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Home My WebLink AboutPermit Building 2002-06-24d/ SPRINGF!ELD Job# 01-01117-01 RESIDENTIAL PERM!T City Of Springfield Community Services Division Building Safety Page 1 of 5 Job Number: 01-01 117-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 00507 Subdivision: Jasper Meadows 225Fifth Street Springfield, OR97477 Location Of Proposed Site: 5911 Montclaire Ln Spr AssessorsMap#: 18020300 Lot:6 Block: Addition crTY oF SPRTNGF7ELD, OREGOTV Owner: Hayden Enterprises Address: 2622 SW Glacier Place #110 Scope Of Work: Single Family Residence Cascade SFR Phone Number: City/State/Zip: New 541-923-6607 Redmond, OR 97756 Value: $99,598 Contractor Type GeneralContr Contractor Hayden Enterprises 2622 SW Glacier Place #110, Redmond, oR 97756 Philips Electric lnc 1298 Bethel Dr, Eugene, OR 97402-2003 Star Landscape 93066 River Rd, Junction City, OR 97448 Dean Heating and Air 4301 Main, Springfield, OR 97478 Brenda Marlene Currier 648 W Oregon Ave, Creswell, OR 97426 5t1t2003 ested before 7:00 Registration # 92208 Expiration Date 7t29t2003 Phone 541-923-6607 541-688-6121 541-998-2039 $$,-ou,u t0s 541-895-3758 ElectricalContr Landscape MechanicalContr Plumbing Contr To request an inspection call the 24 hour recording at726-3769 a.m. will be made the same working day, inspections requested working day. 458 1 33733 Verify Ground Rod Footing Foundation Post and Beam Floor !nsutation Ceiling !nsulation Shear Wall Nailing Framing Walllnsulation Drywall Hold Downs !nstalled Final Building .m. will be made the following Required lnspections Building -lnstall ground rod at footing, and call for inspection in -After trenches are excavated -After forms are erected but prior to concrete -Prior to floor insulation or decking. - Prior to decking. -Prior to cover. -Before covering sheathing with finish materials. -Prior to cover. -Prior to Cover -Prior to taping. -When all required inspections have been approved and the building is complete. \t foundation ir Temporary Power Underground Electrical Rough Electrical Electrical Service Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Backflow Device FinalPlumbing Underfloor Mechanical Rough Gas Rough Mechanical Gas Service FinalMechanical SW-Curbside GC-Standard Street lmprovement: Fully lmproved Curb Cut?f lmprovement Agr.? San Sewer Depth (Ft): 6 - 4 Storm Sewer Available? [{ SpecialReq.: Security Required: Bond Begin DateTime: 00/00/0000 00:00:00 Job# 0{-01117-01 Page 2 of 5 Required lnspections Electrical -Approval required prior to SUB energizing pole -Prior to cover. -Prior to cover. -Must be approved to obtain permanent power. -When all electricalwork is complete. Plumbing -Prior to insulation or decking. -Prior to cover or placement of concrete. -Prior to cover. -Prior to filling trench. -Prior to filling trench. -Prior to filling trench. -After device is installed but before backfilling trench -When all plumbing work is complete. Mechanical -Prior to insulation or decking. -After line is installed and capped if not attached to an appliance. -Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure tes -When all mechanicalwork is complete. Public Works -After forms are erected but prior to placement of concrete -After forms are erected but prior to placement of concrete Sidewalk Type: AdditionalROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: Curbside - 5' I To Curb and Gutter 6 00/00/0000 00:00:00 Special lnstructions: NO OCCUPANCY OR SEWER HOOKUP UNTIL CITY ACCEPTS INFRAS Other Utilities: Types Of Warning Devices Reqd. Project Supervisor: Zoning: LDR FloodPlain?Wetlands? [ Journalnumbers 1= Comments: Planner: Sam Gollah Urban Growth Boundary?[ Quantity Of Fill: Supplier: Drainage: Floodway FEMA: X-White Overlay District: # of Street Trees: Job# 01-01117-01 Page 3 of 5 Land Use: Single Family Dwelling Pave Driveway? V1 Glenwood Area? [ 3 Additional Requirements: Required Attachments: Source Locn: Material: Flood PIain FEMA:1166 ot 2975 Construction Types(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 2 Handicap Access? I (sq. Main: 1230 Accessory:400 Private Garage/Carp/Stor # Of Stories: 1 Height (feet): 18 Gurrent Units: Proposed Units:1 Census Code: New SF - detached Total:1630 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Gheck 10t11t2001 6953Residential Plan Check Total Plan Check 99,598 $367.67 $367.67 Building Permit State Surcharge For Building Permit 8% Building Administrative Fee Tota! Building 02t11t2002 02t11t2002 02t1112002 81 59 81 59 81 59 99,598 $565.65 $39.60 $45.25 $650.50 Minimum Electrical Permit Fee Wiring Footage 1,000 Sq Ft or Less Wiring Footage Each Add'l 500 Sq Ft Temporary: 200 Amps or Less State Surcharge - Electrical 8% Admin Fee - Electrical Total Electrical Electrical 02t11t2002 02t11t2002 02t11t2002 02t11t2002 02t11t2002 02111t2002 81 59 81 59 81 59 8'159 81 59 81 59 1 2 1 $.00 $106.00 $38.00 $50.00 $13.58 $15.52 $223.10 Plumbing Minimum Plumbing Permit Fee Minimum Plumbing Permit Fee Two Bathrooms State Surcharge - Plumbing State Surcharge - Plumbing Backflow Prevention Device 8% Administrative Fee - Plumbing 8% Administrative Fee - Plumbing Total Plumbing 02t11t2002 06t24t2002 02t11t2002 02t11t2002 06t24t2002 a6t24t2002 02t11t2002 06t2412002 81 59 9696 81 59 81 59 9696 9696 8159 9696 1 1 $.00 $31.00 - $254.00 $17.78 $3.1 5 $14.00./ $20.32 $3.60 $343.85 Hood and Exhaust Minimum Mechanical Permit Mechanical 02t11t2002 02t11t2002 $9.00 $.00 81 59 81 59 2: Buildinq 1 Job# 01-01117-01 Page 4 of 5 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanical 8% Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct Dryer Vent Mechanical lssuance State Surcharge - Mechanical Total Mechanica! 02t1112002 02t11t2002 0211112002 02t11t2002 02t11t2002 02t11t2002 8159 81 59 81 59 81 59 81 59 8159 1 3 1 $3.60 $12.00 $18.00 $6.00 $10.00 $3.1 5 $61.75 Public Works 02t11t2002 8159 50New Sidewalk Total Public Works $65.00 $65.00 System Development Residential- Single Family - Storm Residential lmprovement MWMC MWMC Administrative Fee SDC Administrative Fee Residential Sanitary MWMC Residential - lmprovement Residential - Reimbursement Sanitary Sewer SDC Reimbursement Sanitary Sewer SDC lmprovement Total System Development 02t11t2002 02111t2002 0211112002 0211112002 02t11t2002 02t11t2002 0211112002 02t11t2002 02t11t2002 $540.27 $34.83 $10.00 $1 26.1 3 $332.86 $659.76 $1 s5.1 3 $448.77 $341.04 $2,648.79 81 59 81 59 81 59 81 59 81 59 81 59 8159 8159 81 59 1 ,979 1 1 1 1 1 21 21 S.F. Residence - Willamalane TotalWillamalane SDC Willamalane SDC 02t11t2002 8159 1 $1,000.00 ${,000.00 Planning Plan Review Total Planning 02111t2002 8159 1 $50.00 $50.00 Address Assignment Total Permits Wo Srchg Permits Wo Srch 02t11t2002 8159 $8.00 $8.00 Grand Total Plan Check Type lnitial Review-Res Engineering-Res Planning-Res Structural-Res Checked By Lisa Hopper Sam Gollah Tom Max Date Gompleted 10t24t2001 01t30t2002 10126t2001 Steve Templin 11t28t2001 $5,418.66 Comment Subdivision plat not completed. Wrong Tax Lot number on subdivision plat. Wrong North direction. Needed to assign addresses to subdivision. No scale on plans. NO OCCUPANCY OR SEWER HOOKUP UNTIL CITY ACCEPTS IN FRASTRUCTURE. USE EXITSING CURB CUT CONSTRUCTED WITH SUBDIVSION. NO ALTERATION TO CURB CUT WILL BE PERMITTED. ADJUST FLOOR PLAN AS NECESSARY TO UTILZIZE EXISTING CURB CUT, Plannin 1 Job# 01-01117-01 Page 5 of 5 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 furth6r certify inat any and all work performed shall be done in accordance with the Ordinances of the City of SpringfielO anO tne Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCy wiil 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 propefi, and the approved set of plans will remain on the site at all times during construction. ,fA z"l a' '{d{o?- {Saure Dat{ / 225 FIffFI STzu,ET . SPRINGFIELD, OR 97477 o PII:(541)726-3753 r FAX: (541)726-3689 CityJoblqr-5u, Ol-O/ t/7-O I Job o 802 o30 0 €//*,tr4 ,d< Tax Tnf oorcilAssessors Owner /,eu,/r-, E, /o --o rt<z s 7.or z Address S- o<t 4-c puon" fa/-/372 City S tate o Zip ?zzfF BACKFLOW PERMIT IS $51.75 (includes Perrnit Fee, State Surcharge & Administrative Fee) C o ntraclor Info rmatio n Contractor cfty1ar'hdeit 11t/ state O/, zip ?/c/9 Construction Contractors Registration #6;t?r Expires 2tr d3 By signing this permit/application, I agree devise has been installed and is visible for this permit/application is correct. t,IOTICE: ANY 1SO DAY PEBIOD. on (2 o2- For Office Use Date of Application Checked fur HistoricalChecked for Delinq Shared Drive (T:)/Building Fomx,tsack{low Preventionl -02.doc i\rlon Address 1?6 0 R//// K D' Pnon" f?f- ?/22 fhose r ules are set foOGZ{OZ n OAR 952-001-001 0 through OAR 952-001_'tnf1n \/^. L,ili 0F SFtliNrit-iFi [) ?25 FIFiH:rir,[El. ' ttiiF I [:r,D , [.]H '37 4i i i14rJ/10-.11:J t,ri ! r.. {rFtt i t.t DEUF_t.upHr ri I i: [.f Lr [ { i ':, f r}.lL) PUBL I C tiillil^ :) :- L_:::_ -: I:FEB ll 2,:til ii:iFB 112'J0l' _ ':;:*;':::.::':- 1013 SIDEtlIAIIi FTRI,IIT J0BS:01-Lti i1/-0'! 1070 S0C/$T0rll,| J0B*:01-01 1 l7-01 I091 Stl(].SAN RTT|4BURSEHE J0B*:trl-li1l17-01 1092 .st)[l-.SAN lilpR0vtr,tENT i0Br:01-01 lll-01 Ii]94 SDC-I RANS II-IPRl]\lEI,IE J0Bf ;01 .01I l7-tll 1()g3 SDC- TRANS HIII,IBURSE J0B#:01-01 1 17-01 IO55 S'JCIRESiDINTIAI. SAN JOBs:01-0'l1l/-01 IL.i56 SI]O/REGI[]NAL SEI,JER J0Bs :01-() 1 1 17."0 1 I(ji3 SDI/ADI"IIN ,l0Bf : 0l -0.l I I 7-0 i itl74 St]C/ tirlLLA|,!A| ANE J0Bf :rll-011'l/-01 I(jO2 BUIt DINI] PERI'III J0B*:Cl-0il1f -01 1CgB (8I) ADt{tN tEE i08s:01-0t I 17-01 1l]9g SIATE SIJRChARGT (?X) i0Bf ;01-tll 1 1i -0i IO()3 TEI,IPORARY ILECT PER J0B*:01-01 I l7-01 l(Jg8 iBr) ADt*1lN ttE J0BS : rtl ! -0 1 I 1 7-01 1(jgg STATE SURCHARGE(7T) JUB*:01-0lll7-01 Il.)O4 ELECTRIiAL PERI,llT J0Bs:t]l-01 I 17-01 IUSS (8X) AI)HIN FTT J0BS : 0 ! -01 t l 7 -0 1 10gg SrATE :jlrRtHARtlI (7fl) $65 ,00 $540.21 $448 7/ $34 1 , {14 $659. /5 $155.1i $Jb7 .09 $9.25 $120.13 $],1,(.)0.Ut $565 ris $4L?5 $19 , n,j ggrr . [ri) $4 .0rj $.J. 5ir $ ia,r r.r i $'' ' '' i0Br:r ' l I r,'jg: i iHuL I i.\ t j0fifi r., I , ul lilg8 (Bh) AUl4'lN ltL -t0B*;01-0111i-01 1i]8? I'ILCHANiI.JAL ISSUANi.,E rl-1.1111i-ii1 rlR F SS AiS I ljt'lt'r': I'iI 01i17-01 . r iil'18i Nl ''' l i .li. ''',)'11' ' t: l{; i tr,titi ir i -0I '! I li'rgE .j r;f ' <[ii', . '.,.,r-, i \ ) illi* ;rj1 -ti l'l 1 i' ii1 t23t pLAN REVIiil (P0Ui PLAN IliVIEI4 1056 SiICIREGI0NAL Stl^l[i1 F,LAN RFVII lll t r ln $3 . bil $1{l.i.iti $8 , u"r $25.t ..tit $2U . ril $ii./8 $50 .00 $1C,C0 J ,;.. j .l r \'[ [: FR0M itN l-l0t'{ts 'j[ .-r'$4 ,993 .24 $10,00 IOTAL TENDERED $5,009.24 CHANGE t)UE $0.i5 *Pay Name *Mai I Addr *Cty/Sti Z *S"ite Addr :HAYDFN HtJt4E$ :P,0. BtlX 833 :SPRINGFl : 591 1 t'loN ORE(iON 9/478 LL(] i: L.[) , IIil. a=' IHANK Vt]LI !! !!I! SE*ffiEFJ&tr'IHLM Report lD : SPRA103 Voucher lD : 00046985 Handling Code : RE Mann,Pete 3783 Riverway Eugene, OR 97402 City of Springfir,rd Voucher Accounting Date : Vendor Number: lnvoice Date : Invoice # : Approver: Operator: Gross Amount : April25,2002 0000007931 April25,2002 4-25-2002 Puent,David wtLS5940 9.25 AmountDescription Account Fund 9g Subclass BY Proi/Grant Refund of overpayment 482105 611 2002 Comments: Express Check Overpayment of of building permit. Cr-Orll-lrOl Sqrr fnnmlzr;- 9.25 SP]IINGFIELD Job# 01-01117-01 RESIDENTIAL PERM!T City Of Springfield Community Services Division Building Safety Page 1 of4 Job Number: 01 -01 1 17 -01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot #: 00507 Subdivision : Jasper Meadows A. 225 Ftfth Street Springfield, OR97477 Location Of Proposed Site: 591'l Montclaire Ln Spr AssessorsMap#: 18020300 Lot:6 Block: Addition: ctTY oF SPRINGF7ELD, OREGON Owner: Hayden Homes Phone Number: 541-501-4332 Address: Po Box 883 ATTENTIoIT:oregonEiUy{EhJfledqjor lf,orinofield, oR e7478 Scope Of Work: Single Family Resl0llou rules adoptedbythe Oregon Utility Vatue: $99,598 Notification Center. Those rules are set f@rth SFR in OAR 952-001-001 0 through OAR 9SZ-001 - Gontractor Type General Contr ElectricalContr MechanicalContr Plumbing Contr Contractor calling the center. (Note: Hayden Hom CS numberforthe Oregon PO Box 883, Spri Philips Electric lnc 1298 Bethel Dr, Eugene, OR 97402-2003 Dean Heating and Air 4301 Main, Springfield, OR 97478 Brenda Marlene Currier 648 W Oregon Ave, Creswell, OR 97426 ) 458 1 33733 1 03570 Expiration Date 0712912003 05/0'1/2003 0212312003 1211512002 Phone 541-501-4332 541-688-6121 541-767-0626 541 -895-3758 To request an inspection call the 24 hour recording at726-3769. 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. Required Inspections Buildin Verify Ground Rod Footing Foundation Post and Beam Floor lnsulation Ceiling !nsulation Shear Wall Nailing Framing Wall !nsulation Drywall Hold Downs lnstalled FinalBuilding -When all required inspections have been approved and the building is complete. Electrical -lnstall ground rod at footing, and call for inspection in conjuction with footing and/or foundation ir -After trenches are excavated. -After forms are erected but prior to concrete ptacffirlt166. -Prior to floor insulation or decking. -prior to deckins THls PERMIT:llflll ExptRE tF THE W0RK-prior to cover. rrhina wirh finieh marar AUTH0RIZED lID!R ifrs penrr,lir rs ruor :ff:?1""""""r"Jis sheathing with rinish materiars c,MMENcED gl rs neAli,oNiii'ron _prior to cover ANy 190 DAy pERloD, ...'v,rLL' I -Prior to taping. Temporary Power Rough Electrical -Approval required prior to SUB energizing pole. -Prior to cover. Electrical Service Final Electrica! Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Final Plumbing Underfloor Mechanical Rough Mechanical FinalMechanical FloodPlain?Wetlands? Journal numbers 1: Comments: Planner: Sam Gollah Urban Growth Boundary? f] Quantity Of Fill: Supplier: Drainage: Floodway FEMA: X-White Job# 01-01117-01 Required !nspections Electrical -Must be approved to obtain permanent power -When all electrical work is complete. Plum -Prior to insulation or decking. -Prior to cover or placement of concrete. -Prior to cover. -Prior to filling trench. -Prior to filling trench. -Prior to filling trench. -When all plumbing work is complete. Mechanical -Prior to insulation or decking. -Prior to cover. -When all mechanicalwork is complete. Public Works -After forms are erected but prior to placement of concrete Page 2 of 4 SW-Curbside Street lmprovement: Fully lmproved Curb Cut?f lmprovement Agr.? San Sewer Depth (Ft): 6 - 4 Storm Sewer Available? f Special Req.: Security Required: Bond Begin DateTime: Special lnstructions: Other Utilities: Project Supervisor: Zoning: LDR Sidewalk Type: Additional ROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit San Sewer Tee (in): Curbside - 5' 8 To Curb and Gutter 6 Land Use: Single Family Dwelling Pave Driveway? g 00/00/0000 00:00 AM Bond End DateTime: 00/00/0000 00:00 AM NO OCCUPANCY OR SEWER HOOKUP UNTIL CITY ACCEPTS INFRAS Types Of Warning Devices Reqd. Overlay District: # of Street Trees: 2 Glenwood Area? [ 1 3 Additional Requirements: Required Attachments: Source Locn: Material: FIood Plain FEMA:1166 ol 2975 Construction Types:(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 2 Handicap Access? [ Area (Sq. Main:1230 Accessory:4OO Job# 01-01117-01 Accessory Structure # Of Stories: 1 Height (feet): 18 Current Units: Proposed Units:1 Census Code: New SF - detached Total:1630 Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check 1011112001 6953Residential Plan Check Total Plan Check 99,598 $367.67 $367.67 Building Building Permit State Surcharge For Building Permit 8% Building Administrative Fee Total Building 99,598 $565.65 $39.60 $45.25 $650.50 Electrical Minimum Electrical Permit Fee Wiring Footage 1,000 Sq Ft or Less Wiring Footage Each Add'l 500 Sq Ft Temporary: 200 Amps or Less State Surcharge - Electrical 8% Admin Fee - Electrical Total Electrical 1 2 1 $.oo $106.00 $38.00 $50.00 $13.58 $15.52 $223.10 Plumbing Minimum Plumbing Permit Fee Two Bathrooms State Surcharge - Plumbing 8% Administrative Fee - Plumbing Total Plumbing 1 $.oo $254.00 $17.78 $20.32 $292.10 Mechanical Hood and Exhaust Minimum Mechanical Permit 8% Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct Dryer Vent Mechanical lssuance State Surcharge - Mechanical Total Mechanical 1 $9.00 $.00 $3.60 $12.00 $18.00 $6.00 $10.00 $3.1 5 $61.75 1 3 1 Public Works New Sidewalk Total Public Works 50 $65.00 $65.00 Residential - Single Family - Storm Residential lmprovement MWMC MWMC Administrative Fee SDC Administrative Fee Residential Sanitary MWMC ,979 1 1 I $540.27 $34.83 $10.00 $1 26.1 3 $332.86 Job# 01-01117-01 Page 4 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount System Development Residential - lmprovement Residential - Reimbursement Sanitary Sewer SDC Reimbursement Sanitary Sewer SDC lmprovement Total System Development 0211112002 0211112002 0211112002 02t1112002 8005 8005 8005 8005 I 1 21 21 $659.76 $1 55.1 3 $448.77 $341.04 $2,648.79 S.F. Residence - Willamalane Total Willamalane SDC Willamalane SDC 0211112002 8005 I $1,000.00 $1,000.00 Planning 0211112002 8005Planning Plan Review Total Planning $50.00 $50.00 Address Assignment Total Permits w/o Srchg Permits w/o Srchg 0211112002 8005 1 $8.00 $8.00 Grand Total PIan Check Type lnitial Review-Res Checked By Lisa Hopper Date Gompleted 1012412001 $5,366.91 Comment Subdivision plat not completed. Wrong Tax Lot number on subdivision plat. Wrong North direction. Needed to assign addresses to subdivision. No scale on plans. NO OCCUPANCY OR SEWER HOOKUP UNTIL CITY ACCEPTS IN FRASTRUCTURE. USE EXITSING CURB CUT CONSTRUCTED WITH SUBDIVSION. NO ALTERATION TO CURB CUT WILL BE PERMITTED. ADJUST FLOOR PLAN AS NECESSARY TO UTILZIZE EXISTING CURB CUT. Engineering-Res Steve Templin 1112812001 Planning-Res Sam Gollah 0113012002 Structural-Res Tom Marx 1012612001 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 SpringfielO and tne 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 in spections 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 s will remain on the site at all times during construction Signature Date 1 CITY OF SPRINGFIELD -TEMS DEVELOPMENT CHAR( VORKSHEET JOURNAL OR JOB NUMBER: 0l-01117-01 NAME OR COMPANY: LOCATION: TAXLOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS HAYDEN HOMES 59r r l 8-02-03-00-00507 SINGLE FAMILY RESIDENCE I BUILDING SIZE: 1630 SF LOT SIZ: 5000 SF DISCOUNT RATEIMPERVIOUS S.F COST PER S.F $0.000.00 5jVo IMPERVIOUS S.F. r 979.00 COST PER S.F $0.213 $s40.27 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS x xx I. STORMDRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM ITEM l TOTAL. STORM DRAINAGE SDC COST PER DFU $341.042tI NUMBER OF DFU's 2t COST PER DFU $2r.37 $448.77 B.IMPROVEMENT COST: x x 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: $789.81ITEM 2 TOTAL. CITY SANITARY SEWER SDC NEW TRIP FACTORADT TRIP RATE NUMBER OF UNITS COST PER TRIP $6s9.76941.009.57 1 ADT TRIP RATE 9.57 NUMBER OF UNITS I COST PER TRIP $ 16.21 $155.13 NEW TRIP FACTOR 1.00 B. IMPROVEMETIT COST: x xx xxx 3. TRANSPORTATION A. REIMBURSEMENT COST: ITEM 3 TOTAL . TRANSPORTATION SDC $10.00 NUMBER OF FEU'S I COST PER FEU $332.86 $332.86 NUMBER OF FEU's I COST PER FEU $34.83 $34.83 $0.00 SUBTOTAL OF MWMC REIMBURSEMENT,IMPROVEMENT & CREDIT MWMC ADMINISTRATIVE FEE $367.69 B. IMPROVEMENT COST: x x MWMC CREDIT IF APPLICABLE (SEE REVERSE) 4. SANITARY SEWER - MWMC A. REIMBURSEMENTCOST: $377.69ITEM 4 TOTAL. MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS 1,2,3, & 4) SUBTOTAL ADM. FEE RATE 126.13.66 5Vo 5. ADMINISTRATIVE FEE: x $2,648.79 1070 1091 1092 r093 to94 1055 1056 to13 aHaoU &HFo (, E]il TOTAL SDC CHARGES11t28t2001$lr^k,Tur+l;,t- SDC COORDINATOR DATE NUMBER OF NEW FXTURES X UNIT EQUTVALENT = DRAINAGE FIXTURE UNITS FOR CALCULATE THE NET ADDITIONAL.-- ;;* getrgALel.rr DRAINAGE FIXTURE UNITSFIXTURE TYPE (#NEW - #OLD ) BATHTUB ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( 2 0 )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x J 6 DRINKING FOI,]NTAIN 0 0 I 0 FLOOR DRAIN 0 0 J 0 INTERCEPTORS FOR GREASB I OIL ISOLIDS IETC,0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 0 LAUNDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK I 0 J J CLoTHESWASHER - 3 OR MORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (1 PER TRAILER) RECEPTOR FOR REFRIG / WATER STATION IETC. 0 0 t2 0 0 0 I 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 J 0 SHOWER, SINGLE STALL 0 0 2 0 sHowER, GANG (NUMBER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN I 0 -)J SINK:COMMERCIAL BAR 0 0 2 0 SINK: DOMESTIC BAR 0 0 I 0 WASH BASIN 0 0 2 0 LAVATORY -1 0 I J URINAL, STALL/WALL 0 0 5 0 TOILET PUBLIC INSTALLATION 0 0 6 0 TOILET, PRIVATE INSTALLATION 2 0 J 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU's*( 0 - 0 )x 20 0 TOTAL DRAINAGE FIXTURE UNITS *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU'S) set at 167 gallons per day 2t DRAINAGE FIX'UNIT CALCULATION - MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEPARATELY CREDIT FOR LAND (IF APPLICABLE) CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) $0.00 $0.00 YEAR ANNEXED CREDIT RATE PER $I,OOO ASSESSED VALUE YEAR ANNEXED CREDIT RATE PER $I,OOO ASSESSED VALUE I979 OR BEFORE $4.92 1990 $2.06 1980 $4.83 l99l $r.64 198 I $4.77 1992 $ 1.4s 1982 $4.64 1993 $1.31 1983 $4.47 t994 $1.13 1984 $4.30 1995 $0.97 1985 $4.09 1996 $0.82 1 986 $3.78 t997 $0.63 1987 $3.41 I 998 $0.41 1988 $2.98 t999 $o.22 1989 $2.52 2000 $0.04 TOTAL MWMC CREDIT = x 0.000 x $0.00 VALUE / IOOO 0.000 CREDIT RATE $0.00 225 FIFTH STREET SPzuNGFIELD, OREGON 97 477 INSPECTION REQUEST: 7 26-37 69 OFFICE LEGAL o co c) E)gtf JOB ESCRIPTION Date Permits are non-transferabie and expire if work is not started r.vithin 180 days OWNERINSTALLATION The installation is being made on properr-y I orvn wlfch is not intended for sale, lease or rent. Orvners Signature: ELE( ]AL PERMIT APPLICATION Cit1,'Job Num UUU Sq or less 'olt(7*ot BELOW elling unit. Items Cost $ 106.00 $s0.00 $50.00 s25.00 $45.00 z3'o L Z'rl -Oz- cJ ignature sq. ft or portion thereof Each Ivlanufd Home or E. Miscellaneous (Service/feeder not inclurled) -Each installation Pump or irrigation Sign/Outline Lighting Limited EnergylRes Limited EnergyiComm Minimum Electric Permit Inspection Fee is S45.00 l- Surchl l7',l ,rges l_-l\-w 56 kl {. SUBTOTALOFABOVE 7 ofissuance or ifrvork 180 days. .'- is suspended for ENI Electrical CihErroo"to nP pL Z $ re.oo >{, ,, ]] Willamalane Park & Recreation District Job. No.o\.N\\-t.cr\ PHONE: E\T.\.\3?Q- srATE: "Dt-Zrer Q-t+r-r SYSTEM DEVELOPMENT CHARGE WORKSHEET 1 NAME: ADDRESS: LOCATION OF PROPOSED BUILDING SITE: Street Address: Plat Name )pe are on the Deve ax Lot Number: (Check appropriate dwelling(s). SDC calculations and dwelting t back) 6 A-,-N-r3D- Date A Single-Family Detached NO. OF UNITS X $1,000 Per unit = $.(, B. Single-Family Attached NO. OF UNITS X $924 per unlt = $ C. Multi-Family Apartment D. Manufactured Home Park NO. OF UNITS X $699 per unlt e $ WILLAMALANE SDC $ 2. SDC CRED[T (lf appticable) SDCaayer must {umlsh proof of Willamatane ireoiiapprovat. See doc crea Woftshoot' $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (lf SOC reduced for Credit) $ .@ e ofCity [ix:.t aA/{