HomeMy WebLinkAboutPermit Building 2001-1-9
, I
. .
"
"
.
.'
I Job# 00-01778-01 I
Page 1 of 4
TRANS#:01-0004212
DATE:JAN 09 2001
AMT RECD:2 $ 5566,99
CHANGE:
CASHIER: 059
225 North Fifth Street
Springfield, OR 97477
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01778-01
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 6936 Glacier Dr Spr
Assessors Map#: t8020222
Lot: 9 Block: Addition: 1
Address: 769 71 st Street
Scope Of Work: Single Family Residence QIl~ ^~'IJ New
'(\O\'03d ^~~~\";\~~o':)
1<1 S\ 'OU U"- Orll.\ \'1
!:\-::1,~OG~".IS C~(\ C37.\'d S\rll.
Contractor Type..\O~Contract(li;l. '03 :<:IriS l.\V'I'03d O~
General Contr. O~S\ H~~t~r;y's~C6~ruction'.-a';)\l,;
t. _\\\ ~\_
)"OON'6892 Forsythia Drive, Springfield, OR
. 97478
Owner:
Electrical Contr
Mechanical Contr
Plumbing Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Tax Lot #: 03800
Subdivision: Cascade Heights
Brian and Wendi Humphreys
Phone Number: 541-747-3808
Springfield, OR 97478
Value: $212,944
City/State/Zip:
Registration #
Expiration Date
Phone
541-747-3808
Brian and Wendi Humphreys
769 71st Street, Springfield, OR 97478
Deans Heating 133733
,"
PO Box 462, Cottage Grove, OR 97424,,,,~
. "'\ '\1,,\
BMC Mechanical, ,leU' I'" ',' ")0"
.........\ ,}.",\..' ...."',' \~-l\\ ,,' >I\. "
648lN,Oregon, peswell, OR\97430,G\ ,....r
10 .~..r '~J"I~\ . ". ,'l\.'C.o~'''' . C'\,,~ , " ..>1 .
aI.lV~; 3\\\ It.. ''2:,:'''' i'\~Office Us~ .... ,',I
'0, sax "''lJO~ ,<;0',\ .' ,
4RSW :()(\"z~~ ":\1 :;a\(1~~~~,~ Use: ,. Single Family Dwelling
1 . fA \"" 00;>10 'Zoning Code: LDR
--"\\l .
(VN) Wood Frame 'Bedrooms: 4
Electric Range: Electric
541-747-3808
2/17/00
541-767-0626
541-895-4575
# Of Buildings: 1
Occupancy Group: Dwelling
Heat Source: Forced Air Electric
Sq. Footage: 2719
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.
Site
Verify Ground Rod
Footing
Foundation
Slab
Floor Insulation
Shear Wall Nailing
Framing
Required Inspections
I Buildin!l I
- To be made after excavation but prior to selling forms.
-Install ground rod at footing, and call for inspection in conjuction with footing andlor foundation i
-After trenches are excavated.
-After forms are erected but prior to concrete placement.
- To be made after all inslab building service equipment, conduit piping, and other equipment iter
.Prior to decking.
- Before covering sheathing with finish materials.
- Prior to cover.
'I
-
Wall Insulation
Drywall
Final Building
Temporary Power
Verify Ground Rod
Rough Electrical
Electrical Service
Final Electrical
Underfloor Drain
Rough Plumbing
Shower Pan
Water Line
Sanitary Sewer Line
Storm Sewer Line
Perimeter Foundation
Drains
Final Plumbing
Rough Mechanical
Final Mechanical
SW.Curbside
CC-Standard
.
I Job# 00-01778-01 I
Required Inspections
Building
.
Page 2 of 4
- Prior to Cover
-Prior to taping.
- When all required inspections have been approved and the building is complete.
I Electrical I
-Approval required prior to SUB energizing pole.
-Install ground rod at footing, and call for inspection in conjuction with footing andlor foundation i
-Prior to cover.
- Must be approved to obtain permanent power.
- When all electrical work is complete.
I Plumbing
-Prior to cover or placement of concrete.
- Prior to cover.
- Prior to filling trench.
- Prior to filling trench.
- Prior to filling trench.
-After gravel and filter cloth is installed, but prior to backfill.
- When all plumbing work is complete.
Mechanical
- Prior to cover.
-When all mechanical work is complete.
I Public Works I
-After forms are erected but prior to placement of concrete
-After forms are erected but prior to placement of concrete
Street Improvement: Fully Improved
Curb Cut?[?] Improvement Agr,?D
San Sewer Depth (Ft): 6 4
Storm Sewer Available? [?]
Special Req.:
Security Required:
Bond Begin DateTime:
Special Instructions:
Other Utilities:
Project Supervisor:
Sidewalk Type:
Additional ROW?
Size Of Line (in):
Downspouts/Drains:
Enchroachment Permit:
Curbside - 5'
o
8
To Storm Sewer
San Sewer Tee (in):
00100100 00:00 AM Bond End DateTime: 00/00/0000:00 AM
HOOK TO EXISTING STORM SEWER STUB FROM MANHOLE HOOf
Types Of Warning Devices Reqd,
,
.
I Job# 00-01778,01 I
.
Page 3 of 4
Land Use: Single Family Dwelling
Pave Driveway? 0
Zoning: LDR Overlay District:
FloodPlain? 0 Wetlands? 0 # of Street Trees: 3
Journal numbers
1: 2: 3:
Comments:See building permit # 00-01778-03
Planner: Liz Miller
Urban Growth Boundary?D Glenwood Area? 0
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA: Zone X White
Construction Types:(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings: 1
# Of Bedrooms: 4
Handicap Access? 0
iArea (Sq, Feet)
I Main: 2719 Accessory~ 549
Additional Requirements: LDAP Required
Required Attachments:
Source Locn:
Material:
Flood Plain FEMA:
Panel 1167 of 2975
Private Garage/Carp/Stor
# Of Stories: 2 Height (feet): 30
Current Units: 0 Proposed Units:l
Census Code: Does not apply
Total:4268
Fee
Paid On Receipt#
Plan Check
12/12/2000 4016
01/09/2001 4212
Value/Quantity
I
Fee Amount
Residential Plan Check
Hourly Plan Review
Total Plan Check
212,944
2
$446.71
$80.00
$526.71
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
Buildin!l
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
212,944
$687.25
$48.11
$20.62
$755,98
Wiring Footage 1,000 Sq Ft or Less
Wiring Footage Each Add'l 500 Sq Ft
Temporary: 200 Amps or Less
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Electrical
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
1
7
1
$85.00
$105.00
$40.00
$16.10
$6.90
$253.00
Minimum Plumbing Permit Fee
Three Bathrooms
State Surcharge - Plumbing
Administrative Fee - Plumbing
Total Plumbing
Plumbin!l
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
1
$.00
$192.50
$13.48
$5.78
$211.76
Hood and Exhaust
Minimum Mechanical Permit
Administrative Fee - Mechanical
Less than 100,000 BTU
Vent Fan to One Duct
Wood stove
Mechanical
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/200t 4212
1
$4.50
$.00
$1.22
$6.00
$12.00
$15.00
1
4
2,000
.
.
Job# 00-01778-01
.
Page 4 of 4
Value/Quantity Fee Amount
Check 5 foot side setback at corner of house,
30 foot height limit on building. Needs to pick
up LDAP permit also.
Still need engineering for garage floor
structure.
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
aMd set o~lan~;Yrain on ~ site at all times during construction.
/1...I.l//. jJ. (# -,~~~ ({/-/)q -Q/
Signature- ~ I' / -. Date
Fee
Paid On Receipt#
Mechanical
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
1
Dryer Vent
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
New Sidewalk
New Curbcut
Total Public Works
Public Works
01/09/2001 4212
01/09/2001 4212
80
1
Residential - Single Family - Storm
Sanitary Sewer
Residential Transportation
Residential Sanitary MWMC
Residential Improvement MWMC
MWMC Administrative Fee
SDC Administrative Fee
Property Annexed 1979 or Before
Total System Development
System Development
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
01/09/2001 4212
27
3,027
30
1
1
1
1
S.F. Residence - Willamalane
Total Willamalane SDe
Willamalane SDC
01/09/2001 4212
1
Grand Total
Plan Check Type
Checked By
Date Completed
Comment
Initial Review-Res
Wendy Stanley
Steve Templin
Liz Miller
12/13/2000
12/14/2000
12/18/2000
Engineering,Res
Planning-Res
Structural-Res
Don Moore
01/09/2001
$3.00
$10.00
$2.84
$54,56
$60.00
$60.00
$120.00
$820.18
$1,122.00
$810.29
$285.91
$24.33
$10.00
$147.22
$-128.24
$3,091.69
$1,000.00
$1,000,00
$6,013.70
.
.
p.'~ Willamalane
t,,,,!, Park & Recreation District Job, No. oO-~I~~g-ol
,...., SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME: Br~......~ fJ~ t1.....:'lon~
'J t i. .'" ~ . I
ADDRESS: +6q ~I$+ ~"',rl~
LOCATION OF PROPOSED BUILDING SITE:
PHONE: 1l/:r~380i"
STATE: OJt ZIP: qT-<l).R
Street Address: 6~~6 (;.1ll.L.U.A Dr
Plat Name: Tax Lot Number: Jgo~O;!Q.;) ()~^
1. DEVELPPMENT TYPE (Checkappropna(e dwelling(s). SDC calculations and dwclling (
ypc dclinllions are on (he back.)
A. SinaIA-F::Jmilv DAlached
Single Family home
Manufactured home not in a park
NO. OF UNITS
X $1,000 per unit = ,$ l/lna
B. .SinoIA-F::Jmilv Alt::Jr:hArl .
, '
NO. OF UNITS
X $924 per unit = $
C. .Mulfi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
" ,
"
D. ManufaclllrArl Homfl P::Jrk.
I 'j' I
NO. OF UNITS
X $699 per unit '" $
$
,"
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SOc-payer muslfumlsh proof of
Willamalanc Credit approval. See SDC Credit Workshoet. $
!' .,
~ I . . _ ..J ,- I'
3. TOTAL WILLAMALANE NETSDC ASSESSED
(II SDC reduced for Credit) $ I "tjO , OG.
fJ~ HJ
Developmd'fit Servn5es Department
City of Springfield
la I I~ I M
Date
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER: 00-01778-01
NAME OR COMPANY: HUMPHREYS
LOCATION: 6936 GLACIER DRNE
TAX LOT NUMBER: 18-02-02-22-03800
ANNEXATION YEAR ' 1960 LANE COUNfY ASSESSED VALUE (LAND)
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
DWELLING UNITS: I BUILDING SIZE: 4268 SF LOT SIZE:
I' <'0'" n..,,",o'
1 IMPERVIOUS S.F. I, I COST PER S.F.
1 3026.50 $0.27 I
I ITEM 1 TOTAL - STORM DRAINAGE SDC
2 SANlTAllv<;"WPll-rITY-
A. REIMBURSEMENT COST:
1 NUMBER OF DFU's I "1 COST PER DFU
I 30 $21.25
B. IMPROVEMENT COST:
1 NUMBER OF DFU's I" 1 COST PER DFU
1 30 $16.15
I ITEM 2 TOTAL - CITY SANITARY SEWER SDC
.
.1...I.RAN<;POllTA TTON
A. REIMBURSEMENT COST:
1 ADTTRlPRATE I 'INUMBER OF UNITS 1,1
I 9.57 1 I
B. IMPROVEMENT COST:
I ADT TRIP RATE I ,I NUMBER OF UNITS I, I
1 9.57 1 1
rmM 3 TOTAL - TRANSPORTATION SDC
~ANlTARY<;FWPR-M~
A. REIMBURSEMENT COST:
1 NUMBER OF FEU's I" I COST PER FEU I
1 I $285.91
B. IMPROVEMENT COST:
1 NUMBER OF FEU's I' I COST PER FEU I'
I I $24.33
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMlNISTRA TIVE FEE
I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
I SUBTOTAL (ADD ITEMS 1,2,3,&4)
5 ADMINISTRATJVF 1'1'1"
SUBTOTAL
$2,944.47
1,1 ADM.FEERATE
5%
-
~ T-r4
SDC COORDINATOR
12/14/00
DATE
.
$27,055
SF
=1 $820.18 I
=1$820.t8 l
=1
$637.50
=1 $484.50 -..11
=1 $1,122,00 I
COST PER TRIP I I NEW TRIP FACTOR I
$16,12 I' 1.00 =1
$154.27
COST PER TRIP
$68.55
I" I NEW TRIP FACTOR I
1.00 =1
=1
$656.02 --1
$810.29 ,
=1 $285.91
=1 $24.33 I
=1 ($128.24 ) I
=1 $10.00 I
=1 $192.00 --1
=1 $2.944.47 I
=1
TOTAL SDC CHARGES 1
II
II
$147.22
$3,091.69
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
( # NEW # OLD ) x EQ=ENT = FIXTURE
FIXTURE TYPE UNITS
BA TH1lJB ( 2 ) x 3 = 6
DRINKING FOUNTAIN ( ) x 1 0
FLOOR DRAIN ( ) x 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS 1 ETC. ( ) x 3 0
INTERCEPTORS FOR SAND 1 AUTO WASH / ETC. ( ) x 6 0
LAUNDRY TUB ( ) x 2 = 0
CLOTHESW ASHER 1 MOP SINK ( 2 ) x 3 6
CLOTHESWASHER - 3 OR MORE (EA) ( ) x 6 = 0
MOBILE HOME PARK TRAP (I PER TRAILER) ( ) x 12 0
RECEPTOR FOR REFRIG / WATER STATION / ETC. ( ) x 1 = 0
RECEPTOR FOR COM. SINK 1 DISHWASHER / ETC. ( ) x 3 0
SHOWER, SINGLE STALL, ( ) x 2 2
SHOWER, GANG (NUMBER OF HEADS) ( ) x 2 0
SINK: COMMERCIAURESIDENTIAL KITCHEN ( ) x 3 3
SINK: COMMERCiAL BAR ( ) x 2 = 0
SINK: DOMESTIC BAR ( ) x 1 0
WASH BASIN ( ) x 2 = 0
LAVATORY ( 4 ) x 1 4
URINAL, STALL 1 WALL ( ) x 5 0
TOILET, PUBLIC INST ALLA TION ( ) x 6 0
TOILET, PRNATE INSTALLATION ( 3 ) x 3 9
MISCELLANEOUS OFU TYPE NUMBER OF EOD's.
( ) x 20 0
TOTAL DRAINAGE FIXTURE UNITS =1 30
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons peT day
MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION OA TE, CALCULATE CREDIT SEP ARA TEL Y
YEAR CREDIT RATE PER $1,000 YEAR CREDIT RATE PER $1,000
ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE
1979 OR BEFORE $4,74 1990 $1.96 '
1980 $4.65 1991 $1.55
1981 $4.59 1992 $1.36
1982 $4.46 1993 $1.23
1983 $4.30 1994 $1.05
1984 $4.14 1995 $0.90
1985 $3.93 1996 SO,75
1986 S3.63 1997 $0.57
1987 $3.26 1998 S0.35
1988 $2,85 1999 $0,15
1989 S2,40 II
CREDIT FOR LAND (IF APPLICABLE)
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE /1000 CREDIT RATE
27.055 x $4.74 =1
0.000 . x $4.74 =1
TOTAL MWMC CREDIT =1
$128.24
$0.00
$ I 28.24
.
DEVELOPMENT SERVICES DEPARTMENT,,, t 11 'ng
The tollowing proJect as submitted h~~ the 0 OWl
, and dOBS not require specific land use
zoning,
approval., LX) (2...
225 FIFTH STREET Zomng
SPRINGFIELD, OREGON 97&.?tt \_"1-0 \ \
INSPECTION REQUEST: 726-3769, ;::>>...)
OFFICE: 726-3759 Au,,"onzed Signature
t. LOCATION Or INSTALLATIO'~hh.
N- 9 C:;1.y-'0( ry-, (r~r~ Icllj\<...,. A,
. F'\~ t:Y'\
LEGAL DESCRIPTION, ,
1<6' a -;:) ()d ;)~ tfP.K()Q
JOB DE.5..CRIPTIO,N
~:-:; I.:;::.os.."\QPI\( P_
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY/
Electrical Contractor
/'
Address
City
Supervisor
Expiration Dat
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
ELECTRICAL PERMIT APPLICATION
r<tyJob Number
3.
COMPLETE FEE SCHEDULE BELOV
()O~ 0 I =l-:t-I?..or
"
,--
New Residential-Single or
Mul ti-Family per dwelling uni t.
Service Included:
Items Cos t
Sum
1000 sq.ft. or less ~ $ 85.00 ~
Each additional 500
sq. ft or portion
thereof 7 $ 15.00 /O~
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
$ 50.00
$ 60.00.
$100.00
$130.00
$300.00
$ 40.00
"
~
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
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Constr
Date
ature of Supervising Electrician
Owners Name,Bn Qr\ (l1y:I...Y-\; ~l ~~
Address 7C-,Q / I ~ \...~
Ci t~jlYfli~ _Phone ,l.\ I-~
, OVNER ~N '
The installation is being made on
property I own,which is not intended
for sale. lease or rent:
,
OwnrSlignatu~,rj/ /J
f( lJ OJ ./'UVff A( ~ d>y7
DATE~----------~------~----~-
RECEIPT II:
RECEIVED BY:
$ 40.00
$ 55.00
'$ 80.00
volts see "B"
LiO
above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
$
$
$
$
~'$V,6D
/?"/O
/...>'0 ,
""l~",l!>o .,'
----Z::;v,-". .-
40.00
40,00'
20.00
36.00
"