HomeMy WebLinkAboutPermit Building 2018-11-155PR'NGF IT,LD
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Web Address: www.springfietd or.gov
Permit lssued: November i5,201g
Building permit
Residential 1 & Z Fam Dwe ing (New Onty)
Permit Number: 81 1 -18-O0O046_DWL
tVR Numbe| 81t 0i7232B6B
Ema,l Address: perm,tcenter@sprinqrield,or.gov
Category of Construclion: Singte Famjty Dwe ing
Submitted Job Value: $34'1,263.00
Oescription of Work: New single family dwelling
Type o, Work: New
JOB SITE INFORMATION
Worksite address
714 S 72ND ST
Springfield, OR 97478
Parcel
't802022105503
Owner:
Address
CHANEY NICHOLAS
5689 IVY ST
SPRINGFIELD, OR 97478
LICENSED PROFESSIONAL INFORMATION
Business name
OWNER - Primary
License
ccB
Licsnse numbsr
000000
Phone
PENDING INSPECTIONS
Permitsmustbepostedinclearviewonthgworksite,Permitsexpireifwo.kisnotshnodwithin,lsoDaysofissuanceorifworkis
"u"p.nO"A fo, fgO O"ys or longer depending on the issuing agency's Policy'
AllProvisionsof|awsandor(linancesgoverningthistypeolworkwillbecompliedwithwhethelspecifiedhereinornot.Grantingol
a permit does not presrr" to gir" a,rtt o.i[ ;"'i.i"i"'.ri ""*"i "" provrsions of any other state or local law regulating construction
I#:^f,[:,lTSlil.JIi3?,']i3il;'n' o*non,aw requires vo-u tol"llT *::::1'::-:ll::,::""::1"','Jl;t"i:':::6tioncenter
rhose rutes are set tortn ,n oo* ,rr"or1l11"o',il;r;il;; ;;;;;ooso. vou may ootain cop,es or tho rules bv callrns the center at
$'l'l\ st!{st\ or dra\ t11.
,,nd", this germit are required to be hcensed unt".s €xempt€d bv oRS ?01'o1o
ll oelsons or entitres Derlorming uork unoer rn:Ii':'::';;.-;;;;o (ptu.ringt.
l f.,*ffi;;;;;ti' ons n"
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n\edon 1111518
std-BurldinqP6(m{jr
City of Springfield
Development and publjc Works
225 f,fth Street
Sptinqfietd. OR gr4)7
541-726 3753
TYPE OF WORK
Permit Number: 81 1-18-000046-OWL
lnspection
2999 Final Mechanical
3999 Final Plumbing
4999 Final Electrical
6300 On-site Stormwater Facility
9528 Curb Forms
9501 Curbcut - Overwidth
9505 Sidewalk - Curbsrde
1060 Driveway Approach
1065 Sidewalk
1020 Zoning/setbacks
1090 Street Trees
1110 Footing
1118 Footing Drain
1120 Foundation
1160 UFER Ground
1220 Underfloor framing
1260 Framing
1370 Masonry Veneer
141 0 [Jnderfl oor rnsulatron
1420 lnsulation Vapor Barrier
1430 lnsulation Wall
1530 Exterior Shearwall
1440 lnsulation Ceiling
1520 lnterior Shearwall
1999 Final Building
2210 underfloor Gas
2255 Gas Pressure Test
2255 Gas Pressure Test
2300 Rough Mechanical
2310 Rough Gas
2995 Final Gas
31 30 Footing/Foundation Drains
31 70 Underfloor Plumbing
3200 Sanitary Sewer
3315 Water Line
Pnnted a^ 11/15/1A
Inspection grouP
1-2 Famdwell
1-2 Famdwell
'1-2 Famdwell
Public Works
Public Works
Public Works
Public Works
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
'1_2 Famdwell
'1_2 Famdwell
'1_2 Famdwell
'1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1-2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
'l_2 Famdwell
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
]_2 Famdwell
lnspection status
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
Pending
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Pendrng
Pending
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Page 2 of 5
std-8!rd|ngpermrl pr
Page 2 at 5
Permit Number: 8t 1.iB-0OOO46-DWL
3400 Storm Sewer
3500 Rough Ptumbing
4500 Rough Etectrical
4000 Temporary Power Service
4225 Service or Feeder
Page 3 of 5
1_2 Famdwelt
1_2 Famdwe,,
1_2 Famdwell
1_2 Famdwell
1_2 Famdwell
Pending
Pending
Pending
Pending
Pending
Various inspections are minimally required on each project and often dependent on the scope of work. Contact lhe issuing
jurisdiction indicated on the permit to determine required inspections for this project.
Schedule o. track inspections at www buildlngpermits.oregon.gov
Schedule by phone call 1-888-299-2821 use IVR number: 8'1'1017232868
Schedule using the Oregon ePermittrng lnspectron App, search "epermitting" in the app store
std-BuildingPermit-PrPage 3 of 5
Pdnted on: '11115/1E
SCHEDULING INSPECTIONS
Page 4 of 5
Permit Number: 81'l -l 8-000046-DWL
Fee DescriPtion
Residential wiring
Technology Fee
Air handling unit of uP to 10,000 cfm
Aar conditioner
Balance of minimum permit fees - mechanical
Clothes dryer exhaust
Ventilation fan connected to single duct
Plan Review - Major, CitY
Sanitary sewer _ (New Res) Total linear feet
Single Family Resadence - Eaths
storm sewer - (New Res) Total linear feet
Water service - (New Res) Total linear feet
Address assignment - each new or change requested externally, per each
Continuing Education fee
Copies - > 5, up to 11x17, Per each
SDC: Reimbursement Cost - Local wastewater
SDC: Total MwMc Administration Fee - Local
SDC: Total Transportation Administration Fee
SDC: Total Sewer Administration Fee
SDC: Total Storm Administration Fee
SDC: Administrative Fee - MWMC Regional Wastewater SDC
SDC: Compliance Cost - |4WMC Regional wastewater SDC
SDC: Improvement Cost - MWMC Regional Wastewater SDC
SDC: Reimbursement Cost - MWMC Regional Wastewater SDC
SDC: MWMC Credit - Regaonal Wastewater SDC
SDC: Improvement - Transportation SDC
SDC: Reimbursement - Transportataon SDC
SDC: Improvement Cost - Storm Drarnage
SDC: Reimbursement Cost - Storm Drainage
SDC: Improvement Cost - Local Wastewater
Fire SDC - New Res Construction Sq Ft fee - enter sq ftg
Structural plan review fee
Structural buildjng permit fee
Willamalane fees - Single Famaly Detached, per unit
State of Oregon Surcharge - Elec (12olo of applacable fees)
State of Oregon Surcharge - Bldg (12olo of applicable fees)
State of Oregon Surcharge - Plumb (12olo of applicable fees)
State of Oregon Surcharge - Mech (12olo of applicable fees)
Quantity
3418
Fee Amount
$336.00
$267 .31.
$21,00
$17.00
$7.00
$12.00
$36.00
$313. o0
$0.00
$561.00
$0.00
$0.00
$49.00
$2.s0
$83.50
$4,481.9s
$75.84
$t7 t,79
$3 33.49
$ 113.93
$10.00
$22.42
$1,563.66
$t23.20
$-2O2.91
$3,272.7 s
$162.98
$1,350.76
$927.79
$2,147.76
$205.08
$ 1,367,60
$2,104.00
$3,72t.00
$40.32
$252.48
$67 .32
$ 11.16
1
1
3
1
99
3
99
99
1
1
167
4481.95
75.84
t71.79
333.49
113.93
10
22.a2
1563.66
123.2
-202.91
327 2.7 5
162.98
13 50.76
927,79
2147.76
3418
1
sld Bu drngPermit_pr
PERMIT FEES
Permit Number: 8l 1 -18-000046-OWL
Curb cut and Sidewalk construction - multiple permit discount
Curb cut fee - enter # of cuts
Curb cut and Sidewalk construction - multiple permit discount
Curb cut fee - enter # of cuts
Overwidth / Second Driveway
Sidewalk construction - permit. first 90 linear feet
Sidewalk construction - permit, first 90 linear feet
Pdnted on 11/15/18
1
1
1
1
1
I
1
Total Fees:
Page 5 of 5
$-39.00
$114.00
$-39.00
$114.00
$61.00
$r 14.00
$ 114.00
$24,509.08
Page 5 ol 5 sld EuildingPermil_pr
Clrv or SPRINcFIELD, oREGoN
Structural Permit Application
$-ffi
DEPARTMENT USE ONLY
la-(bo&6-L
Date: 6 |o5
This permit is issued under OAR 918-460-0030. Permits e{pire if work is not started within 180 days of issuarce or if work is
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
lTlis projecl has final land-use approvai l. Valuation information
S ignalure lJirI.(al Job description
225 Fiith Sueer . Spnngfield, OR 97477 . PH(541)726-1753 . FA-X(541 )726- 1689
l
This
PerII)lt no
e5projec! has DEQ rpproval
Si
n Commercial
Occupancy
h"r,t,
ffqp t. ea
(d)
Cost per square foot
Other information
t\uls togaa a'lL
i ^yt Y,,d.t\ 9trgu
'r,f::l'{ffi\'
QJvt 6fi- CLjcuktY,'
0$ tiuYrv'ou-\ to
toffi:sh,rrsrfr
Zoning approval verified: D Yes E Xo
P$peny is within ood plain: ! Yes ! lo
CATEGORY OF CONSTRUCTION
E Residential ! Govemment
JOB SITE INFORMATION AND LOCAIION
Job site address 7tv s ATN Zf.<-|
City: (p. :-t (;c-la/State: g2 ztP ol l9A
Subdivision I Lot no
Reterence Taxlot
PROPERTY OWNER
Name: I Jr\-t C L.^,n
4n
city: J/:.: -,.{,e tc/Sate: Q(aY,c1*49
Phone: t 2l- ?4,FiN
this applicationoflzln
E-mail: n i ((
Building Owner or Owner's agent
I This installation is being made on resrdenlial or farm properw owned by
me or a member of my immediate family, and rs exempt from lraensing
requiremen6 under ORS 701 010.
CONTRACTOR INSTALLATION
Business narne
Address
City 9-/s,u,.i-ZIP
Phone Fax
E-maii
CCB license no
Pnnt name
Signature
Square t'ee!: ZLS I
Type ofHeat F"".e -( h.(
Energy Prth
A oew L-lalteratron L-l additron
(b) Foundation-only permit? tr !'es E tlo
Iotal valuation:S
2. Building fe€s
(a) Permit fee (use vuluarion tablel S
(b) Invesligative t'ee (equal 10 [2al)S
(cl Reinspeclion (S per hour)
(number ofhours x fee per hour)S
(d) Enter 129/o surcharge (.12 \ [2a+zbi]cl)ri
(er SubtoEI of fees Bbore (2! throogh :d)s
J. Platr review fees
is
(b) Fire and life safety (55"/. \ permil lee [2a])r s
(c) Subtotal of f€es above l3a and 3b)j
{. }Iiscellaneous fees
(a) Seismic fee. l% (.01 x permit iee [2a])'!
(b) Tech fee. 5ol. (.05 x permit fee[2a]+PR fee [3c])S
l:.5{r
JOTAL f€es and surchxrges (2ef3cr{a+tricrd):s
SUB.CONTRACTOR INFORMATION
CCB License #
Elcrtricai
Plum birg
llechanical
Last edited 5-5-1017 BJoo€s
; t?-
FEE SCHEDULE
Dare
Construction type:I
lAddress:hb
I
I
Sigr here:
(a) Plan review (6570 x permit fee [2a]):
(c) Continuing Education Fee 52.50 '
\
Phone \umber
)
I
CITY OF SPRINGFIELD, OREGON
Electrical Permit A lication
225 Fiftb Street. Spritrgfield. OR 971770 PH ( 541 );26-37510 FAX54l )126-3689
Signature of signing super"'isor
h
Date: l\IBIS
This permit is issued under OAR 918-309-0000, Permits are nontransferable, Permits erpire if \+ork is Dot started withiD 1E0
davs of issuance or if work is suspended for 180 dal,s.
s 33.00 s)G
S
s
S
j(
5
Over 600 amps or 1.000 volts. see services or feeders section above
Signal circuil or a limited-energ,"- panei.
alteradon. or extension (:)
(A) Enter subtoral ofabove fees
(Mitrimum Permit Fee 593.00)s
S
(D) Continuing Education Fee $2.50
s
Permil no 0004u
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? [ Ves E I.,Jo
CATEGORY OF CONSTRUCTION
dential E Govemment I Commercia]' Joe sre INFoRMATToN AND LocATloN
robsire address: -ll4 S. -1}*a SfYeLt
Citr .sp'nr*,ftr\ <t-State oa zy,an478
I t^totReference: v
DESCRIPTION OF WORK
ft )e^; \-il.t,
PROPERW OWNER
lJi L elhT
Name
Address
*.:,^ {,rt)st"t.' O4 ^P:
qw.?P)
TtPhone: S{Fax
This installation is being made on residential or farm prcperq
owned b1' me or a member of ml, immediate family. This
propertt- is not intended for sale. exchange, lease, or rent. OAR
479.540(l ) and 479.560(l ).
Signature
lE-mail: N
CONTRACTOR INSTALLATION
Address T\)
Cin -Srfte:ZIP
Phone Fali
E-mail --)
BCD license no
Signrng supen,rsor's hcense no.i
Print name ofsigning supen isor
FEE SCHEDULE
Number ofitrsp€ctions per itetrl ( )Qt]Cost
e8"
Total
cost
Residential. p€r unit. senice included
1.000 sq. ft. or less (4)s171.00 $,21
Each additional 500 sq. ft. or ponion
thereof
Limited energ]'(2)i lsot.*
Each manufacrured home or modular
dwelling service or feeder (2)s 81.00
Services or feedelsi rnstallation. alteration. relocation
200 amps or less (l)s 103.00 s ro3
.$120.00 S
401 to 600 amps (2)$203.00 s
601 to 1.000 ahps (:)I szer.oo j S
Over 1.000 amps or volts (2)i $ses.oo I S
Reconnecl onl) (:)$ 81.00
Temporary seri,ices or feede.\. instalLation. alteration. reloca.ion
200 amps or less (:)s 81.00 8lS
201 to 400 amps (2)s 111.00 S
Brench circuits: rleMt alteration. extension per panel
401 to 600 amps (2)sl62_00
Each branch circuil
b. Fee for braDch circuils without purchase ofa service or feeder fee
s 81.00 $Firsl branch circuit (l)
Each additional bmnch cicuit $ 7.00 S
Miscelletreous fe€s: sen'ice or Ieeder not included
Each pump or irigation circle (2)s 81.00 !
Each sign or outline ligiling (2)$ s3.00 s
5 33.00
Each additional inspectioB: (l )$93.00 s
DEPARTMENT USE
(B)Enter I29i! surcharge (.12 x [A])
;q
TOTAL fees and surcharges (A througb D):
s2.s0
Lasr edited 5'5'!201i llJones
Cit\':
20i to 400 amps (2)
I a. Fee for branch circui[s with purchase ofa service or feeder fee:
DEPARTMENT USE ONLY
I l
a-r
I
s z.oolsI
Business narne:
CCB license no.:
(C) Technolos Fee (5% oflAl)
Property Owner Statement
Regarding Construetion Responsibilities
Oregon Law requires residential construction permit applicants who are not Icensed with the
,/1^^^+-,,^+i^- /^^^+--^r^-- D^ -...J +^ ^i^^ +A^ 4^ll^,.,;-^ k^{^,^ ^ A,,il,{l-^ ^^.-i+ ^^- k^
issued. (ORS 701.3?5 (2],)
I have read and understand the lnformation Notice to Homeowners About Construction Responsibilities,
and I hereby cedify that the information on this homeowner statement is true and accurate.
lV ,cL C l,-.^
Print Name of PermilApplicant
t-f -/>
Signarure of PermitApplicant
18-ulJAb - tD.lLPermit #:
Address
.a\,-( \7e Sl=
lssued by N Date: l\t8I
It,
S+*-.*.-^-.,{ <- CL,*r; e*-9-
This statement is required for residential buiiding, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants, exempt from Iicensing under ORS 701.010 (7],, need not
submit this statenrent. This statement will be filed with the permit.
Please check ihs appropriaie box
tr I own, reside in, or will reside in the completed structui-e and my general contractor is
l'laine Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
Iicensed with the Construction Contractors Board.
or
I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. lf I change my mind and hire a general contractor, I will select a contractor
whc rs licensed with the CCB and will immediately give the name cf the contractor to the office
rssuing this Building Permit.
Ihis Copy for Permit Offices
I
tr
Jate
I r-Jl.J \<-
lnformation Notice to Owners About
Construction Responsi bil ities
anPs 7nl ll?q r?t\
Homeowners acting as their own general contractors to construct a new home
or make a substantial improvement to an existing structure, can prevent many problems
by being aware of ihe following res ponsibilities:
e HomeouineTs who use labor orovided by rvorkers not licensed by the Construction Contractois
Board, may be ccnsiciered an employer, and ihe woi-kei-s who provjde the labor may be consiclered
employees. As an employer, you must comply with the follou,ing:
c Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages
at the time employees are paid. You will be Iiable for the tax payments even if you don't actually
withhold the tax from your employees. For more information, call the Department of Rev3nue at
503-378-4988.
o Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insuTance
purposes on the wages of all employees. For more information, call the Oregon Employment
Department at 503-947-1488.
o Oregon's Business ldentification Number (BlN): is a combined number for both Oregon
\Mthholding and Unemployment lnsurance Tax. To flle for a BIN. go online to the Oregon Business
Registry. For questions, call 503-945-809'1.
o Workers Compensation lnsurance: Employers are subject to the Oregon Workers Compensation
Law, and must obtain Workers Compensation lnsurance for their employees. lf you fail to obtain
Workers Compensation Insurance, you could be sub.iect to penalties and be liable for all claim costs
if one of your workers is injured on the job. For moTe information, call the Workers Compensation
Division at the Department of Consumer and Business Services at 800-452-0288.
c Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from
employee wages. You may be Iiable for the tax payment, even if you didn't actually withhold the tax.
For a Federal EIN number, go online to www.irs.oov.
Other Responsibilities of Horneowners:
Code Compliance: As the permit holder for a construction pro1ect, the homeowner is responsible
for notifying building officials at the appropriate times, so that the required inspections can be
performed. Homeowners are also responsible for resolving any failure to meet code requirements
that may be found through inspections.
Property Damage and Liability lnsurance: Homeowners acting as their own contractors should
contact their insurance agent to ensure adequate insurance coverage for accidents and omissions,
such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not
otherwise covered as employees by Workers Compensation lnsurance.
Expertise: Homeowners should make sure they have the skills to act as their own geneial
contractor, and the expertise required to coordinate the work of both rough-in and flnish trades.
CONSTRUCTION CONTRACTORS BOARD
PO Box 14140, Salem OR 973C9-5052
Telephone: 503-378-4521 - Fax 503-373*2007
Website Address: www oreoon.oovlccb
f/propert-y_owner adopted 9-2016 This Copy for Permit
I
I
i
SPRINGFI
www.sprinq6eld o..9ov
Addressr 714 S 72ND ST, Springfield, OR 97478
Parcel Number: 1802022105503
Transaction Receipt
Record Number: 81 1-18-000046-DWL
Receipt Number: 464524
Fee Items Paid
CITY OF SPRINGFIELD
Development and Public Works
225 Fifth Street
Springfield.OR 97477
Phone:541-726-3753
permitcenter@springfi eld-or.gov
Recelpt Date: 1/5/LB
Structural plan review fee 224-00000 425602-1030 $ 1,367.60
$ 1,367.60
Payment Summary
Credit Card Authorization -
03490D
N cholas A Cheney $1,357.50
$ 1,367.6O
Printed: ol/asl2ala
{6
125 FIFTH STREET . SPRINCFIELD, OR91471 . PHr(541)726-3753 . FAX: (541)726-3689
One and Two Family Dwelling Building Permit Application Checklist
NOTE: Missing information that is
required lor complete plan revievr can
delay the permit process until all required
inlormation is provided. Permits will not
be issued untilthe completed plan review is
approved.
Permit #Map/Lot
Address
Associated Permits:
f] Eleqtrical I Plumbinq n Mechanical
E other:
rB- Land and Drainage Alteration Permit (LDAP)
AII new one and two family dwellings require an LDAP
Refer to Fact Sheet 1.1 to determine type of LDAP
/B-2 complete sets of Legible Plans Including site Plan
.r-n
KI
Received b Date
On 11 x 17 paper at minimum
Must be drawn to scale, showing conformance to applicable local and state
burldrng codes, to rnciude the following:
E-- site/ptot ptan
Drawn to 1:20 scale with scale indicated
North arrow
Adjacent street names and street elevations shown
Building setback dimensions (Distances from property lines)
Location of easements and driveway
Location of utilities and how they are connected
Footprint of structure (including decks, porches, roof covers)
Location of wells/septic systems
Lot dimensions
Buildinq coverage and percentage of impervious surface in hillside
areas
Show all existinq structures on site; indicating height of all structures
inclusive of ridgelines
Site Topography in 2!0" Increments including Surface drainage
Show how stormwater and wastewater connect to the public system,
septic or drywell.
Show orientation of structures
Foundation Plan
N Dimensions
E Footing sizes, lsolated footings, Step Foundations and Retaining Walls
m Hold downs and rejnforcing type, size and spacing
K connection details
A Vent size and location
S cripple Walls
E Girder sizes and locations
E} .loists or post and beam type, sizes and spacing
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T lBuildrng Forms\One_and_two famrly_dwelling buildrngjermit_checklrsr.05.09 doc
I ApplicArtoN lN rAKE c.EVIEW wtLL BE coNDUcrFD FoR AL-
RFSTDFNTIAL PERMITS,
re
BE
Floor Plans
Ftr
Show dimensions
Identify all rooms
lnclude window and door sizes
Locat,ons of:
Smoke and carbon monoxide alarms/ water heater, furnace,
ventilation fans, plumbing fixtures, balconies and decks 30 inches or
more above grade, porches, stairs, etc...
ts Cross Section(s) and Details
ts Show all framing member type, sizes and spacing such as floor
beams, Headers, joists, sub-floor, cripple wall and wall construction,
roof construction and metal connectors (lvore than one cross section
may be requjred to portray construction clearly)
iX Show details of all cripple walls, wall and roof sheathing, rooflng, roof
slope, cerlrng height, siding material, footings and foundation, stairs,
firepiace construction, thermal insulatjon, etc...
El Show attrc ventilation
ts Energy Path: Example - High Efficiency HVAC
m Elevation Views
E Provide elevatjons for new construction
Exterior elevat,ons must reflect the existing and proposed grade if
the change in grade is greater than two feet at building footprint
13 Floor/Roof Framing
Bearn calculations, especially for enqineered wood products and non-
uniform loads
Provide plans for all floors/roof assemblies indicating member sizing,
spacing and bearinq locations, incjuding decks, porches, roof covers
E Metal connectors and tie straps clearly shown
B Show headers and beams supporting floor or roof
E Prescriptive lateral bracing andlor engineered shear walls
Provide all calculations and adjustment factors used.
E EngineersCalculations
[+ Wel signature stamped engineering calcuiations, specificatjons and
deLarls snatl be orov,ded wl.ere reqrrred.
B Manufactured Floor/Roof Truss Desiqn Details must aqree with
plans and engineering
The undersigned acknowledges that the rnformation rn this applicatjon s correct and accurate
Agent/Builder OR
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Property Owner
ignature Agent)
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T ,Eurldins FormsrOn€ a,rd xvo family-dwelling-burldrng,_!emir_checklrsl05.09doc
Signature (Owner)
(Print Name)
,!
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az
E6
E
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B
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Make sure that minimum bathroom fixture distances are met
Check to make sure stairs meet code
Check roofinB materi com posltion shi , Spanish tile, metal, etc.)
Check for attic access and underfloor access on plans
Check beam sizes
Read over all the general notes to make certain that nothin8 was missed and there are no conflicts
Make sure that Willamalane form is attached.
Transfer all notes made by other work groups until there are two identical sets of plans (jobsite and city set)
lnclude standa rd attachments :
Exterior Wall Envelope Self-Certification Form
Moisture Content Acknowledgement Form
High-Efficiency Lighting Systems Oregon Residential Specialty Code (ORSC)
Noise Ordina nce Notice
Smoke Alarm
Ventilation Requirements for Kitchens and Bathrooms
Green Approved Plans Cover Sheet (Found under "Cover" in file cabinet)
Add all inspections and fees into Accela (including Willamalane fee and addressing fee)
Stamp plans with the "Reviewed for Code Compliance" stamp, sign the approved by line and perforate
Approve Building Review line in Accela & call or email application with fees due
Signed electrical a pplication received
Plan check items/notes
oNScr r-.s Pre*'rr-r C2ga @ E +rrrr\ra- i^rspc
E
Plqn Review Checklisr
IIIIIIIIII
Check address on plans is correct
Check to see if LDAP has been issued. I?-cl.ow -tr. r=!-L{€
ReadallcommentsfromotherworkgroupstoseeifanythingneedstobeconsideredduringstrUcturalreview.@
Check Setbacks on Site Plan
Check RLID to make sure taxlot matches what is shown on drawings and that topography lines are on the plans.
check to see if lot is sloped or flat -[Fll6i-e? will back deck meet setbacks
Check soils to determine whether or not a Geotechnical evaluation should be required
lf property is on septic, check for proper setbacks from building to tank, distribution box, and leach field
Check that everything required to be engineered has engineering and that the stamp is current
Check the truss package and make sure it matches the pla ns (qty of trusses, type, attachements) - lf the numbering doesnrt -Th.}4's r4ralA t. rs Fo1-
*match but the uplift and reactions look correct it is oK. Falls under field verify *"?J[jlti'r.o3i$-'* {*Make sure that if there is HVAC equipment in the attic, the trusses were designed to support it
Check to make sure that Trusses are built to support HVAC equipment if it is going in the attic.
Check to see if anything over 4000lbs is bearing down on strip footings. lf so this needs to be enlarged.
Check Hold Downs
Check Foundation Venting
Check header sizes
Check footing sizes
Check energy code requirements
*Make sure that insulation called out meets the energy code and if not make note of the required R value.
*On additions/remodels where existing conditions come into play, see code section N1101.3 & table N1101.2
Check tempered glazing
Check bedrooms for egress (window sizes, make sure that garage door to house doesn't go into bedrooms)
Check to see if there is a living area above the garage, if so, make note of 5/8" type X gyp board fire separation requirement.
Check for mechanical equipment protection (bollards) inthegarage B€,u.r, d. Efi-c,6, tg l-t L-G.,!'L- c€.v 61-
f DETACHED garage is being built less than 3ft to existing structure in needs to have 1/2 gyp board on the interior walls
Check for smoke d etectors/Ca rbo n Monoxide detectors
Check wall bracing
Check for fire chases that need to be blocked.
Check minimum room size
IIIII
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JOURNAI OR JOB NUMBER
NAME OR COMPANY:
LOCATION:
TAX LOT NTJMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
ITEM I TOTAI - STORM DRAINAGE SDC
2 SANITARY SEWER - CITY
A, REIMBT]RSEMENT COST:
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
l8-00016
CHANEY
1802022t05501
Sioslc Iamil
ult_ulNG sIZE (sF)LOT SIZE (SF
I S]QRM DRAINACD
I)IRE!] RL]NOII I O CI I Y S TORM SYSTEN1
A III]IMBIJRSE]\,1I.-N I (I)S I
IMPERVIOUS S T'
3.1I1.00
I]. IMPRO\€MENT COST
COST PER S,F
s0 l7l
COST PER S F
s0 i96
COST PER DFU
s t5.r 55
COST PER DFU
$75..r1
NUMBER OF IJNTIS
I
NUMBEROF IJNITS
I
COST PIJR FEU
sl2l.20
COST PER FEU
sr.561 66
s22 82
ADM, FEE RATE
AREA DRAININC TO
DRYWELL
0
CHARCIJ
$927 _79
CHARGI:
$1,350.76
NEW TRIP T'AC I OR
t00
NEW TRIP I'ACTOR
100
NUMBER OE DFU!
l9
I] IMPROVEMENT COST:
NUMAER OF DIU s
29
52.278.s.18
s6,669.71
COST PER TR]P
17 03
COSTPERTRIP
s31l 98
s1,516.77
s11,90o.76
CH,q.RGE
s695 04
I'I-D}I 2 TOTAL - CITY SANI'TARY SE\}f,R SDC
3. TR}NSPORTATION
A. REIMBI]RSEMENT COST
ADT TRIP RATI:
951
I] IMPROVLNll:N I CoS I'
957
NUMBEROF FEU'S
I
B IMPROVEMEN'I'COS'I'
NT-]}!'IBER OF FEIJ'S
I
C COMPLIANCE COST
SUBTOTAL
s 13.900 76
r r t:]t .l TOT{L - TR!\SP()RI l O\ SD('
4 SAMTARY SEWER . MWMC
A. REIMBURSEMENT COST:
MWMC CREDIT IF APPLICABLE (SEE RE\ERSE)
MWMC ADMINISTRATI\E FEE
II [}I {'tOT{I-. \I\T \I(' STNITARY SE\\ ER SD(]
SUBTOTAI, (ADD TTENIS I,2,3, &.I)
5, AI)MINISTRATIVE FEI:
TOTAI STORM ADMINIS] RATION FEE
TOTAL MWMC ADMINISTRATION FEE . LOCAI
TOTAL SEWER ADMINISTR TION FEE:
TOTAI- TRANSPORTATION ADMINISTRATION FEE:
0
s3,13s.7.1
3411 10000
s.r,181.95
Effi
s162.98
s.t,272.75
Emn
s22.82
(s202.91)
st 0.00
sr r3.93
s?5.8J
.]ll.{9
s1t,59s.80
sl7l.79
1070
1092
I09l
t091
l0i1
t054
t056
to19
l07E
-2
@
I@
PREPARED BY Sle!en Petdrsen D,\lll 2t6/2018
II[,IL SDC CH.\R(;ES
7t4 72ND St'
I
ADT TRIP RA I]
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tffi-
| 5r.s6J.66
INtx,/grR or FFrrtll Eos fll r+u----_l
FTXTURE TYPE
I'oTAL DRAIN,\(;E FIXTURE UNITS
.t,Dtl uivalenl Dwelli Unir
DRAINAGE FIXTURE UNIT DF CALCULATION TABLE
NtIMBER OF NEW FIX1 URES x UNIT EQUIVAI-IjNT = DRAIN-{CE FIXTURE UNTTS
NOTF FOR RFMODF CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. Ot: F.IXTLIRES
LIN IT
NEW OLD UIVAIEN-I
NUMBER OF EDU'S
20
DRATNAGE
FIXTURE
TJNITS
0
isadi d\rllin unit (20 Df-U's) setat 167
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4.63
$4.40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
IS LAND ELCIBLE FOR ANNEXATION CREDIT?
(Enter I for Ycs, 2 forNo)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
CREDIl'FOR LAND OF APPLICABLE)
t9'79
VALUE / IOOO
$38.36
CREDIT RATE
s5.29x
cREI)l I ljoR IMPROVEMIINr' (IIr AITER ANNI-]XAtlON)
VALUE / IOOO CREDIT RATE
$0.00 x $5.29
TOTAL MWMC CREDIT$1.5S
$1.45
$'t.25
$1.09
$0.e2
90.72
$0.48
$0.28
$0.09
$0.05
t]ATHTUB 1 3
DRTNKING FOUNl'AIN 0
0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 0
LALINDRY TUB 2
CI,OT}IESWASHI]I{ / MOP SINK 0 3 3
CI-OT}IESWASHII{ - 3 OR MORE (I'A)0 6 0
MOBILE HOME PARK TRAP (I PI]R I'I{AILER)0
RECEPTOR F'OR REFzuC / WAI'I.]R STATION / ETC 0
RECEPTOR FOR COM. SINK / DISTIWASHER / ETC 1 3
SHOWER STNGLE STALL 2
SHOWE& GANG (NUMBER OI.' III'ADS)0 0 0
SINK: COMMERCIAI,/RESIDENIIAI, KITCHEN 0 3 3
SINK: COMMDRCIAI- BAR 0
SINK: WASH BASIN/DOUBLE LAVATORY 0 0 0
SINK: SINGLE LAVATORY/RESIDI]NTIAI- BAR
URINAL, STAIL / WALL 0 0.IOILET, PUBLIC INSTAI,LATION
1'OILET, PRIVAI'D INSTALLAIION 9
29
YEAR
ANNEXED
CREDIT RATE/$I,OOO
ASSESSED VAIUE
BETORI] I979
t9'79
l9ll0
l98l
l98l
1933
l98l
l98i
1987
r988
1989 0
1990
l99l
1992
l99l
199.r
l99t
r996
I997
1998
2000
l00l
Iry
MISCELLANEOUS DFU TYPE
I
0
2
I
1986
lol3l=lololll=
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0
0112 l=lo ffillt o Tl
lj t=lolol2l=T2l =l4lo rT O I ' I=lo 0 a 6--T_-=Iot3to3
$202.91