HomeMy WebLinkAboutPermit Building 1999-07-13SPR!ITIGFIELD
RESIDENTIAL PERMTT APPLICATION
CITY OF SPRINGFIELD
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
Page 1
Job Nurnber: 990843
725 -37 s9
726 -37 69
225 North Fifth Street
Springfield, OR 97477
Location of Proposed Work: 2290 33RD ST
Assessors Uap #z L7O2L943
Lot: 34 Block:
office
Inspection Line
Tax Lot #: 03400
Subdi-vi-sion : AMBLESIDE
Owner: SCOTT CARLSON
Address: 1-230 E 19TH AVENUE
Describe Work: S.F. RESIDENCE
Phone #: 484-9285
clty/state/zip: EUGENE, oREGON 974O3
NEW
General:
Plumbing:
Mechanical:
Electrical:
Contractor
SCOTT CARLSON 0012491.
1230 E 19TH EUGENE OR 974030000
MCM]CHAEL PLUMB OO28832
40108 BOOTH KELLY RD SPRINGFIELD OR
MARSHALLS OIL OO2579O
4110 OLUVIPIC ST SPRINGFIELD OR 9747
L & E 0083195
ConsE.
Contractor #Expires
03/20/o0
oe/2L/ee
t2/23/ee
os/L4/oo
Phone
484 - 9286
7 44 - 9099
747-7445
579-7L35
QUAD AREA: 3RNC
# OF UNITS: 1
CONSTR. TYPE: VN
SECONDARY HEAT: FP
fNSUL PATH: P1
OFFICE USE --
LAND USE: 1111
ZONING CODE: LDR
# OF BDRMS: 3
WATER HEATER: G
SQ FOOTAGE: 2597
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: FG
RANGE: E
To request an inspecEion, call- the 24 hour recording aL 726-3759.
A11 inspections requested before 7:00 a.m. will be made the same working day,
inspections request.ed aft.er 7:00 a.m. wil-l be made the following work day.
--- REQUTRED TNSPECTTONS ---
SITE - To be made after excavation but prior to setting forms.
FOOTING - After trenches are excavated.
FOITNDATION - After forms are erected but prior to concrete placement
ITNDERFLOOR PtITMBING - Prior to insulation or decking.
ITNDERFLOOR MECHAIiIICAL - Prior to insulation or decking.
ROUGH cAS - after line is installed and capped if not attached to an
appliance
POST At{D BEA.trI - Prior Eo floor insulation or decking.
fNSULATfON - Floor; prior to decking Wa1l/Ceiling; Pri-or to cover
WATER LINE - Prior to filling trench.
SATiIITARY SEWER LINE - Prior to fi]ling trench.
STORM SEWER LINE - Prior to filling trench.
ITNDERFLOOR DRAIN - Prior to cover or placement of concrete.
ROUGH PLITMBING - Prior to cover.
ROUGH ITIECIIAIiIICAL - Pri-or to cover.
ROUGH ELECTRICAL - Prior to cover.
ELECTRICAL SERVICE - Must be approved to obtain permanent power.
SHEAR WALL NAILING - Before covering sheaLhing with finish materials
FR.AITIING - Prior to cover.
INSULATION - Ffoor; prior to decking wa1l/Ceiling; Prior to cover
DRYWALL - Prior to taping.
CURBCUT - After forms are erected but prior to placement of concrete
SIDEWALK - After excavation is compleLe, forms and sub-base material
in p1ace.
SP]IINGFIELE!
.Iob Number: 990843
SPruNGFIELD,a
Page 2
FINAL PLIndBINc - When all plumbing work is complete.
FINAT MECHAI{ICAL - When all mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is complete.
GAS SERVfCE - After line is installed and line has been connected to a
minimum of one appliance. Pressure test done at this point.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Faces: E
Topography: 2
Lot Type: INTERIOR
House
Garage
Lot Sq. Ft.: 7316
Tota1 Height: 25
LoL Coverage: 20.6 %
Solar Approved: Y
N
5
Setbacks
SW
5
7
E
19
Item
Main
Garage
PORCH
Total Va]ue
Building Permit Fee
Surcharge/admin
TOTAL FEE
--- BUILDING PERMIT ---
Square Feet x
2091
500
$/Square Feet
69 .54
18.34
(A)
Val-ue
145, 035.00
9, 170 . 00
0.00
155, 205 . 00
559
44
00
72
603.72
--- PLIIMBING PERMIT ---
Item
Residential Bath (s)
Plumbing Permit
Surcharge/aamin
TOTAL CHARGE
J
Fee
L92 .50
L92 .50
15.41
(c)207.9L
--- MECHA}iIICAL PERMIT ---
Furnace
Exhaust Hood
Vent Fan
Dryer Vent
GAS LrNE s,. W/H
GAS F. P.
Mechanical PermiL
Issuance
Surcharge/admi-n
TOTAT PERMIT
4
5.00
4 .50
12.00
3.00
5.00
4.50
(D)
35.00
10.00
2.BO
47.80
--- MISCEI.I,ATiIEOUS PERMITS ---
Surcharge/admin
Sidewalk
Curb Cut
WILLAMALANE SDC
CITY SDC
TOTAL MISCEI,I,ANEOUS PERMITS
0.00
50.00
50.00
1, 000 . 00
2 , 442 .03
3 ,562 . 03
Ttul Eb4rc*L
(E)
24, oe
(Excluding Electrical )
unlegs otherwise noted
.. - TOTAIJ AMOI'NT DUE - - -
(A, B, C, D, and E combined)4 , 42L.45
43,"
SPFI]t'GFIELD
Job Number: 990843
SPruNGFIELT',
Page 3
--- BUILDING VALUE, PLAIiI CHECK AND BUILDING PERMIT ---
This permit is granted on the express condition that the said construction
sha11, in all respects, conform to the Ordinance adopted by the City of
Springfield, including the Development Code, regulating the construction and
use of buildings, and may be suspended or revoked at any time upon violation
of any provisions of said ordinances.
Pl-an Check Fee: 363.35 Date Pai-d:
Received By:
Plans Reviewed By: DON MOORE Date:
Building Site Reviewed By: LISA HOPPER
06/21,/ee
o7 /L2/ee
Receipt Number: 34547
--- ADDITIONAL COMMENTS
A & T NOT LISTED IN COUNTY SYSTEM AS OF 5/28/99
PROPERTY EXEMPT FROM SOLAR RQMNTS PER S. SUMMERS
PATH 1; SEPARATE ELECT. PERMIT IS REQUIRED
ENGINEER APPROVAL FOR SITE IS REQUIRED
DRIVEWAY REQUIRED TO BE PAVED
2 STREET TREES REQUIRED
By signaEure, 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 f further certify that any and all work performed
shal1 be done in accordance with the Ordinances of the Ci-ty of Springfield,
and the Laws of the State of Oregon pertai-ning to the work descri-bed herein,
and that NO OCCUPANCY will be made of any sLructure wlthout permission of the
Community Services Division, Building Safety. I further certify that only
contracLors and employees who are in compliance with ORS 701.055 will be
used on this project.
I further agree to ensure that alf required inspections are requested at the
proper t.i-me, thaL each address is readable from the street, that the permit
card is located at the front of the propert.y, and the approved set of plans
will remain on the site aL aff times during construction.
/3
ture Date
--- VAIJIDATION ---
Receipt Number:
Date Paid:
Amount Received:
Received By:
<y' sro
z/t s /rr
.6a
a
,
CITY OFSPB OREGO'U
approval.
Zoning
-t
225 FIFTE STREET
Date
SPRINGFIELD, OREGOT{u9flr4}? Sisnature
INSPECTION REQIIESTz 726-3769
oFPICE: 726-3759
<Y-'
1. LOCATION OF INST
t2
LEGAL
JOB ON
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI..ATTON ONLY
Electrical Contractor
Address
Ci tv Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Name
'Address /23 !-t-,/7b
ci Phone hy'-7zea
SPT FIELO
BLEGTRICAL PBRHIT APPLICATION
Ci ty Job Number
COHPI.,BTE FEE SCBEDIILE BELOIJ
Nev Residential-Single or
MuIti-FamiIy per dvelling unit.
Service Included:
I tems Ccs t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home- or
Modular Dve1ling
SerVice or Feeder
s 85.00
s 1:,.00
s 40.00
The lollowing proiect as submitted has the tollowing
ionins, ,no-,joei not require specific land use Qfr,
v>(>
3
A
Sum
B. Services or Feeders
InstaIlation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs __40L amps to 600 amPs _
601 amps to 1000 amPs-
Over 1000 amps/volts
-
Reconnect OnlY
C
$ 50.00
s 60.0c
$1Oo.0o
s130.00
s300.00s 40.00
Temporary Services or Feeders
Insiallation, Alteration or Relocation
200 amps''or Iess l/
201 amps to 400 amps
-
Over 401 to 600 amps
0ver 600 amps or lOOOEft
Branch Circuits
00
00
00
4(l
55
80
$
$
sss
fu*
D.
ee; ..Brr a56iE
Nev, Alteration or Extension Per Panel
$ 3:i.00
$ 1.oo
One Circuit
Each Additional
Circuit or vith Service
or Feeder PermitOITNER INSTALI,ATION
The installation is being made on
property I ovn vhidh is not intended
for sale, Iease or rent.
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
S
Sidr/OutIine-Lighting-T $
l,imi ted Energy/Res S
Limited Energy/Comm S
4$.00
40.00
2{).00
36.00Omers
DATE:
5. SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTALRECETVEDB
ture:
oo
3 q t
fris.
JouRNAt oR JoB No. Wo643
c r ry 0F s pn r r're r I E Lf;rr#|Til,"
orrr
r,o pM ENr .HARG E
WORKSHEET
NAME OR COMPANY 5a,7f C*nt5oN
LOCATION:2 790 33zn 3T
DEVELOPMENT TYPI
BUILDING SIZE SIZ
1. STORM DRAINAGE
IMPERVIOUS SQ. FT
2. SANITARY SEWER_CITY
NO. OF PFU'S 23
(See Reverse Side)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X t,c:t X$475.32
x $475.3?
4. SANITARY SEWER.MWI.4C
A. REIMBURSEMENT COST
N0. 0F FEU'S t X tzz.++ PER FEU
B. IMPROVEMENT COST
Ft.
x $0.227 PER SQ. Fr. $ +5t ,gG
X $47. 14 PER PFU $ /,o Ez . zz--
$ 4fto. o7
$ 277, Hl
$ zf, zo
$X
NO. OF FEU'S X z<,zc-.,PER FEU
Mt,Jl"lC CREDIT IF APPLICABLE (SEE REVERSE)
I"ll^lMC ADMINISTRATIVE FEE
SUBTOTAL (ADD iTEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES:
BASE ABOVE) X .05
SDC Coordi nator
ATTACH'4. hIPD
TOTAL-MI^J['4C SDC
$ 10.00
$ 3 aq,41
$ is -<.71
$ tlG Zq
Date: 6-zq-qq
TOTAL SDC $ Z.142,03---7-
tqq
FIXTURE UNIT CALCULAIION TABLET Number or New Fixtu' - X Unit Equivatent = Fixture units
(NOTE: For remodels, calculate only
FIXTURE TYPE
NET additional fixtures)
NUMBER OF
NEW FIXTURES
3
3
Bathtub.....
Drinking Fountain.
Floor Drain. ..........:.....
lnterceptors For Grease/Oil/Solids/Etc...............
lnterceptors For Sand/Auto Wash/Etc...............
Laundry Tub/Clotheswasher......
Clotheswasher - 3 Or More.....
Mobile Home Park Trap (1 Per Trailer)......
Receptor For Refrigerator/Water Station/Etc......
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Sta11.....r....
Shower, Gan9.........
Sink: Bar, Commercial, Residential Kitchen........
Urinal, Stall/Wall..
Wash Basin/Lavatory, Single........
Toilet. Public lnstallation.
Toilet, Private.......
Miscellaneous:
UNIT
EOUIVALENT
FIXTURE
UNITS
la
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
TOTAL FIXTURE UNITS 2:<-------------)-
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits separates.
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
O.Lt 3, l{
(Rate X Assessed Value)
(Rate X Assessed Value)
CREDIT TOTAL
X $ /Cacsct
$3 , /5-
Year
Annexed
Rate per $1,OOO
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
1979 or before
1 980
1 981
1982
1 983
1 984
1 985
1 986
1 987
1 988
$4.27
4.18
4.12
3.99
3.83
3.68
3.48
3.1 8
2.82
2.42
1 989
1 990
1 991
1 992
1 993
1 994
1 995
1 990
1 997
$1.98
1.55
1.15
o.96
o.B3
0.67
o.52
o.38
o.21
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
Residential.
Commerical..........
lndustrial...
Governmental.......
o.4
0.9
o5
o.5
FIXUNIT.WPD IMPERVIOUS AREA = TOTAL LOf SIZE X RUNOFF COEFFICIENT
I
Willamalane
Park & Recreation District Job. No.
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME PHONE:
ADDRESS:STATE:
LOCATION OF PROPOSED BUILDTNG SITE:
Street Addre &
Plat Name:Tax Lot Number:
1. DEVELOPMENT TYPE (Check appropriate dwelting(s). SDC calcutations and dwelling t
ype definitions are on the back.)
A. Single-Family Detached
I Single Family home__<_Manufactured home not in a
NO. OF UNITS X $1,000 per unit = $
B. Single-Family Attached
NO. OF UNITS X $924 per unit = $
C. Multi-FamilyApartment
NO. OF UNITS
vn
g)
D. Manufac'tured Home Park
NO. OF UNITS X $699 Per unit
WILLAMALANE SDC $
2. SDC CREDTT (if applicable) SDCpayer must fumish proof of
Willamalane ireait approval. See SDC Credit Wotksheet- $
3. TOTAL WILLAMALANE NET SDC A,SSESSED
(i( SDC reduced for Credit)$tcOD a)
Ir
$
Se
City of Springfield
= I tJLt 7:Datb
.oo
X $692 per unit = $
-
(
b
)
MORTIER
ENGINEERING, P.C.
1 245 PEARL STREET
EUGENE, OREGON 97401
PHONE (541) 484-9080. FAX (541) 484-68s9
STRUCTURAL
BUILDING DESIGN . FIRE PROTECTION
CODE CONSULTANT. PLAN CHECKING
CONSTRUCTION INSPECTION
July 14, 1999
Scott Carlson Construction
r230E. t9.d,
Eugene, OR 97403
RE 2290 33'd Street. Springfield. OR (Ambelside Meadows - Lot #34) - Excavatron, Fill and
Compaction lnspection - W.O. # 11962
As you requested, an inspection has been made during the performance of the excavation and
placement of gravel fill on this site in preparation for the construction involving foundation I'or the
proposed residence. The excavation involved removal of surface organic soil and othe r unsuitable
material and the placement of 6" minimum of 3/4" rninus crushed rock in accordance with our
standard procedures. Pelimeter drains to connect to drainage swale behind house. The compacted
surface of the crushed rock is adequate for a foundation bearing capacity of 1000 psf, which is
adequate to support the proposed conventional wood frame residence. The compaction of the gravel
surface is greater than957o of a standard proctor per ASTM D698-91. (See attached data sheet).
I hope you find this report adequate for your purposes at this time. Thank you for this oppor-tunity
to be of service. If you have further questions, please do not hesitate to contact me at 484-9080.
Very truly yours,
Eryires:6-30- ot
1
Owen Grover P.E.
TJiWmm
-r.
MORTIER
ENGINEERING , P.C.
. 1245 PfiA,RL STREET
EUGENE. OREGON g/4OI
PHONE (541) 484-90S0 . FAX (541) 484-6859
STRUCTURAL
BUILDING DESIGN . FIRE PROTECTIoN
CODE CONSULTANT. PLAN CHECI(NG
CONSTRUCTION INSPECTION
Per ASTM D 1556
TESTNITMBER: I oArEoFrESr: 7/l+/11
rEsr LOCATIoN: TESr BY: f fln
no&f,.r"e?r#*I,;uarobscrvarion): t - ,a;;;' 'Vl,iin*e
Lr-^ sr,, ,t ),p r tn1f,el{ ,t
uNIT \\'EIGII'r or- sAND usED pott hltts sV^l l't.t'
FIBLD I.INIT WEIGHT - SAND CONE METHOD
w.o.# tl l6Z- p5&
't i' t/
Ps (sa.d) =7i; f,,a-l
I
\/OLUME OF CONE 1\rr) = 0.0389 ft"3
I\{OISTURE CONTEN T d
FIELD TEST DATA
Ini(ial \\/eigh( of Jar + Sand (\\'r)
\\'eight of Jar + Sand a[(cr test (Wz)
Volumc of hole r\Yr-Wz -Vt = Vz
I\{oist unit rveigh( of soil pm = Wr = f' {, 3O,7"
Vz
I\{oisture conten( oI soi[,
\\'7o = (rvcigh{ moist) - (rveight drl') X I00
(rvcight dry)
Dr1' Uni( \\'eigh( of Soi[ Pa :P
1 + \\/%
100
{o Z
0.01 17{+"
a
Jt
o
rveigtrt of jar net rveight
\Yet rveigh(
Drl,rvcigh(
No(cs:
lo o l5,A,z.
llz uof
I
llY ,oi
t
ryWW
-flINGFIELO
approval
225 FIFTE STREET Zoning
sPRrNGFrEl,D, oREGoN 97 477
INSPECTION REQTIEST:
OFFICE: 726-3759 AuthorizedSignature
1. LOCATION OF
o
IJGAL DESCRIPTIONlrztf/3 03vob
JOB DESCRIPTION
s. f.R,
The tollowing proiect AS submitted has the lollowlng
zoning, and does not require specilic land use
LD ELECTRICAL PERHIT APPLICATION
City Job Nunber f'?o rq3
3. COHPIJTE FBE SCBSDTILE BELOV
A Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
Sum
I g Bs. oo ff*
. sq. ft or portion D/thereof I
WORK Each Manuf'd Home. or
-
$ 1s.oo ( o
Erectricar conANX"lPS
e and expire
<A(
Address
Ci ty Phone ffiq - qL{gr+
Supervisr:rr License Number
Expiration Date
Constr Contr. Number 5t{
Expiration Date (2
Signa ture of Su pervising Electrician
0vners Name {c, 17 '- /s,o-,t
Address l2lO t1 ."/
Ci ty El^ 9/-r.Phone q?rt f
OgIIER INSTALI,ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
0vners Signature:
DATE:
ENOT Modular Dvelling
$ 40.00Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
20L amps to 400 amps
-40J. amps to 600 amps _601 amps to 1000 amps_
Over L000 amps/volts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000-l6Tts
I,D
Branch Circui ts ; ..
Nev, Alteration or Extension Per Pane1
one(circuit $ 35.00
Each'AdditionalCircuit or vith Service
or Feeder Permit
-
$ 2.00
Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/0utline Lighting_
Limited Energy/Res
Limited Energy/Comm
FOB
B
r
s s0.00
s 60.00
s100.00
s130.00
s300.00s 40.00
C
s
$
$
s
s 40.00
$ 40.00
$ 20.00
$ 36.00
40.00
55.00
80.00
ee rrBrr aE6E
D
SUBTOTAL OF ABOVE
1f/ State Surcharge''32 Admini.strative Fee
TOTALRBCEIVED
(tr (1
5
.-e/75
/(). /i'.q.zf
lJ-7. st
t
Permi ts areif vork is
of issuance
180 days.
2
ti('1 L{ -s
-1 c;
This permit is required for any site activity in the flood plain and eve
fifty (50) cubic yards of material or more and/or if a drainageway is
rrywhere
affe'Lted,
SideThis BeTo OutFilled by
site alteration consists of
within City limits and
,'r)ity pf Springfield'
3
Permit Expiration DateLTqar
4t/
Date of Application
Property Owner
Address :
i 230
Site Address Springfield, Oregon
State
C-a-f ra-rn-
2Z{o *Arrl
/7-02-/7 -49
Journal number applicablo Land Use Appllcati
Tak Lot:31@
on
tr ucB Tax Map No
Suoolier ; Mate&
tr
Phone
Project Supe rvrsor
al
Sourcg Location
Destination:
GRADING, Ouantity
tr FILL, ouantity
EXCAVATION, Ouantity
Supplier:
Address
E(
tr
tr
tr
tr
tr
SITE PLAN Reouired Oata:Ouantity of matorial, Property lines and .descriptions, Tax.map and
lot number, Site address, Existing contour lines, Propo-sed contOur lines, tsxlstlng gralnage
*avs. Prooosed drainaqe wavs, Siqnificant trees and foliage, G1ou4d cover, Soll types, .
Buifdihgs,'septic systeits, Sdwers, Areas subject to flooding, Utililies, Areas subJect to land
slides, Proposed site improvements.
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
REPLANTING PLAN
PHONE
STATECITY
PFIONE
STATECITY
COMPANY NAME
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
PROJECT SUPERVISOR:
ADDRESS:
FAX
+74 -l
Expi /ation Date:
CITY::.
OFFICE PHONE
72L/q /
MOBILE PHONE
STATE ZIP:
PROJECT SUPERVISOR
CONTRACTOR NAME:
4o/ , EMERGENcYPH
Registration Number:
ADDRESS:
I understand that I or my successors may have future plans for.my property. which may be anticipated or qnanticipatod-at .ifriiii-". iuriOeistanO that such future ilans may require permits bhd,developoment approvals !r9m the City.of Spring-field.
i rnd"isianJ thit notwithstanding any d'pproval oi tnii Larid and Drainage Alteration Permit (LDAP), that at the time of
lppffiiit^ ,iiuiure p"rmiti or aiprovalb'the City may revlew and reconsider all ac-tione-which I or my successors have
,i'Aertit en persuant io this LOAi. I understand that the Glty mry !3 a condition of lny -futur6-approval, require the . - - -,ria"l.g,in[^ging, or modification of any actions which I hive uhdortaksn as a result of the City's approval of this LDAP.
By signature, I state and agree, that I hava carefully exarlined the com.pleted applicatio4 and do hereby certify that all
iniorfration herein is true aird correcr, and I further cortify that any bnd all work perfornied shall be done in accordance
*itfr tne Ordinances of the City of Springfield, applicable.City Standard specifications ahd Drawings, and the laws of the
Siate ot Oregon pertaining to the wdrk dlscribeitherein, I further certify that onlf contractors and employees who are in
compliance ;/ith'ORS 7Oi.O55 will be used on this project. '
The City may inspect the work site described in this pormit at an_y ti,me.duqs -a olg yebr period following.the receipt by.
the City of nbticd of completion of the described woik and specify, at the City's sole dosecration,.a.ny additional restoration
work rdquired to return tie site to a standard acceptable to the City. The permitteb wilt be notified in writing of any work
_
required'and will have thirty (30) days from the daie of the notiCa to__complete the.work. Work not completed at the end of
thi thirty days will be perfdrmed by the City and the costs will be billed to the psrmittee.
Data
all reqr
set of
uired
ns
project address is readable from
5
are requestod at thB proper time, that
th6 site tt all times during constru
I further agree to ansure that
and the
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WETLANDS, Descripti on
FLOODWAY, FEMA Community Panel No.:
E NaturalDRAINAGE, Q Storm, El Ditch,.O Cul
FLOOD PLAIN, Zone:FEMA Community
$20.00
$30.00
$40.00
$40.00 For the tirsr 10,000 cubic yards, plus
$20.00 for each additional 10,000 cubic yards or fraction thereof
$220.00 For tho lir;t 100,001 cubic yards, plus
|2O.0O for.rch a(l(litlonal 10,000 cubic yards or fractlon thcreof
i340 For thc'tirst 200,001 cubic yards, plus
$6.OO for each adrlitional 1O,OOO cubic yards or fraction thereof.
$ 30.00
$3O.0O For the lrr:,t IOO cubic yards, plus
$14.OO for each arl(litional 10O c-ubic yards or fraction thereof.
$156.00 For the first 1,000 cubic yards, plus
$12.00 for each a(l(litional 1,000 cubic yards or fraction thereof.
$264.OO For'thc Iir:;t 1O,OOO cubic yards, plus
S54,OO for oach additional 1O,OOO cubic yards or fraction theroof
$750.00 For the first 100,001 cublc yrrds, plus
930.00 for each arlrlitional 10,000 cubic yards or fraction thereof
Date
KD
K.(?t
Estimated Volume:
tu.a O Date:
100,001 To 200,000
2OO,OO1 CUBIC,YARDS OR MORE
Received By:
Grading Per:mit fee:
Received by:
Pran check r"", 4 ?O . OO
PLAN CHECK FEES:
UP TO 1OO CUBIC YARDS
101 TO 1,OOO CUBIC YARDS
1,001 TO 1O,OOQ CUBIC YABDS
10,000 To 100,000 cuBtc YARDS
GRADTNG PERMIT FEES:
UP TO 1OO CUBIC YARDS
1O1 TO l,OOO CUBIC YARDS
1,001 TO 10.000 CUBrC YARDS
10,ooo To 100,ooo cuBrc YARDs
100,001 To 200,000
e..
Receipt No:
Date:
Rccoi
Date:
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AMBLDSIDE MDADOWS SUBD.
1'his propcrty is located in an arca of heavy clay
soils (expansivc clays). A liccnsed enginecr shall
verify the stability ofthe soils in the proposed
buildiug area and make any rcconrrnendations
neccssary to assurc thc continucd slability ofthc
soil. A copy ofthe enginecr's report shall be
submittcd to the Building OlTicial prior to
bcginning construction of thc structure.1*he
UALE
Date
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Planning:
Engrnt9nng:
Building:
:
Maintehanqe:
Permit Nrrmber lssued by Date
Date
Required Fihal lnspeetions-.
Date
Date:
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5 tr Land and Drainage. activity.as outlined in this permit has been completed in accordance withthe provisions of this perririt.tr hn#,?{t r?6?i!prg,".t$iyilJf&ffyf]'"ed in this permit has not been compteted in accordance
tr Land and Drainage activity was performed prior to application for this permit.
Accepted by: __ Date
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1/6/1998
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