The URL can be used to link to this page

Home My WebLink AboutPermit System Development Code Charge 2002-10-31Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541:726-37 69 Inspection Line Buildin g/C ombination Permit PERMIT NO: COM2002-01258ISSUED: 1013112002APPLIED: 10/3112002E)GIRES: 04/3012003 VALUE: SITE ADDRESS: 615 63RD ST ASSESSOR'S PARCEL NO. : 17 023424037 00 PROJECT DESCRIPTION: SDC Fees for sewer connection SPRINGFIE TYPE OF TYPE OF USE: Single Family Residence Owner: Address: SMITH CHRIS A & MARCUS WILES PO BOX 1602 PORTLAND OR 97207 Contractor Type Owner Contractor SMITH CIIRIS A & MARCUS WILES License Expiration Date Phone CONTRACTOR INFORMATION BUILDING INFORMATI( # of Buildings: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Im pervious Surface Area: SETBACKS Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Paved Drive Rqd: oh of Lot Coverage: Street Storm Sewer Available: Special Instruction: Notes: Description Type of Construction $ Per Sq Ft Square Footage Total Value of Project Sidewalk Type: Downspouts/Drains R.EQUIRED PARKING Total: Handicapped: Compact: DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS lof2 Value Date Calculated Valuation Descrintion I Status: Issued 225 Fifth Streel SpringfieH, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Buildin g/C ombination Permit PERMIT NO: COM2002-01258ISSUED: 1013112002APPLIED: 10/3112002E)GIRES: 0413012003 VALI]E: Iees Paid Fee Description SDC MWMC Administration SDC MWMC Improvement + 57o San & Storm Admin Fee Sanitary Sewer - Improvement SDC MWMC Reimbursement Sanitary Sewer - Reimbursement Total Amount Total Fees Paid Prior to 9130102 Amount Paid Date $10.00 $34.83 $s1.93 $28s.43 $332.86 $37s.s3 Receipt Number 2200200000000000136 2200200000000000136 2200200000000000136 2200200000000000136 2200200000000000136 2200200000000000136 Received By dlm dlm dlm dlm dlm dlm t0t3y02 t0t3u02 t0t3u02 t0l3u02 t0t3u02 t0t3u02 $1,090.58 Plan Reviews 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. will be made the following work day. Reouired Insnect By signature, I state and agree, that I have carefully examined the completed application and do hereby certiS 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 certiS 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 st that the permit card is tocated at the front of the property, and the approved set of plars will remain on the site at Owner or rs Signature 2of2 Date /4nPp2- ao//Z CITY OF SPRINGFIEI }YSTEMS DEVELOPMENT CHA E WORKSHEET JOURNAL OR JOB NUMBER: 0 Loa zAo?--bt?-tt NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING LTNITS 0 0 17 -02-34-24-03100 SINGLE FAMILY RESIDENCE I BUILDING SIZE: O SF LOT SIZE: O SF 1 a rrl U & trlFa H& I 055 105 6 070 09r 092 093 094 V I 1 IMPERVIOUS S.F COST PER S.F DISCOTINT RATE 0.00 $0.282 50%$0.00 IMPERVIOUS S.F 0.00 COST PER S.F $0.282 $0.00 RLNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM x x x $0.00ITEM 1 'TOTAL - STORM DRAINAGE SDC COST PER DFU 17 $1 79 $285.43 NUMBER OF DFU's 17 COST PER DFI] $22.09 $375.53 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: B.IMPROVEMENT COST: x x $660.96ITEM 2 TOTAL - CITY SANITARY SEWER SDC ADT TRIP RATE NUMBER OF TINITS COST PER TRIP NEWTRIP FACTOR 9.57 0 $74.17 1.00 s0.00 ADT TRIP RATE 9.51 NUMBER OF TINITS 0 COST PER TRIP s 16.81 NEW TRIP FACTOR 1.00 $0.00 B.IMPROVEMENT COST: x x x x x x 3. TRANSPORTATION A. REIMBURSEMENT COST: $0.00ITEM 3 TOTAL - TRANSPORTATION SDC $ 10.00 NUMBER OF FEU's 1 COST PER FEU $332.86 $332.86 NUMBER OF FEU's 1 COST PER FEU $34.83 $34.83 s0.00 SUBTOTAL OF MWMC REIMBURSEMENT,IMPROVEMENT & CREDIT MWMC ADMINISTRATIVE FEE $367.69 B.IMPROVEMENT COST: x x 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: MWMC CREDIT IF APPLICABLE (SEE REVERSE) s377.69ITEM 4 TOTAL - MWMC SANITARY SEWBR SDC $l 038.65SUBTOTAL (ADD ITEMS 1,2,3, & 4) SUBTOTAL $ 1,038.65 ADM. FEE RATE 5%$51.93 51.93 5. ADMINISTRATIVE FEE: x TOTAL TRANSPORTATION ADMINISTRA TION FEE TOTAL SANITARY ADMINISTRATION FEE: $1,090.58 SluLk*-,t^l;",- SDC ('OORDINATOR t013U2002 TOTAL SDC CHARGESDATE 1019 I 078 1 NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NETADDITIONAL FIXTURES) NO. OF FIXTURES (#NEW - #OLD LINIT EQUIVALENT DRAINAGE FIXTI]RE LINITS),. BATHTUB DRINKTNC FOUNTATN I 0 0 0 ( ( ( ( 0 )x )x J 3 0 0 FLOORDRAIN 0 )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x J 0 INTERCEPTORS FOR GREASE I OTL ISOLIDS / ETC. INTERCEPTORS FOR SAND Z EUTO WASH / ETC. LAUNDRY TUB CLOTHESWASHEI Z IAOP CLOTHESWASHER- 3 OR 0 J o t 0 0 0 6 0 0 0 2 ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( 0 0 2 t, SINK NIORE (EA) 1 3 0 0 0 0 0 0 0 0 6 0 MOBILE HOME PARK TRAP (1 P.FR TRAILER) RECEPTOR FOR REFRIG / WATER STATION / ETC. RECEPTOR FOR COM. SNK / bISHWASHER / ETC. SHOWER, SIryGLESTALL sHowER. GANG (NUMBER OF HEApSt SINK: COMMERCIAL/RESIDENTIAL KITCHEN SINK: COMMERCIA'BA. SINK:DOMESTTC BAR WASH BASIN LAVATORY uRrNAL, srtLll \yA1a TOILET, PUBLIC IrySTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS DFU TYPE NUMBER OE rDi's* t2 0 0 J (, 00 2 U 00 2 0 I 0 0 J 3 0 0 0 2 0 001 0 2 0 2 0 0 0 0 2 5 0 6 0 J 6 (0-0 )x 20 TOTAL DRAINAGE FIXTURE UNITS :t7*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gal'lons per day 0 DRAINAGE FIXTURE UNIT CALCULATION TABLE MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE $0.00 AFTER ANNEXATION DATE, CALCULATE CREDIT SEPARATELY CREDIT FOR LAND (IF APPLICABLE) CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) $0.00 s0.00 YEAR ANNEXED CREDIT RATE PER $1,OOO ASSESSED VALUE YEAR ANNEXED CREDIT RATE PER $1,OOO ASSESSED VALUE I979 OR BEFORE I 980 I 981 982 983 984 985 986 987 988 989 92 s7.a: So rl $4.64 sq.n $4.30 s7.oq $3.78 $3.41 $2.98 sz.sz I 990 I 991 1992 I 993 1994 I 995 I 996 1997 I 998 t999 2000 s2.06 $1.64 $1.45 $l.x $11t soqz _ $!.82 _$ry3 $0.41 so.zz $0.04 TOTAL MWMC CREDIT : 0.000 x $0.00 IF IMPROVEMENTS OCCURRED VALUE / 1OOO 0.000 x CREDIT RATE $0.00 FIXTURE TYPE J 1013U2002 4:30:51PM City of Springfietd Development Services Department Public Works Department Official Receipt 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Receipt #: 2200200000000000 1 36 Date: 1013112002 rne Items: Job/Journal Number Amount Paid coM2002-01258 coM2002-01258 coM2002-012s8 coM2002-01258 coM2002-01258 coM2002-01258 Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration + 5%o San & Storm Admin Fee ryments: 375.s3 285.43 332.86 34.83 10.00 51.93 Line ltem Total:$1,090.58 Type of Payment Paid By Received By Check Number Confirm No How Received Amount Paid Check PEPSCO LLC dlm 1022 In Person 1,090.58 TotaI: Page I of I cReceipt.rpt ltGTMfrJJil Descrintion CCB - Find A Licensee - fts51rlrs Find A Licensee - Results Name ALLTUCKER, ELIZABETH ANN ALLTUCKER, JOHN MICHAEL ALLTUCKER, JOHN WALLACE Description Corporate Officer Corporate Officer Corporate Officer Page I of2 Effectivr 2t23t200 1t1t1990 2t23t198 LICENSE NUMBER: NAME: ADDRESS: WORK PHONE NUMBER: LICENSE STATUS: EXPIRATION DATE: 44524 EUGENE SAND & GRAVEL INC PO BOX 1067 EUGENE OR 97440-1067 5416836400 DATE FIRST LIGENSED:2t23t1984 BOND COMPANY: AMERICAN INSURANCE co BOND AMOUNT: BOND EFFECTIVE TO: $ 15000 2t23t2005 Associated Name lnformation License Number 44524 44524 44524 Bond lnformation License Number 44524 44524 44524 ENTITYilp;,' Corporation LICENSE General CATEGORY: Contractor/All Non-Exempt (Has Employees - Must Have Workers' Comp Coverage) ST PAUL INSURANCE FIRE & GOMPANY: MARINE INS CO INSURANCE AMOUNT: INSURANCE EFFECTIVE TO: $ 1000000 3t31t2003 Entity Type cPo cPo CPO Bond Gompany 12 - AMERICAN INSURANCE CO 12 - AMERICAN INSURANCE CO 12 . AMERICAN INSURANCE CO Bond Number s16450691 s16450691 s16450691 Bond Amount $15,000 $10,000 $5,000 Active 2t23t2005 EMPLOYER STATUS: lnsurance lnformation http://ccbed.ccb.state.or.us/new_web/asp/new_search_resultsjrint.asp?regno:44524 1013112002 CCB - Find A Licensee - ft951,1t5 lnsurance Company 85 - ST PAUL FIRE & MARINE INS CO 106 - RELIANCE INS CO - EXPIRED 4t30t01 106. RELIANCE INS CO - EXPIRED 4t30t01 106. RELIANCE INS CO - EXPIRED 4t30t01 Policy Number Policy Amount Effective From Page2 of 2 Effective To KK08700067 1000000 9t22t2000 3/31/2003 44524 PQ113441002 1000000 5t1t2000 5t1t2001 44524 PQ1134410 500000 5/1/1998 5t1t2000 44524 Q811344105 500000 5/1/1995 5/1/1998 Specialized Training lnformation Name No records returned. Description DISCLAIMER: lnformation concerning contractor credentials and specialized training has been obtained by the Construction Contractors Board (CCB) from contractors who want this information noted in their licensing records. The contractor must also notify the CCB if the credential has expired or terminated. As a result, the CCB does not warrant or guarantee the existence or accuracy of the information about the credentials or specialized training. SIC Codes License Number 44524 SIC Code 1611 1623 17 11 Description Highways And Streets Water, Sewer, Pipeline Communication And Power Lines Plumbing, Heating And Air Conditioning http://ccbed.ccb.state.or.us/new_web/asp/new_search resultsjrint.as p?regno:44524 l0l3ll2OO2