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Home My WebLink AboutPermit Building 2001-04-02Job# 01-00258-01 RESIDENTIAL PERMIT Gity Of Springfield Community Services Division Building Safety SPRINGFIELD TRAllSS: 0i-0004gIC DATE:AFFi 02 IOC] REID:I S 46?0.4I IHf;I{ET: [A3t{itR:0]t nlrT11! il 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2263 00037th St Spr AssessorsMap#: 17021943 Lot: 157 Block: Addition:1st Job Number: 01 -00258-01 Office:726-3759 !nspection Line: 726-3769 Tax Lot #: 08900 Subdivision: Ambleside ctTY oF SPRfiNGFfiELq ORECON Owner: Scott Carlson Const Address: 1230 E 19th Ave Scope Of Work: Single Family Residence Phone Number: City/State/Zip: New 541-484-9286 Eugene, OR 97403 Value: $158,873 Contractor Type GeneralContr MechanicalContr Plumbing Contr Contractor Scott Carlson 1230 East 19th Avenue, Eugene, OR 97403 Comfort Flow Heating Co 1951 Don St Ste D, Springfield, OR 97477-1993 McMichael Plumbing Service 40108 Booth Kelly Rd, Springfield, OR 97478 Registration # Expiration Date 6127101460 Phone 541 -579-8408 541-726-0100 541-744-9099 Quad Area: # Of Units: Constr. Type: Water Heater: 3RNC 1 (VN) Wood Frame Gas Office Use - Land Use: Single Family Dwelling Zoning Code: LDR Bedrooms: 3 Range: # Of Buildings: 1 Occupancy Group: Dwelling Heat Source: Forced Air Gas Sq. Footage: 21BB To request an inspection call the 24 hour recording at726-3769. All inspections 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 working day. Required lnspections Buildin Site Verify Ground Rod Footing Foundation Post and Beam Floor lnsulation Geiling Insulation Shear Wall Nailing Framing -To be made after excavation but prior to setting forms. -lnstallground rod atfooting, and callfor inspection in conjuction with footing and/orfoundation i -After trenches are excavated. -After forms are erected but prior to concrete placement. -Prior to floor insulation or decking. - Prior to decking. - Prior to cover. -Before covering sheathing with finish materials. -Prior to cover. Page 1 of4 Walllnsulation Drywall FinalBuilding Temporary Power Rough Electrical Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Perimeter Foundation Drains FinalPlumbing Underfloor Mechanical Rough Gas Rough Mechanical Gas Service FinalGas FinalMechanical SW-Curbside GC-Standard Street lmprovement: Curb Cut?f San Sewer Depth (Ft): Storm Sewer Available? Special Req.: Security Required: Bond Begin DateTime: Special lnstructions: Other Utilities: Project Supervisor: Fully lmproved Improvement Agr.? 6-4 00/00/00 00:00 AM Sidewalk Type: Additional ROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: Curbside - 5' 8 To Curb and Gutter 6 00/00/00 00:00 AM Job# 01 -00258-01 Page 2 of 4 Required Inspections Buildinq -Prior to Cover -Prior to taping. -When all required inspections have been approved and the building is complete Electrical -Approval required prior to SUB energizing pole. - Prior to cover. -When all electrical work is complete. Plumbinq -Prior to insulation or decking. - Prior to cover or placement of concrete. - Prior to cover. - Prior to filling trench. -Prior to filling trench. -Prior to filling trench. -After gravel and filter cloth is installed, but prior to backfill. -When allplumbing work is complete. Mechanical - Prior to insulation or decking -Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure tet -When allgas work is complete. -When all mechanicalwork is complete. Fublic Worki I -After forms are erected but prior to placement of concrete -After forms are erected but prior to placement of concrete Types Of Warning Devices Reqd. Job# 01-00258-01 Page 3 of 4 Land Use: Single Family Dwelling Pave Driveway? Z Zoning: LDR FloodPtain? [ Wetlands? [ Journal numbers 1: Comments: Planner: Ruth Klein Urban Growth Boundary?! Quantity Of Fill: Supplier: Drainage: Floodway FEMA: n/a 2 3: Additional Requirements: LDAP Required Required Attachments: Source Locn: Material: Flood Plain FEMA:nla Overlay District: # of Street Trees 2 Gtenwood Area? ! Construction Types(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? [ (Sq. Feet) Main: 21BB Accessory530 Accessory Structure # Of Stories: 2 Height (feet): 28 Current Units: Proposed Units:1 Census Code: New SF - detached Total271B Fee Paid On Receipt# Value/Quantity Fee Amount PIan Check Residential Plan Check Total Plan Check 03t19t2001 4707 158,873 $367.74 $367.74 Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building Building 0410212001 0410212001 04t02t2001 4820 4820 4820 158,873 $565.75 $39.60 $16.97 $622.32 Minimum Plumbing Permit Fee Three Bathrooms State Surcharge - Plumbing Administrative Fee - Plumbing Total Plumbing Plumbing 04t02t2001 04t02t2001 0410212001 04t02t2001 4820 4820 4820 4820 1 $.00 $192.50 $13.48 $5.78 $211.76 Mechanical Hood and Exhaust One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct Gas Fireplace Dryer Vent Mechanical lssuance State Surcharge - Mechanical Total Mechanical 04t02t2001 04t02t2001 0410212001 0410212001 04t02t2001 0410212001 0410212001 04t02t2001 0410212001 0410212001 4820 4820 4820 4820 4820 4820 4820 4820 4820 4820 1 1 $4.50 $2.00 $.00 $.87 $6.00 $e.00 $4.50 $3.00 $10.00 $2.03 $41.90 1 3 1 1 Public Works New Sidewalk New Curbcut 0410212001 0410212001 4820 4820 60 $65.00 $65.001 Job# 01-00258-01 Page 4 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Public Works Multiple Permit Discount - 2nd Permit Total Public Works 0410212001 4820 1 $-30.00 $100.00 Residential- Single Family - Storm Sanitary Sewer Residential Transportation Residential Sanitary MWMC Residential lmprovement MWMC MWMC Administrative Fee Sanitary Sewer SDC Reimbursement SDC Administrative Fee Property Annexed 1997 Transportation SDC Reimbu rsement Total System Development System Development 4820 4820 4820 4820 4820 4820 4820 4820 4820 4820 0410212001 04t0212001 0410212001 0410212001 0410212001 04t02t2001 04t0212001 04t02t2001 0410212001 04t02t2001 1,882 24 1 1 1 1 24 $510.02 $387.60 $656.02 $285.91 $24.33 $10.00 $510.00 $126.88 $-.5e $154.27 $2,664.44 S.F. Residence - Willamalane TotalWillamalane SDC Willamalane SDC 04t02t2001 4820 $1,000.00 $1,000.00 Grand Total Plan Check Type Ghecked By Date Completed Comment lnitial Review-Res Lisa Hopper 0312212001 Engineering-Res Steve Templin 0312312001 Planning-Res Ruth Klein 0312712001 Structural-Res Tom Max 0312812001 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 701.055 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 of plans will in on the at alltimes during construction re Date $5,008.16 1 1 1 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSMET NAME ORCOMPA].IY: LOCATION: TAX LOTNUMBER: ANNEXATIONYEAR DEVELOPMENT T'IIPE: DWELLINGUNITS: 2263 37TII STREET l7-02-19-43-08900 $1,037 SCOTTCARLSON SF LOT SZE: 6000 SF1 BUILDN{G STTE: JOURNAL OR JOB NUMBER: 0l-00258-01 SINGLE FAMILY RESIDENCE 1997 LANE COLTNTY ASSESSED VALUE (LAI$D) COSTPERS.FIMPERVIOUS S.F. 10.021 1. STORMDRAINAGE x ITEM 1 TOTAL. STORMDRATNAGE SDC COSTPERDzuOF DFtIs .60s16.1524 NUMBEROFDFLIS 24 COSTPERDFU $2r.25 $510.00 B.IMPROVEMENT COST: x x 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: .60ITEM 2 TOTAI - CITY SAI{ITARY SEWER SDC NEW TRIPNUMBEROF UNITS COSTPERTRIPADTTRIPRATE 1.00 $6s6.021$689 ADTTRIPRATE 9.57 NUMBER OF I.]NTTS 1 COST PERTRIP $16.12 NEWTRIPFACTOR 1.00 $54.27 IMPROVEMENT COST: x xx x xx 3, TRANSPORTATION A. REIMBURSEMENT COST: rTEM 3 TOTAL . TRANSPORTATION SDC $10.00 NUMBEROFFEU's 1 COSTPERFEU $285.91 $28s.91 NUMBER OF FEI.I'S 1 COSTPERFEU $24.33 B.IMPROVEMENT COST: x x 4. SAMTARY SEWFR- lverIVMC A. REIIVIBURSEMENT COST: MWMC CREDTT IF APPLICABLE (SEE REVERSE) MWMC ADMIMSTRATTVE FEE $319.6sITEM 4 TOTAL . IVTWMC SANITARY SEWER SDC 37.56SUBToTAL (ADD ITEMS l, 2, 3, & 4) ADM. FEE RATESUBTOTAL $85%.56 5. ANMIMSTRATTVEFEE: x $2,664.443t26t0ttlr,wk.r*l;* SDC COORDINATOR TOTAL SDC CHARGES DATE $24.33 ($0.s9) DRAINAGE F'IXTI.IRE T]I\"IT CALCULATION TABLE IVIWMC CREDIT CALCULATION TABLE: BASED ON COIINTY ASSESSED VALUE Dtr'U NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FD(TURES DRAINAGE FD(TI.'RE UMTS(#NEW - #OLD )x I]NIT EQUWALENTFDffURETYPE BATIIIUB ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( I )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x 3 DRINKING FOUNTAIN I 0 FLOORDRAIN 3 3 6 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 I-AUNDRY TUB 7 0 CLOTHESWASHER / MOP SINK J 3 cLorrrESwASlrER - 3 !Bl4qBE{E4)6 0 MOBILE HOME PARK TRAP (I PER TRAILER)t2 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. RECEPTOR TOR COM. SINK / DISIIWASIIER / ETC. I 0 0 SIIO\UEX" SDIGr,E tT4Il I 2 2 sHowER, GA.I.{G (NUMBEROF HEADS)2 0 SINK: COMMERCIAL/RESIDENTIAL KITCIIEN 1 3 SINK: COMMERCIALBAR 2 0 SINK: DOMESTICBAR I 0 WASHBASIN L 0 LAVATORY 4 1 4 URINAL, STAIL/WALL 5 0 TOILET PUBLIC INSTALLATION 6 0 TOILET,PRTVATEINSTALLATION 5 3 9 MISCELI-A}IEOUS DFU TY?E NUMBEROF EDUs* ( -'-) *20 0 TOTAL DRAINAGE FIXTURE UITIITS = iEDU (Equivalent Dwelling Unit) is a discharge equivalent to a single &rnily dwelling unit (20 DFU's) set at 167 gallons per day 24 IT IMPROVEMENTS OCCURRED AFTER AI.INEXATION DATE, CALCULATE CREDTT SEPARATELY CREDTT FORLA].{D (M APPLICABLE) CREDM FOR IMPRO\IEMENT (IF AFTER ANNEXATIO}D $0.s9 I'EAR ANNE)(ED CREDIT RATE PER $I,OOO ASSESSED VALUE YEAR ANNE)GD CREDIT RATE PER $I,OOO ASSESSEDVALUE 1979 OR BEFORE s4.74 1990 $ 1.96 1980 $4.65 1991 $1.55 198 I $4.59 1992 $1.36 1982 $4.46 I 993 s1.23 1983 $4.30 1994 $ l.0s 1984 $4. 14 1995 $0.90 I 98s $3.93 l 996 $0.7s l 986 s3.63 1997 $0.57 I 987 $3.26 l 998 $0.35 1988 $2.8s I 999 $0.15 1989 $2.40 TOTALIVTWMC CFJDIT 0.000 x $0.57 VAIUE/ IOOO CREDITRATE 1.037 x $0,57 1 t Willamalane Park & Recreation District Job. No. C0.OO1Rt.Cy SYSTEM DEVELOPMENT CHARGE WORKSHEET NAME So,+*,0rr" \.qon ADDRESS: LOCATION OF PROPOSED BUILDING SITE: Street Address:qr\ Sf r"* Lot Number: PHoNE: tl4 qnou srATE: -u- 71p; 4r<CI8 Plat 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwetling t 1pe definitions are on the back.) A Single-Family Detachecl \ Single Family home Manufactured home not in a park No. oF UNITS x $1,000 per unit = $ \COf't ,oO B. Single-Family Attached NO. OF UNITS X $924 per unit C. Multi-Familv Aoartment NO. OF UNITS X $692 per unlt D. Manufactrrecf Home Park NO. OF UNITS X $699 per unlt $ WILLAMALANE SDC 2. SDC CREDff (r appticaUte! SDOaayermust (umlsh proof of Willamalane Cre'dit approval. See SOC Credit Wotl<sheet. 3. TOTAL WILLAMALANE NET SDC ASSESSED (lf SDC reduced forCredit) $ $ &$ $ $ a 0 t boo .oD Date City of L nt \13D, \eo.ttA:n ".,,, JAtaa SP'IIi|GF!ELD BACKFLOW PREVEMION DEVICE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 FIFTH STRBET SPRINGTIELD OR 97477 OFFICE: INSPBCTION LIM: 726-3759 726-3769 JOB LOCATION:)e c: jl+t^ <Y ASSESSORS MAP *:l1o3tq+a TAX LOT *:zqa) owNER: 1f " +Con lrr,^ Co ^9 < l, o,^ ADDRESS: CITY: lp30 lql-h PHONE *:+8t)-qlKb q140<STATE: OR ZTP BACKFLOI,I PERMIT IS $15.00 + 1.05 (STATE SURCHARGE) + $.45 (ADl'tIN. FEE) =$16.50 CONTRACTOR:{n ADDRESS: DO. [3"( €)PHONE *:6xtr- 7nt CITYI 4[''^JUT(STATE: O f?ZTP:. CONSTRUCTION CONTRACTORS REGISTRATION #:6zq EXPIRES: 1'3O- Ol BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPBCTION ONCE THE BACKFLOV PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION (726-3769). r ALSo STATE THAT ALL TNFoRMATIoN 0N THIS PERMIT/APPLICATIoN IS CORRECT. = /?- o( FOR OFFICE USE DATE OF APPLICATION:7lr>lot .ros *, 0l-@25&-ol RECEIPT *:blaT TSSUED BY: D -"{ 13;trD :[>VJ n.;a,rrr m G:r-l ." *+rjf L{ ".to EI riJ l'J l-- Fr I{#FJ(} F..l c)F(:] . {fFLn o r..-l(} F' T.J TOTAL AI.IOI'NT COLLECTED:s\b 50 ( CITY ? l.tog SPRTNGFIELD Job# 01-00258-01 RESIDENTIAL PERMIT Gity Of Springfield Community Services Division Building Safety Page 1 of4 Job Number: 01 -00258-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot #: 08900 Subdivision: Ambleside 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2263 00037th St Spr AssessorsMap#: 17021943 Lot: 157 Block: Addition:1st crTY oF SPRINGFIELD, OREGOTV Owner: Scott Carlson Const Address: 1230 E 19th Ave Scope Of Work: Single Family Residence Phone Number: City/State/Zip: New 541-484-9286 Eugene, OR 97403 Value: $158,873 Contractor Type GeneralContr ElectricalContr Landscape MechanicalContr Plumbing Contr Contractor Scott Carlson 1230 East 19th Avenue, Eugene, OR 97403 L&EElectriclnc 85014 Spencer Hollow Rd, Eugene, OR 97405 Decker landscape and irrigation 27390 Bth st, alvadore, OR 97409 Schoolcraft 2155 Musket, Eugene, OR 9740'l McMichael Plumbing Service 40108 Booth Kelly Rd, Springfield, OR 97478 Registration # Expiration Date 105475 3t3012002 460 612712001 Phone 541-579-8408 541-933-2653 541-688-7991 541-744-9099 Quad Area: # Of Units: Gonstr. Type: Water Heater: 3RNC 1 (VN) Wood Frame Gas Office Use - Land Use: Single Family Dwelling Zoning Code: LDR Bedrooms: 3 Range: # Of Buildings: 1 Occupancy Group: Dwelling Heat Source: Forced Air Gas Sq. Footage: 21BB To request an inspection call the 24 hour recording a1726-3769. All inspections 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 working day. Required lnspections Buildinq I Site Verify Ground Rod Footing Foundation -To be made after excavation but prior to setting forms. -lnstall ground rod at footing, and call for inspection in conjuction with footing and/or foundation i -After trenches are excavated. -After forms are erected but prior to concrete placement. Post and Beam Floor lnsulation Ceiling lnsulation Shear Wall Nailing Framing Walllnsulation Drywall FinalBuilding Temporary Power Underground Electrical Rough Electrical Electrical Service Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Perimeter Foundation Drains Backflow Device FinalPlumbing Underfloor Mechanical Rough Gas Rough Mechanical Gas Service FinalGas FinalMechanical SW-Curbside CG-Standard Street lmprovement: Fully lmproved Curb Cut?f lmprovement Agr.? San Sewer Depth (Ft): 6 - 4 Storm Sewer Avaitable? f Special Req.: Security Required: Bond Begin DateTime: 00/00/0000 00:00 AM Special lnstructions: Other Utilities: Project Supervisor: Job# 01-00258-01 Page 2 of 4 Required lnspections Building I - Prior to floor insulation or decking. - Prior to decking. -Prior to cover. -Before covering sheathing with finish materials. - Prior to cover. -Prior to Cover -Prior to taping. -When all required inspections have been approved and the building is complete. Electrical -Approval required prior to SUB energizing pole. - Prior to cover. - Prior to cover. -Must be approved to obtain permanent power. -When all electrical work is complete. Plumbi -Prior to insulation or decking. - Prior to cover or placement of concrete. - Prior to cover. -Prior to filling trench. -Prior to filling trench. -Prior to filling trench. -After gravel and filter cloth is installed, but prior to backfill -After device is installed but before backfilling trench -When allplumbing work is complete. Mechanical - Prior to insulation or decking - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure ter -When allgas work is complete. -When all mechanicalwork is complete. Public Works l -After forms are erected but prior to placement of concrete -After forms are erected but prior to placement of concrete I Sidewalk Type: AdditionalROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: Curbside - 5' I To Curb and Gutter 6 00/00/0000 00:00 AM Types Of Warning Devices Reqd. Zoning: LDR FloodPlain? [Wetlands? [ Journal numbers 1= Comments: Planner: Ruth Klein Urban Growth Boundary?f] Quantity Of Fill: Supplier: Drainage: Floodway FEMA: n/a Overlay District: # of Street Trees: Job# 01-00258-01 Page 3 of 4 Land Use: Single Family Dwelling Pave Driveway? Z 2: Glenwood Area? [ 2 3 Additional Requirements: LDAP Required Required Attachments: Source Locn: Material: Flood Plain FEMA:nla Construction Types(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? [ (sq Main: 2188 AccessoryS3O Accessory Structure # Of Stories: 2 Height (feet): 28 Current Units: Proposed Units:1 Census Code: New SF - detached Total2718 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Gheck 03t19t2001 4707Residential Plan Check Total Plan Check 158,873 $367.74 $367.74 Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building Building 04102t2001 0410212001 04t02t2001 4820 4820 4820 158,873 $565.75 $39.60 $16.97 $622.32 Electrical Wiring Footage 1,000 Sq Ft or Less Wiring Footage Each Add'l 500 Sq Ft State Surcharge - Electrical Administrative Fee - Electrical Total Electrical 0511512001 05t15t2001 0511512001 0511512001 5375 5375 5375 5375 1 4 $85.00 $60.00 $10.1s $4.35 $159.50 Minimum Plumbing Permit Fee Minimum Plumbing Permit Fee Three Bathrooms State Surcharge - Plumbing State Surcharge - Plumbing Backfl ow Prevention Device Administrative Fee - Plumbing Administrative Fee - Plumbing Total Plumbing Plumbing 04t02t2001 0711212001 0410212001 04t02t2001 07t12t2001 0711212001 0410212001 0711212001 4820 6122 4820 4820 6122 6122 4820 6122 1 $.00 $5.00 $192.50 $13.48 $1.05 $10.00 $5.78 $.+s $228.26 1 Hood and Exhaust One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Mechanica! 0410212001 0410212001 0410212001 0410212001 1 1 $4.50 $2.00 $.oo $.87 4820 4820 4820 4820 Job# 01-00258-01 Page 4 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Mechanica! Less than 100,000 BTU Vent Fan to One Duct Gas Fireplace Dryer Vent Mechanical lssuance State Surcharge - Mechanical Tota! Mechanical 0410212001 04t02t2001 04t02t2001 04t02t2001 0410212001 04t02t2001 4820 4820 4820 4820 4820 4820 1 3 1 1 $6.00 $9.00 $4.50 $3.00 $10.00 $2.03 $41.90 Public Works New Sidewalk New Curbcut Multiple Permit Discount - 2nd Permit Total Public Works 04t02t2001 0410212001 04t02t2001 4820 4820 4820 60 1 1 $6s.00 $65.00 $-30.00 $100.00 Residential - Single Family - Storm Sanitary Sewer Residential Transportation Residential lmprovement MWMC MWMC Administrative Fee SDC Administrative Fee Property Annexed 1997 Residential Sanitary MWMC Sanitary Sewer SDC Reimbursement Transportation SDC Reimbursement Total System Development System Development 4820 4820 4820 4820 4820 4820 4820 4820 4820 4820 04t02t2001 0410212001 0410212001 0410212001 04102t2001 04t0212001 04t0212001 04t02t2001 0410212001 0410212001 $510.02 $387.60 $656.02 $24.33 $10.00 $126.88 $-.5e $285.91 $510.00 $154.27 $2,664.44 1,882 24 1 1 1 1 1 24 1 S.F. Residence - Willamalane TotalWillamalane SDC Willamalane SDC 04t02t2001 4820 1 $1,000.00 $1,000.00 Grand Total Plan Check Type Checked By Date Completed Comment lnitialReview-Res Lisa Hopper 0312212001 Engineering-Res Steve Templin 0312312001 Planning-Res Ruth Klein 0312712001 Structural-Res Tom Max 0312812001 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 701.055 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. $5,184.16 Signature Date Community Services Div, E 'ng Safety CITY OF SPRINGFIELD, OREGON 225 5'h Sueet, Springfield, OR97477 Ph.726-3759 ua l*,arcss-2l rL3 2ze City Iob# fi/' )){l-dl FIELD AMBLESIDE MEADOWS SIIBDTVISION-I.ST ADDITIoN - new This form may be used as a temporary verification to allow constructiorr lq csnrinue on the job site until the corrsultant's stamped affidavit on the site soil compaction and stabilization is submittcd to the City. This form must be completed by a Iicensed design professional (engineer or architect) or his/her authorized employeg and submitt€d to the building inspector prior to requesting City inspections or placing foundation concrete.It is important that all questions be answered completely for the foundation site to be approved for construction. *-6 C*f;-.ugcd Co*S7t. Owner and/or Contractor I L B ave .t 1. Date of the design professional's site evaluation? j I ?o 2. Has the design professional reviewed a copy of the geotechnical informalion for the subdivision that was provided with the buitding permit? Yes:lNo_ If not, please contact this ffice for a copy of the report. The design professional must be familiar with the geoteclmical inforrnation before completing this form. on 3. What was the size and depth of the Apacpx Rot y. *,r)' )\ 4 excavation and /or fill? Was ex.isting non-structural fill or expansive soil encountered on the lot? Yes vll'lo_ If "yes", what tlpes, depths and locations? 5o tu< urrsF-lF Pg-rynufuI ^N \For(d . A,cLruo9'. ts]vTlGtg- .t-dT As. Por-,Lar.u S J stJ LL=?5\ What measures DFcc,*rPoc€O were taken to remedy the soil Vot.C.Ar.j tG engineered fill used to stabilize the soil)? &t{- c s N\e5 r $Ft &rrt- e-t-+l-tt tvt IN 2-' Bq?,.e.f r.rl 6-rrs . &.e.onru1 fr*ru4S t- (2.-crc- { r t[-'e) <tt. @<>^ f) €ensre O.r,r* C.,-'\^1 ro ?z€OPlek t,,,Nrec[r Nfsjfkt p*-lyvlFTFfi= lter* Fea-r1pc$ - g,Fa.+c-s ,w/ 6^\rJ ba-u LrGEr { {Lr', ,',)ruvt-t<-g-;x.c^ . Site Investigation Questionnaire for Consulting Design Professionals Community Services Div, Bu -.ng Safety Job CITY OF SPRINGFIELD, OREGON 225 5'h SreeL Springfield, OR97477 Ph.726-3759 Address 27b '7? D City Job #ol'-o) ./ Is the site as prepared adequate 6 tnadequate 3 to maintain constant moisture content in thi sub grade? Note: Verification of moisture stabilization in thc sub grade is a requirement of the geotechnical report, and must be ffirmed before construction can continue. If inadequate, what measures are needed to provide constant moisture content in the sub L eri t, P.e-fFrl <Fr"Kr F{l&- ,/ Is the site as prepaled adequate Vinodrquote D to support the proposed structure? in affirmative answer is requisite to proceeding with construction- If inadequate, what additional work is needed to provide adequate foundation support? 4. Did the design professional witness placement and compaction of the engine€rd titt,bt is there a special inspectigE repo{ forthcoming from a -/q".nn"a agency? I witnessed Placement {special Insp/compaction report V S. The design professionat intcnds to use the following method for installation q(?lt"sr).d 9c,rus \a{-tF \!l <TegLt, 9aYvtP of perforated perimeter footing drains: The design on the attached drawing provided by the design professional ....u D,Zd.I The method shown on the original construction drawings The typical 'Foundation Drain' drawing attached to permit Perforated perimeter drains are not required ... Comments: Note: City inspectors will inspect installed drains prior to cover upon request"' Call: 726-3769 to schedule inspection. 2 Community Services Div, b ..-.ring Safety lob Addtess 2-2G'D CITY OF SPRINGFIELD, OREGON Citv Job # 225 5'h Sreet, Springfield, OR 97477 Ph.726-3759 Post Low-point crawl space drains are requird to prevent the build'up of excess moisture inside the foundations during (and after) construction. This drain may be instalted after foundation placement onlv with the exoress permission of the desien professional. a. The design professional has determined the following; The crawl space d.rain is required when the fom.dation is installed..... tr The low-point drain can be installed afier fomdation placement without a significant moisture buitd-up problemwithin the foun'dation"" """"i { (The low-point drain may be installed at the of construction) b. Has the design professional observed and approved the installation of t), required low point drain?...... Yes, - No V tf "yes", where is the low point drain located under the building and where does it terminate at this time? (must be an approved location, i.e. street gutter, stofin sewer, sump pump and. discharge line to the street, etc. elc. The design professional must determine whether the approved permit drawingshave adequatJfoundation steel. Is any additionat foundation steel required that is not shown on the foundation drawings for the building? yes _ Uo _{-. If "yes", describe additional steel required (or provide drawing)- The following statement must be signed by the individual doing the observations and prouiding diiectionfor the excavation and site preparation work on the property' 3 Community Services Div, B 'ng Safety CITY OF SPRINGFTELZ; OREGON hb taaress Z2G5 - 37 Z 97- CityJob# O{'-p 225 sth Sreet, Springfield, OP.97477 Ph-726'3759 The underctgned design professional (or authorized employee) o.frests that helshe obsemed re[uired moisture stability procedures on this site, and that such procedures nrr, *"oiplisheil before any changes occured in the moisture content of the sub- grade un1ei and aroindthc building (where expansive soils were encountered). The "understgneilfurther attests ttut the sub-grode, as prepared, is odequate to support the building proposedtor this sile. Additional comments: (Note): A copy of this report shall be kept on site with the approved Plans at all times. This report shall be followed by an affidavit, signed and stamped by the aeslSn- profess^ional under whose auspi"es this report was completed, affirming the information ^herein. The signed/stamped affidavit together with a copy of this report shall be submitted to this office prior to requesting framing inspection for the building. Title Company PhoneGS+'a3'r7 fu4r lgrLDf License /q4 tb The geotechnical report for the Ambleside Meadows - I't Addition Subdivision ,*o**"nds immediate moisture stabilization of exposed expansive sub-grades, and that expansive soils be over-excavated and replaced with at least 12 inches of fill compacted to at least 95Vo of.ASTM D698 for foundation preparation. The report also recommends that measures be taken to prevent water from collecting in or around the foundation areas during and after the construction process, and that positive site drainage be provided to reduci the infiltration of surface water into the expansive soils. The geotechnical report further emphasizes that the finish grade of landscape soil adjaJent to the foundation should be at least 24" abovethe expansive bearing soils, firmlv compacted to reduce the infiltration of water at the surface. The adequacy of fill soil *"t.ri.l *ound the building must be verified to the satisfaction of the design professional. 4 Community Services Div, Bu*rng Safety CITY OF SPRINGFIELD, OREGON Job Ad&ess '2.'2.107 tu'-- ciryJob# e("2o"-9'dl 225 5'h Street, Springfield, OR 97477 Ph.726-3759 SPRINGFIELD Affidavit For Site Investigation Questionnaire Foundation Sub-Grade Approval for Residential Building Site in Ambleside Meadows - 1" Addition Subdivision The undersigned hereby affirms that the excavation, structural fill and moisture stabilization methods for the buitding site at the address shown above was observed by me or an authorized employee of my firm and that the following is true: l. The foundation sub-grade is capable of supporting a minimum of 1500 psf, and is adequate to support the building proposed for this site' Z. The moisture content of the excavation was adequately maintained during the site preparation process and was adequately covered to stabilized moisture content pdor to any significant change in moisture content of the sub-grade. 3. The site is adequately graded and drained to prevent the collection of water in the excavated area during construction. 4. The accompanying rePort titled "Site Investigation Questionnaire for Consulting Professionals" containing field observations and instructions made on date)for the building site was completed either by or an employee of my firm under my supervision. To the best of my knowledge, the information contained in that report is complete and accurate. Name of Licensed Professional (print)hr /*ke-- Stamp 1e174 oRlooN ISOTNN Date t*azrtf, ln-Place Job: 37.01 Client: Scott Cadson Constr ASTM D698 Max. Dry DensitY 139.0 Pcf ln-Place Desnity Test Results 2263 37th St. Springfield, OR City Job # 01-00258-01 Moisture Content Average Std. Dev 4.9% 0.8% 98.5% 4.2% 19171 t i Wet Densitv, pcl Dry Density, pcl otlo CompactionWeiqht, g Weight, lb.Pan, g Moist Sample + Pan, q Dry Sample+ Pan, g. Moisture Conlent, o/oTest No. lnitial Readinq, cl Final Readinq, cl.Volume, cl 103%3.94 151.6 128.1 5.4%1440.02600 1788.4 '1916.5 1825.510.0'158 0.0418 134 97%1660.4 3.66 141.9 128.9 '1789.3 1705.9 5.3%2 0.0158 0.0416 0.02580 3.62 138.3 133 95%1643.2 120 1763.2 1699.9 4.0%3 0.0156 0.0418 0.02620 K&AEngineering, lnc. 7 04105t2001 225 FIFTE STREET SPRINGFIELD, OREGON 97477 INSPECf,ION REQUEST: 7Mg (u -o l-000 sq. f t. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home. or Modular Dvelling Service or Feeder RJ 200 amps or less 201 amps to 400 amPS __401 amps to 600 amPs - 601 amps to 1000 amPs ,' i':'Over 1000 amps/vo1ts D. Branch Circuits SPFlINGFIELO TRfl irlft+ .''11 -finn E "rri:I llnl{r l*ttI I lrtitr- l-I l. I nl,Tr,M^v 1tr {lnn1Un I L.l ln t .LJ I:.UUJ- nl ll l\LLru r L \,P lLr./ ! JU Til,'lili:,l:: , i-,1 iIi !r:11..- , n,+f,i-.1Tl:!-i - iri-:? CAt PERHIT APPLICATION L'HNNIL ''J'JJ Sum Job Number COHPLETE FEE SCEEDTILE BELOTI Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost @, I:,:"J:),;l'JJ:le::iH3,['."r*f |"""T'L"'T* aPProval loning oFFrcE: 726-3759 Authorized signature 1. LOCATION OF INST LEGAL JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 1BO days of issuance or if vork is suspended for 1.80 days 2. CONTRACTOR INSTAII,ATION ONLY Electrical Contracto ,)_*E Elock Address so Electrician Ovners Name OVNER INSTALLATION The installation is being made on property I ovn which is not intended for sale, lease or rent. 0vners Signature: DATE: I sBs.oo #: ( s ls.oo @- s 40.00 3 A Ci ty Phr." (oBY - ?Y B ? Supervirsor License Number fz/- Expiration Date (o zDo 3 Constr Contr. Number I o 5\a,5 Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date 3 () C s 50.00 s 60.00 s100.00 s130. 00 s300.00 $ 40.00 .00 .00 .00 rBil a6oveSignaggrpiof ea 200 amps'"or Less $ 201 amps to 400 amps - $ over 4bL to 6oo amps - $ 0ver 600 amps or 1000-75fTs se 40 55 BO e Address 12rO E /2a rF ciry fuz.B pno". fuf-Z&L Nev, Alteration or Exterrsion Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E Miscellaneous (Service/feeder -Each installation Pump or irrigation $ sign/outline Lighting- S t imited Energy/Res - $ Limited Energy/Comm S not included) 40.00 40. o0 20.00 SUBTOTAL OF ABOVE 7% State Surcharge 32 Admini.s trative Fee TOTALRECEIVED BY: 5 -ffiw l+r B. Services or Feeders Installation, Alterations 1a T.,raor Relocation: KtsUtsITT f