU's
o
$242,76
PER FEU
x
0,
$22,05
PER FEU
x
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
=
TOTAL,MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
$0,00 I
$241.35 I
$0,00 I
$0.00 I
$0,00 I
$0,00 I
$0,00 I
$0,00 I
$0,00 I
$0.00 I
$241.35 I
5, ADMINISTRATIVF FFES:
BASE CHARGE (SUBTOTAL ABOVE) x
~T~'
SDC COORDINATOR
0,05
OS/24/2000
DATE
TOTAL SDC CHARGES I
,
$12_07 I
$253.42 I
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PLUMBING FIXTURE UNIT (PFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = PLUMBING FIXTURE UNITS
!NOTE, FOR REMODElS, ~AI.~I1LA TE ONl.Y THE NET ADDITIONAL FIXTURES)
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN
INTERCEPTORS FOR GREASElOIUSOLIDS/ETC,
INTERCEPTORS FOR SAND/AUTO WASH/ETC,
LAUNDRY TUB/CLOTHESWASHERlMOP SINK
CLOTHESW ASHER - 3 OR MORE
MOBILE HOME PARK TRAP (1 PER TRAILER)
RECEPTOR FOR REFRlGERA TOR/W A TER ST A TION/ETC.
RECEPTOR FOR COMMERCIAL SINK! DlSHW ASHER/ETC,
SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)
SINK: BAR, COMMERCIAL, RESIDENTIAL KITCHEN
URlNAL,STALLAVALL
WASH BASIN/LA VA TORY, SINGLE OR DOUBLE
TOILET, PUBLIC INSTALLATION
TOILET, PRIVATE INST ALLA TlON
MISCELLANEOUS:
FIXTURES UNIT
NEW OLD EQUIVALENT
2
1
2
3
6
2
6
6
1
3
2
1
2
2
1
6
4
PLUMBING
FIXTURE
UNITS
o
o
o
o
o
o
o
o
o
o
2
o
2
o
1
o
o
o
o
o
TOTAL PLUMBING FIXTURE UNITS~I 5
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL
YEAR
ANNEXED
1979 or before
1980
1981
1982
1983
1984
1985
1986
1987
1988
RATE PER $1,000
ASSESSED VALUE
$4.47
$4,38
$4,32
$4:20
$4,03
$3,88
$3.68
$3.38
$3.03
$2.62
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFTER ANNEXATION DATE)
YEAR
ANNEXED
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
RATE PER $1,000
ASSESSED VALUE
$2.18
$1.75
$ 1.35
$1.17
$1.03
$0.86
$0.71
$0,57
$0.39
$0,18
x
x
$0.00
$0,00
CREDIT TOTAL $0,00
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. ff~~~ OF G-'~~ON
() d.. ! 00
2. ''-CONTRACTOR INSTALLATION ONLY
Elec~l Contractor
Address ~
City
Supervi.sor
Expiration
Constr Contr, Number
(,
""
"'"
Expiration Date
Signature of Supervising Electric~
O,mers Name ("Je.y~I,J 1hvm /1 S,
Address (; ,)(6~ nl;,t.;v-
Ci ty s,{)), h.55.,a1 ~ Phone 7lfr/6r:b
OVNER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent,
Ovners Signature:
---------------------------------------
DATE:
RECEIPT II:
RECEIVED BY:
ELECTRICAL PERMIT APPLICATION
City Job Number ()O~ Go 9-03-0(
3.
COMPLETE FEE SCHEDULE BELOY
LEGAL ~S~PTION
I <;;'?(j'o1-U3 II
JOB DE':;\;RIPT+D~ - .1- ~. "vl,",JOOO sq. f t, or less
IlAM'" Vv...... f~lu- PIWAJ jXl.f1JV\AJ-.JIc.>U'()'~ch addi tional, 500
\ ,sq, ft or ,portIon
Permits are non-transferable and expire thereof
if work is not started within 180 days Each Manuf'd Home, or
of issuance or if work is suspended for Modular 'Dwelling
180 days, Service or Feeder
A.
New Residential-Single or
Multi-Family per dwelling
Service Included:
Items
B. Services or Feeders
Installation, Alterations
or Relocation: '
200'amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to' 1000 amps
Over 1000 amps/volts
Reconnect Only
unit.
Cost
Sum
$ 85,00
$ 15.00
.$ 40,00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.,00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less
201 amps to 400,amps
Over 401 to 600 amps
Over 600 amps or 1000
D. Branch Circuits
$ 40.00
$ 55.00
$ 80.00
volts see "B" aoove
.'
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35,00
$ 2.00
Miscel~aneous (~erv~~7/feAder'bot inF~~)
-Each InstallatIon pI,n ~ l~,
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36,00
SUBTOTAL OF ABOVE )5 ~
7% State Surcharge
3% Administrative Fee
TOTAL, 16,'aUi
E.
5.