HomeMy WebLinkAboutPermit Land Drainage Alteration 1998-1-23
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"PAINQFIELD
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 971619
225 North Fifth Street
Springfield, OR 97477
Office, 726-3759
Inspection Line, 726-3769
Location of Proposed Work: 6737 GLACIER DR
Assessors Map #, 18020311
Lot: 5 Block, 10
Tax Lot #: 04300
Subdivision, CASCADE HGHTS 1
Owner: SURELOCK HOMES
Address: PO BOX 5932
Phone #, 342-4732
City/State/Zip: EUGENE, OREGON 97405
Describe Work, S.F. RESIDENCE
NEW
Contractor
Const.
Contractor #
Expires
Phone
Plumbing,
SURE LOCK HOMES
PO BOX 5932,EUGENE OR
V-TECH
0040745
97405
0082331
08/28/98
342-4732
General,
05/18/95
522-1210
Mechanical, CRYSTAL CLEAR
0085504
10/26/95
Electrical: DOUG PALMER 0090725
PO Box 482 Junction City OR 9744800
05/03/99
998-3047
QUAD AREA: 4RSE
# OF UNITS, 1
CONSTR. TYPE, VN
WATER HEATER: E
SQ FOOTAGE, 2750
OFFICE USE --
LAND USE, 1111
ZONING CODE: LOR
# OF BDRMS, 3
RANGE, E
# OF BLDGS, 1
OCCY GROUP, R3
HEAT SOURCE, FE
INSUL PATH: P1
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
ROUGH GAS - after line is installed and capped if
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;
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
DRYWALL - Prior to taping.
CURB CUT - After forms are erected but prior to placement of concrete.
SIDEWALK - After excavation is complete, forms and sub-base material
in place.
concrete placement.
not attached to an ~~~at\.~
CV:: ~y-~\t\.~ \f' "'i ~"'i \S ~a"'i
~O~~~t\.~\"'i S~"'~t\. "'i\\\S ~~:~tlf'at\.
"'i~\S "7~tl \}~'v B",~tlO
Prior ",~~e;;~tl at\. \S po:
CO~~~~C ~ ~~t\.\atl.
~~ ,\v,l)OP'
wall/ceiling; Prior to cover
SPAINOFIELD
Job Number, 971619
Page 2
PRE BACKFILL: To verify site is clean of debris prior to final grading
and backfill.
GAS SERVICE - After line is installed and line has been connected to a
minimum of one appliance. Pressure test done at this point.
FINAL PLUMBING - When all plumbing work is complete,
FINAL MECHANICAL - When all mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Faces, N
Topography, 7
Solar Approved, Y
Lot Sq. Ft.' 7010
Total Height, 28,5
Lot Type: INTERIOR
Setbacks
S W E
17 15
Lot Coverage,. 25,8 t
Setbk From NPL: 40
N
House
Garage 20
15
Item
Main
Garage
Total Value
BUILDING PERMIT
Square Feet x
2317
757
$/Square Feet
64.66
16.27
Value
149,817.00
12,316,00
162,133.00
Building Permit Fee
Surcharge/Admin
574,75
45,98
TOTAL FEE
(A)
620.73
PLUMBING PERMIT ---
Item
Residential Bath(s)
3
Fee
192.50
Plumbing Permit
surcharge/Admin
192.50
15.41
TOTAL CHARGE
(Cl
207.91
--- MECHANICAL PERMIT ---
Furnace'
Exhaust Hood
Vent Fan
Dryer Vent
GAS LINE I< W/H
GAS F.P,
4
6.00
4.50
12.00
3.00
5.00
4.50
Mechanical Permit
Issuance
Surcharge/Admin
35.00
10.00
2.80
TOTAL PERMIT
(D)
47.80
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
Sidewalk
Curb Cut
CITY SDC
WILLAMALANE SDC
PLAN REVIEW ADJUST,
LAND ALTER. PERMIT
0.00
22.00
15.10
2,535.59
1,000,00
23.40
44,00
TOTAL MISCELLANEOUS PERMITS
(E)
3,640.09
'SPRINOFIELD
Job Number: 971619
Page 3
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE - - -
(A, B, C, 0, and E combined)
~'p'~
4,516.53
-1-3 rc
1-5'5e;.73
--- 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
350.19
Date Paid: 11/13/97
Receipt Number, 27999
MOORE Date, 12/11/97
By, LISA HOPPER
- - - ADDITIONAL COMMENTS
VERIFY MECH/PLMB CONTR REGISTRATION
SEPARATE ELECTRICAL PERMIT IS REQUIRED; PATH 1
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
2".~'"-;'"~D~~.=",=.HO". 1/23/9P,
"'~gnature ~ \ Date! / -
- - - - VALIDATION
Date Paid,
;2.$ 5S'n
1/2.)/,~
I I
4()*~, 73
'~~
Receipt Number:
Amount Received:
Received By:
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City of Springfield
22S Fifth Slrcel, Springlield. Oregon 97477. Oevelopme,{t services
Date C?~ Application II /11> / <) ., Expiration Date:
,
Property Owner ~ >-r>.c<, I ~d'.<2_ ~'p_c?"'"
Address: RD , P-.I"l )Ci.-~~a -:z. '7_
Phone: ~4'L4..7 ~ '"t.....
Clty~?-. State:.ag.zlp~-:
Site Address: (n 7 ~? (!,Lr"r I e r
o UGB Tall Map No: /1< r> 2 O~ II
. Jo. No. of previous land us~....!.E~~~~!!Z~,
. Springfield, Oregon
Tax Lot:" q SO (')
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FILL. Quantity 90 rcls . Source Location ~. G.or-aije... Dr, .lfIJHl'{
Supplier D,.,J~ .;:;;. 04 (,:> . Material '~/ 4'1 .-' ,
GRADING. Quantity t~ \, d ~ '
EXCAVATION. Quantity ~ Yds Destlnotlon: Del~ <G~ G:.
Supplier: " Project Supervisor t:>o- (' rd l G, I'>:k.y
Address Ro, &~ c:e.~ "J_ P'7 "J' ~ . Phone 34? Cl7 OS ?
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SITE PLAN Required Deta:Quantlty of material. Property lines and descriptions. Tax map and
lot number. Site sddress. Existing contour lines, Proposed contour IInas. EXlstinR drsinage
ways. Proposed drainage ways. Significant trees and foliage. Ground cover, So types.
Buildings. Septic systems. Sewers. Araas subject to floodfng. Utilities. Areas subject to land
slides, Proposed site Improvements. , .
a CROSS SECTIONS,
a SOILS & GEOLOGY PLAN,
q DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
a REPLANTING PLAN
a ADDITIONAL INFORMATION,
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
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CITY
STATE
.' PHONE
,CITY
STATE
CONTRACTOR NAME: SV (~ (U.,("'~ Jp~a..".
PROJECT SUPERVISOR: ""':r-~, r.p 1\ C, Id.....~ PHONE '?:,q'l..- ~f7 ? 'L-
Registration Numbar: 1(j.t;l4-1 ~ 1 , Expiration Dste: ,=}' /Cj ~
. ADDRESS: I'(CO. P:..V'lC ~?,."'2, ~1_TY: e-t..~ .
STATE: Ote . ZIP: a, 14D~ OFFICE PHONE .~"2 +1? ZFAX <A-11'1c:.
MOBiLE PHONE: 9~ 4- II s:<.~ ,EMERGENCY PHONE: ::<1I/2-4-7~...z.--
BV slgnature,l atata and agraa, that I ha.a caralullv ..amlnad tha complatad application and do harabv cartlfv that all
Information haraln la trua and corract. and I rurthar cartllv that anV and all work parformad shall ba dona In accordanca with
lha Ordlnancaa of tha City or Sprtngflald, appllcabl. ChV Standard spaclflcatlons and Drawlnga, and tha lawa oltha Slata of
Dragon partalnlng to.tha work descrlbad haroln. I furthar cortlfV thot onlv COnlrOClora and amplovaas who oro In compllanco
with ORS 701.055 will ba usad on this projoct, ,
Tha ChV mav Inspacttha work alta descrtbad In this parmlt it anv tlmo during a ona vaar parlod fOllowing tha racalpt bV tha
City 01 notlca 01 complatlon oltha daacrlbod work and spacllv~ at tha Chv's lola da..cratlon, anv additional raatoratlon work
raqulrad to ratum tha Ilta to a standard accaptabla to tha City. Tha parmlttaa will ba notlflod In writing 01 anv work raqulrad
and will ha.a thirty 1301 davslrom tha ta of tha notlca to complota tha work. Work not complatad ot tha and 01 tho thlrtv
dIva will ba parlormad bV tha CIIV a a costs will ba blllod to tha parmlttoa.
.
I further agree to enlur, that ell r!~u!red action. Ira requeated at the proper time, that project address I. readable from
tho .treet. e['td the approved lot C"711", remain on the lit. at all tlm.. during construction.
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o DRAINAGE, 0 Storm, Q Ditch, Q Culvert, Q Natural
~ETLANDS, Description
o FLOOD PLAIN, Zona: .1J;/t , FEMA Community Panel No.:
~ FLOODWAY, FEMA cZ:unlty Panel No.: L-- , Date:
PLAN CHEC,K FEES:
UPTO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
1,001 TO 10,OOO,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 1,000 CUBIC YARDS
1,001 TO 10,000 CUBIC YARDS
10,000 TO 100,000 CUBIC YARDS
100.001 TO 20,0.000
$20.00
. $ 30.00
$40.00
$40.00 For Iho flrsl 10,000 cubic yards, plus
$20.00 for oach addlUonal 10,000 cubic yards or Iractlon thorool.
$220,00 For tho IIrst 100,001 cubic yards, plus
$20,00 lor oach additional 1 0,000 cubic yards or fraction thoro of ,
$340 For tho first 200,001 cubic yards, plus
$B.OO lor ooch oddltlonall0,OOO cubic yords or Iractlon thoroof,
$30,00 _
$30,00 For tho IIrsl 100 cubic yards, plus
$14,00 '.roach additional 100 cubic yards or fraclion thoroof,
$156.00 For tho IIrst 1,000 cubloyards, plus
$12.00 for oach additional 1,000 cubic yards or fraCllon Ihoroof,
t264,OO For tho IIrst 10.000 cubic yards, plus
$54.00 lor OIch addltlonsll 0,000 cubic yards or fraction tharaol.
$750.00 For tho IIrstl00.00l cubic yards. plus
$30.00 for oach addltlonoll0,OOO cubic yords or fraclion tharoof,
Estimated Volume:
Plan Check Fee:
(J.
Date:
Receipt:
Received By:
Date:
Grading Permit fee:
//+, t?rO
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Date:_1/2 ~
Racelpt
Date:
Racelved by:
,:T!;, \T .o/Jl-lq'~ 7'0 ~ffhl:7'/F/? <?o,v'L?!7/n>.p' - Ki:;;;/ 1J.eLJJ~A-/-,/;
( CUIlA c,.'7""/~,'AJ ) HCM OA//!I?<v' '''''II<[)., C;J)LC.
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W"Plannlng~;-It )}~ ~ X-f
S-- Engineering ~J:;~Lj .
S-Bullding: #~ J?C;~.t
Date:
12 - III -'71
, J
/ / - :21~ --f'1
/Z-9-'7?
Date:
Date:
o Maintenance:
. Date
Permit Number~ l'f
Finn' Inspection.'
Planning:
/-/~
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Date: 0p~
Issued by:
Date
Engineering:
. .Date
Building:
Date
Maintenance:
Date:
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JOB NO. 971c:'/Q
~ ATTACHMENT A ~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY:
5UR.ELocK.
!-Io MEL,
LOCATION:
c; 7 37 f-I LJj ("/ € /2..
DEVELOPMENT TYPE:
~.F.I< .
BUILDING SIZE
lOT SI1F
SO Ft.
1. STORM ORA I ~IA(;F
IMPERVIOUS SO. FT. 2/ b2...o X $0.226 PER SO. FT. $ t:)Q2,JZ-
2. SANITARY SFWER-rrTY
NO. OF PFU'S ~~
(See Reverse Side)
X $46.86 PER PFU
$ IJII/' ru
3. TRANSPORTATiON
,NO OF UNITS X TRIP RATE X COST PER TRIP
X 1.01 X $47249
$ 477."2.1
x
X $472. 49
$
X
X $472 49
$
4. SANITARY SFWFR-MWMr
OLl
NO.OF.FEln I' X 777.7bPER FEU + $10 MWMClADM FEE $ 2R7,7h
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$ - In, 7+
TOTAL-MWMr sor
$ I 74 , 02-
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
--
$ 24/4- .8S
f
5, AOMTNTSTRATTVF FFFS
BASE CHARGE (SUBTOTAL ABOVE) X ,05 '
'$ /2.0, 7t
j, 9-L I
SDC Coordinator
Da te: j 1- 14...::!l.7
TOTAL SOt;.
$ '7 ,l),~ C St:.r
'I',
.' '.n.' '-"~ U.. VI." vr"'\&..\JV LJ-\ . IV'" I MULL. j~umoer or New rrxtures X Unit Equivalent:;:: Fixture Units !1
(NOTE: For remodels, calculate 0.' e NET additional fixturesl. . . '
, 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 Wash/Etc..................
Laundry Tub/Clotheswasher,...,..,.,........ ,.,............"
Clotheswasher. 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower. Single Stall,.."....,........ ... ..,......".,..,...,...,...,
Shower, Gang."........,." ,. ..,.., ,.. ... ,.,."... "...".."..",...,
Sink: Bar, Commercial, Residential Kitchen........................
Urinal. Stall/Wall.."..,..,....,.,.,......,.,.....,....,..".",.." ...,
Wash Basin/Lavatory, Single......,........................,..
Toilet, Public Installation, ........"...... ,. .,...................
Toilet, Private..................,......, .............................
Miscellaneous:
"7
'Z
3
TOTAL FIXTURE UNITS
2
1
2
3
6
2
6
6
1
3
2
I/Head
2
2
1
6
4
4
'2...
:2.
z...
...
, 2...
2-~
CREDIT CALCULATION TABLE:
calculate credits separates.
I Ye.ar
I = Annexed
I
Based on assessed value. If improvements occurred after annexation date in table,
Rate per $1,000
Assessed Value
~"l~
3.89
3,83
3.70
3.55
3,39
3.20
2,91
Year
Annexed
~G"
1979 or befnrA
1980,'
1981
1982
1983'
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
117,,-;74
Credit for Parcel or Land Only If Applicable
3.'1-' X $ 2~,c.~
(Rate X Assessed Value)
X $
, (Rate X Assessed Value)
Improvement (if after annexation date)
=
=
CREDIT TOTAL = $
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
Residential...:..,..,...,............, 0.4
Commerical........................, 0,9
Industrial............................ 05
Governmental",.....,..,.....',..,. 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
Rate per $1,000
Assessed Value
$2.56
2.17
1.73
1.31
0.92
0.74
0.61
0.45
0.31
0.17
II~,~
.
.
Job. No.
97/?/ S
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SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME: :>u:,.ec= ~c/c:: ;I~~ PHONE: ?'f2-~?;SL
ADDRESS: ~&/~_?'J,~ '., #t~~,' STATE:.!\tJ, ZIP: CJ 7.:ft1r
LOCATION OF PROPOSED BUILDING SITE:
Street Address: ? 7?'? ,,0'~&, J~ ~
v
Plat Name: !J>rs ~ Tax Lot Number: leal. 0,3 II 1)4JLJ7.J
, FlA.ST ~J .
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SOC calculations and dwelling t
ype definitions are on the back.)
A. iliD..QIA-FRmilv Dp.tRr.hp.ri
, NO. OF UNITS
Manufactured home not in a park
X $1,000 per unit = $ I c.::; b i) .
y-- Single Family home
B. Sinolp.~FRmilv AttRChp.ri
NO. OF UNITS
X $924 per unit = $
C. Multi-FRmilv Aoartment
NO. OF UNITS
X $692 per unit = $
D. Manufactured HomA PR~
NO. OF UNITS
X $699 per unit = $
WILLAMALANE SDC $
2. SDC CREDIT (if applicable) SOC-payer must furnish proof of
Willamalane Credit approval. See SDc Credit Worksheet. $
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SOC reduced for Credit)
$ . / fJ8D &0()
,
Development Services Department
City of Springfield
/ I 2-:1 I , @
Date
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