HomeMy WebLinkAboutPermit Building 1999-08-26SPRTNGFIELD
General:
Plumbing:
Mechanical:
El-ectrical_:
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFTELD
COMMI'NTTY SERVICES DTVISION
BUILDTNG SAFETY
page 1
ilob Nr:rnber: 99103 3
225 North Fifth Street
Springfield, OR 97477
Location of proposed Work: 3439 PARKER LNAssessors Map #: L7021943
Lot: 11 Bf lON:Ur
wOwner: SCOTT
Address : ),230
Descri-be Work
Contractor Center is1
Con
Office
Inspection Line
725 -37 59
725 -37 69
egon iay!Subdiv
Tax Lot #: O11OO
ision: AMBELSfDE
syou to
97 403
SCOTT CARLSON OO7249L1230 E 19TH EUGENE OR 974o3oooo
MCMTCHAEL PLI]IVIB OO28B3240108 BOOTH KELLY RD SPRINGFIELD ORMARSHALLS oo257so4110 OLYMPTC ST SPRINGFIELD OR 9747L & E 0083195
Expires
03 /20 / oo
0e/2a/ee
t2 /23 / se
03/20/oo
Phone
484 - 9286
7 44 - 9099
747 -7445
4BO - 7 989
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: FG
INSUL PATH: P1
QUAD AREA: 3RNC
# OF UNITS: 1
CONSTR. TYPE: VN
WATER HEATER: G
SQ FOOTAGE: 2OBO
SITE - To
FOOTTNG -
FOUNDATION - After forms are erecte
UNDERFLOOR PLITMBING - prior to insu
I'NDERFLOOR MECHANICAII Prior
POST AI.ID BEAM Pri-or to floor
-- oFFICE USE __
LAND USE: 1111
ZONTNG CODE: LDR
# OF BDRMS: 3
RANGE: E
To request an inspect,ion,call the 24 hour recording at 72G-3759.
A11 lnspecti-ons requested before 7:00 a.m. wir-1 be made the same working day,inspections requested after 7:00 a.m. wirr be made t.he folJ-owing work day.
--- REQUTRED TNSPECTTONS ___be made after excavation but prior to set.t ing formsAfter trenches are exca
fNSULATION - Floor; prior to decking
WATER LINE - prior to filIi-ng trench ANYl
ROUGH GAS - after 1ine is instal-led andappli-ance
ROUGH MECHANICAL - prior to cover.
ROUGH ELECTRICAL - prior to cover.
c
FOB
Prior to cover
capped if not attached to an
SANITARY SEWER LINE _ prior to filli_ng trenchSTORM SEWER IJINE - prior to fil_l-ing trench.
ROUGH PLIIMBTNG - Prior Io cover.
GAs sERvrcE - After ]ine is installed and rine has been connected to amin'mum of one appliance. pressure test done at this point.ELECTRT.AL SERVT.E - Must be approved to obtain permanent power.SHEAR *ALL NArLrNc - Before covering sheathing with finish materials.FRAIIING - prior to cover.
rNsuLATroN - Floor; prior to decking wa11/Cei1ing,- prior to coverDRYWALL - prior to taping.
FINAL PLITMBING - When all plumbing work is complete.FINAL MECHANICAL - When all_ mechanical- work is complete.FINAL cAS - When all gas work is complete.FfNAL ELECTRfCAL - When all electrical work is complete.FrNAt BUTLDTN. - when all required inspections have been approved. and
the
PERMITIS
SPFINGFIELE
rTob Number: 991033
o a
Page 2
Lot Faces: N
Solar Approved: Y
House
Garage
Total Height: 17
Lot. Type: INTERIOR
Setbacks
SWE
21_55
5 33
Setbk From NPL: 34
N
27
21_
Item
Main
Garage
Total- Value
Building Permit Fee
Surcharge/Admin
TOTAL FEE
--- BUII,DING PERMIT ---
Square Feet. x
1680
400
$/Square Feet
69.54
18.34
(A)
Value
115, 995. 00
7 ,336.00
1,24 ,331_ . OO
489.25
34.25
t4.sr|<
538. 36
--- PLI'MBING PERMIT ---
Item
Resldential- Bath (s)
Plumbing Permit
Surcharge/Admin
TOTAL CHARGE
)Fee
150.00
(c)
150.00
tt.z0
4. 80
i76. 00
--- MECHANICAL PERMIT ---
Furnace
Exhaust. Hood
Vent Fan
Dryer Vent
GAS LINE & APPL
Mechanical permit
fssuance
Surcharge/Admin
TOTAL PERMIT
2
5.00
4 .50
5.00
3.00
2 .00
2L.s0
10.00
1. 5i
.65
33. 66(D)
--- MISCELLANEOUS PERMITS
Surcharge/Admin
Si-dewalk
Curb Cut
WILLAI\4J\LAI{E SDC
PLAN REVTEW FEE
CTTY SDC
TOTAL MISCELIJAI.IEOUS PERMITS (E)
0.00
50.00
60.00
1, 000 . 00
80.00
2 ,432 .92
3 , 632 .92
--- TOTAL AMOI'NT DUE ---(Excludj-ng Elect,rical )unless otherwise noted
(A, B, c, D, and E combined)
--- BUTLDTNG VALUE, PLAN CHECK AND BUILDING PERMIT ---
4,380;9{? L.
This permit 1s granted on the express condition that the said constructionshall-, in all- respects, conform to the ordinance adopted by the city ofspringfield, including the Development code, regulating the construction anduse of buildings, and may be suspended or revoked at any time upon violationof any provisions of said ordinances.
SPRINGFIELD
'Job Number: 991033 Page 3
Received By:
Plans Reviewed By: AL WARD
Building Site Reviewed By: LISA HOPPER
Date: 08/23/99
--- ADDITIONAL COMMENTS ---
DEFAULT AMOUNT USED FOR A & T FOR CREDTT PURPOSES
SAME AS 3421 PARKER
DRIVEWAY REQUIRED TO BE PAVED
2 STREET TREES REQUIRED
By signature, f state and agree, that I have carefully examinedthe completed applicatlon and do hereby certify that all information hereonis true and correct, and f further certify that any and al-l work performed
shalL be done in accordance wj-th t.he Ordinances of the City of Springfield,
and the Laws of the State of Oregon pertaining to the work d.escribed herein,
and that NO OCCUPANCY will be made of any structure without permission of the
Communj-ty Services Division, Building Safety. I further 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 al-l- regulred inspections are requested at theproper time, that each address j-s readable from t.he st.reet, that the permitcard is located at the front of the property, and the approved set of plans
wi-Ll- remain on the site at all times during consEruction.
,?
L6
Signa Dat
--- VALIDATION ---
Recei-pt Number:
Date Pai-d:
Amount Receiwed
Recei-ved By
03{st z
(lt 11
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JoURNAL or,-- roB No.q / o -7s
ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY: 5 o7T C ARLgad)
LOCATION
DEVELOPMENT TYPE:
BUILDING SZ.E
3 3 ,lt(5
5FL
Paof -24y ,4 = 45C.zw la = 3E
)oyZ/A ? z+O
,2'1 ,1 € l.?69DP - zt y z2t '4AX
IMPERVIOUS SQ. FT 2,qb4 x$0.232 PER SQ. FT
2. SAMTARY SEWER-CITY
NO. OF PFU'S / t' X $48.27 pER pFU
(See Reverse Side)
3. TRANSPORTATION
NO OF LINITS X TRIP RATE X COST PER PM PEAK HOUR TRIP
X l,o I X 5486.73 PER TRIP
X 5486.73 PER TRIP
4. SANITARY SEWER-MWMC
A. REIMBI.IRSEMENT COST:
NO. OF FEU'S X 4L 70 PER FEU
B. MPROVEMENT COST:
NO. OF FEU'S I X zz.os?ER FEU
MWMC CREDIT IF APPUCABLE (SEE REVERSE)
MWMC ADMIMSTRATryE FEE
TOTAL-MWMC SDC
SUBToTAL (ADD ITEMS t,2,3 & 4)ADMINISTRATTVE FEES:
BASE (SUBTOTAL ABOVE) X .05
SDC Coordinator
ATTACH'A.WPD
LOT SIZE Se, Ft.
s aR7, 65
s 868. &e
S 4nt, a
S 7b
S ZZ,€
<$ - s,6< >
$ 10.00
$ - G&,q6
$ z, s r-2. o-z
$ rr,s,g<
I. STORM DRAINAGE
$X
5
-q
TOTAL SpC $ 2ft32 , q.?-
FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivatent: Fixrure Units
(NOTE: For remodels, calculate only the NeT additional fixtures)
FIXTURE ryPE
Bathtub........
Drinking Fountain......
Floor Drain.
Interceptors For Grease/O iUSolids/Etc
Interceptors For Sand/Auto Wash/Etc.
Laundry Tub/Clotheswasher/lvlop Sink.
Clotheswasher - 3 Or More
Mobile Home Park Trap (l Per Trailer).
Receptor For RefrigeratorAVater S tation/Etc...........
Receptor For Commercial S inVD ishwasher,Gtc......
Shorver, Single Stall.
Shower, Gang...
Sink: Bar, Commercial, Residential Kitchen..........
Urinal, Srall^Vall.
Wash Basin/Lavatory, Single...........
Toilet, Public Installation.
Toilet, Private..-......
Miscellaneous:
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexarion date in table, calculate
credits
Credit for Parcel or Land Only If Applicable e;:l y g t{,ood =
Value)
(, Af
(Rate X Assessed
Improvement (if after annexation date)X$
(Rate X Assessed Value)
CREDIT TOTAL - $q ,R<
NUMBER OF
NEW FIXTURES
LTNIT
EQUIVALENT
FIXTURE
I-INITS
2
I
2
3
6
2
6
6
I
3
2
1
2
2
I
6
4
)-
----8-
/Head
a
L
Year
Annexed
Rate per $ 1,000
Assessed Value
Year
Annexed
Rate per $ 1,000
Assessed Value
l 989
1990
i99r
1992
l 993
1994
l 995
1996
2.18
t.75
1.35
t.t7
1.03
0.86
0.7 t
0.57
l8
0
I 998
1979 or before
1980
1981
1982
1 983
1984
r985
1986
1987
1988
$4.47
4.38
4.32
4.20
4.03
3.88
3.68
3.38
3.03
2.62
RUNOFF COEFFICIENTS FOR STORM DR{INAGE
(For Estimating Purposes OnlY)
Residential...
Commerical.
Industrial......
GovernmentaI......................
0.4
0.9
0.5
0.5
FIXUNTT.WPD IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
IG
Job. No.
NAME:
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
PHONE:
ADDRESS:
LOCATION OF PROPOSED BUILDING SITE:
Street Address:
Plat Name Tax Lot Number:
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calcx-tlations and dwelling t
ype definitions are on the back.)
A. Single-Family Detached
\ Single Family home Manufactured home not in a park
NO. OF UNITS x $1,ooo per uoit = $ \ Doo 'Oc)
B. Single-Family Attached
NO. OF UNITS X $924 per unit = $
C. Multi-Family Apartment
NO. OF UNITS X $692 per unit = $
D. Manufactured Home Park
NO. OF UNITS X $699 per unit = $
srArE: BR-zre,Q]H@
.ooWILLAMALA,NE SDC
3. TOTAL WI
(if SDC reduced for Creditl
SDC ASSESSED
$[o oo.od\ --(, . '/>'\) I I
Date
$
2. SDC CREDIT (r applicable) SDC+ayer must fumish proof of C
Willamatane iredit approval. See SOC Credit Worksheet. g Y
City of
me
eld
lNillamalane
Park & Recreation District
1 OF
IINGFIELI,
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
BLECTRICAL PERHIT APPLICATION
Ci ty
FEE SCEEDTIIJ BELOV
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost
ffra))
/ s ss.oot5
7 s 1s.oo
43'
.00
.00
.00
.00
A
PEBIVIIT ENOT
17,qq,
Oltu/
ttao
Sum
AnsHflruAsrEqqP'v oa tq\3
O
Permits are non-transferable and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATTON ONLY
Address
Each Hanuf'd Home. or
-Hodular Dvelling
Sertice or Feeder $ 40.00
B Services or Feedersfnstallation, Alterationsor Relocation:
s s0.00
s 60.00
s100. 00
s130.00
s300.00
s 40.00
C. Temporary Services or Feedersfnstallation, Alteration or Relocation
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
-Over 600 amps or 1000ToTls
Branch Circuits
Nev, Alteration or Extension per panel
3linFifflli'on., $ 3s'oo
.Circuit or vith Serviceor Feeder Permit _ $ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
ci
Supervisor Lice
Expiration Date
"". GgL{ - qLlS+
nse Number Qt'i r{ -5
200 amps or less
20L amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps-
0ver 1000 amps/volts
-
Pump or irrigation
Sign/OutIine Lighting-
Limi ted Energy/Res
-
Limited Energy/Comm
SUBTOTAL OF ABOVE
2??'State Surcharge
3Z Administrative Fee
TOTAL
A
Y
Constr Contr. Number
Expiration Date (2
Signature of Supervising Electrician
0vners Name 9c. t/ (a*/sn-
Address t2)o € /?nt
phone ttL/-?/8 L
+4t
$ 40.00
$ ss.00
$ 80.00
a56veilxBsee
D
Ci ty
OIINER INSTALI.ATION
The installation is being made onproperty I ovn vhich is not intendedfor sale, Iease or rent.
0vners Signature:
E
$40
$ao
$20
s36
0
oBRECETVED
6o5DATE: lo 1 11
/ qt
Job Nunber
Electrical con ,r^.ror 1€'[ E lec/{l< Itt<.
I
t*
ty of ppringfieldii
This Side To Bci Filled Out Applicant
This permit is required for any site activity in the flood plain and everywhere
fifty (5O) cubic yards of material or more and/or if;a drainageway is affectedh,
sitl alteration consists of
wlthin City limits and
)
Dato of Application */rl/qi---.-- -permrt Expiration Date: l'
.
Property owner . fco tf, (-2, r/rryr^-- '
,713r a, '7
-r4a
Address :
sito Addres s At_^//&old, Oregon
Fhone:
UGB Tax Map N<.r
Journal number appl
.ot:llOOtr-0
icable Land Use Applicatjo
Tar
Materialq
u
tr FILL, Ouantity_ .-, Source
Project Sr.lpervisor_.
-
Supp lier
EXCAVATION, O,uantity
GRADING, Ouantity
Destination, '
Supplier:
Address
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SITE PLAN Required Data:Ouantity of material, Property lines and descriotions. Tax mao andlot number, Site address, Existing.con_tour lines, Proposed contour lines, Existin'g drainajeyqy:, Proposed drainage w-ays, Significant trees anti foliage; Ground c6ver, Soi[ types,
9,yllglnqs, septlg systems, Sewers, Areas subject to flooding, Utilities, Areas subject to landslides, Proposed site improvements.
CROSS SECTIONS,
.:SOILS&GEOLOGYPLAN, : I i
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
ADDITIONAL INFORMATION,
PHONE
STATE
PHONE
STAT
CITY
CITY
COMPANY NAME:_ -
PROJECT SUPERVISOR
ADDRESS:
COMPANY NAME:-
PROJECT SUPERVISOR:
ADDRESS:
, CITY:
QFFTCE PFIONE FAX
, EMERGENCY PHONE:
ztP
Expiration DateRegistration Number: 7 2-'l tl (
PROJECT SUPERVISOR
MoBILE PHoNE:-f 7q - X /0 [
CONTRACTOB NAME:tr
ADDRESS:
STATE:
l.understand that lor my successors may.have future p_lans.for my prop€rty whiclr may be anticipated or unanticipated atthis time. I understand that such future plans may require.permits-ahd devilopoment biprovals fiom tha City of S'pringfieid.I understand that notwithstanding any approval of this Land and Drainage Altbration Peimit (LDApl, that at ine time oIapplication of future permits o_r approvals the City may roview and recoisider all actlons wrrictr t oi'my successors haveundertaken p€rsuant to this LDAP. I understand that.the City may as a condition of any future approvit, require the -
undoing, changing, or modification of any actions which I hivo uhdertaken as a resuh bt tne ciiitsibpiovi't oitrrii r-onp.
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By signature., I state and agreo, that I 66v6.c,lrefully examined the completed application and do hereby cortiry that allinformation herein is true an_d correct, and I further certify-tliat any and all wori'performed snitt Ui Oone in aicorOinCewith the Ordinances of the City or Springfield, applicablc'City Standard specificaiiona ano-oiawinss, ind thi lawi oi ttrestato.of oreson p_e1!i!['g to_the work dtscribed herein. tfuhher certiiv itral onri dJniiiitois i;a%fii;y;;; ";i,;;;;'i;compliance with ORS 701.O55 wrl ho used on this project;
The City may inspect the work site described in this pdrmit at an-yiime.durqls.a on? yeqr period following th€ recsipt bythe Citv of notice of completion of the deicribed woik and specily, at tnoCti'! "5ic'a,*"!ilij;11 ;; aa?iiionatliitbiritionwork required to return the sil€^to.a standard.accaptablo.to.ttre.Clty. The perrhitrib witt',Ue noiliiib i'i'wr1ii.rg-;'ii"V;;;i-"required and will hav6 thirty (30) ttays from rhe date of the notice io_.comilete the woi(, Woii nii liLmptitia-at ifr'e enJ oftho tlrirty doys will bo porfornrrrrl lry tlro City unrl tho bortr wlll bc blllod to ttti p"imitio;. - -- --
il
fromare rcguoltsd !t
on thr rltc rt tllIt
further to that€nsuro allagree
endthestro€1,
Signaturo aff
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F'tr Date:
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onniruRcr, E Storm, E.Ditch,.E cu lve O N;rtural
FLOODWAY, FEMA CommunitY Panel No.
WETLANDS, Description
FEMA Community Panel NoFLOOD PLAIN, Zone:
$20.00
$30.00
$40.00
94O.OO For the f irst 1O,OOO cubic yards, plus
$20,OO for oabh arklitionRl 10,000 cubic yards or fraction thereof,
$220.00 For the tirst 100,001 cubic yards, plus
S20.OO for each additional 1 0,000 cubic yards or fraction thereof'
0340 For th6 first 2OO,0O1 cubic yardc, plua
96,00 for €aoh ac,rlilional 10,000 cubiC yards or fraction thoreof ,
$30.00
$3O.OO For the lirsr 100 cubic yards, plus
i14,OO lor cach addltlonal 100 cu6lc yarde or lractlon thorcot.
$ 1 56.00 For thc f init 1,000 cubic yards, plus
S1 2.OO for 6ach adclitional 1,OOO cubic yards or fraction th€reof'
S264.OO For the f irst 10,000 cubic yards, plus
$54.00 tor each atttlitional 10,000 cubic yards or fraction thereof
$750.OO For the first 100,001 cubic yards, plus
930.OO for each a(l(litional 10,000 cubic yards or fraction thereof
Date:
Received By:
Date
tt,"
,v45?o
bDate
Bcceipt *",945 q0
Plan Chec kFee: $2.
Received by:K,D.
Grading Permit r.,", $BO. Oo
100,001 To 200,000
2OO,OO1 CI,JBIC YARDS OR MORE
Receipt No
Date:
PLAN CHECK FEES:
UP TO 1OO CUBIC YARDS
101 TO 1,OOO CUBIC YARDS
1,001 TO 10,000 cuBlc YARDS
10,000 To 100,000 cuBlc YARDS
GRADING PERMIT FEES:
UP TO 1OO CUBIC YARDS
101 TO 1,ooo cuBlc YARDS
1,001 TO 10,b00 cuBlc YARDS
10,ooo To l oo,ooo cuBlc YARDS
1oo,oo1 To 2oo,ooo
Estimated Volume: 50 C
NMBI-ESIDE MEADOWS SUI]D.
This propcrty is locatcd in an arca ofhealy clay
soils (cxpansivc olays). A licensed engineer shall
vcrily the stability ofthe soils in thc proposed
building arca and makc any recommcndations
ncccssary to assurc thc conlinued stability oftlrc
soil. A copy of the cngineer's rcport shall be
submitted to the Building official prior to
bcginning construction oothe struc'ture.
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L,th
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Date:
Building:
{engineoring
tr Planni
Date:
Date
Planning:
Engineering:
Buifding:
Malptenance
Datelssued by;
Date
Date:
Reqrrired Fihal lnsnections'
Permit Number
Date-
Date
Land and Drainage activity as outlined in this permit has been completed in accordance with
the provisions ofthis Perrilit.
Land and Drainaqe ac-tivity as outlined in this permit has not been completed in accordance
with the provisio'hs ot tnts permlt.
tr Land.and Drainage activity was performed prior to application for this permit.
Date:
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Accepted by: -.
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1/6/1998
is Side To Be Fill
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By City Staff"
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