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Home My WebLink AboutPermit Building 2019-11-05OREGON Web Address: www.springfield-or.9ov Building Permit Residential 1 & 2 Fam Dwelling (New Only) Permit Number: 81 l-f 9-OO24O1-DWL M Number: 811033059257 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Email Address : permitcenter@springfield-or. gov SPRINGFIELD ,9h Permit Issued: November 05, 2019 Category of Construction: Single Family Dwelling Type of Work: New Calculated Job Value: $228,583.36 Description of Work: New SFD - Bridlewood Lot 3 **SAME AS** 42lt horace Worksite Address 4270 HORACE ST Springfield, OR 97478 Parcel 1802052405303 Owner: Address: BRUCE WIECHERT CUSTOM HOMES INC 3073 SKWIEW LN EUGENE, OR 97405 Business Name BRUCE WIECHERT CUSTOM HOMES INC - Primary OREGON CUSTOM PLUMBING INC COMFORT FLOW HEATING CO L&EELECTRICINC License ccB ccB CCB ccB License Number tot7t7 19 1 104 460 t05475 Phone 541-686-9458 54t-434-tr46 54t-726-OLOO 541-933-2598 Permits expire if work is not started within 180 Days of issuance or lf work is suspended for 18O Days or longer dep€nding on the issuing agency's potacy. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Granting of a permit does not pnesume to give authoriw to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. ATTENTIONT Oregon law requires you to follow rules adopted by the Oregon Utility Notlfication Center. Those rules are set forth in OAR 952-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain copies of the rules by calllng the Center at (503) 232-L987. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O (Structural/ Mechanical), ORS 479.540 (Electrical), and ORS 693.010-O20 (Plumbing) Printed onr 11/5/19 Page 1 of 5 C:\myReports/reports//production/01 STANDARD [* TYPE OF WORK JOB SITE INFORMATION LICENSED PROFESSIONAL INFORMATION PENDING INSPECTIOI{S Permit Number: 81 1-19-OO24O1-DWL Inspection 2999 Final Mechanical 3999 Final Plumbing 4999 Final Electrical 1060 Driveway Approach 1065 Sidewalk 1530 Exterior Shearwall 1260 Framing 2300 Rough Mechanical 3170 Undefloor Plumbing 4500 Rough Electrical LO2O Zoning/Setbacks 1090 Street Trees 1110 Footing 1120 Foundation 1160 UFER Ground 1220 Underfloor Framing/Post and Beam 1410 Underfloor Insulation 1430 Insulation Wall 1440 Insulation Ceiling 1520 Interior Shearwall 1999 Final Building 2020 Underground Gas 2200 Underfloor Mechanical 2250 Gas Piping/Pressure Test 3 130 Footing/Foundation Drains 3200 Sanitary Sewer 3300 Water Service 3400 Storm Sewer 3500 Rough Plumbing 3620 Backflow Device 3650 Shower Pan 4000 Temporary Power Service 4220 Electrical Service Inspection Group 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 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 Page 2 of 5 Inspection Status Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Pending Printed on: 11/5/19 Page 2 of 5 C: \myReports/reports//production/0 1 STAN DARD SCH EDULING INSPECTIONS Permit Number: 81 1-19-002401-DWL Various inspections are minimally required on each project and often dependent on the scope of work. Contact the issuing jurisdiction indicated on the permit to determine required inspections for this project. Schedule or track inspections at www.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811033059257 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Printed on: 11/5/19 Page 3 of 5 c :\myReports/reports//production/0 1 STANDARD Page 3 of 5 Permit Number: 81 1-19-OO24O1-DWL Page 4 of 5 Fee Description Residential wiring Technology Fee Air conditioner Clothes dryer exhaust Decorative gas fireplace Furnace - up to 100,000 BTU Gas fuel piping outlets Range hood/other kitchen equipment Ventilation fan connected to single duct Water heater Plan Review - Major, City Single Family Residence - Baths Address assignment - each new or change requested externally, per each SDC: Improvement Cost - Storm Drainage 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 - MWMC Regional wastewater SDC SDC: Improvement Cost - MWMC Regional Wastewater SDC SDC: Reimbursement Cost - MWMC Regional Wastewater SDC SDC: Improvement - Transportation SDC SDC: Reimbursement - Transportation SDC SDC: Reimbursement Cost - Storm Drainage SDC: Reimbursement Cost - Local Wastewater SDC: Improvement Cost - Local Wastewater Fire SDC - New Res Construction Sq Ft fee - enter sq ftg Master plan review - second and subsequent reviews Structural building permit fee Willamalane fees - Single Family Detached, per unit State of Oregon Surcharge - Elec (L2o/o of applicable fees) State of Oregon Surcharge - Plumb (l2o/o of applicable fees) State of Oregon Surcharge - Bldg (12olo of applicable fees) State of Oregon Surcharge - Mech (l2o/o of applicable fees) Curb cut fee - enter # of cuts Curb cut and Sidewalk construction - multiple permit discount Printed on: 11/5/19 Page 4 of 5 Quantity 2158 1 1 1 1 4 1 3 1 1 3 1 1016.46 89.48 190.09 343.56 85.83 10 22.82 1620.85 135.93 36t1.72 190.06 700.13 4603.5 2267.73 2158 1 Fee Amount $294.00 $179.93 $ 19.00 $ 13.00 $ 19.00 $23.00 $9.00 $ 19.00 $39,00 $19.00 $251.00 $613.00 $54.00 $ 1,016.46 $89.48 $ 190.09 $343.s6 $8s.83 $ 10.00 $22.82 $1,620.85 $13s.93 $3,6LL.72 $ 190.06 $700.13 $4,603.50 $2,267.73 $129.48 $338.00 $ 1,680.64 $3,805.00 $3s.28 $73.s6 $20 1.68 $19.20 $ 12s.00 $-42.00 1 1 1 C: \myReports/reports//production/0 1 STAN DARD PERMIT FEES Permit Number: 81 1-19-OO24Ol-DWL Sidewalk construction - permit, first 90 linear feet 1 Total Fees: Page 5 of 5 $ 12s.00 $22,930.93 Construction Type Printed on: 11/5/19 Occupancy Type R-3 1&2family U Utility, misc. Unit Amount L,674.00 484.00 Unit Unit Cost Sq Ft $t22.46 Sq Ft $48.73 Total Job Value: VB VB Job Value $2O4,998.04 $23,585.32 $228,583.36 C:\myReports/reports//production/01 STANDARDPage 5 of 5 VALUATION INFORMATION SPRINGFIELD tb ORE6ON www.springfi eld-or. gov Woksite address:4270 HORACE ST, Springfield, OR 97478 Parcel:'l 802052406303 Transaction Receipt 8{1-19-002401-DWL Receipt Number: 472898 Receipt Date: 11/5/19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 permitcenter@springfield-or.gov Transaction date Units 1115119 1.00 Ea 1115119 2,158.00 SqFt 1115119 3.00 Qty 1115119 1.00 Ea 11t5t19 1.00 Ea Description Structural building permit fee Residential wiring Single Family Residence - Baths State of Oregon Surcharge - E:lec (121/o ot applicable fees) State of Oregon Surcharge - Plumb (12o/o ot applicable fees) Air conditioner Clothes dryer exhaust Decorative gas fi replace Fumace - up to 100,000 BTU Gas fuel piping outlets Range hood/other kitchen equipment Ventilation fan connected to single duct Water heater State of Oregon Surcharge - Mech (12.Y" of applicable fees) Account code 224-00000425602-'l 030 224-00000-426'l 02- 1 033 224-00000-425603- 1 034 82 1 -00000-2 1 5004-0000 82 1 -00000-21 5004-0000 224-00000425604-1 031 224-00000425604-1 031 224-00000-425604- 1 03 1 224-00000-425604- 1 03 1 224-00000-425604- 1 03 1 224-00000425604-1 031 224-00000425604-1 031 224-00000425604-1 031 82 1 -00000-2 1 5004-0000 '11t5119 11t5119 11tst19 11tst19 11tst19 11tst19 11tst19 11tst19 11tst19 1.00 1.00 1.00 1.00 4.00 1.00 3.00 1.00 1.00 Ea Ea Ea Ea Qtv Ea Ea Ea Ea Fees Paid Fee amount $1,680.64 $294.00 $613.00 $35.28 $73.56 $19.00 $13.00 $19.00 $23.00 $9.00 $19.00 $39.00 $19.00 $19.20 Paid amount $1,680.64 $294.00 $613.00 $35.28 $73.56 $19.00 $13.00 $19.00 $23.00 $9.00 $19.00 $39.00 $19.00 $19.20 Printed: 11l5/19 4:28 pm Page 1 of 3 Fl N_Transaction Receipt_pr u^ Transaction Receipt 8t I -19-002401-DwL Receipt number: 472898 Transaction date 11t5t19 11tst19 11tst19 11t5119 11t5t19 Units 1.00 Ea 'r.00 Ea 700.13 Amount 1,016.46 Amount 4,603.50 Amount 2,267.73 Amount 190.06 Amount 3,611.72 Amount 135.93 Amount '1 ,620.85 Amount 22.82 Amount 10.00 Amount 85.83 Amount 343.56 Amount 190.09 Amount 89.48 Amount 11tst19 11t5t19 11t5t19 11t5t19 11t5t19 11t5119 11tst19 11t5119 11tst19 1115t19 11t5t19 11tst19 Printed: 11/5/19 4:28 pm Fees Paid Description State of Oregon Surcharge - Bldg (12o/o ol applicable fees) Plan Review - Major, City SDC: Reimbursement Cost - Storm Drainage SDC: lmprovement Cost - Storm Drainage SDC: Reimbursement Cost - Local Wastewater SDC: lmprovement Cost - Local Wastewater SDC: Reimbursement - Transportation SDC SDC: lmprovement - Transportation SDC SDC: Reimbursement Cost - MWMC Regional Wastewater SDC SDC: lmprovement Cost - MWMC Regional Wastewater SDC SDC: Compliance Cost - M\ /MC Regional Wastewater SDC SDC: Administrative Fee - M\A/MC Regional Wastewater SDC SDC: Total Storm Administration Fee SDC: Total Sewer Administration Fee SDC: Total Transportation Administration Fee SDC: Total MWMC Administration Fee - Local Curb cut fee - enter # of cuts Account code 82 1 -00000-2 1 5004-0000 1 00-00000-425002- 1 039 6 1 7-00000-448029-8800 6 1 7-00000-448028-8800 61 1 -00000-448024-8800 61 1 -00000-448025-8800 434 -00000 -448026-8800 434 -00000 -448027-8800 433-00000-448024-88 1 0 433-00000-448025-88 1 0 433-00000426607-881 0 61 1 -00000-426604-8800 7 1 9-00000-426604-8800 7 1 9-00000-426604-8800 7 1 9-00000-426604-8800 7 1 9-00000-426604-8800 Fee amount $201.68 $251.00 $700.1 3 $1,016.46 $4,603.50 $2,267.73 $190.06 $3,611.72 $13s.93 $1,620.85 $22.82 $10.00 $85.83 $343.56 $190.09 $89.48 Paid amount $201.68 $251.00 $700.1 3 $1,016.46 $4,603.50 $2,267.73 $190.06 $3,611.72 $135.93 $1,620.85 $10.00 $85.83 $343.56 $190.09 $89.48 $125.00 Fl N_TransactionReceipt_pr 1.00 Qty Page 2 of 3 20 1 -00000-428060- 1 069 $125.00 $22.82 Transaclion Receipt 8l I -19-002401-DwL Receipt number: 472898 Transaction date 11tst19 11t5t19 11tst19 11tst19 11t5t19 Units 1.00 Ea 1.00 Ea 1.00 Ea 1.00 Automatic 1.00 Qty Fees Paid 11tst19 2,'158.00 SqFt Description Curb cut and Sidewalk construction - multiple permit discount Sidewalk construction - permit, first 90 linear feet Address assignment - each new or change requested externally, per each Technology Fee Willamalane fees - Single Family Detached, per unit Fire SDC - New Res Construction Sq Ft fee - enter sq ftg Account code 201 -00000-428060-1 069 201 -00000-428060-1 069 22 4 -0000 0 - 425602 -0000 20 4 -00000-425605-0000 82 1 -00000-2 1 5023-0000 1 00-00000-424005-1 09 1 Fee amount $(42.00) $125.00 $54.00 $179.93 $3,805.00 $129.48 Paid amount $(42.00) $12s.00 $54.00 $179.93 $3,805.00 $129.48 Payment Method: Payment Method: Credit card authorization: 02644d Check number'.31748 Payer: BRUCE WECHERT CUSTOM HO Paver: BRUCE WIECHERT CUSTOM HO Payment Amount: Payment Amount: $9,500.00 $13,092.93 Cashier: Katrina Anderson Receipt Total:$22,592.93 Printed: 11/5/19 4:28 pm Page 3 of 3 Fl N_Tra nsaction Receipt_pr Structural Permit Application DEPARTMENT USE ONLY permitno.: lq-W?4,O\ I Date: tol>;>L1 This permit is issued under oAR 9rE460-0030. permits expire if work is not started within lt0 days of issuance or if work is)^tr A<for 180 lg 225 Fifth Street o Springfield, OR 9?427 . pH(S4l)726-3753. FAX(54 I )?263689 OREGOtI LOCAL GOVERNMENT APPROVAL has final land-use approval.This project Signature:Date: This project has DEQ approval. Signature:Date: Zoning approval verified: f] yes E No Pmperty is within flood plain: [Yes ENo CATEGORY OF CONSTRUCTION I Government I Commercial JOB SITE INFORUATION AND LOCATION Job site address:o o|^b cd citv, 5 p {-State:ZIP: Lot no.: Reference: f $ fl]O 5 2 t\Taxlot: PROPERW OWNER Name:I Address: CiU:State:ZIP: Phone:Fax: E-mail: Building Owner or Owner's agent authorizing this application: Sign here: fl This installation is being made on residential or farm property owned by mc or a member of my inrmediate family, and is exempt from licensing requirements under ORS 701.010. CONTRACTOR INSTALLATION Business name:, e.hr-"r C;Sfu u'l !^)aadress: 3C 7] SEVt,itol _Cty: €.uti(.r*&State,'O {lu ztp:cl Z , Phone5ri II. W fo*,Fax: E-mail: j . g$e,laler & C*'nc.i-S| . N er CCB license no.:1a177't Print name:r; Ltb 4\+-&f.. Signature: Name CCB License #Phone L* l{Electrical p, r#5zlI rlY 0r (:uthr. ?ldaA Plumbing ftt o4 ci rY 68c c Mechanical {o*ft*,r f 1o "Vbo 7Zb*ol( FEE l. Valuation information (a) Job description: Occupancy Construction q?e: Cost per square foot: Square feetl Other infonnation: Type of lleat: Energy Path: fl additionE new flalteration ft) Foundation-only permit? fl yes D No Total valuation:$ 2. Building fees (a) Permit fee (use valuation table):$ (b) Investigative fee (cqual to [2a]):s (c) Reinspection (g perhour): (number ofhours x fee per hour)$ (d) Enter 12% surcharge (.12 x[2a+2b+2c]):t (e) Subtotal of fees ebove (2a through 2d):s 3, PIan review fees (a) Plan review (65%x permit fee [2a]):$ zb5.( (b) Fire and life safety (55% x permit fee [2a]):$ (c) Subtotal offees above (3a and 3b):$ 4. Miscellaneous fees (a) Seismlc fee, lo/o (.01 x permit fee [2a]):$ (b) Tech fee,5Yo (.05 x permit fee[2a]+pR fee [3c])$ I'OTAL fees end surcharges (2er3ef4a+b):$CJ \tL btn t f"^--rrN* 0 Last cdited 5-5-2019 BJones Subdivisiln: il SUB.CONTRACTOR INFORMATION CITY OF SPRINGFIELD, OREGON Electrical Permit A tion tPrtxo'leo DEPARTMENT USE ONLY Permit no Date: 225 Fifth Stre€toSpringlield, OR 9477 rPE(541)72G3753aFAX(54f )72G3589 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days ofissuance or ifwork is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zonng approval verified?Yes No CATEGORY OF CONSTRUCTION E Residential I Govemment E Commercial JOB SITE INFORMATION AND LOCATION Job site address: A2-lO Crty:State:ZTP: Reference Taxlot. DESCRIPTION OF WORK PROPERW OWNER Narne: Address: Crty:State TP Phone Fax: E-mail: !NSTALLATION Business name:g Crty:ps\d It State:Ot(zrP:11\18 z-s,*,51t-931 ' T>78 d"^ouc\en O aot.coYrn CCB license no.:BCD license no.: LO 3 s license no.(Iq- d Signature of sigrring suPervisor: FEE SCHEDULE Number of inspections per item ( )Qtv.Cost ea. Total cost Residential, per unit, serwice included: 1,000 sq. ft. or less (4)$1E6.00 $ Each additional 500 sq. ft. or portion tlrereof $36.00 $ Limited energy (2)$44.00 $ Each manufactured home or modular dwelling service or feeder (2)$89.00 $ Servlces or feeders: installation, alteration, lelocation 200 amps or less (2)$112.00 $ 201 to 400 amps (2)$131.00 $ 401 to 600 amps (2)s221.00 $ 601 to 1,000 anps (2)$2E5.00 $ Over 1,000 amps o. volts (2)$654.00 $ Reconnect only (2)sE9.00 $ Tcmporary services or feeders: installation, dlteration, relocation 200 amps or less (2)$E9.00 $ 201 to 400 amps (2)$122.00 $ 401 to 600 amps (2)$177.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Brancb circuits. new, alteratiorr' ertension per panel a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch ctcuit s8.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2)$E9.00 $ Each additional branch circuit $t.00 $ Miscellaneous f*s: service or Jeeder not included Each pump or irrigation circle (2)sE9.00 $ Each sign or outline lighting (2)$89.00 $ Signal circuit alteration, or, or a limited-energy panel, extenslon s89.00 $ Each additional insPection: (1)s102.00 $ DEPARTMENT (A) Enter subtotal of above fees (Minlmum Permit Fee $102.fi)) $ (B)Enter 127o surcharge (. 12 x [A])$ (C) TechnologY Fee (5% of[A])$ TOTAL fees and surcharges (A through D):$ Last edited 7/1/2019 Blones Signature: co Ad&ess: E-mail: supervisor: EdPrint name of siPing ,l& SPRIf.tGfIELD Ofle GO,{ www. springfield-or. gov Worksite address.4270 HORACE ST, Springfield. OR 97478 Parcel: 1802052406303 ,rfi Transaction Receipt 811-19-002401-DWL Receipt Number: 472772 Receipt Date: 10/23119 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54r-726-3753 permitcenter@springfi eld-or.gov Fees Paid Transaction date 10t23t19 Units 1.00 Ea Description Master plan review - second and subsequent reviews Account code 224-00000-425602- 1 030 Fee amount $338.00 Paid amount $338.00 Payment Method: Credit card authorization: 04413d Payer. BRUCE WIECHERT CUSTOM HO Payment Amount:$338.00 Cashier: Thayne Smith Receipl Total:$338.00 Pnntedr 10123i19 9:43 am Page 1 of I FIN_TransaclionReceipt_pr JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX I.OT NUMBER: DE\IEI,OPMENT TYPE: NEW DWELLING UMTS IMPERVIOUS AREA I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET l9-002401-DwL BRUCEWIECHERT 4207 HORACE ST 18020s2406303 Residence A. REIMBURSEMENT COST -II',[PFR\,1C,'I.S.S"E. I 2126.00 B. IMPROVEMENTCOSTl-ffiffi I n26.oo ITEM 1 TOTAL. STORM DRAINACE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's 27 B. IMPROVEMENT COST: NUMBER OF DFU's 27 COST PER S.F. $0.301 COST PER S.F. $0.437 COST PER DFU $170.50 COST PER DFU $83.99 NUMBER OF T]NITS 1 NUMBEROFUNITS I COST PER FEU s1 35.93 COST PERFEU $ r,620.8s COST PER FEU $22.82 ADM. FEE RATE s% AREADRAINING TO DRYWELL 0 $1,716.59 COST PER TRIP 19.86 COST PER TRIP $377.40 $3,801.78 C}IARGE $708.96 CHARGE $700.1 3 CHARGE $1,016.46 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR 1.00 x x ITEM 2 TOTAL - CITY SANITARY SEWER SDC A. REIMBURSEMENT COST: ADT TRIP RATE 9.57 x x x x x x B, IMPROVEMENT COST: ADT TRIP RATE 9.57 xx xx ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's 1 B. IMPROVEMENT COST: NUMBEROFFEU's 1 C. COMPLIANCE COST: NUMBEROFFEU's I x x MWMC CREDIT IF APPLICABI-E (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5. ADMINISTRATIVE FEE: SUBTOTAL $14,r79.20 TOTAL STORM ADMINISTRATION FEE TOTAL SEWER ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: TOTAL MWMC ADMINISTRATION FEE . IOCAL 0 I LOT SIZE 4792 $700.r3 73 $135.93 s22.82 $t0.00 $89.4E $14,888.16 1070 l09l 1092 1093 1094 1055 I 056 1079 1077 1078 a rIJa (, EIFa q..l il -E IEil@ 789.60 179.20 BY Petersen TOTAL SDC CHARGES t $c8?tJ3 DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEW FXTURES x UNIT EQUIVAIENT : DRAINAGE FIXTURE LTNITS FOR CAI-CUI-A.TE ONLY TI{E NET ADDITIONAI NO. OF FIXTURES I.-TNIT FIXTURE TYPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS lsa toa unit at 16'7 MWMC CREDIT CALCULATION TABLB: BASED ON COUNTY ASSESSED VALUB 20 DRAINAGE FIXTURE UNITS 0 2 2 t979 *EDU .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 ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE / 1OOO CREDIT RATE $0.00 x $5.29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/ IOOO CREDITRATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.4s $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 1 0 3 3 DRINKING FOLINTAIN 0 0 1 0 FLOORDRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND i AUTO WASH / ETC.0 0 o 0 LAUNDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 1 0 3 3 0 6 0CLoTHESWASHER- 3 ORMORE (EA)0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.1 0 3 3 SHOWER, SINGLE STALL 1 0 2 2 0 2 0SHOWER, GANG (NUMBER OF HEADS)0 SNK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 3 SINK: COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 4 0 I 4 5 0URINAL, STALLi WALL 0 0 TOILET. PUBLIC INSTALLATION 0 0 6 0 TOILET, PRIVATE INSTALLATION 3 0 3 I 27 YEAR ANNEXED CREDIT ASSESSED VALUE BEFORE I979 1979 1980 t98l 1982 I 983 I 984 I 985 1986 1987 1 988 01989 1990 1991 1992 1993 1994 1995 1996 1997 l 998 1999 2000 2001 Crry on SpRINcFIIILD, oREGoN Structural Permit Application DEPARTMENT USE ONLY permitno.: V-W?qO\ I Pry: trl>zlt1 This permit is issued under OAR 91E460-0030.Permits expire if work is not started within ltO deys of issuance or if work is )LEE<for re O.r 225 Fifth Street o Springfield, OR 97477 .PH(S4I)?,26-37S3. FAX(54I)72636E9 0U- l.ln 8"["^--r* &t- LOCAL GOVERNiiENT APPROVAL This project has final land-use approval. Signature:Date: This project has DEQ approval. Signature:Date: EI NoZoning approval verified: n yes Property is within flood plain: ! yes D No CATEGORY OF CONSTRUCTION I Govemment I Commercial JOB SITE INFORiIATION AND LOCATIOI{ Job site address:lo 00^6 cd city: 5 c{*State:ZIP: C rid Lot no.: Reference:l$DaO52q TarJot:flnfr.\ PROPERW OWNER Name: Address: City:State:ZIP: Phone Fax: E-mail: Building Owner or Owner's agent authorizing this application: Sign here: E This installation is being made on residential or farm properry owned by mc or a ncmber of my irnmediarc family, and is excmpt from licensing requirements under ORS 701.010. CONTRACTOR INSTALLATION Business name:, ech.,- " f C;s +r }}o /r)eddress:3C 7] 5(Vv;ei Lwa.State:O-R-ZrP:c/ 7' Phoae$'i 1"& 5*o 5-O Fax: & CorrlCr.Sl .,.ve.tE-rnail: j, q)e, }ovcr CCB license no., i O ;7t', 4\h, t ,,.Print name:r' Llk Signature: SUB.CONTRACTOR INFORMATION Name CCB Licensr #Phone ElectricalL*{p, r+s 5zlgtfY Plumbing 0r Cuthn ?t"tAA l\t o4 4t\ 6a'c c f 1u,, Mechenical (rcr^1i"'t t'Yto 7 ?-{,*o i ( FEE l. Valuation information (a) Job description: Occupancy Construction !pe:I Cost per square foot: fcet: Other information: Typ€ of Hert: Ener$/ Path: E new [alteration fl addition (b) Foundation-only pennit? f] yes f] No Total valuation:$ 2. Building fees (a) Pcrmit fce (use valuation table):$ (b) Invcstigative Ge (equal to [2a]):$ (c) Reinspection ($ perhour): (number ofhours x fee per hour)$ l2a+2b+2cl):Erler l2o/o surcharge (. I 2 x $ (e) Subtotel of fes above (2a through 2d):$ 3. Plan review fees (a) Plan review (65% x permit fee [2a]):s 3bg"e Q) Fire and life safety (65% x permit fee [2a]):$ (c) Subtotal offees above (3a and 3b):$ 4. Miscellaneous fees (a) Seismic fee, lYo (.01 x permit fee [2a]):$ (b) Tech fee,SYa (.05 x permit fee[2a]+PR fee [3c])$ I'OTAL fees and surcharges (2e+3c.l4a+b):$ Last cditcd 5-5-2019 BJones () Subdivisiin: F