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HomeMy WebLinkAboutPermit Building 1998-07-07NOTICE: THls PERMIT st"rALL ExplBE IFTHE nrum(DENrrArJ pERlrrr Appr,rcArroN AUTHORIZED UNDHB THIS pERMIT lS Nor crrY oF sPRTNeFTELD ..MMEN.ED oft is AtsAND,NED Fd *T;llr:ffi"ffi:rDrvrsroN ANY 180 elAv pEplgCI, SPBIiJGFIELD 225 North Fifth Street Springfield, OR 97477 Location of Proposed Work: 5732 SIEMON DR Assessors lutap #: :..'1 0234L1, Lot: 10 Block: \ct> Office: Inspection Line: Page 1 ilob Number: 980704 125 -3'7 59 126-3169 Tax Lot #: Subdivision: 04200 LEVI LANDING aTr oF SPTNGFIEI-D, OnEGON Owner: SIERRiA BUILDERS Address: 670 PINE CT. Describe Work: S/F/RESfDENCE Phone #: 7448267 Citylstate/zip: CRESWELL oR. 97426 NEW General: Plumbing: Mechanical- Electrical ContracEor SIERRA BUILDERS 0094352 570 PINE CT CRESWELL OR 97425OOOO BMC MECHANIAL O1O48O5 PO BOX 292 TERREBONNE OR 9775OOOOO GARIDAY HEATING OO85O4O PO Box 375 Klickitat WA 985280000 ROSE ELECTRICAL O111O9O 15383 NW WOODED WAY BEAVERTON OR 97 Const. Contract,or #Expires 06 /2s / ee o3 /1,3 / eB ro/1,4/es 01./24/e8 7 44 - 825't 548 - 7510 795-4704 590 -7 7 36 QUAD AREA: 5RNE OCCY GROUP: R3 HEAT SOURCE: FG oFFrcE usE -- LAND USE: 1111 CONSTR. TYPE: VN INSUL PATH: P1 # OF BLDGS: # OF BDRMS: SQ FOOTAGE: 1 3 1858 To request, an inspection, cal_l the 24 hour recording at 726-3769. A11 inspecti-ons 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. --- REQUIRED INSPECTIONS --- FOOTING - After trenches are excavated. FOITNDATION - After forms are erected but prior to concrete placemenL. ITNDERFLOOR PLIIMBING - Prior to insulation or decking. ITNDERFIJOOR MECHAIiIICAL - prior to insul_ation or decking. WATER tINE - Prior to filling trench. SA.MTARY SEWER tINE - Prior to filling trench. STORM SEWER LINE - Prj_or to filling trench. POST AI\ID BEA!,I - Prior to floor insulation or decking. rNsuLATroN - Floor; prior to decking wa1l/ceiling; prior to cover ROUGH PLtIMBfNc - Prior to cover. RouGIr GAs - after line is installed and capped if not attached to an appliance ROUGH MECIIAI{ICAL - Prior to cover - ROUGH ELECTRfCAL - Prior to cover. SHEAR WALL NATLTNG - Before covering sheathing with finish materials. FR.AIIfNG - Prior to cover. rNsuLATroN - Floor; pri-or to decking waII/ceiling; pri_or to cover DRYWALL - Prior to taping. CURBCUT - After forms are erected but prior Lo placement of concrete. srDEwArJK - After excavation is complete, forms and sub-base material in p1ace. FINAL PLITMBING - When all plumbing work is complete. FfNAL MECHAI{fCAL - When af1 mechanlcal work is complete. FrNAr- ErJEcrRrcAL - when all electrical work i-s complete. FINAL GAS - When aLl- gas work is complete. FrNAL BUTTJDTNG - when all required inspections have been approved andthe building is complete. Phone SPRII{GFIELE, rfob Number : 9807 04 CITY OF ONEGON Page 2 GAS SERVICE - After l-ine is instal-fed and fine has been connected to a minimum of one appliance. Pressure test done at this point. Lot Faces: S Topography: 2 Solar Approved: Y House Garage Lot Sq. Ft.: 5400 Total- Height: L4.6 Lot T),pe: INTERIOR Lot Coverage: 35 ? Setbk From NPL: 18 N 2B Setbackssw 5 1B E 5 Item Main Garage Total Value Bui-Iding Permit Fee Surcharge/admin TOTAIJ FEE --- BUILDTNG PERMIT --- Square Feet x L468 400 $/Square Feet 64 .66 1,6 .27 (A) Val-ue 94 , 921 .00 6, 509 . 00 ).o1_ , 429 .00 437.50 35.01 47 2 .5L --- PLIIMBING PERMTT .-- ftem Residentj-al Bath (s) Plumbing Permit Surcharge/Admin TOTAL CHARGE 2 Fee 160.00 150.00 1,2 .80 L72 .80(c) --- MECHANICAL PERMIT --- Furnace Exhaust Hood Vent Fan Wood Stove/LnserL/Fireplace Unit Dryer Vent GAS PIPE Mechanical Permit Issuance Surcharge/Admin TOTAL PERMIT 3 5.00 3.00 9.00 4.50 3.00 2.OO 27.50 10.00 2 .21, (D)39.7L --- MISCELLANEOUS PERMTTS --- Surcharge/admin Sidewalk Curb Cut CITY SDC ELECTRICAL PERMIT WILLAMLANE TOTAL MISCETI.ATiIEOUS PERMTTS (E) 0.00 19.00 14.80 2 ,388 .36 L57.50 1, 000. 00 3,589.55 (Excluding Electrical) unless otherwise noted --- TOTAL AMOT'NT DUE --- (A, B, C, D, and E combined)4,274,8 SPIIIiI-GFtELD Job Number: 980704 CITY OF SPilNGFIELT', ONEGON Page 3 .-- BUILDING VALUE, PLNiI CHECK AI{D BUILDING PERMIT --- Thi-s permit is granted on the express condition that the said construction sha1I, in all respects, conform to the Ordj-nance adopted by the City of Springfield, including the Development Code, regulatlng the construction and use of buildings, and may be suspended or revoked at any ti-me upon violation of any provi-s j-ons of saj-d ordinances. Plan Check Fee: 284.38 Date Paid: Received By: Plans Reviewed By: AL WARD Date: Building Site Reviewed By: BOB BARNHART 06/L2/eB 07/07/ee Receipt Number: 30298 --- ADDITTONAL COMMENTS DR]VEWAY REQUIRED TO BE PAVED 2 STREET TREES REQUTRED By signature, I Etate and agree, that I have carefully examined the completed application and do hereby certify that al-l- information hereon is true and correct, and I further certify that any and a1l- work performed sha11 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 permi-ssion of the Community Services Division, Building Safety. I further certify that. only cont.ractors and employees who are in compliance with oRs 701.055 will- be used on this project. I further agree to ensure that al-l required inspections are requested at the proper time, that each address j-s readable from the street, that the permit card is located at the front of the property, and the approved set of pl-ans will- remain on the sit.e at all times dur ing constructiontu Slgnature Date --- VALIDATION --- Receipt Number: Date Paid: Amount Recei-ved: Received By: 0?a 67 b '(z lrr {(4iz ,/r/r) SPFINGFIELE, Page l- ENGINEERING DIVISION DEVELOPMENT PLAN REVIEW RESIDENTIAL IMPROVED STREET CITY OF SPilNGFIELT', ONEGON Developer: SIERRA BUILDERS Mail Address: 570 PINE CT. CRESWELL OR. 97426 Tax Lot #: L70234LLO4200 Project Address: Subdivision: LEVI LANDING Lot: 10 Blk: .fob No phone #: 5732 SIEMON DR Eng. Rev. No.: .: 9BO7O4 7 448267 Book: Street Gravel Ac 5732 SIEMON DR Existing Curbcut: N EXISTING IMPROVEMENTS Mat Curb Fu11 Imp SW Width Curbsj-de Y 5 FEET 12:1 FLAIRS Setback ENGTNEERING REQUTREMENTS Additj-ona1 Right of Way: fmprovement Agreement : Easements: N N N SAIiIITARY SEWER CALL THE UTILITIES NOTIFICATION CENTER BEFORE YOU DIG 1-8OO-332 -2344 Avai-Iabl-e: Y Size of Line: I Locatj-on From N, Make Connection: Stubbed Out To Property Line: Y Depth: 4-6 In. Tee: 5 In. S, E, W Property Line: AS SHOWN ON DRAWING OR AS-BUfLT PER PLUMBING CODE FT Availabl-e: Y Pipe Downspouts And Drains To Pipe Parking Lot Drainage To: STORU SEWER CURRB & GUTTER N/A SIDEWAIJK AtiID DRIVEWAY INFORMATION New Curbcut Appr.: y STANDARD width: 20 Ft Fl_airs: 5 Si-dewal-k Permit: y Width: 5 Ft Length: 50 Ft Curbcut Permit: Y Width: 32 Ft FT ENCROACHUENT A}.ID ASSESSMENT Encroachment Permit Required: N Sanitary Sewer fn Lieu Of Assessment: N SPECIAI. NOTES ATiID REQUIREMENTS A11 work within the public right of way shal-I be in conformance with the Cityof Springfiel-d standard specifications for construction. A11 existing unused curbcuts or portions thereof sha1l be restored t.o full- curb height as directedby the City. The owner,/developer is responsible to relocate any utilities andestablish private or public easements when t.he util-ities conflict with the dewelopment, at their expense. Reviewed By: DENNIS ERNST Date:06/:-9/98 SEE DR,A'WINGS ON SPECIAL REQUIREMENTS FOR FURTHER IMPORTAI{T INFOR!,IATION l appro?frl. r'^'a.1- AUIHORIZED U NDEB THIS PERMIT SPRINGFIELD, INSPECTION REQTIEST: OFPICE: 726-3759 1 INSTALLATI t ON Permits are non-transferable and expireif vork is not started vithin 1B0 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INST ONLY Electrical Contractor 4 7 Signature sing t ri cian ? D 0vners Name NOTICE: THIS PEFMITSHALL EXPIRE IFTHE ,n",. fl+48{107 PEHrcD. OR ,S ABANDONED r0R Ci ty Job Number 0, COHPLETE PEE SCBEDTILE BELOV (*fi, WORK IS NOI EI,ECTRICAL PERI{IT APPLIcATION Nev Residential-Single orMulti-Family per dvelling unit. Service Included: Items Cost SI>RIh{GFIEL.) 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular 'Dwelling Service or Feeder Services or Feeders Installation, Alterationsor Relocation: 3 A 8I I A 85 ao Sum s 85.00 s 1s.00 s 40.00 ee rrBtt aEove \ B Address 7Z city k hA z/Yz Phone 6 EL-oq/5 Supe / rvisor License Number ./il 9S Expiration Date o consrr conrr. Number €'4//3/ C Expiration Date ?,/Za / /tr Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or less I20L amps to 400 amps -Over 401 to 600 amps -Over 600 amps or 1000 vorfs Branch Circui ts 200 amps or less 201 amps to 400 amps - 401 amps to 600 amps - 601 amps to 1000 amps- over 1000 amps/vo1ts - Reconnect OnIy $ s0.00 s 60.00 s100. 00 s130. 00 s300.00s 40.00 $ s $ s, s 40.00 S a0;00. s 20.0d $ 36.00 g40.00 55.00 80.00 Addr Ci ty OVNER TNSTALLATION The installation is being made onproperty I ovn vhich is not intendedfor sa1e, lease or rent. 0vners Signature: DATE: Nev, Alteration or Extension Per Pane1 One Circuit $ 35.00 Each Additional Circuit or vith Serviceor Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Outline Lighting- Limi ted Energy/Res -Limited Energy/Comm SUBTOTAL OF ABOVE 52 State Surcharge 3Z Administrative Fee a) DDnrrlmn n A/ 5 162.40 JOB No . O,O 7OF ATTACHMENT A CITY OF SPRiNGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME OR COMPANY 1,Betc-rtEtLl LOCATION A7<1tn€aa) Drz DEVTI-OPMENT TYPE BUILDiNG SIZE <.F [2. CI SIZ 0. Ft i SIORM DRAI|IAGE IMPERVI0US S0 FT. ^, <j3 X $0.226 pER SQ. Fr. $ 572,!l.G 2. SANITARY SE:!ER_CIIY NO OF PFU'S ?_o X $.16.86 PER PFU s Q 37, zt> (See Reverse Side) 3. TRANSPORTATiON NO OF UNITS X TRIP RATE X COST PER TRIP X l,ol x $472 49 $ 477, zl x $472 49 x $472 49 4 . SAN ITARY SEWER - Mh;MC Ou'< N0. 0F fftrs x -72.- P ER FEU + $10 I'II^IMC/AD["1 FEE $ 257, Ze MI^J['4C CREDIT IF APPLICABLE (SEE REVERSE)$ TOTAL-MI^II*,1C SDC $ 287,7a SUBTOTAL (ADD iTEMS 1,2,3 & 4) $ 2,274,63sry BASE CHARGE (SUBIOIAL ABOVE) X .05 X X $ $ SDC Coordi nator Date: 6-n*7& T0IAL spc $2FJlJo., I I lr\ t lrr.lL \rrt\aI | lLrrrJL.ra I lfvrl\l (NOTE: For remodels, calculate on' he NET FIXTUBE TYPE Bathtub...... Drinking Fountain. Floor Drain.. lnterceptors For GreaseiOil/Solids; Etc............ lnterceptors For Sand/Auto WashrEtc............ Laundry Tub/Clotheswasher. Clotheswasher - 3 Or More. Mobiie 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, Residerrtial Kltchen....., Urinal, Stall/Wall... Wash Basini Lavatory, Single.. Toiiet, Pubiic installation. Toilet, Private....... Miscellaneous: r AI)LE. Number ot New Fixtures X Unit Equivarent = Fixrure Units additional fixtures) NUMBER OF UN|T F1;TURE NEW FIXTURES EOUIVALENT UNITS z 2_ 2- 2 1 2 .) b i Head 2 6 o 1 3 2 i, 2 2 1 b 4 -r I z- 2- Zd z ? TOTAL FIXTURE UNITS _T CREDIT CALCULATION TABLE: Based on assessed value lf improvements occurred after annexation date in rable, calculate ci'edits se arates Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) (Rate X Assessed Value) XS (Rate X Assessed Value) x $_ CREDIT TOTAL =$ Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per S1,COO Assessed Value 1979 or before 1 980 1 981 1 982 1 983 1 984 1 985 1 986 $ 3.97 3.89 3.83 3.70 3.39 3.20 2.91 1 987 1 988 1 989 1 990 1 991 1 992 1 993 1 994 1 995 1 996 )z.co 2.17 1.73 1.31 o.92 o.74 o.61 0.45 o.31 0.1 7 RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) Fesrden riai. Commerical lndustrial.... Governmental 0.4 0.9 o5 o.5 IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT Willamalane Park & Recreation District SYSTEM DEVELOPMENT CHARGE WORKSHEET Job. No. ' SG-r'r' NAME: ADDRESS: LOCATION OF PROPOSED BUILDING SITE: ressStreet Add Plat Name: 1. DEVELOPMENT TYPE (Check ype definitions are on the back.) A. Single-Family Detached -I Single Family home NO. OF UNITS B. Single-Family Attached NO. OF UNITS C. Multi-Family Apartment NO. OF UNITS Tax Lot Number: dwelling(s). SDC calculations and dwelling t Manufactured home not in a park X $1,000 per unit = $tw)p X $924 per unit X $692 per unit $ $ D. Manufactured Home Park NO. OF UNITS X $699 per unit $ WILLAMALANE SDC 2. SDC CREDff (if applicable) SDOpayer must fumish proof of Willamalane Credit approval. See SOC Credit Worksheet. 3. TOTAL WILLAMALANE NET SDC ASSESSED (lf SDC reduced for Credit) 1000 o0$ $ $ v oo ,1lt lt Date City of pment Se s Department 7tr PHONE: 00A&tt(w00 I CITY OF SPR OREGON' D EV ELOP M ENT S ERVICES DE PARTME NT SPRTNGFIELO ono t 225 FIFTH STREET SPRINGFIELD, OR 974N (s41) 726-37s3 FAX (s41 ) 726-368s NOTICE; THIS AGREEMET{T is entered into thibetveen the City of Springfieg', ahereinaf ter called. City, ind )rOthe Applicant.' VEEREAS, the aDivision for i improvements t Oregon. or vithin the City ,s Assess6i's Hap and Tax Lot nunber rHrs pEHMtT sI{ALL EXpTRE ,F Erffiil(ffiy.id;Ilillr#}?rro, A UTHOR'ZED UNDEH THIS PENilii]Ifrid,Oiiii - iirgii' . COMMENOED OR IS ABANDONFN .""'-' ANY IAO OAY PEflODl'^* s day of co , DfY by andtateE oregon,run rDoraS ,, hereinafter called c pplicant has applied to the City Communi ty Services Building ssuance of certa Lion rmits for devel opment o be located at Springfield, et Coun ty vEEREAS' -the applicant has asked the City to authorize the Applichnt toinnediately commence developmelt inprovements vithout a compiitea plan reviev orsubsequent approvar as required by the springfield Building i"i.iv:coa"-: -- VEEREAST-the Applicant has subnitted to the City a completed perult application,! (three)-sets of 'coirstruct.lon dravings, specificaqioni, and other datl requlredfor the city to conplete the necess"ri if"ii reviev'of the pioposed developmentinprovement. i vHPRpAs, the intendbd development improvement is of a nature that requires noother reviev approval from other State or local irgencies and is'"x"rit from thecriteria established by the Building Safety Divislon, attached as gxilibit A of .this Agreemen t . VHEREAS' the City has not revieved or approved the submitted materials for thedevelopment inprovement, the city is thliefore unable to confi;;-;;-;hir-iii"vhether-the permit applicatic.-: submitted vill- be approved, and vhether therequired construction permits can be issued. SH.EREAS' the.applicant has requested th[: city to .provide expedited authorizationto proceed vith_certain phasei of construction prior to the'completion oi theCity's reviev of the permit application. IItsER{fs,.t1," gity's fee for the administrative services ."nd"rea in providingexpedited iuthorization is 9150.00. NolJr-THEREFoRE, in consideration of the foregoing recitals and of the mutualpronises contained herein, the City authorizEs immediate commenc€ment of thedevelopment improvement specified in the. permit application subject to thefolloving terms and conditions, Authorization to Proceed Agreement Page 2. 1 City agrees that the Applicant may immediate ly commence vi th thedevelopment i mprovements set forth in the permit application.Ci ty, sau thorization to proceed is conditi oned hoveve r, upon Applicant,s agreementthat the pro ject vill be construct ed as set forth in the attached submitteddravings and speci fications , except as may be nodified by City, and villcomplyvith all applicable lavs and ord 1 nances.cant's iurnediateconmencement of coDstnrction is at 1i camt's ovn noassurance or consttllc 2' City agrees !.o reviev Applicant's. pernit application in the normal revievprocess and to thereafter: a) issue Applicant the appropriate construction permits; er b) advise Applicant of deficiencies in the proposed construction vhichmust be renedied before pernits can be issued;'o; - c) advise Applicant of any statutes, ordinances or code provisions vithvhich Appltcant Eust compiy vith betoie-citv can issue ti,;-;;;;i;: -"" 3'. Applicant agrees that if city firg: {Rnlicant,s pernit appllcatlon andsubnitted naterials-inadequate or deficrliri-in any nanner inliuairig.L-ui--notlinlted-tor- the appllcatlon or tt" piopo""i "or,"ti-uctlon do not conpry vithall agnllcable stitutesl- ordlnances' or' code froviii"""r- atiSe"nt vipexpedltloqsly-ctre the deflclencles so irr.i [n. ciiy rniv--iI"u. the requlredpernlts. Shourd Appllcant fatr to-exteditrouiiv "ori.Ii'"i[irtt"a uaterlals,or should comec-t-ion.prove inpossibre, aiit-r"i rn ii;s ai""r"tro"; a;k;;;ior all of the folloviirg actlons, '' - s^cs 1) stoP all further construction of_the project in the tranner prescribed.1l t!:--springfierd Buirding Safety coae iaministrativ. Coa" tglcAci,sEcTroN 201 (d) b) order disconnection of serving utilities in a manner as prescribed inBSCAC, SECTToN 201 (f) c) issue a NoTTCE -l3D o?oER for renoval of all- such ror!: in a panner asprescribed i!-PScAc, sEcrroN 204. ABATEHavT-oF ursiari, -SuisrerqoARD oRDAficERous BurLDrNcs, srRucrrrREs oR BurtorNc ssR\[cE Eouii#G:"ir;;"""receipt of such notice, Applicant "h;irtirreaiateiv ;;;;;;. the vorkspecified in the Notic" "i.,i 0rder. 4' Appricant agrees, if the issuance of the permit is denied: a) to remover dt.the Appricant,s sole cost and expense, arr completedconstruction or irnprovements; and b) to restore the site or structure to it's pre-agreement'"onortion ,nafree of all hazards -- - r' s s6lEsrusrrL t or constnrct Authorization to Proceed Agreement Page 3. 5 Applicant agrees construction vill no ttothat until Appticant,s permit applicatiori is approved, beyond the point of authorizati on approvedby the Ciry,s Building 0 Applican t's Point of Authorization is 6. Applicant agrees thaaccessible and exposed0fficial nor City shall replacement of. any Eate ! "11 vork performed under this agreenent shal1 befgt iTrpsction purposes and that neither the Buildingbe liab1e for the expense entailed in the removal oirial necessary to allov insp-ciion. 7- AppricaTt agT::s rhat-3rI o= arr.deficiencles identlfied during thenecessary inspections v111-be pronptly renedlea, ai ap;ii;t,s sole costand expense before-proceedlng irttht."i ruiit,"i "on"trirltton. appltcani-ii=oasrees that these tnspectroni do not ieprace th;-;;ili;;e-;i.;';;;i;;-nI.-jothey inply any approvir of the subnittei ,.i"ii"r".' 8' Applicant agrees that no vork-shall be done-on any part of the buildlngor structure beyonl !h" polnt indicated ln each succlsiire lnspection e vithout first "irt"inilg ih;--;p;roval of trre-nutlalng offlctal. such approvalshall-be given only afier an iirspectlon tas ueen nade of each successlvestep ln the construction as indti:ated on the attached Exhibit g. 10.Appall licant agrees to defend, indenni ty hold Ci harnless fron inyandcosts (including attorney fees), liabill ty or danages of any kind ornature vhat soever, for personal inJury danage arislng from theAppllcant's early coulencenent of const the vork undertaken orcompleted and. property ruction and 11' The terms of this Agreenent shall extend to and be binding upon theparties he.reto and tireii heirs, successors and assigns L2- rf any suit, action or other pro-ceedingr or an appeal therefrom, isinstituted to obtain, establish,. enfor;;; ;; iomper any right or.obligationresulting from this Agreement, ih. pr.r.iting-paity stratr Ee entitled torecover from the adveise party, in iaaition io'costs and disbursementsr.suchadditional sums as the "oir.ts-,'both t.i.i-.ni apperlate, may judgereasonable attorney fees. lssued. Authorization to Proceed Agreement Page BEToRESIGNINGTHISAGREEMENT,PLEASEREADANDUNDERSTANDTEE MEANINGoFEACEPARAGRAPEoFTHISAGREEMENII.TTAFFECTSYoUR INTERESTSTNTIIEPRoPERTYAND,INTEEEJENToF.DEFAI,I,T,ITPI,ACES YouPERSoNALr,YATRIsxaNo'TTTTSUBJECTPRoPERTYATRISKoF FoREcLosIIRE FoR cosfs A}I, - ExPENsEs INCI,RRED BY :tEE cITy IN ENFORCING TIIE TERUS OF TEIS AGdEEUENT' IN TEE EVE}IIT TEAT YOU DO NOT T'NDERSTAND ANY TERI'IS OR CONDITIONS OF TEIS AGREEI'IENE' PI'EASE SEEK ANY LEGAL OR OUTSIDE OPINIONS YOU I{AY DESIRE' CITY City of SPringfield By: Building official I,A}ID,PROPERTY OWNER (E I TERMS AIID CONDITIONS Business Addres CC Registration # APPLTCANT Contr q4 (- u WE EAVE RE:AD l[EE ABOVE AUSEORIZAUON T'NDERSAAIID WEAT IT EXPRESSES A}ID TEE UPON US AS ![EE IJA}ID /PRoPERrv OIVIIER6 r/wE AGREE ![O BE BOT'![D rO PROCEED AGREEMENE RESPONSIBIIJIIIIES IIT r/wE PI,ACES BY AIJI, a AGREEMElflT Narne Addre VALIDATION: CTTY JOB # RECEIPT NUMB DATE PAID 6 AIJIOUNT REC EIVED bDc /a,ae c-f ozesk Qa/ de. IU 0 ? RECEIVED BY o ,00 Purpose . The purpose of this agreement is to allov'certain development improvements to" occur prior to.obtaining plan reviev approval from the Springfieia C"*rrrityServices Division Scooe The use of this agreement shall be limited to certain one and tvo-familydvellings not complex in nature as determined by the Building 0fficial andninor alterations or modifications to existing tommercial ani industrialbuildings-vhich are of a non-structural"type ind do not advers"rv.iie"i.nystructural'uenbgr of the butlding or any iirt of the building having iii"- ' resistant construction. One and tvo-fanily dvelling plans for structures that are complex in nature thathave been prepared..by an oielon licensed architect or engine"i ."a "s"orp."i"a.by a letter of reviev prepared by said architect or engiieer, stating thlt thesubuitted material is in iompliance vith the one and Tio-Fari1y orefifn!specialty code, nay be considered eligibre for this agreenent. ErHrBfT A The folloving iteos include but are not liuited to certain conditlons ofdevelopnent identified as tneligibre for tliis agrebment: a) developtrent requiring site approvar vhich.has not been obtained; b) nev deveropment located on land vith over six-percent slope; c) lots having expansive (c1ay) soil; d) developnent located vithin flood hazard area.s; . e) developnent located vithin vetland areas; f) pole buildings or other such type of structure that is not of conventionalcons truction. EXHIBIT B Required Iaspectioas To reguest an lnspection, you must call 726'-3769. This La a 24 hour recording. A1!. lnspectlons requested before ?:0O a.m. will be made the same working day, Inspectlons requested after 7:O0 a.m. wtlI be made the following work day. teuporary Electric Slte - To be made after excavatlon, but prlor to settlng forms Footl.ug - After trenches ard excavated Fouadatiou - After formg are erected but prtor to concrete placen€ht Uaderfloo3 tlrrnlrtsg - Prlor to fllIlng trench Uaderfloor Mechanlcal - Prlor to lnsul-atLon or deckl,ng Post & Beaar - PrLbr to floor lnsulatlon or decklng Uaderfloor fasulattoa - Prlor to decklng SanLtary sewer - Prlor to flIllng trench Storn sewer - Prlor to flIllng trench water,Liue - prlor to filllng trench _4 _/ L/ _1 _4 L--'- II.J;J ;llI e / apprwal. 225 FIFTH STR-EET SPRINGFIELD, OREGON INSPECTION REOUEST: 0FFICE: 726-3759 97 1. LOCATION OF TNSTALI,ATTON LEGAI DESCRIPTION+ JOB Add ress Ci ty Phone Supervi*sor License Number Expi:--ation Date Permits are non-transferable and expireif vork is not started vithin 1BO daysof issuance or if vork i.s suspended tor 180 days. 2. CONTRACTOR INSTALLATTON ONLY Electrical Contractor lhe lollowing proieci zoning, and do€e not rcqulre op€cfro lartd oanbnrltted hagttle lollowing SPra .iFIELE, 200 amps or less 201 amps to 400 amps - 401 amps to 600 amps - 60L amps to 1000 amps- Over 1000 amps/vo1ts - Reconnect 0n1y 200 amps''or I 201 amps to 4 Over 40L to 6 0ver 600 amps D. Branch Circui ts u86 ELECTRICAL PERHIT APPLICATION COHPLETE FEE SCEEDI]LE BELOV Nev Residential-Single orMulti-Family per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500sq. ft or portion thereo f Each Manuf,d Home. or - Modular Dvelling Sertice or Feeder s 8s.00 s ls.00 $ 40.00 Services or FeedersInstallation, Alterationsor Relocation: slettd,r. nf4 .-{ ry Job N*b", ?aa)a Y 3 A Sum ON B $ s0.00 s 60.00 s100.00 s130. 00 $300.00 $ 40.00 Constr Contr. Number Expi::ation Date Signature of Supervising ELectrician ovners Name Srefu4 &arb€S Add ress b 7o Ptue cf Ci ty /do4 Y/'txoone OIINER INSTALLATTON The instailation is being made onproperty I ovn r,,hich is not intendedfor sa1e, lease or rent. Temporary Services or FeedersInstallation, Alteration or Relocation C 33'",r. -"'tr13:33 g 00 amps S BO.O0 =-or 1000-vofTs see I'Bt' aEotE- Onners Signature, A zzZzZLZ M*Z Nev, Alteration or Extension per panel One Circui t Each Addi tional Ci rcui t or vi th Servi. ceor Feeder Permi t $ 3s.00 s 2.00 E. Misce1laneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utline Lightirg- Limited Energy/Res - Limited Energy/Comm 5. SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Admini.s trative Fee TOTAL 4ra> $ 40.00 $ 40.00 s 20.00 $ 36.00 DATE: eRECEIVED BY:e /a':- 32 < : ntzz<;a-) Z2ZZt,u'L-