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Home My WebLink AboutPermit Building 2005-07-13Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00333ISSUED: 0711312005APPLIED: 0312412005EXPIRES: 01/1312006VALUE: $ 250,000.00 SITE ADDRESS: 2728 PHEASANT BLYI) ASSESSOR'S PARCEL NO.: 1703220002603 PROJECT DESCRIPTION: Springfield TYPE OF WORI(: Swimming Pool TYPE OF USE: Addition Three outdoor pools and accessory building Owner: Address: Contractor Type Architect General Electrical Plumbing COURTSPORTS-SPRINGFIELD VOTAJ ENTERPRISES INC 4242 COIM]$'IERCE ST EUGENE OR 97402 0u16t2006 12n0t2007 10t3u2006 Commercial Phone 541-344-9157 541-683-3607 541-48s-0922 541-746-1621 Contractor GERALD MCDONNELL AND ASSOCIATES LEE CONSTRUCTION COMPANY BTIILDERS ELECTRIC INC IIARVEY & PRICE CO License Expiration Date 63579 4296 77 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I A5 13.00 nla VA REQUIRED PARI(NG Total: Handicapped: Compact: Street Improvements: ATTENTION: Oregon law requires you to 3ffi :i,ffLtiffil}g;:f ta:,"Jjtfl ,:,,:h:aj:tlkl, Sidewalk Type: Downspouts/Drains: in OAR 952-001-0010 through OAR 952-001_.C?0. You may obtain copies of the rutes by ll,rq the center. (Note: the telephone , , tor the Oregon Utility Notification :., rri:ter is .l -900_332 _2944). PUBLIC IMPROVEMENTS Notes: Page I of5 I ItUrL[[].'l\, ll\I(T.r(.tYIAIlt l\ | 668 ut! v tlL(rrNIl,N r rN I( uI(lYlA I l(rl\ I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-72G3676Rsx 541-7 26-37 69 Inspection Line ITY Building/Combination Permit PERMIT NO: COM200S-00333ISSUED: 0711312005APPLIEDz 03t24t2005EXPIRES: 01/13 t2006VALUE: $ 250,000.00 Descriotion Estimate Paving Tvpe of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 55,000.00 195,000.00 Value $55,000.00 $195,000.00 $250,000.00 Date Calculated 04t2st200s 04t25t200s Fee Description Plan Review Comm/Ind/Public -Mechanical Issuance Fee- + l0%o Administrative Fee + 77o State Surcharge Backllow Device Building Permit Fixture Minimum/Adj ustment Mechanical Paving Planning Final Occy Inspection Sanitary Sewer - lst 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Storm Sewer Each Addtl 100' Vent Fan Water Line - lst 50 Feet Water Line - Each Addtl l00' + l0o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Value of Project Date PaidAmount Paid $684.55 $r0.00 $159.85 $s0.69 $14.00 $390.1s $98.00 $39.00 $874.40 $143.00 $45.00 $274.16 $360.66 $10.00 $528.48 $s0.10 $131.88 $r0s.66 $1,509.32 $342.13 $1,675.86 $45.00 $28.00 $6.00 $45.00 $14.00 $15.90 $11.13 $33.00 $126.00 Receipt Number 2200s00000000000338 1200s00000000000801 1200500000000000801 r200500000000000801 1200s00000000000801 1200s00000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200s00000000000801 1200s00000000000801 1200500000000000801 1200500000000000801 1200500000000000801 r200500000000000801 1200500000000000801 120050000000000080r 1200s00000000000801 1200s00000000000801 2200500000000000922 2200s00000000000922 2200500000000000922 2200500000000000922 3t24t0s 6t8t0s 6/8/05 6t8t05 6/8/0s 6t8t0s 6/8/0s 6t8t05 6/8/05 6t8t05 6/8/0s 6/8/0s 6t8t0s 6t8t0s 6t8t05 6/8/0s 6t8105 6/8/0s 6/8/0s 6t8t05 6/8/0s 6t8t05 6/8/0s 6/8/0s 6t8t05 6/8/05 7lt3t05 7n3t0s 7fi3tos 7n3t0s tr'ees Peid Total Amount Paid $7,820.92 Paee 2 of5 Valuation Description I Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM200S-00333ISSUED: 0711312005APPLIEDz 0312412005EXPIRES: 01/1312006VALUE: $ 250,000.00 PIan Reviews Fire Department Reyiew 0312512005 0411112005 OK GRG 0312512005 04n4t2005 APP SB IO JMP Plans Review: Addition of 3 outdoor pools (lap, recreational, and therapy). Job #COM2005-00333. Occupancy Classification: A-5 (not A-3 as stated on Cover Sheet A-1). Construction Type: V'A Sprinklered. This building was originally plan reviewed by Al Gerard under the 1998 Oregon Structural Specialty Code and 1998 Springlield Fire Code as an A-2.1 occupancy with Type V-l hr. construction (sprinklered) on November 2nd, 1998 and January 11, 1999. Provide illuminated exit signage meeting requirements of 2004 OSSC 1011 for the two exits serving the pool area. Plan Sheet A-2, Sheet Note #3 states requirement to "extend existing automatic fire sprinkler system into equipment building." Subcontractor shall submit sprinkler plans to Springfield Fire Marshals Office for review and approval (2004 Springfield Fire Code 901.2'). Site Plan Modiliaction Minor was submitted for review on3124105. Will be approximately 4-6 week review time before sign offon bldg. permit. LDAP ready to issue. HOLD for Issuance of LDAP. SDCs added. Impervious surface covers future roof. No encroachment into Rights-of-way or Public Easements proposed. WE. Danny Klute delivered Addendum I and cosUvalue. Called him to ask about contractors and special inspection forms. He said they will be supplied later. Initial Review Planning Review Public Works Review 03t25t2005 03t2st200s 03t25t200s 05/11/200s SKG EMM APP APP Structural Review 04t22t2005 04t22t2005 Paee 3 of5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00333ISSUED: 0711312005APPLIEDT 0312412005 EXPIRESz 0111312006VALUE: $ 250,000.00 Structural Review Structural Review Structural Review Structural Review SUB Review SUB Review 0s/03/2005 0s/03/2005 ro JMP 0s/10/2005 05/10/200s ro JMP WE. Received from Danny the contractor data. Received from Doug Lee a fax of the special inspection forms (original to follow in the mail). WI. Processed Special Inspection form. Donovan asked sbout secondary containment for pool chemicals and DWP. Received final internal approval. See attached 10 structural comments faxed to Danny Klute. JMP called Danny Klute about the missing information on boilers and swimming pools. 05/11/2005 03125t2005 05fiu2005 04t06t200s APP JMP JMPWE 03t28t200s 04t0u200s WE JF 04n8t2005 04/18/2005 APP JF To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. witl be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Roofing: Prior to installing any roof covering. Drywall: Prior to taping. Masonry: Epoxy Anchors: To be done by Certilied Spcial Inspector. Provide Inspection results to City Building Inspector. Structural Masonry: To be done during construction by a State Certified Special Inspector. Provide results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Pase 4 of 5 Keourred InsDecfions I Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00333ISSUED: 0711312005APPLIEDz 0312412005EXPIRES: 01/1312006VALUE: $ 250,000.00 Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Underground Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Backllow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Water Line: Prior to lilling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Plumbing: Following City Rough Plumbing inspection approval and prior to cover. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting 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 eccordance 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 structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 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 property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Pase 5 of5 Date \I 225 Fifth Street Spring{ield, Oregon 97 477 541-726-3759 Phone 4ity of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT#: 2200500000000000922 Date: 0711312005 2ztt:44PM Job/Journal Number coM2005-00333 coM200s-00333 coM2005-00333 coM2005-00333 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7%o State Surcharge + l0% Adminishative Fee Amount Due 126.00 33.00 1 l.13 15.90 Item Total:$186.03 Payments: Type of Payment Paid By unecKNumDer Authorization Received By Batch Number Number How Received Amount Paid Check BUILDERS ELECTRIC llh 92049 By Mail $186.03 Payment Total : -5i8-6^o-t 7n3/2005 Page I of I ro,D iH Ec-J 477 CONTRACTOR ':726-3769 Fax Line 541-726.3676 Eleckical lnspector S41-726-3663 General intorination 54t-726-3759 Date:i -06 Job O:ru"+ sturFL = !IEf"$"t io=$ [il ; City of Springfietd 225 Fifth Street Springtield, OR 91417 I uoo Owners Name: Description of Work: l Expires: Expires: l @ Etectricat Supervising Electrician Supervisors License #: Construction Conlractors ro^rd O, W /r'-/ - d2 t2-10"01 1&2 HAVE lHspecrroru Typt AppRovlt Dlre TEMPORARY UNDERGROUND sEEVlCE LOW VOLTAGE MANUF HOME SERVICE MANUF HOME CONNECTION >-./44-H,_ FINAL THIS AN TO BE REMOVED ONLY BY BUILDING OFFICIAL UNDERSLAE ROUGH SIGN f'ttctL Zlo.'r) OF Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00333ISSUED: 06/08/2005APPLIEDz 0312412005EXPIRES: 1210812005VALUE: $ 250,000.00 SITE ADDRESS: 2728 PHEASANT BLVD Springfield TYPE OF WORK: Swimming Pool ASSESSOR'S PARCEL NO.: 1703220002603 TYPE OF USE: PROJECT DESCRIPTION: Three outdoor pools and accessory building Owner: Address: Contractor Type Architect General Electrical Plumbing COURTSPORTS-SPRINGFIELDO/"TAJ ENTERPRISES INC 4242 COIMNIERCE ST EUGENE OR 97402 0U16t2006 12n0t2007 10t3u2006 Commercial Phone 541-344-9157 541-683-3607 541-485-0922 541-746-1621 Contractor GERALD MCDONNELL AND ASSOCIATES LEE CONSTRUCTION COMPANY BTIILDERS ELECTRIC INC HARYEY & PRICE CO License Expiration Date 63579 4296 77 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Lot Size: A5 Lst Floor: 2nd Floor: Basement: Garage/Carport Other: VA Load: REQUIRED PARIilNG Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh ofLot Coverage: Sidewalk Type: Downspouts/I)rains: PUBLIC INIPROVEMENTS Notes: Page 1 of5 hl 668 F' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00333ISSUED: 06/08/2005APPLIEDz 0312412005EXPIRES: 1210812005VALUE: $ 250,000.00 Description Estimate Paving Tvpe of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $r.00 $1.00 Square Footage or Bid Amount 55,000.00 195,000.00 Value $55,000.00 $195,000.00 $250,000.00 Date Calculated 04t2st200s 04t25t2005 Fee Description Plan Review Comm/Ind/Public -Mechanical Issuance Fee- + l0Yo Administrative Fee + 7o/o State Surcharge Backllow Device Building Permit Fixture Minimum/Adjustment Mechanical Paving Planning Final Occy Inspection Sanitary Sewer - lst 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Storm Sewer Each Addtl 100r Vent Fan Water Line - lst 50 Feet Water Line - Each Addtl 100' Total Value of Project Date PaidAmount Paid $684.5s $10.00 $159.85 $s0.69 $14.00 $390.1s $98.00 $39.00 $874.40 $143.00 $45.00 $274.16 $360.66 $10.00 $528.48 $50.10 $131.88 $105.66 $1,509.32 $342.13 $1,675.86 $45.00 $28.00 $6.00 $45.00 $r4.00 Receipt Number 2200s00000000000338 1200s00000000000801 1200s00000000000801 1200500000000000801 1200500000000000801 1200500000000000801 120050000000000080r 1200500000000000801 1200s00000000000801 1200s00000000000801 1200s00000000000801 1200s00000000000801 120050000000000080r 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200500000000000801 1200s00000000000801 1200s00000000000801 1200s00000000000801 1200s00000000000801 1200500000000000801 1200s00000000000801 1200s00000000000801 1200500000000000801 3t24t0s 6/8/0s 6/8/0s 6/8/05 6t8t05 6/8/05 6/8/0s 6/8/05 6t8t0s 6t8t0s 6/8/0s 6/8/0s 6t8t05 6/8/0s 6/8/0s 6t8t0s 6/8/05 6/8/05 6t8t0s 6/8/05 6/8/05 6/8/05 6/8/05 6t8t05 6/8/0s 6/8/0s tr'ees Pnid Total Amount Paid $7,634.89 Paee 2 of5 Plan Reviews I" Valuation Description I F Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR S4l-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00333ISSUED: 06/08/2005 APPLIEDT 0312412005 EXPIREST 1210812005VALUE: $ 250,000.00 Fire Department Review 0312512005 04nu200s OK GRG 03t2st200s 0411412005 APP SB IO JMP Plans Review: Addition of 3 outdoor pools (lap, recreational, and therapy). Job #COM2005-00333. Occupancy Classification: A-5 (not A-3 as stated on Cover Sheet A-1). Construction Type: V-A Sprinklered. This building was originally plan reviewed by AI Gerard under the 1998 Oregon Structural Specialty Code and 1998 Springfield Fire Code as an A-2.1 occupancy with Type V-l hr. construction (sprinklered) on November 2nd, 1998 and January 11, 1999. Provide illuminated exit signage meeting requirements of 2004 OSSC 1011 for the two exits serving the pool area. Plan Sheet A-2, Sheet Note #3 states requirement to "extend existing automatic fire sprinkler system into equipment building." Subcontractor shall submit sprinkler plans to Springlield Fire Marshal's Office for review and approval (2004 Springfield Fire Code 901.2). Site Plan Modiliaction Minor was submitted for review on3124105. Will be approximately 4-6 week review time before sign offon bldg. permit. LDAP ready to issue. HOLD for Issuance of LDAP. SDCs added. Impervious surface covers future roof. No encroachment into Rights-of-way or Public Easements proposed. WE. Danny Klute delivered Addendum 1 and cosUvalue. Called him to ask about contractors and special inspection forms. He said they will be supplied later. Initial Review Planning Review Public Works Review 03tzst2005 0312s12005 0312512005 05/11/2005 SKG EMM APP APP Structural Review 04t22t2005 04t2212005 Paee 3 of5 I Buildin g/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2005-00333ISSUED: 06/08/2005 APPLTED| 03t24/2005 EXPIRESz 1210812005VALUE: $ 250,000.00 Structural Review Structural Review Structural Review Structural Review SUB Review 05/03/2005 0s/03/200s ro JMP 05/10/200s 0s/10/2005 ro JMP WE. Received from Danny the contractor data. Received from Doug Lee a fax of the special inspection forms (original to follow in the mail). WI. Processed Special Inspection form. Donovan asked about secondary containment for pool chemicals and DWP. Received final internal approval. See attached 10 structural comments faxed to Danny Klute. JMP called Danny Klute about the missing information on boilers and swimming pools. 05fiu2005 03t25t200s 0smt200s 04t06t2005 APP WE JMP JMP 03t28t2005 04t0U2005 WE JF SUB Review 04/18t2005 04n8t2005 APP JF To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 work day. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Roofing: Prior to installing any roof covering. Drywall: Prior to taping. Masonry: Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. Structural Masonry: To be done during construction by a State Certified Special Inspector. Provide results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rpnrrired fnsneetinns Page 4 of 5 r Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00333ISSUED: 06/08/2005APPLIED: 0312412005 EXPIRESz 1210812005VALUE: $ 250,000.00 Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Underground Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Plumbing: Following City Rough Plumbing inspection approval and prior to cover. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting 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 Springfield and the 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 701.005 will be used on this project. I further agree to ensure that all inspections are requested at the proper time, that each address is readable from the street, that card is at the front of the property, and the approved set of plans will remain on the site at all times 6, Owner or (y'' Pase 5 of 5 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springlield Official Receipt evelopment Services Department Public Works Department RECEIPT #: 1200500000000000801 Date:06/08/2005 10:02:45AM Job/Journal Number ccM200s-00333 coM200s-00333 coM2005-00333 coM2005-00333 coM2005-00333 -cfM2005-00333 ' ictvtzoos-oo::: ccM2005-00333 c'1M2005-00333 coM2005-00333 coM2005-00333 coM2005-00333 coM2005-00333 coM2005-00333 coM2005-00333 coM2005-00333 coM2005-00333 cDM2005-00333 coM2005-00333 coM200s-00333 coM2005-00333 coM2005-00333 cbuzoos-oor::-( cbM2005-00333 c5M2005-00333 ( Description Fixture Sanitary Sewer - 1st 50 Feet Water Line - lst 50 Feet Water Line - Each Addtl 100' Storm Sewer - lst 50 Feet Storm Sewer Each Addtl 100' Backflow Device Vent Fan Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Building Permit Paving + 7%o State Surcharge + l0% Administrative Fee Planning Final Occy Inspection Amount Due 98.00 45.00 45.00 14.00 45.00 28.00 14.00 6.00 39.00 10.00 1,675.96 360.66 274.16 342.13 1,509.32 50.1 0 528.48 10.00 131.88 105.66 390.15 874.40 s0.69 159.85 143.00 Item Total:$6,950.34 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check LEE CONSTRUCTION djb 9836 In Person Payment Total: $6,950.34 -56,eso-34' 61812005 Page 1 of I I :l 4 (Aru" zM - OoZa3 {J^* Teo"to'^ C-ot ^"-eos - ooab?. City of Sprlngficld Corn:nunii;* 3i;'.' ictr Divisi ol 225 Fifih Sract Sgringficld, OE 974'17 Tclcphonc: (54 l)'t26-17 59 Fax: (54 l) 126-3689 Building Pcrmit # Co'c Bt S€oe+S BEFORE A CERTIFICATE OF OCCUPANCY WILL EB I$$UED: Thc $pccial Inspcction Agency shall rubmit to tho Building Ofricial a srrhmcnt inspcction havc bccn fullilhd and rcportcd rnd wcrt to lht bcal of thc in*pocror's knowlodgc,ln confonnancr with thc rpproved plant, rpccitic*lions provirions. Thosc itenrs r0t tested ond/or inspcctod shall bo notcd i:. thE statcmart, Thc report is to bc aubmincd to thc Oty prior -ro * rlqorrr for fu,rl ACIff{O1YLEDGMENTS 65-o3-65 Dalc EE Fts NEs {Jt ts !T UJ H --J hlm LJfi -J crt SP]lINGFlELD ' Protgcl-! itis Z1,zA ?*.e-AtRr{:T 9u! D. Projcct Address Spcchl Irlpcetlotr And Telting h.v! lirfrhld...knGvldt nud!.rr$dhtof ti. infoE ion hy rlanint b.h.r. rd.du thlr lorm to fic Aty. BBFons A PERMIT cAlt B! $tsufDr Ttt o{r[l.r oro*E!'t tcprs.ntdiv!. m tf! dylc. ofrhc f.pon bl. Pllilcd Elghrcr or Art}ircct, rhdl complctq rign, rad rirhnh ro rhc Clty fo, l.vtrlr md rprro'ril rhL tum ronpbtd both 6a frodt .nd b.d( T!. (}trn.rlrd C.i. l Cmtr*ror, whrm rpplhrblg tlr.ll .lto roknorvl.d8c $. follolYi!8 cordhioot lpptlc$h to Sprciri lnrpccrior tldro. T.r!in& l. CoilGll.r ls ialotiSlc lor !rcp.f nolilic.tion 6r h.l!!D..ilor or Tr.tlng ol Im! Utlcd. !, T.rdll8 lrtoritor], rLrall tkc rpproplul $rryhr ! d ranrpon r.m to lh!i,l.bodDry for nmfarayduatho or tctting,, . Copi.r oftll hbontory ltport.rd hrp.c ont ara b ba $rit to fi. Ciry by th. Tcdt|g AlaEy. l. Sn.dnl trrr..otr Arlrc,l ir lo rlbhll i.m.. lrd +rllfcrlonr ofo{F.lE Spccitl h!p.chr. to ftc Clt lor rpprortl. 4. Sp!.lnl tntpcEtd.$tlt pruvrdc hlprclior Fport! to th. bdlding oafEirl of.ll lnrlac on.ctlv i., 5. C.rtrrctrr i! EToitibh to !!vhy tlE Clly.pprovld Dllllr for.ddldon.l lll!f,.cth[ ff ta.thg, l!$dr.m.[a d|lt mly b. !ot.d. that rll itcmr rcquiring and applicablc workmanrhl. <-:-* OwnerNamc (Plintcd)Owncr Signrture orA Firm (Enginccr Sign FEE lesnrur:"trlsp-,. Gen.Contnactor Firm Nrmc (Printcd) 8lU rC Spccial c Ccneral Signature Rcp Sign. ll]}firrl srr Tcrdng Laborarory Namc (Printcd)Tcsting Laboratory p Sigraturc Building ! Namc'(Printcd) Spccial Insp. Signature ftH-t |fI LOllnHz6)iTl.H mTtJ fECJzr'"tanfi,tc Grrn t4 Grout Mortur forcsd Concrctr, Gun 6rout rnd Morlar: Prrc slt/Pro-r trasrcd Con crete: a I ROOFTNG Insu [ation installat lonirR-valu e* :_ Teil strips/scflmi SMOKE CONTROLT fi,o/,c FIREPROOFING: Placement inspectionLeakale Esting Cmtrol verification Dcnsity Tcsts Thicknccs tests Inspect betching GRADINGI BXCAVATION' AND FILL Accephnce tEsts r PSF Establish final gradc Fill pl acernent i nrpection/continuous SoilDensity STR UCTURAL STEE T,AJT'ELDING I Sampla and test (list speci{ic members belorv) Shop matcrial identification (milt cert) Weld inspection Shop _ Field Ullraronic inspcction Shop _ Ficld A490 _Ft X F Mctal deck wctding Tnspcction Rcinforcing SterI wclding inspcction . Reinforcing steel mlll ceilificale/ Metal stud wclding lnspection Concrcte insert welding inspection Momcnt rcsisting steel frames STRUCTURALWOOD: Shcar wall nailing inspcction Shcar wallanchors Inspeclion of Glu-lnm fab, '_ T/C psi Inspection oftruss joist fab. Sample and tcst componcnr3 Ftbricntion welding of steel accessories Spccial inrpection strssrcs used-r fm f B Prcliminary acceplance testr (mmonry units, wall prisrns) Subscquenl lesls (mortar, grout, fiGId wall prisms) Placemcnt inspccliorr oi unils, nrul rehrlorccmctrl Mrsonrry, monlar, gmut, and reinforclng steel certiltcales + MASONRY: High rtrength boltlng 4325 _ H Fietd F Shop _ x SPECIAL IITISPECTION AND TESTING SCHEDULE 0THER TEST, & INSPECTIONS:Forrn completcd f)H-t tl-rl mlInHZtr'rl H mrH { NAL INSTR b lIDf)m E-J rs+ tsts t\]E6 UI !T fuJts --J hJm fuJm -.J cl1 rpnovlnpsrRENGTft RgeutRED By ARcHlrEcT oR ENcINEER oR coNTRAcr DoCUMENT LocATIoN oF vALUEs tl "2 CITY/. ATTACHMENTA UNGFIELD SYSTEMS DEVELOPMENT CHARGF I'' -KSHEET .105-00333 COURTSPORTS JOT-IRNAIORJOB NUMBER: NAMEORCOMPANY: LOCATION: MAP & TAXLOTNUMBER: DEVELOPMENT TYPE: 2728Pleasant 17 0322 00 02603 Addition NEW DEVELOPED AREA (S.F.): EXSTING DE\IEI,OPED AREA (S.F.): TOTAL TMPERVTOUS SURFACE (S.F.): 668 ITE: ITE: LOT SrZE (S.F.): 492 5,406 l. STORMpRAINAGE Thg s coceras IMPERVIOUS SQ. Fr. s406 x |C,2 ee*bre Pa( da. + 1(a11 2. SANITARY SEWER-CITY A REIMBI.IRSEMENT COST: NUMBER OF DFU's B. IMPROVEMENTCOST: NUMBER OF DFL-rs (sEE RE\ERSE SrDE) 3. TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBIIRSEMENT COST: 0.668 x 32.93 x $ 18.30 PERTRIP x B. IMPROVEMENTCOST: x 32.93 x $ 80.72 PER TRIP x E)OSTING A REIMBURSEMENT COST: 0.000 x 0 $ O.3IO PER SF TOTAL STORM DRAINAGE INCLUDES 1 DRAIN FIXTURE FOR FUTURE TRENCH DRAIN TO SAN]TARY 15 $ 24.04 PERDFU 15 x $ 18.28 PERDFU TOTAL LOCAL SAN-SEWER SDC:634.82 $ 634.82 0.8s NTF NTF850 $ 342.13 $ 1,509.32 B. IMPROVEMENT COST: 0.000 x 0 x $ 18.30 PER TRIP x $ 80.72 PER TRIP x O NTF O NTF TOTAL TRANSPORTANON REIMBURSEMENT SDC: TOTAI TRANSPORTATION IMPROVEMENT SDC: TRANSPORTATION SDC:$ 1,851.46 $ 1,851.46 4. SANITARY SEWER- MWMC NEW: A REIMBURSEMENTCOST: NUMBEROFFEU's B. IMPROVEMENTCOST: NUMBER OF FEU's E)ilSTING: A REIMBURSEMENTCOST: NLIMBEROFFEU's B. IMPROVEMENTCOST: NUMBER OF FEU's 0.668 0.668 0.000 0.000 MWMC CREDIT II'APPLICABLE (SEE RE\ERSE) $791.14 $O.OO PERFEU SUBToTAL (ADD ITEMS 1,2,3,&.4) x $75.00 PERFEU PER FEU $50.1 0 $ 528.48 $x x $O.OO PERFEU $ INDUSTRIAL STRENGTH INCREASE TOTAL MWMC REIMBURSEMENT FEE TOTAL MWMC IMPRO\EMENT FEE MWMC ADMIMSTRATIVE FEE TOTALMWMC SDC:$ 588.58 $ s88.s8 $ 4,750.72 5. ADMINISTRATI\{E FEES : BASE CHARGE (SUBTOTAI ABO\€)$ .Stevew W. Beaud,ru BaYwesU 4/1312005 TOTAL TRANSPORTATION ADMINISTRATION FEE TOTAL SEWER ADMINISTRATION FEE 4,750.72 x 5%:$237.54 $ $ $360 $ 342.13 $ 1,509.32 $ 50.10 $ 528.48 10.00 $ tos.oo lrrilz 4,988.26 131.88 C&fizE&QF?$tB9*'pon', 2728 pheasa nt. xr s DATE TOTAL SDC CHARGES 1 JULY 2OO4 DRAINAGE FDffURE I.INIT (DFI.I) CALCULATION TABLE NUMBER OF NEW FD(TURES X UMT EQT]TVAIENT = DRAINAGEFXTURE UMTS 0'{OTE: FOR REMODELS, CArcULATE ONLY T}IE NET ADDITIONAL FXTURES) COURTSPORTS DRAINAGE FXTURE UNITS LINIT FD(TTIRE TYPE BATHTUB DRINKING FOUNTAIN FLOORDRAIN INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRYTUB CLOTFIES WASHER,/MOP SINK cLorHEs WASHER - 3 oR MORE (EA) MOBILE HOME PARK TRAP (1 PER TRAILER) RECEPTOR FOR REFRIGERATOR/WATER STATIONIETC. RECEPTOR FOR COMMERCTAL SINK/ DISHWASHER/ETC- SHOWER, SINGLE STALL SHOWER, GANG GTIJMBEROF HEADS) SINK: COMMERCTAL, RESIDENTIAL KITCFIEN STNK: COMMERCIAL BAR SINK: WASH BASIN/DOIIBLE LAVATORY SINK: SINGLE LAVATORY/RESIDENTIAL BAR TIRINAL, STALI]WALL TOILET, PUBLIC INSTALI-ATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OFEDU'S*l5 0 TOTAL DRAINAGE FDfllIRE LTNITS:15 -gnU eqrira"rt O*.tttrg CREDIT CALCULATION TABLE: BASED ON ASSESSED VALT,E IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCIILATE CREDITS SEPARATELY RATE PER $I,OOO ASSESSED VALUE FD(TURES NEW OLD J I J 3 6 2 3 6 12 I J 2 2 3 2 2 1 5 6 J 0 YEAR $1.45 $1"2s $1.09 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (rF AFTER ANNEXATTON DATE) x x $0.00 s0.00 YEAR ANNEXED RATE PER $I,OOO ASSESSED VALI'E 1979 1980 198r 1982 1983 1984 1985 1986 1987 1988 1989 r990 t99t or before $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 1992 1993 1994 1995 t996 1997 I 998 1999 2000 2001 2002 2003 2004 s0,00 s0.00 COM2005-00333, COurtsports, 2728 Pheasant-xls CREDIT TOTAL 1 JULY 2OO4 0 l5 0 0 0 0 0 0 0 0 0 0 0 5