HomeMy WebLinkAboutPermit Building 1999-03-10OF SPruNGFIELT',
, SPRI]l.GFIELD
RESIDENTIAL PERMIT APPLICATION
CTTY OF SPRINGFIELD
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
Page l-
ilob Nurnber: 990059
225 North Fifth Street
Springfield, OR 97477
tocaEion of Proposed Work: 3323 PARKER LN
Assessors Map #: 1-7021-900
Lot : 1,7 Block:
Office:
Inspection Line:
t 26 -37 59
725-3759
Tax Lot #
Subdivision
03200
AIVIBLESIDE
Owner: TOM WIRFS/COZY HOMES
Address: PO BoX 237
Descri-be Work: S. F. RESIDENCE
Phone #: 747-8704
Cltylstate/zip: SPRINGFIELD, oREcON 9i477
NEW
ContracEor
ConsE.
Contractor #Expires
06/28/ee
L2 /Ls / ee
),2 /23 / ee
04/28/ee
Phone
7 47 -47 04
473 -2827
747 -7445
587-1851
General:
Plumbing:
Mechanical:
Electrical:
TOM WIRFS OO32947
I275 S 2ND SPRINGFIELD OR 97477OOOO
B M C 0103570
648 W OREGON AVE CRESWELL OR 974250
MARSHALLS OO2579O
4110 OLYMPIC ST SPRINGFIELD OR 9747
BTLLS ELECTRIC 0021351
3170 I^I 11TH EUGENE OR 9'74O2O0OO
QUAD AREA: 3RNC
# OF UNITS: 1
CONSTR. TYPE: VN
WATER HEATER: E
OFFICE USE --
LAND USE: 1111
ZONING CODE: LDR
# OF' BDRMS: 3
RANGE: E
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: FE
SQ FOOTAGE: 250)-
To request. an inspection, caLl_ the 24 hour recording aL 726-3769.
A11 j-nspections requested before
inspections requested after 7:00
will be made t.he same workj-ng
be made the following work day.
7:00 a.m.
a.m. will
--- REQUTRED TNSPECTTONS ---
FOOTING - After trenches are excavated.
FOITNDATION - After forms are erected but prior to concrete placement.
ROUGH GAs - after l-ine is instal-l-ed and capped if not attached. to an
appliance
ITNDERFLOOR PI,ITUBING - Prior to insulation or decking
TNDERFLOOR MECHANICAL - prior to insulati_on or decking
POST AND BEAITI - prior to floor insulation or decking.
rNsurJATroN - Floor; prior to decki-ng wal1/Ceiling; prior to cover
WATER LINE - Prior to filling trench.
SANITARY SEWER LINE - prior to fi1ling trench.
STORM SEWER LfNE - prior to fil_1ing trench.
ROUGH PIJTIMBING - Prior to cover.
ROUGH MECHANICAL - Prior To cover.
ROUGH ELECTRfCAL - prior to cover.
ELECTRTCAL sERvrcE - Must be approved to obtain permanent power.
SHEAR WALL NATLTNG - Before covering sheathing with finish materials.
FRA.UING - Prior to cover.
INSULATION - Floor,- pri_or to decking Wa11,/Ceiling; prior Lo cover
DRYWALL - Prior to taping.
CURBCUT - After forms are erected but prior to placement of concrete.
STDEWALK - After excavati-on is complete, forms and sub-base materj_a1
,rfi\6.,.s$NL:*:
.r(f,
es\os
tos
hN'
ATTENTION:Oregcn law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952'001-
0090. You may obtain copies of the rules by
caltlng the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1 -800-332-2344).
in place
SPRI]tGFIELD
Job Number: 990059
OF
Page 2
FINAL PLITMBING - When all plumbing work is complete.
FINAL IIECHAIiIICAL - When alL mechanical- work is complete.
FINAL ELECTRfCAL - When all electrical work is complete.
GAS SERVICE - After line is i-nstaI1ed and line has been connected to a
minimum of one appliance. Pressure test done at this point.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Faces: N
Topography: 2
Solar Approved: Y
House
Garage
Lot Sq. Ft.: 5525
Total Height: 22
Lot Type: INTERIOR
Setbacks
swE
1585
5
Lot Coverage: 40.2 %
Setbk From NPL: 30
N
18
Item
Main
Garage
PORCH
Total Va1ue
Building Permit Fee
Surcharge/Admi-n
TOTAL FEE
--- BUTLDING PERMIT ---
Square Feet x
2005
528
aaaztz
$/Square Feet
69 .54
18.34
15
(A)
Vafue
t39 ,528 . OO
9 ,684 . O0
4, 080.0o
153,392.0O
554.50
44.37
598.87
--- PLIIMBING PERMIT
Item
Residential Bath(s)
Plumbing Permit
Surcharge/admin
TOTAL CHARGE
3
Fee
1,92 .50
(c)207 .91,
--- MECHANICAT PERMIT ---
Furnace
Exhaust Hood
Vent Fan
Dryer Vent
GAS LrNE & W/H
GAS F.P.
Mechanical Permit
Issuance
Surcharge/Admin
TOTAL PERMTT
4
5.00
4.50
12.00
3.00
s.00
4.50
35.00
10.00
2 .80
(D)47.80
--- MTSCELLANEOUS PERMITS
Surcharge/Admin
Sidewalk
Curb Cut
WILLAMALANE SDC
CTTY SDC
ELECT. PERMTT
TOTAL MISCELLAI{EOUS PERMITS
0.00
13.60
15.40
1, 000 . 00
2 , 934 .93
199.80
4,L63.73
3@,43/tLex ,qEttrEtD
(E)
15 z4 -to
L92 .50
15.41
SPFIilGFIELD
rTob Number: 990059
OF SPI?INGFIEIT',
Page 3
(Excluding Elect,rical )
unless otherwise noted
--- TOTAL AT{OI'NT DUE ---
(A, B, c, D, and E combined)-5.;-effi-;31-537A,4
--- BUILDING VALUE, PLAN CHECK AND BUILDTNG PERMTT ---
This permit is granted on the express condition that the said construction
sha11, in all respects, conform to the Ordinance adopted by the City of
Springfield, including the Development Code, reguJ-ating the construction and
use of buildings, and may be suspended or revoked at any time upon vioLati-on
of any provJ-sions of said ordinances.
Received By:
Pl-ans Reviewed By: DON MOORE
Building Site Reviewed By: LISA HOppER
Date: 01,/28/99
--- ADDITIONAI, COMMENTS ---
A & T ESTTMATE ONLY FOR CITY SYSTEM DEVEL CREDIT
PATH 1/SUPER GOOD CENTS
DRIVEWAY REQU]RED TO BE PAVED
2 STREET TREES REQUTREDNq /*to /&*/f.
By signaEure, I sEate and agree, that I have carefully examinedthe completed application and do hereby certify that all information hereoni-s true and correct, and I furt.her certify t.hat any and al-l- work performedshalf 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 struct.ure without. permission of the
Community Services Division, Buildj-ng Safety. I furt.her certify that onlycontractors 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 request.ed at theproper time, that each address is readable from the street, that the permitcard is located at the front of the property, and the approved set of planswill- remain on the site at a1l times dur ing construction.
-/o-?Signature Date
--- VALTDATION ---
d7Rece j-pt Number:
Date Paid:
Amount Received , ;3 70 71
Recei-ved By
ATTACHMENT A 77os?
CITY OF SPRINt.. IELD SYSTEMS DEVELOPMLIIT CHARGE
WORKSHEET
NAME OR COI\4PANY:{ow.. lrJi
LOCATION ?7zT ?rr \tt r-lJ^rr^J
DEVELOPMENT TYPE efD
BUILDiNG SiZE:fL
IL
1 STORM DRAiNAGE,.
-Azt+s,s)^r
(,2) +/rt 3oz5o t f tt(z+)* 2?Co,s )+6,€
iMPERVIOUS SQ FT 3+3b x $0.227 PER SQ. Fr. $ "771 ?7
2. SANITARY SEI^/ER-CITY
No. 0F pFU's 2L x $47.14 pER pFU s /Z)5,6?
(See Reverse Side)
TRANSPORTATION
NO OF UNITS X TRIP RI.II X COST PER TRIP
x ot x s475.32 $ @,OV
x $475.32
4. SANITARY SEWER-MWMC
A. REIMBURSEMENT COST
NO. OF FIU'S I X N1.++PER FEU s T11 ,4+
B. IMPROVEMENT COST:
NO. OF FEU'S X Z?,ZO PER FEU $ 25.20
t,
$Y
MI^/MC CREDIT iF APPLICABLE (SEE REVERSE)
MI^/MC ADMINISTRATiVE FEE
< $ 3,/-f ,
$ 10.00
s Ut,47
Lnqq, / 7
$ )7q,7C
5 ADMINISTRATiVE FEES:
BASE CHARGE (SUBTOTAL ABOVE) X .05
fnb u
TOTAL-MWMC SDC
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
u
SDC Coordi nator
ATTACH 'A. I^/PD
Date: I
TOTAL spc s- i 7+,13
Lso/ Lor sizE-sQ.
(NOTE: For remodels, calculate onl,, ,he NET "00,,,.'*-,It;|;";"'
ur rYtsvv rrxtures x unlt equtvalent = Fixture Units
FIXTURE TYPE
Bathtub.. . . .
Drinking Fountain.........
Floor Drain.......
lnterceptors For Grease/Oil/Solids/Etc.................
lnterceptors For Sand/Auto Wash/Etc.................
Laundry Tub/Clotheswasher....
Clotheswasher - 3 Or More....
Mobile Home Park Trap (1 per Trailer)......
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.....:....
Shower, Gang..
Sink: Bar, Commercial, Residential Kitc:ren.
Urinal, Stall/Wall..
Wash Basin/Lavatory, Single.......
Toilet, Public lnstaltation.
Toilet, Private...
Miscellaneous:
CREDIT CALCUL.ATION TABLE:Basec on assessed value. lf im
NUMBER OF
NEW FIXTURES
UNIT
EOUIVALENT
FIXTURE
UNITS
---
2
1
2
2
6
2
6
6
1
J
2
l lHead
2
2
1
6
4
-_=-
z
Z_
/z
....-:..-
zb
v-
-
-
///t
TOTAL FIXTURE UNITS
provements occurred after annexation date in taole,calculate credits se rates
Credit for Parcel or Land Only lf Appticable
lmprovement (if after aanexation date)
x$J 3 lE
(Rate X Assessed Value)x$
(Rate X Assessed Value)
CREDIT TOTAL
/,71
s
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
1 986
1 987
1 988
s4.27
4.18
4.12
3.99
3.83
3.68
3.48
3.18
2.82
2.42
1 989
1 990
1 991
1 992
1 993
't994
1 995
1 996
1 997
$1.98
1 trtr
1.15
o.96
0.83
o.67
o.52
o.38
o.21
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating purposes Ontyl
Residential...o.4
Commerica1......................... O.g
lndustrial......o5
Governmenta1...................... O.5
FIXUNIT.WPO IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
€6
Sr..aNGF|ELO
ET,ECTRTCAL PERT{IT APPIJCAEON
ty Job Numbei
FEE SCEEDTII,E BELOV
idential-Single or
FamiIy per dvelling unit.
ce rncruded: rtems cost
225 FIFTE STREEf,
SPRINGFTEI,I), OREGON 97
INSPECTION REQUEST: 7
OFEICE: 726-3759
1
I,EGAL DESCRTlnh\ta(Y)
3
.B
c
D
Sum
ON
I
Pe its are non-transferable and expiretfvork is not started vithln 180 daysof issuance or if vork is suspended for
180 days.
,
2. CONTRACTOR INSTALI,ATTON ONLT
f/rl,
I $ 8s.00 %
l..rDL
,Electrical Contractor
Add (^)e4-.4-r
ci tv-
Supervisor License Number ?trO .'
Expi ration Date
200 amps or less S 50.00
201 amps to 400 amps
-
S 60.00
401 amps to.600 amps
-
$1OO.O0
601 anfs to'1000 ampsl $130.00
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or less -l-_201 amps to 400 amps
0ver 401 to 600 amps
Over 600 amps or tOOOEI[-ts
Branch Circuits
Services or Feeders
Installation, Alterations
or Relocation:
One Circuit
Each AdditionalCircuit or vith Service
or Feeder Permit
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
$ 1s.00
$ 3s.00
s 2.00
nBu aEffi
constr contr. Number e /3 S I
Exp iration Date
'-?t-
Electrician
Ovners Name
Cl t1 Phone (
6t[) rNSrALrnrroN
The installation is being made on
property I ovn vhiih is not intendedfor sale, Iease or rent.
0vnersBSignature:
DATE:
Nev, Alteration or Extension Per Panel
$40sss
$eo
see
.00
.o0
.00 I
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/OutIine Lighting-
Limited Energy/Res
-Limited Energy/Comm
s 40.00
$ 40.00
$ 20.00
s 36.00
RECETVED B
5
lh.
fr looo sq.ft. or ress
Each additional 500
. sq. ft or portion
thereof
Each Hanuf'd Home. or
ModuIar.'Dve1ling'
Sertice or Feeder
Phone
ture
$ 40.00
.''.{.UUillamalane
Park & Recreation District Job. No.
SYSTEM DEVELOPMENT CHARGE
\ WORKSHEET
NAME:PHONE:
ADDRESS
LOCATION OF PROPOSED BUILD SITE
Stre
Plat
et Add
Tax Lot Number:
1. DEVELOPMENT TYPE (Check
ype definitions are on lhe back.)
A. Single-Family Detachect
( Single Family home
appropriate dwelling(s). SDC calcxllations and dwelling t
C. Multi-Family Aoartment
NO. OF UNITS X $692 per unit
D. Manufac{ured Home Park
. NO. OF UNiTS X $699 per unit
WILLAMALANE SDC
2. SDC CREDTT (if applicabte) SDC4ayer must fumish proof of
Willamalane Credit approval. See SOC Credit Wodaheet
Manufactured home not in a park
NO. OF UNITS X $1,000 Per unit = $
B. Single-Family Attached
NO. OF UNITS X $924 per unit $
Iwg)
$
$
l0D oo
$
-L r /e r 7f
$
$d)3. TOTAL WILLAMALANE
(if SDC reduoed for Credit)
SDC ASSESSED
City of Springfield
Date
srArE: Wry
8PllINGFIE LO
BACKFLOV PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 FIFTH STREET
SPRINGFIE.:,D OR 97477
JoB L0cAr.toN: 33 Z3
OFITICE: 726_3159
__:::nr.rroN r,rNE: 726..376e
.^'1Jxu@(L a
ASSESSORS MAP *:7 #t+66me-q
O1INER:THISPERMI ENOT
ADDRESS:ZNUS 7a
CITY:NJ slYtg0 LrP 3ry71
BACKFLOTJ PERMIT IS 515.00 + $.75 (STATE SURCHARGE) + g.45 (ADMrN. FEE) = $16.20
(
ADDRESS:-13ou(Z follow rules
CTTY:STATE:
CONSTRUCTI CONTRACTORS REGTSTRATION *:
numberfor
FOR OFFICE USE
BY SIGNING THIS PERHIT/APPLICATION, I AGREB TO CALL FOR AN INSPE ]TION ONCN THEBACKFLoU PREVENTI0N DEVICE HAS BBEN INSTALLED ar,rn fS VISIBLE FOn TNSpECTI()N(726-3769), r ALso srATE THAT ALL rN['ORHATrontn rnrs pERMrr/A[.,LrcATroN ISCORRECT.
-21 -7
/4fDATE OF /.PPLICATION:
RECEIPT I':ISSUED BY:
TOTAL AH(rUNT COLLECTED , I J}
,,,tff209 7
TAX
10 through (1
I ao
ility ltl
Thls permit ls required for any site activity in the flood plain and everywhere elte alteratlon consists of
flfty (5O) cubic yards of material or more and/or if a drainageway is affected, within City limits and
This'-,de To Be Filled Out by Applicant
323 Springfield, Oregon
Date of Appll catlon q - q- f ?
o(,-Property Owner
Address :
Permlt Explratlon Date
Site Address:
Phone:
Journal number appllcable Land Use Application
I 7ooTax Lot:No: 11'oz-tq-43tr ucB Tax Map
w
E
E}
, Project Supervlsor
, phone
EXCAVATION, Oua
GB{D!NG, Ou
Destination:
Source Location
Matsrlal
FILL, Ouantity,
Supplier:
Address
E(
tr
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CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
DRAINAGE, POLLUTION AND EROSION CONTROL P
STATE
CITY STAT
COMPANY NAME _, PHONE
and
n d
REPLANTING PLAN
COMPANY NAME:
es
PBOJECT SUPERVISOR
ADDRESS:
ADDITIONAL INFORMATION,
PROJECT SUPERVISOR
ADDRESS:
It
a7qq7
FAx7y7 r8e5'
?\
?
Expiration Date:
, EME RGENCY PHONE: /Dafc<- ? Zy <77 F
Registration Number:
PHONE
CITY:ADDRESS:
STATE:
PROJECT SUPERVISOR:
CONTRACTOR NAME:
ztP: 4'l y l-t oFFtcE pHoNE
MOBILE PHONE: 5oI T3 q
lunderetand that l.or mv succossora may have future plans for.my property whlch may bc antlclpatod or unanticipated atthla tlme. I underrtand that euih tuture litani -iiieq,itre per-rii'a-na tivitopemcnt approvala rrom ttI'cjili'ii"d""?i,?fia.I underetand that notwlthstandlng any !'pproval oi ttrtb t-ario and Dratnasc AtiSraiiin p-ir'nirtt-i-iOAFi,'tiiii ii'ir,i'ti,il""i"''"'applicatlon of luturo permits.o_r approvall'the City may revlew snd nCof,itiii-iiiicli6#;itEii;i'my ercceslois ira*undortrkon porruant to thls LDAP. I undorstand rhar.r.he city may as tco;oltro; oi'i.iirirtriJ'"p-jri";r, requtrb rtre - -
undolng, changlng, or modlflcatlon of orry actlorrs *trict' itr,ivo uhJJn"tiiiiii riarrt bii6iLrtirr-"ppro"ot of thto LDAp.
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8y llgnaturc, I ctatc and aoroo, that I hnvo corofully exomlnod tho complotcd appllcatlon and do horoby aortify thot onlnformatlon hereln lg true and corroct, and I further.'co1tlty^t-t "1_"ny;;i"sn';;i;iiioi'ri.r'"J inirr L'i' jon" tn accordancowlth tho ordinances o, tho city of Sprinsfield, applic;bl;'citt-siaiodii ip.Crii"iii6iJ'.'"i-o-ri.nJridrland rhe taws of rhestato.of oregon p-ert-alnlng to_the wdrk ti'oscri6ei'hei€i". tlrhtdii"iltiiitiit onty contractors and emptoyees who are incompliance with ORS 701.O5S will be used on this project.
The City may lnapec-t tho work slto doscribod ln this pormlt at sn-y time.durlng a one ycar perlod followlng lho recelpt bythe Citv of notlce of completion of the doscriboo woit< ana-sp""t1y,'rltfiitlty'a aole desecratlon. any additional rostorationwork required to r€turn tho sito to a standard ,"""ptiu6.to-thJclti. iil;p;#itt;; ;iib; ;iriir'a-l',i wririns of any workrequirod and will have thirty (3ol davs from the daie of itrJ noilco'to iiir[rit" ttre woii<. Woi['n-oi iomprotod at tho end ofthe thirtv davs will bo perfdrmed by'tho city and rhe cosrs wifl uo uirrea i5 trii i'eimitte'J.
aro requostod at.tho propor tims, that projed address is roadable fromon tho sito at all tlmos durlng construclioh,
Date ,-1- 2?
the rematn
I further agree to onsuro that
Street, 0nd tho
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DRAINAGE, 0 Storm, E
WETLANDS, Descri
FLOOD PLAIN, Zono:
Culvert, El Natural
FEMA Community Panel No.:
FLOODWAY, FEMA Community panel No Date
$20.00
$30.o0
$40.0o
94O.OO For the first lO,OOO cubic yards, plus
$20;00 for each additional IO,OOO cubic yards or fraction thereof,
922O.OO For rhe first lOO.OOl cubic yards, plus
92O,OO for each additional lO,OOO cubic yards or fraction thereof.9340 For the first 2OO,OO1 cublc yarde, plue
$6.00 for each additional lO,OOO cubid yards or fraction theroof.
$30.oo
$3O.OO For tho flrst I OO cubic yarda, plus
$14.OO for each additional 1OO cublc yards or fraction ihereof.
$ 1 56-00 For the first 1,OOO cubic yards, plus
$ 1 2.OO for each additional I,OOO cubic yirds or fraction theroof.$264.00 For the first lO,OO0 cubic yardi, plus
$54.00 for each additionar lo,ooo cubic yirds or fraction thereof.$75O.OO For the first lOO,OOl cubic yards, plus
$30'00 for each additionar ro,ooo cutic yards or fraction thereof.
Received by:\r0-,,
0 ?R /'l^5
o Date:
Recoivod
Plan Check Fee
Grading Permit 1"", #
2OO,OO1 CUBIC YARDS OR MORE
1,OO1 TO 10,OOO CUBTC YARDS
lo,oo0 To 100,ooo cuBtc YARDS
100,001 To 20o,ooo
Receipt No:
Dato:
Estimated Volume:
PLAN CHECK FEES:
UP TO lOO CUBIC YARDS
101 TO 1,000 cuBtc YARDS
l,OOl TO 10,000 cuBtc YARDS
10,000 To 100,000 cuBtc YARDS
100,001 TO 200,000
GRADING PERMIT FEES:
UP TO lOO CUBIC YARDS
101 TO l,OOO CUBIC YARDS
Receipt N.{50 4)}162 D"t".
Date:
3@-
1,
ng
Date:
Date:
tr Maintenance:
tr Buirding:Date:
Date
Dato
Pprmit Number lssued by:Date:
Date
Date
Date:
Beqr rirerl Finnl lnsFpetinns.
Plannlng:
Enginoering:
Building:
Maintonance:
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ifl$r9"1?"BliTPiatrX[lfl.as outlined in this permit has beon compretod in accordance with
h,l#,flLdr?69i!P"S"%?tiYilJf&8YJJi"ed in this permit has not been compreted in accordance
Land and Drainage activity was porformed prior to apprication for this permit.
Accepted by:
Date:
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