HomeMy WebLinkAboutPermit Building 2004-02-23CITY F
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
S4l-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004
EXPIRESz 0312312005VALUE: $ 45,000.00
SITE ADDRESS: 149f 5th St Springfield TYPE OF WORJ(: Apartment Building
ASSESSOR'S PARCEL NO.: 1703264200800
TYPE OF USE: Alteration Commercial
PROJECT DESCRIPTION: Make apartments #14,15, and 19 ADA accessible.
Owner: MAINSTREAM HOUSING INC
Address: 433 W 8TH AVE APT 001 EUGENE OR 97401
Contractor Type
Architect
General
Electrical
Mechanical
Plumbing
Contractor
BERGSON & DELANEY
MAINSTREAM HOUSING INC
CHRISTENSON ELECTRIC INC
OWNER
TWIN RIVERS PLUMBING
License Expiration Date
156059 07t25t2005
0st0u2007
Phone
s41-683-8661
s41-4844868
541-688-6121
0311u2005 541-688-1444
458
17695
CONTRACTOR INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Sprinkled Building:
O(
-{o$
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
\o Ft Other:
,oo Dl
Load:
REQUIRED PARIilNG
Handicapped:
Compact:
Secondary Construction
# of Bedrooms:
!t'
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
\S(o
Sidewalk Type:
Downspouts/Drains:
Notes:
Paee I of3
r\
\t
Heat:
Type:
w
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-726-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004
EXPIRESz 0312312005VALUE: $ 45,000.00
Description
Estimate
Type of Construction
Estimate
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 45,000.00
Total Value of Project
Amount Paid Date Paid
Value
$45,000.00
$45,000.00
Date Calculated
0u08t2004
Fee Description
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
-Mechanical Issuance Fee-
+ l0o/o Administrative Fee
+ 7o/o Stile Surcharge
Building Permit
Exhaust Hoods
Fixture
Furnace - Unit Heater
PIan Review Fire & Life Safety
Vent Fan
Refund - Admin Fee
Refund - Mechanical
Refund - Surcharge
+ l07o Administrative Fee
+ 7o/o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Copies - Ea Addtl @ 50 Cnts Ea
Copy 6th @ 75 cents
Plan ReviedCom,Ind,Pub Hourly
Total Amount Paid
Receipt Number
2200400000000000016
2200400000000000016
1200400000000000235
120040000000000023s
1200400000000000235
1200400000000000235
1200400000000000235
1200400000000000235
1200400000000000235
1200400000000000235
120040000000000023s
VOUCHER #7316I
voucHER #73161
voucHER #7316r
1200400000000000347
1200400000000000347
r200400000000000347
1200400000000000347
22004000000000013s4
2200400000000001354
22004000000000013s4
$221.91
$136.s6
$10.00
$54.84
$38.39
$341.40
$27.00
$126.00
$36.00
$-136.s6
$18.00
$-3.60
$-36.00
$-2.52
$8.s0
$5.95
$43.00
$42.00
$4.00
$0.75
$45.00
u8t04
1t8t04
2t23t04
2t23t04
2123t04
2t23t04
2t23t04
2t23t04
2t23t04
2t23t04
2t23t04
2t26104
2t26t04
2t26t04
3n9t04
3t19t04
3n9t04
3n9t04
tuU04
tUu04
tUu04
$980.62
tr'ees Paid
Plan Reviews
Initial Review
Planning Review
Public Works Review
0u13t2004
0il13t2004
0y1312004
0u16t2004
0u09t2004 0u1912004 APP LLH Permit taken in under apartment
#19. Changed address to main
address of apartment complex since
job was for 3 different apartments.
NO SDC'S, CREDITS EXCEED
FEES.
JMP left message with Joyce to give
to Eileen Lahey that we still need tht
contractor information.
APP
APP
EMM
SB
0u13t2004 wE JMPStructural Review 0u1212004
Page 2 of3
q
Valuation Descrintion I
Status Issued
225 Fifth Street, Springfield, OR
54l-726-3753 Phone
541-726-3676Fax
541-726-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004
EXPIRESz 0312312005VALUE: $ 45,000.00
Structural Review
SUB Review
09t23t2004 09t23t2004 IO JMP
0ut3t2004 0111612004 APP JF
Chris Kent requested replacement
plans. Called Joyce at Mainstream
Housing and she said to add George
Braddock. Made copies, signed,
stamped, punched, stickered and
called Chris with fees and hours for
pick up.
R-l not considered under
Non-Residential energy code.
To Request an inspection call the24 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. wiII be made the following work
day.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Drywall: Prior to taping.
Finat 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.
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Final Plumbing: When all plumbing work is complete.
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.
nsnections
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 wilt 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 atl 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.
oor
Owner or Contractors Signature
Page 3 of3
Date
225 Fifth Street
Springfield, Oregon 97 477- 541-726-3759 Phone
city of Springfield Official Receipt
;velopment Services Department
Public Works Department
RECEIPT #: 22004000000000013s4 Date: 1,110112004 10:50:26AM
Job/Journal Number
coM2004-00028
coM2004-00028
coM2004-00028
Description
Plan RevieilCom,Ind,Pub Hourly
Copy 6th @75 cents
Copies - Ea Addtl @ 50 Cnts Ea
Amount Due
45.00
0.75
4.00
Item Total:$49.7s
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number IIow Received Amount Paid
CreditCard ROBERT ALVORD jmp 022526 In Person $49.75
Payment Total:
-Sffi
tUt/2004 Page I of I
&Ft*trear*Ltt
SPRINGFIELD
h,
City of Springfr.,ld
Voucher
Report lD : SPRA103
Voucher lD :
Handling Gode :
00073161
RE
Accounting Date :
Vendor Number:
lnvoice Date :
lnvoice # :
Approver:
Operator:
Gross Amount :
Proi/Grant
February 26,2004
0000004386
February 26,2004
coM2004-00028
Puent,David
wrLS5940
42.12
Amount
2.52
36.00
3.60
Mainstream Housing, lnc.
433 West 8th Ave. #1
Eugene, OR 97401
Description
Refund
Account Fund 9gg SubClass BY
215004
425602
426605
821
100
100
2004
2004
2004
Comments:
Express Check
Mechanical refund $36.00/State Surcharge $2.52lAdmin Fee $3.60
Refund Ok'd by Lisa Hopper/l49't sth StreeUCom2OO4-OOO2B
(tny2na'lOoc 2{
(S4HtDlo{g6ggroiect as submitted has the lollowing
';onirit, ani &?es not require specific land use
approval.
Zoning
225 FIFTH STREET . SPRINGFIELD, OR97417 o PII:(541)726-3753 . FAX:
E LE CTRI CAL P ERMIT AP P LI CAT I A N
City Job NumberCOrr?V Date
1.
Itt/fI 9+q >f 1
LEGAL DESCRIPTION
70=z6q OOSDC
JOB D
Xs
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
)
Electrical Conhactor 5',u1/\ ae u
Address D4 [ lleYh el )tt
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 Amps/Volts
Reconnect Only
New Alteration or Extension Per
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
A.
B.
D.
E.
s106.00
$ r9.00
$50.00
$ 63.00
$ 75.00
s125.00
$ 163.00
s375.00
$ s0.00
City
Supervisor License Number
Expiration Date o 0r o{
b-3q L
Expiration Date C)
of Supervising Electrician
Owners Name
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 AmPs $ 69.00
401 Amps to 600 Amps $100.00
Over 600 or 1000 Volts see "B" above.
C.
Panel
1
,13
Address L
Cify w Phone
OWNER INSTALLATTdI$;] T I fi E :
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
TYoState Surcharge
l0% Administrative Fee
TOTAL
$ 43.00
$ 3.00
$ s0.00
s s0.00
$ 2s.00
s 45.00
Y,{
S
COIIMENCED OR I
tl_UZ
h
{
The installation is being
is not intended for sale,
Owners Signature:
*J,ii!1,Priii.dttr,Eu^
teasdlorrr6rrfl, Z t Li U li D
ANY 180 OAY PERIOD
,ZfO
7 L
Inspection Request: 726-3769
Shared Drive(T:/Building Fonns/Electrical Permit Application 1-03'doc
(1n4
& ir,,- Pton" tot? 'G l> I
3r <q
Oreg UI
llino tt
f)
Permit Inspection Fee is $45.00 * Surcharges
+lt_tl\tt-(:rb
IF
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 lnspection Line
PERMIT NO: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004
EXPIRESz 0910412004VALUE: $ 45,000.00
SITE ADDRESS: 149f 5th St Springfield TYPE OF WORJ(: Apartment Building
ASSESSOR'SPARCELNO.: 1703264200800
TYPE OF USE: Alteration Commercial
PROJECT DESCRIPTION: Make apartments #14, 15, and 19 ADA accessible.
Owner:
Address:
MAINSTREAM HOUSING INC
433 W 8TH AVE APT OO1 EUGENE OR 9740I
Contractor Type
Architect
General
Electrical
Mechanical
Plumbing
Contractor
BERGSON & DELANEY
MAINSTREAM HOUSING INC
CHRISTENSON ELECTRIC INC
OWNER
TWIN RIVERS PLUMBING
License Expiration Date
156059
458
17695
07t2st2005
05t0y2007
Phone
s41-683-866r
s41484-4868
s41-688-6121
03/11/2005 541-688-1444
CONTRACTOR INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
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:
Impervious Surface Area:
R-1
\rN
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
)09
REQUIRED PARI(NG
Total:
Handicapped:
Compact:
Streetlmprovements: N0TICE:
storm sewer Availabte' THIS PERMIT
Special Instruction:
e: AUTHoRIZED
COMMENCED
Notes: ANY 1S0 DAY ffi*t#ii:f$r[irsr
Sidewalk Type:
Downspouts/Drains
PUBLIC IMPROVEMENTS
Page 1 of3
I
I'U ILL'II\ U I].\ I L,IUYIA I I(JI\ I
TION:Orego
rt
numberfor
;€
-o01-00
calling the
10 throrrgh OAR 952-00
Building/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: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004EXPIRES: 0910412004VALUE: $ 45,000.00
Description
Estimate
Fee Description
PIan Review Comm/Ind/Public
Plan Review Fire & Life Safety
-Mechanical Issuance Fee-
+ lOoh Administrative Fee
+ 7o/o State Surcharge
Building Permit
Exhaust Hoods
Fixture
Furnace - Unit Heater
Plan Review Fire & Life Safety
Vent Fan
Refund - Admin Fee
Refund - Mechanical
Refund - Surcharge
+ l0o Administrative Fee
+ 7o/o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Total Amount Paid
Type of Construction
Estimate
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 45,000.00
Total Value of Project
Amount Paid Date Paid
Value
$45,000.00
$45,000.00
Receipt Number
2200400000000000016
2200400000000000016
1200400000000000235
1200400000000000235
1200400000000000235
1200400000000000235
1200400000000000235
r200400000000000235
1200400000000000235
1200400000000000235
1200400000000000235
VOUCIIER #7316I
voucHER #73161
voucHER #73161
1200400000000000347
1200400000000000347
1200400000000000347
1200400000000000347
Date Calculated
0u08/2004
$221.91
$136.s6
$10.00
$54.84
$38.39
$341.40
$27.00
$r26.00
$36.00
$-136.56
$18.00
$-3.60
$-36.00
$-2.52
$8.s0
$5.9s
$43.00
$42.00
U8t04
u8t04
2123t04
2t23t04
2t23t04
2t23104
2t23t04
2t23t04
2t23t04
2t23t04
2t23t04
2t26t04
2t26t04
2t26t04
3n9t04
3fi9t04
3n9104
3fi9104
$930.87
Fees Paid
Plan Reviews
Initial Review
Planning Review
Public Works Review
Structural Review
0u1312004
01n3t2004
EMM
0u0912004 0111912004 APP LLH Permit taken in under apartment
#19. Changed address to main
address of apartment complex since
job was for 3 different apartments.
NO SDC'S, CREDITS EXCEED
FEES.
JMP left message with Joyce to give
to Eileen Lahey that we still need the
contractor information.
R-l not considered under
Non-Residential energy code.
APP
APP SB
0u12t2004 0u13t2004 wE JMP
APP JFSUB Review 0u13t2004 0U1612004
Paee 2 of3
LLi
Valuation Description
0u1312004
0yt6/2004
F'IELD
Building/Combination Permit
F
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004EXPIRES: 0910412004VALUE: $ 45,000.00
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.
6
4
5
I
8
9
3
7
,|
10
11
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Drywall: Prior to taping.
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.
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Final Plumbing: When all plumbing work is complete.
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.
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 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 Date
Paee 3 of3
-:
T
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
.f City of Spriagfield Official Receipt
Development Services Department
Public Works Department
ate:8:13:32AM
coM2004-00028
coM2004-00028
coM2004-00028
coM2004-00028
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7%o State Surcharge
+ l0o/o Administrative Fee
Item Total:$99.45
43.00
42.00
5.95
8.50
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check MAINSTREAM HOUSING INC djb 61173 In Person
Payment Total:$99.4s
$99.4s
isffiffi{}"
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: COM2004-00028ISSUED: 02/23/2004APPLIED: 01/0812004EXPIRES: 0812312004VALUE: $ 45,000.00
SITE ADDRESS: 1491 5th St Springfield TYPE OF WORK: Apartment Building
ASSESSOR'S PARCEL NO.: 1703264200800
TYPE OF USE: Alteration Commercial
PROJECT DESCRIPTION: Make apartments #14, 15, and 19 ADA accessible.
Owner: MAINSTREAM HOUSING INC
Address: 433 W 8TH AVE APT 001 EUGENE OR 97401
Contractor Type
Architect
General
Electrical
Mechanical
Plumbing
Contractor
BERGSON & DELANEY
MAINSTREAM HOUSING INC
CHRJSTENSON ELECTRIC INC
OWNER
TWIN RIVERS PLUMBING
License Expiration Date
156059 07t25t200s
05t0U2007
17695
Phone
541-683-8661
541-484-4868
541-688-6r21
03/11/2005 541-688-1444
4s8
CONTRACTOR INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
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:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Yo ofLot Coverage:
R-l
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
follow rulsadopted bY the Oregon
Those rules are set forth
0through oAR952-001-
copies ol tho rul€s by
calling the center . (Note: the telePhone
number forthe Oregon Utility Notification
VN
to
Street Imorovements:
storm su,n"""#,flil9f t
specia, r..,"**f,#ri,,#trf,[it
!.
Ix d{d, #Notes: CQMM
ANY 1B
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Page I of3
Center is 1-800-332 -2*11
T
ItUIL-l-rll\t, Il\-l] tTI(lYIA I t(J1\ |
F
Building/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: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004
EXPIRESz 0812312004VALUE: $ 45,000.00
Description
Estimate
Tvpe of Construction
Estimate
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 45,000.00
Total Value of Project
Amount Paid Date Paid
Value
$45,000.00
$45,ooo.oo
Date Calculated
01/08/2004
Fee Description
Plan Review Comm/Ind/?ublic
PIan Review Fire & Life Safety
-Mechanical Issuance Fee-
+ l0Yo Administrative Fee
+ 7o/o State Surcharge
Building Permit
Exhaust Hoods
Fixture
Furnace - Unit Heater
Plan Review Fire & Life Safety
Vent Fan
Total Amount Paid
$221.91
$136.s6
$r0.00
$54.84
$38.39
$341.40
$27.00
$126.00
$36.00
$-136.s6
$18.00
u8104
u8t04
2t23t04
2t23t04
2t23t04
2t23tO4
2t23t04
2t23t04
2t23t04
2123t04
2t23t04
Receipt Number
2200400000000000016
2200400000000000016
r200400000000000235
1200400000000000235
120040000000000023s
1200400000000000235
1200400000000000235
120040000000000023s
r20040000000000023s
120040000000000023s
120040000000000023s
$873.54
E'ees Paid
Plan Reviews
Initial Review
Planning Review
Public Works Review
Structural Review
SUB Review
0U1312004
0u13t2004
0u1312004
0u16t2004
0y09t2004 0u1912004 APP LLH Permit taken in under apartment
#19. Changed address to main
address of apartment complex since
job was for 3 different apartments.
NO SDC'S, CREDITS EXCEED
FEES.
JMP left message with Joyce to give
to Eileen Lahey that we still need the
contractor information.
R-l not considered under
Non-Residential energy code.
EMM
0u1212004 0u13t2004 WE JMP
0u1312004 0U1612004 APP JF
APP
APP SB
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
wilt be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
Paee 2 of3
Valuation Descriotion I
Building/Combination Permit
Status Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00028ISSUED: 0212312004APPLIED: 01/0812004EXPIRES: 08/2312004VALUE: $ 45,000.00
1 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
2 Drywall: Prior to taping.
3 Final Fire Department. After all requirements of the Fire Department have been met.
4 Final Building: After all required inspections have been requested and approved and the building is complete.
5 Rough Plumbing: Prior to cover and including required testing.
6 Shower Pan. Prior to covering and including required testing.
7 Final Plumbing: When all plumbing work is complete.
8 Rough Mechanical: Prior to Cover
9 Final Mechanical: When all mechanical work is complete.
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 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
during construction.
or Contractors Signature , ,
Ma,ntfrs^'A tfu 3,^5 fuA
Date
.6,
Paee 3 of3
fT. l
Keourreo InsDectlons
coM2004-00028
AQUARIUS I APARTMENTS
JOURNAL ORJOB NUMBER
NAMEORCOMPANY:
LOCATION:
MAP & TAX LOT NUMBER:
DEVELOPMENT TYPE:
l49t sTH ST
t7 0326 42 00800
1
$
$
$
$
$
$
#Dtv/o!
#Dtv/o!
NE
NEW DEVELOPED AREA (S.F.):
EXSTING DEVELOPED AREA (S.F.):
TOTAL IMPERVIOUS SURFACE (S.F.):
I. STORM DRAJNAGE
IMPERVIOUS SQ. FT,
2. SANITARY SEWER-CITY
A. REIMBURSEMENT COST:
NUMBEROFDFU's
B. IMPROVEMENTCOST:
NUMBEROFDFU's
(SEE REVERSE SIDE)
LOW RISE APARTMENT REMODEL
x $ 0.290 PER SF
-3
-3
ITE:
LOT SrZE (S.F.):0
TOTAL STORM DRAINAGE SDC:
ITE
3. TRANSPORTATION
BLDG AREATGSF xTRIP RATE xCOST PERADT XNEWTRIP FACTOR
NEW
A. REIMBURSEMENT COST:
0.00 x 6.59 x $ 17.23 PER TRIP x
B. IMPROYEMENTCOST:
0.00 x 6.59 $ 76.0I PER TRIP x
E>(STING
A. REIMBURSEMENT COST:
0.00 x 0 $ 17.23 PER TRIP x
B. IMPROVEMENTCOST:
0.00 x 0
4. SANITARY SEWER - MWMC
NEW:
A. REIMBURSEMENTCOST:
NUMBEROFFEU.S
B. IMPROVEMENTCOST:
NUMBEROFFEU's
E)ilSTING:
A. REIMBURSEMENTCOST:
NUMBEROF FEU's 0.00
B. IMPROVEMENTCOST:
NLMBEROFFEU's 0.00
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
NTF
NTF
NTF
$ 76.01 PERTRIP X O NTF $
TOTAL TRANSPORTATION REIMBURSEMENT SDC:
TOTAL TRANSPORTATION IMPRO\EMENT SDC:
TOTAL TRANSPORTATION SDC
0.00 x $269.68 PER FEU $
0.00 x $I83.62 PERFEU $
x
x $ 22.64 PER DFU
x $ 17.21 PERDFU
TOTAL LOCAL WASTEWATER SDC
$O.OO PERFEU
0x
x
x
x
$
5. ADMNISTRATI\TE FEES:
BASE CIIARGE (SUBTOTAL ABOVE)
Stevew W . BeavLdrg BaYwes U16t2004
$O.OO PER FEU $
TOTAL MWMC REIMBURSEMENT FEE:
TOTAL MWMC IMPROVEMENT FEE:
MWMC ADMINISTRATIVE FEE:
TOTALMWMC SDC:
SUBTOTAL (ADD ITEMS I,2,3, & 4)$
x 50
TOTAL TRANSPORTATION ADMINISTRATION FEE
TOTAL SEWER ADMINISTRATION FEE
$
$
$
$
)
c8R9o6P-B&?d)dfr9ftrus Aprs, 14s1 srH sr.*rs DArE
TOTAL SDC CHARGES
JULY 2OO1
ATTACHMENTA
CITY C. ,,RINGFIELD SYSTEMS DEVELOPMENT CHARGE J(SHEET
:$
1070
l09l
fi92
r07$
1079
DRAINAGE FIXTIIRE UNIT (DFU) CALCTJLATION TABLE
NUMBER OFNEWFD{TURES x UNIT EQUTVALENT: DRAINAGE FXTLIRE UMTS
(NOTE, FOR REMODELS, CALC
IIT "#ffi
FIXTURE TYPE NEW OLD UNITS
TOTAL DRAINAGE FXTURE UMTS:-3
+EDU (Eouivalent Dwellins Unit) is a discharse eouivalent toa sinsle familv (20 DFLI) set at 167 gallons per day
-93
0
3
I
3
3
6
2
3
6
t2
I
3
2
2
3
2
2
I
5
6
3
0
0
0
0
0
0
0
0
63
0
0
0
0
0
0
0
0
0
0
0
CREDIT CALCULATION TABLE: BASED ON ASSESSED VAIUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCIILATE CREDITS SEPARATELY
YEAR
ANNEXED
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFTER ANNEXATION DATE)
RATE PER $I,OOO
ASSESSED VAL
2.06
1.64
1.45
l.3l
1.13
0.97
0.82
0.63
0.41
0.22
0.04
$0.00
$
$
$
$
$
$
$
s
$
$
$
x
x
RATE PER $1,OOO
ASSESSED VALT]E
YEAR
ANNEXED
1979
1980
l98l
1982
I 983
1984
1985
1986
1987
1988
1989
or before $ 4.92
$ 4.83
$ 4.77
$ 4.64
s 4.47
$ 4.30
$ 4.09
$ 3.78
$ 3.41
$ 2.98
$ 2.s2
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
$0.00
$0.00
COM2004-00028, AQUARIUS APTS, 1491 5TH ST.xls
CREDIT TOTAL
BATHTTIB
DRINKING FOUNTAIN
FLOORDRAIN
INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC.
INTERCEPTORS FOR SAND/ALIO WASH/ETC.
T-AUNDRY TUB
CLOTHES WASHER/MOP SINK
CLOTHES WASHER - 3 OR MORE (EA)
MOBILE HOME PARK TRAP (I PER TRAILER)
RECEPTOR FOR REFRIGERATOR/WATER STATION/ETC.
RECEPTOR FOR COMMERCIAL SINK/ DISHWASHER/ETC.
SHOWE& SINGLE STALL
SHOWER. GANG (NUMBER OF HEADS)
SINK: COMMERCIAL, RESIDENTTAL KITCHEN
SINK: COMMERCIALBAR
SINK: WASH BASINiDOUBLE LAVATORY
SINK: SINGLE T-A,VATORY/RESIDENTIAL BAR
URINAL, STALI-/WALL
TOILET, PUBLIC INSTALLATION
TOILET, PRIVATE INSTALLATION
MISCELI-ANEOUS:
NUMBER OF EDU'S*
JULY 2OO1
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City o( Springfield Official Receipt
Development Services Department
Public Works Department
Receipt #: 1200400000000000235 Date: 0212312004 10:20:46AM
coM2004-00028
coM2004-00028
coM2004-00028
coM2004-00028
coM2004-00028
coM2004-00028
coM2004-00028
coM2004-00028
coM2004-00028
Exhaust Hoods
Furnace - Unit Heater
Building Permit
-Mechanical Issuance Fee-
Vent Fan
+ 7Yo State Surcharge
Fixture
+ lDYo Administrative Fee
Plan Review Fire & Life Safety
27.00
36.00
341.40
10.00
18.00
38.39
126.00
54.84
(136.56)
Item Total:$515.07
Payments:
Type of Payment Paid By Received By
Check Number
Batch Number Authorization Number How Received Amount Paid
Check MAINSTREAM HOUSING INC dIM 6l138 In Person
Payment Total:
$515.07
$s1s.07
(