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Home My WebLink AboutPermit Building 2001-07-30SI:'NTNGFIELD Job# 01-00617-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 3 Job Number: 0't-0061 7-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 00900 Subdivision: 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 7655 Thurston Rd Spr AssessorsMap#: 17023511 Lot: Block: Addition: clTY oF SPRTNGFIELD, OREGON Owner: Roy Carmack Address: 7655 Thurston Road Scope Of Work: Single Family Residence Addition to existing house Phone Number: City/State/Zip: New 541-741-1731 Springfield, OR 97478 Value: $65,000 Contractor Type GeneralContr Contractor Roy Carmack 7655 Thurston Road, Springfield, OR 97478 Registration # Expiration Date Phone 541-741-1731 Quad Area: # Of Units: Constr. Type: Water Heater: 5RNE I (VN) Wood Frame Office Use - Land Use: Zoning Code: LDR Bedrooms: Range: # Of Buildings: 1 Occupa Heat 824 7:00 the following : Accessory Structu To request an inspection call the 24 hour recording at a.m. will be made the same working day, inspections working day.ps nsrS Footing Foundation Post and Beam Floor lnsulation Ceiling lnsulation ShearWall Nailing Framing Walllnsulation Drywall FinalBuilding Rough Electrical Final Electrical -After trenches -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. -Prior to Cover -Prior to taping. -When all required inspections have been Electrical -Prior to cover. -When all electricalwork is complete a (U\s Required oh'{ ? Underfloor Plumbing Underfloor Drain Rough Plumbing Shower Pan Storm Sewer Line Drywell FinalPlumbing Underfloor Mechanical Rough Mechanical FinalMechanical Job# 01-00617-01 Required lnspections Plu - Prior to insulation or decking. - Prior to cover or placement of concrete. - Prior to cover. - Prior to fllling trench. - Engineered Drywell is required. -When all plumbing work is complete Mechanical -Prior to insulation or decking. -Prior to cover. -When all mechanicalwork is complete. Page 2 of 3 Zoning: LDR FloodPlain? ! Wetlands? [ Overlay District: # of Street Trees: 3: Additional Requirements: Required Aftachments: Source Locn: Material: Flood PIain FEMA: Land Use: Pave Driveway? Panel 1167 of2975 Journal numbers 1: 2: Comments: Planner: Liz Miller Urban Growth Boundary?! Glenwood Area? [ Quantity Of Fill: Supplier: Drainage: Floodway FEMA: Zone X White Construction Types(VN) Wood Frame Occupancy Groups:Accessory Structure # Of Buildings: 1 # Of Bedrooms: Handicap Access? # Of Stories: 1 Height (feet): Current Units: Proposed Units:1 Gensus Gode: Does not apply Area (Sq. Main:824 Accessory400 Total:1224 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check ResidentialPlan Check Total Plan Check 0611512001 5842 65,000 $213.20 $2'.13.20 Buildins Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 0713012001 071301200'l 0713012001 6279 6279 6279 65,000 $328.00 $22.96 $9.84 $360.80 Electrical Branch Circuits WO Feeder or Service State Surcharge - Electrical Administrative Fee - Electrical Total Electrical 07t30t2001 07t3012001 0713012001 6279 6279 6279 7 $47.00 $3.29 $1.41 $s1.70 Job# 01-00617-01 Page 3 of 3 Fee Paid On Receipt# Value/Quantity Fee Amount Plumbinq Minimum Plumbing Permit Fee Number of Fixtures State Surcharge - Plumbing Storm Sewer Footage Administrative Fee - Plumbing Total Plumbing 0713012001 07t30t2001 07t3012001 0713012001 0713012001 6279 6279 6279 6279 6279 b 15 $.oo $60.00 $5.95 $25.00 $2.55 $93.s0 Mechanical Minimum Mechanical Permit Administrative Fee - Mechanical Vent Fan to One Duct Alter/Add to ea Appl Unit or System Dryer Vent Mechanical lssuance State Surcharge - Mechanical Total Mechanical 07t30t2001 0713012001 07t3012001 0713012001 0713012001 0713012001 0713012001 6279 6279 6279 6279 6279 6279 6279 1 1 1 $.00 $.63 $3.00 $15.00 $3.00 $10.00 $1.47 $33.10 Residential- Single Family - Storm SDC Administrative Fee Total System Development 0713012001 07t30t2001 6279 6279 1,368 $185.36 $e.27 $194.63 Grand Total Plan Check Type lnitial Review-Res Engineering-Res Planning-Res Structural-Res Checked By Bob Barnhart Steve Templin Liz Miller Don Moore Date Completed 0611812001 0612212001 0612912001 $e46.93 Comment Need Lane Co Appvl. for septic system (for added bedroom) and drain field location/possible conflict with building. Owner provided information indicating that existing bedroom is being rebuilt bigger and that the sewer line adjacent to the addition is a solid line serving the former bathroom & utility room. There are no added bedrooms or bathrooms, and the drainfield is remote from the addition on the site. The Septic tank is 1000 gal. concrete, according to the owner. lt appears that no septic modifications or permits are necessary. Structural-Res Don Moore 07t06t2001 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. t furthei 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. ?=E *i ,.*,(, C-*-r,*.o-e-A_7-5t *o CITY OF SPRINGFIE SYSTEMS DEVELOPMENT CH. .}E WORKSHEET NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS:O BUILDING SIZE: O SF LOT SIZE: O SF 7655 THURSTONROAD t7-02-35-t l-00900 CARMACK ADDITION JOURNAL OR JOB NUMBER: 0l-00617-01 IMPERVIOUS S.F COST PER S.F DISCOUNTRATE 1368.00 90.27t 50% IMPERVIOUS S.F 0.00 COST PER S.F $0.27t $0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS $18s.36 x x x I. STORMDRAINAGE DIRECT RLINOFF TO CITY STORM SYSTEM $185.36ITEM 1 TOTAL - STORM DRAINAGE SDC COST PER DFUNUMBER OF DFU's .0001 6.15 NUMBER OF DF[.]'S 0 COST PER DFU $21.2s $0.00 B.IMPROVEMENT COST: x x 2. SAMTARY SEWER- CITY A. REIMBURSEMENTCOST: $0.00ITEM 2 TOTAL - CITY SANITARY SEWER SDC NEW TRIP FACTORNUMBER OF I.INITS COST PER TRIPADT TRIP RATE 1.00 $0.000$68.ss9.57 ADT TRIP RATE 9.57 NUMBER OF UNITS 0 COST PER TRIP sl6.12 $0.00 NEWTRIPFACTOR 1.00 B.IMPROVEMENT COST: xxx xxx 3. TRANSPORTATION A. REIMBURSEMENT COST: $0.00ITEM3 TOTAL - TRANSPORTATION SDC $0.00 NUMBER OF FEU's 0 COST PER FEU $28s.91 $0.00 0 COST PER FEU $24.33 $0.00 s0.00 SUBTOTAL OF MWMC REIMBT]RSEMENT,IMPROVEMENT & CREDIT MWMC ADMINISTRATIVE FEE $0.00 B.IMPROVEMENT COST: x x MWMC CREDIT IF APPLICABLE (SEE REVERSE) 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: $0.00ITEM 4 TOTAL - IT{WMC SANITARY SEWER SDC $185.36SUBTOTAL (ADD ITEMS 1,2,3, &4) ADM. FEE RATESUBTOTAL s9.275%$ 18s.36 5. ADMINISTRATIVE FEE: x $194.63 (r)r! cU &r!F(n cI!& 1070 l09l r092 1093 r094 1055 1056 t073 7l30l0rStu4.Tu*l;4- SDC COORDINATOR TOTAL SDC CHARGES DATE NUMBER OF FEI..]'S UTU NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE LTNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE FIXTURE UNITSFIXTURE TYPE (#NEW - #OLD )x UNIT EQUIVALENT BATHTI-]B ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( 0 0 )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x J 0 DRINKING FOLINTAIN 0 0 1 0 FLOORDRAIN 0 0 J 0 INTERCEPTORS FOR GREASE I OIL I SOLIDS / ETC 0 0 J 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 0 LAUNDRYTIJB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 J 0 CLoTHESWASHER- 3 ORMORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 t2 0 RECETO&FORREFRTG / WATER STATTON/ ETC. RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 I 0 0 0 J 0 SHOWER, SINGLE STALL 0 0 2 0 sHowER, GANG ALIMBER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 J 0 SINK: COMMERCIAL BAR 0 0 2 0 SINK:DOMESTIC BAR 0 0 1 0 WASHBASIN 0 0 2 0 LAVATORY 0 0 I 0 URINAL, STALL/WALL 0 0 5 0 PUBLIC INSTALLATION 0 0 6 0 TOILET, PRIVATE INSTALLATION 0 0 J 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU's* ( 0 - 0 )x 20 0 TOTAL DRAINAGE FIXTURE UNITS : *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day 0 DRAINAGE T ..URE UNIT CALCULATIC ]ABLE MWMC CRE,DIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE $0.00 IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEPARATELY CREDIT FOR LAND (IF APPLICABLE) CREDIT FOR IMPROVEMENT (IF AFTERANNEXATION)$0.00 YEAR ANNEXED CREDITRATE PER SI,OOO ASSESSED VALUE YEAR ANNEXED CREDIT RATE PER $I,OOO ASSESSED VALUE 1979 OR BEFORE s4.74 I 990 $ r.96 I 980 $4.6s l99l $1.55 198 I $4.59 t992 $1.36 1982 s4.46 1993 $1.23 1983 $4.30 1994 $ 1.05 1984 $4.14 I 995 $0.90 I 985 s3.93 1996 $0.75 I 986 $3.63 1997 $0.57 1987 $3.26 I 998 s0.35 I988 s2.85 1999 $0.1 5 l 989 $2.40 $0.00 TOTAL IVIWMC CREDIT x 0.000 x $0.00 VALUE / IOOO 0.000 CREDITRATE s0.00 UNDERGROUND INJECTION CONTROL REGISTRATION Single-Family Stormwater Discharge & Geothermal HeaUng SYstemsa EErI Oregon Department of Environmental Quality (see pp. 2 for detailed insbudions) LegalNamqp<o C^r ;J6-a1 €-2. CommonName:' City, State, Zip Code: $pr1 ,.1d - t rl O < 17 V7 y 4. FacilityMailing Ad&ess: City, State, Zip Code:7\Sen^e- 5. Latitude: 44 a"gr"o 3 Xinur"s /a seconds Longinrdc /Q.3a"gr.o .s3 -.,4[- secondsminutes 7- ResponsibleOfficialNamq 5 ccrra. €_, Address: city, Stare,zp codc: 6. FacilityConactName: 2o-( d-"ne5 Cc.crr o-l< ContactTelephone#: 5V/- ?.{ l- l-7 O t Fax #: l. Land usc zoning of facility: E mAusrial fl Commercial frResidential E Ottr". 2. Drinking water source: Monthly average us:rge (galld"v),!|Q-? E Public water [t hivate Well 3. Depth to winter high water table: - feet If not available, iverage depth to groundwater: l20 feet 4. What other means to dispose of the water are available to you? (e.g. city stormwater)PA 5. Distancetonearestdomestic/pubticwaterweU ?oQ {cef 6. Source of injection water (check one;: fiRoof E Paved area (&iveway or street) tr Shop/Garage fl Other- 7. Well Type: El CeottremrA Heat Districts or Building Drywell E] Floor Drain D Cbscd Irop Heat Pump Return - Resid€otial Usc I Specia Drainage Watcr El Stormwater (sump, drywell, roof drain) [ Ottrer Wetts _ 8. Well Status: [l ective I Under Construction I Inactivey'l.Iot.in usc ft Decommissioned (closed) g. InstallationDate, 7 - "2oo 1 10. Well Depth: _-. 6 ker ft WellDiaureter: 4"u'/' n I I . Ifyou have more than one well, please explain here:Atso .Yfs r"n c,o{ <r- c,.)< it 1t -<A ct-r o- 12. List any other DEQ or public agency permits applied for or issued to this facility:G er +ts o t7-o To the of fill out this form in its I hereby certify that the information contained ln this reglstrauon is true and correc-t to the best of my knowledge and belief. t{qtn-ta Ol,Jn e r or Print) ?- 3oo t of Legally Authorized Title Date {r.rr-e J Cn-.r^^.o<-[<-Ur?o Name of Legally A. FACILITY NAME, LOCATION & CONTACT C. SIGN,\TURE OF LEG.\LLY .IUTIIORIZED REPRESENT,\TIVE DEQ\WQ\document # UICGEO- I OO4 (0 l/0 r )I of 2 Jl=, B. FACTLITY DESCRTPTION (ATTACH DOCUMENTS AS NEEDED).. UIC REGISTRATION INSTRUCTIoNYFOR SINGLE FAMILY STORM WATER DRATNA'GE AND GEOTHERMAL SYSTEMS A FACILITY NAME, LOCATION & CONTACT l. Enter the legal name of the applicant. This name must be the legal Oregon corporate name (i.e., Acme Products, Inc.) or the Iegal rcpresentative of the company if the company operates under an assumed business name (i.e., John Smith, dba Acme Products). The name must be a legal, active name registered with the Oregon Department of Commerce, Corporation Division (503) 378-4752, unless otherwise exempted by the Department of Commerce regulations. 2. Enter the common name of this facility if different than the legal name. 3. Enter the physical location ofthe facility (not mailing address), including city, state, and zip code. 4. Enter the mailing address of the facility if different from the physical location. 5. Enter the latitude and longitude of the approximate center of the facility or site in degreeVminuteJseconds. Latitude and longitude can be obtained from United States Geological Survey (USGS) quadrangle or topographic maps by calling l-888 ASK-USGS, orby accessing MapBlast's web site at http:/rwww.mapblast.com/mblast/mAdr.mb. DEQ also has instructions for obtaining latitude and longitude from maps at http://waterqualitv.deq.state.or.us/wq/wqpermiVLatLonglnstr.ndf or by calling the number at the end of these instructions. 6. Enter the name, telephone and fax number of the facility contact; this would be the person to call in case there are any questions about this registration. 7. Enter the name and mailing address of the responsible official or organization, if different from #4. 2. FACILIW INFORMATION l. Indicate if the facility is located on property that is zoned for industrial, commercial, residential, or some other use. 2. Estimate the monthly average usage of drinking water in gallons per day and indicate the source. 3. Provide the depth in feet to the winter high water table. If that information is unavailable or unknown, provide the average depth to grormdwater in feet from your well log. If you do not have your well log; you may be able to access it through the Orcgon Water Resources Dspartrnent (WRD) web site at http://www.wrd.state.or.uVeroundwater/index.shtrnl. or by calling l-800-62+3199 (toll-free in Oregon) or (503) 378-8455. The Natural Resource Conservation Service in your area may also havethisinformation. f.t_.:, 't \ t. t '/ 4. Indicate if therc are any other means to dispose of this wastewater. 5. Estimate the distance in feet of the UIC system to the nearest dotnestic or public water suPPly well. This information is used by the DEQ to evaluate the risk to sensitive sites that could be impacted by accidental spills or contamination. 6. Indicate the source of injection water (roof drain downspout, driveway, floor drain in garage, etc.). 7. Select the well type(s) that you are registering. 8. Enter whether the UIC system is active, under constnrction, inactive, or permanently abandoned (closed)- g. Enter the date the UIC system was installed. The year of installation is sufficient. 10. Enter the well depth and diameter in feet. I l. If you have morc than one well, state the total numbeir of wells and describe. Attach a sketch showing the relative positions of the buildings and drYwells. 12. In order for DEe to cooidinate with other DEQ offices and public agencies, list all permits applied for or iszued to this facility. .c.SIGNATUREoFLEGALLYAUTHoRIZEDREPRESENTATIVE The sigrrature ofa legally authorized representative must be provided in order to process this registration' REGISTRATION SI'BMITTAL AND QUESTIONS t I sole Proprietorship - owner(s) [eoch owner must sign the applicationJ o Ctty, County, State, Federel, or other Public Facility - Principal executive offtcer or ranking elected ofiicial o Limited Uabiltty Company- Member [articles of organizationJ of general aorbusinesswhofrrnctions;or performs principalanypergontreasurer,vice-presidengpresident,secretaryaCorporation to documentszuchaccordancelntosigrISthatauthorizedcorporateprocedureoneofmoreorfacilitiesmanager andtheiraddresses numbersJtelephoneGeneralPAftners,flistpartneraPartnership a Trusts - Acting trustee fiist of truslees, their addresses and telephone numbersl Plc'ase also p rovide the inlormation requested in brackets 1/ Definition of Legalty Authorized Represeniative: Avenue,OR 972046rhPortland,I8 SWIaterwDivision,DEQ Quality Priest atBarbaracontact (503)For questions, 229-6993TTYinside503)II (ator -80045240 Oregon),I (toll-free, Or Site:thevisit NetUIC Send the reg istration form to the DEQ Water Quality Division: DEQ\WQ\ document # UICGEO-1004 (7/00)2 of} 229-5945, approval " Zoning 225 FIFTE STREET SPRTNGFTELD, oREGoN INSPECTION REQTIEST: oFFICE: 726-3759 9 LEGAI DESCRIPTION OL OO JOB DESCRTFTION 180 days. 2. CONTRACTOR INSTAII.'ATION ONLY Electrical Contractor- Address Ci Supervisor Li r Expirat ion constr con r Expiration Date Signature of Supervising Electrician Ovners Name L_ -/Ad,dress /b TA u'reS ci Phone V// ' n3 I CAL PBRHIT APPLICATION ity Job Nunb .r(A 3. COHPLETE TEE SCMDULE BEtOg Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost Each additional 500 sq. ft or portion thereof Each Manuf'd Eome. or Modular Dvelling Sertice or Feeder $ 8s.00 $ 1s.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: SD,STTilGFBELI, 200 amps or less 201 amps to 400 amPs - 40L amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amPs/volts - Reconnect 0n1Y The following prolect as submitted has the following zoning, ano doe6 not require specilic land use 0 A Sum I/\Permits are non-transferable and expire Gf vork is not started vithin 180 days of iss\ance or if vork is suspended for s s0.00 s 60.00 s100.00 s130. 00 $300.00 $ 40.00 40.00 40.00 20.00 36.00 ee trBtr aE66 .>{ $ 35.00 ) ) $ z.oo iz c D. 5. SUBTOTAL OF ABOVE 7% State Surcharge 3Z Admini.strative Fee TOTAL 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 1OOOloITs $ $ $ s $ $ $ $ 40.00 s5.00 80.00 Branch Circuits Nev, Alteration or Extension Per Panel OIJNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent' E. Miscellaneous (Service/feeder not included) one Circuit -LEach Additional Circuit or vith Service, or Feeder Permi t L- -Each installation Pump or irrigation Sign/0ut1ine Lighting- Limited EnergY/Res - Limited EnergY/Commture: ,{7 DATE:ab.--yZRBCEIVED l.j (r- )-1 LDL - oC-t€>t 7 -C I '' S#Y'#,i'ifX":[ rtt t?9ad Signa BI: