HomeMy WebLinkAboutPermit Building 2001-06-21Job# 01-00564-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 3
SPRINGFTELD \jgr_'.,t t L-l
h,
i ai!_'uiLLr:i;itr:iJJ-lLrl l-:-Lli r LJIJ-!
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1919 00022nd St Spr
AssessorsMap#: 17032500
Lot:53 Block: Addition:
Job Number: 01-00564-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00204
Subdivision:Maia Park
crTY oF SPRTNGFTELD, OREGOTV
Owner: William Simmons
Address: PO Box 177
Scope Of Work: Manufactured Home in Park
Space 53
lvlH in nark
ContractorType Contractor
GeneralContr Gooden-Harrison Construction
1441 hwy 99n, Eugene, OR 97402
ElectricalContr Hertiage Electric
X,X,X
Registration # Expiration Date
Phone Number:
City/State/Zip:
New
541-915-4191
Siletz, OR 97380
Vatue: $63,069
Phone
541-689-7762
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
2RNW
1
(VN)Wood Frame
Office Use
-
Land Use: Mfg Home - Not in a ParJ # Of Buildings: 1
Zoning Code: LDR Occupancy Group: Dwelling
Bedrooms: Heat Source:
Range: Sq. Footage: 1782
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
Buil
Verify Ground Rod
Footing
Foundation
Shear Wall Nailing
Framing
FinalBuilding
MH Electrica!
Rough Electrical
MH Service
Final Electrical
- 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.
-Before covering sheathing with finish materials.
- Prior to cover.
-When all required inspections have been approved and the building is complete.
Electrical
-When blocking, setup, and plumbing inspections have been approved and the home is connect
-Prior to cover.
-When all electrical work is complete.
Underfloor Drain
MH Plumbing
Water Line
Sanitary Sewer Line
Storm Sewer Line
FinalPlumbing
MH Set Up
MH Final
Zoning: LDR
FloodPlain? [ Wetlands? !
Journal numbers
1:
Comments:
Planner: Liz Miller
Urban Growth Boundary?[
Quantity Of Fil!:
Supplier:
Drainage:
Floodway FEMA: n/a
Overlay District:
# of Street Trees:
3:
Additional Requirements:
Glenwood Area? [ Required Attachments:
Source Locn:
Material:
Flood Plain FEMA:nla
Land Use: Mfg Home - Not in a Park
Pave Driveway? E
Job# 01-00564-01 Page 2 of 3
Required lnspections
Plumbing I
- Prior to cover or placement of concrete.
-After home has been connected to water and sewer.
-Prior to filling trench.
-Prior to filling trench.
-Prior to fllling trench.
-When all plumbing work is complete.
ufactured Home
-When all blocking is complete.
-After all required inspections are approved and porches, skirting, decks, venting, house number
2
Construction Types(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings: 1
# Of Bedrooms:
Handicap Access?
# Of Stories: 1
Current Units:
Census Code: New Mfg Home
Height (feet):
Proposed Units:1
Area (Sq.
Main:1782 Accessory*40 Total2222
Fee Paid On Receipt# Value/Quantity Fee Amount
PIan Check
Residential Plan Check
Total Plan Check
06t04t2001 5651 13,069 $67.93
$67.93
Building Permit
Foundation Only
State Surcharge For Building Permit
Building Administrative Fee
Total Buitding
Building
06t2112001
06t21t2001
0612112001
06121t2001
591 1
591 1
591 1
591 1
8
5
,069
,000
$74.50
$50.50
$8.75
$3.75
$137.50
Manufactured Home Service\Feeder
Branch Circuits With Feeder or Service
State Surcharge - Electrical
Administrative Fee - Electrical
Total Electrical
Electrical
0612112001
06t21t2001
06t21t2001
0612112001
2
1
$80.00
$2.00
$5.74
$2.46
$90.20
591 1
591 1
591 1
591 1
Job# 01-00564-01 Page 3 of 3
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbin
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Water Service Footage
Sanitary Sewer Footage
Storm Sewer Footage
Manufactured Home Connection
Administrative Fee - Plumbing
Total Plumbing
06t2112001
0612112001
06t21t2001
0612112001
0612112001
0612112001
06t21t2001
591 1
591'1
591 1
591 1
591'1
591 1
591 1
50
50
80
1
$.00
$7.35
$25.00
$2s.00
$40.00
$15.00
$3.15
$115.50
Manufactured Home Setup Fee
Manufactured Home State lssuance
State Surcharge For Manufactured Hom,
Manufactured Home Administrative Fee
Total Manufactured Home
Manufactured Home
06t21t2001
0612112001
06t2112001
06t2112001
591 1
591 1
59'11
59'11
50,000
1
$105.00
$40.00
$7.35
$3.15
$155.50
Residential- Single Family - Storm
Sanitary Sewer
Residential Transportation
Residential Sanitary MWMC
Residential lmprovement MWMC
MWMC Administrative Fee
Sanitary Sewer SDC Reimbursement
SDC Administrative Fee
Transportation SDC Reimbursement
Tota! System Development
System Development
06121t2001
06t21t2001
06t21t2001
06t21t2001
0612112001
06t21t2001
0612112001
06t2112001
06t2112001
591 1
591 1
591 1
591 1
591 1
591 1
591 1
591 1
591 I
2,856
20
1
1
1
1
20
$773.98
$323.00
$656.02
$285.91
$24.33
$10.00
$425.00
$132.63
$154.27
$2,785.14
Manufactured Home - Willamalane
TotalWillamalane SDC
Willamalane SDC
06121t2001 5911 $1,000.00
$1,000.00
Grand Total
Plan Check Type Checked By Date Completed Comment
lnitial Review-Res Bob Barnhart 06/05/2001
Engineering-Res Steve Templin 0610712001
Planning-Res Liz Miller 0611212001
Structural-Res Tom Max 0611212001
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*rry)dil:,^:- remain on the site at alltimes durins construction
$4,35'.1.77
Signature
.o
1
1
Date
n
Willamalane
Park & Recreation District
NAME n QL;,^^ \
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
Job. No.
ttPHONE:-\\1\
zP: t'l
d
\SrATE: OqADDRESS:
LOCATION OF PROPOSED BUILDING SITE:
Street Address:\1\1 *\ \t S5
Plat Name: lt lOS&Scn - Tax Lot Number: CJt>&_Oc{
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calcrllalions and dwelling t
ype detinitions are on the back.)
A. Single-Family Detached
Single Family home f Manufactured home not in a park
CA
NO. OF UNITS X $1,000 per unit = $tGr t)__
B. Single-Family Attached
NO. OF UNITS X $924 per unit $
C. Multi-Family Apartment
NO. OF UNITS X $692 per unlt
D. Manufach'red Home Park
NO. OF UNITS X $699 per unlt
WILLAMALANE SDC
2. SDC CREDTT ([ applicable) SDOaayermust (umlsh proo( of
Willamalane Credit approval. See SOC Crcdit Wotl<shoet.
3. TOTAL WILLAMALANE NET SDC ASSESSED
(lf SOC reduoed for Credit)
$
$
$
$
$
Services -L,Date
eld
2/o/
C>\ qps6.to\
I
-CITY OF
.TPFlINGFIELO
approval.
Zoning
225 FIFTB STREET nate
SPRINGFIEI,D, OREGON 9747,7norized sisnature
INSPECTI0N REQI ESTI 726-3769
0FFICE: 726-3759
The following project as submitted has the followifio
zoning. and-does not require specific land use
r> ((
3t-o{
^ut't+g'o*# u=
3
A
PERHIT APPLICATION
City Job Nurnber O/ -oos67-c t
COMPI.ETE FBE SCEEDII.^E BELOS
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
l-
1 LOCATION OFt7t1 zz
IJGAL DESCRTPTIONnD3 ZS6a AOZDL/
DESCRTPTION
'/C -L Ct fc*'i
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRAC:TOR INSTALI.,ATION ONLI
/ 1000 sq.ft. or less.+ Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
-Hodular 'DveIIing
SerVice or Feeder 1-
Services or Feeders
Installation, Alterations
or Relocation:
Su
i
\$ 8s.00
$ 1s.00
g 40.00 80
00
oo
ee (Br a56G
B.
te,-ffu>
!
I
I
Electrical Contractor
Address 21L ,4''*fip-
6-zr-r- Phone 74J - /Soct
200 amps or less $
20L amps to 400 amps
-
$
401 amps to 600 amps
-
S
601 amps to 1000 amps- $0ver 1000 amps/voIts
-
S
Reconnect 0n1y S
200 amps''or less $
201 amps to 400 amps
-
$
0ver 401 to 600 amps
-
$
Over 600 amps or 1000-T6ffis s
Branch Circuits
-Each installation
Pump or irrigation $
Sign/outline Lighting- S
Limi ted Energy/Res
-
$Limited Energy/Comm $
SUBToTAL 0F ABoVE
'7 fl State Surcharge' 32 Administrative Fee
TOTAL
00
00
00
00
00
00
50.
60.
100
130
300
40
Ci ty-_--_v--
Supervisor License Number
Expiration Date 1U a{
Constr Contr. Number
C. Temporary Services or FeedersInstallation, Alteration or Relocation
VF€_S
9
Expiration Date
Signature of rv]'s
0040.
55.
80.ing Electrician
h5'^*'
0wners Name
Address
ci Phone
OVNER TNSTALINTION
The installation is being made onproperty I ovn vhieh is not intended
for sale, Iease or rent.
0nners Signature:
DATE:
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each AdditionalCircuit or vith Service, .;.
or Feeder Permir I $ 2.00 2
E. Hiscellaneous (Service/feeder not includer
S
40.00
40.00
20.00
36.00
8L
RBCETVED
5
I
D.
,a a
CITY OF SPRINGFIEL-SYSTEMS DEVELOPMENT CHA }E WORKSHEET
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS:I BUILDING SIZE: 2222 SF LOT SZE: 7434 SF
1919 22ND # 53
t7-03-25-00-00204
STNGLE FAMILY RESIDENCE
SIMMONS
JOURNAL OR JOB NUMBER: 0l-00564-01
DISCOUNT RATECOST PER S.FIMPERVIOUS S.F
$0.00$0.271 50%0.00
IMPERVIOUS S.F
2856.00
COST PER S.F.
s0.271 $773.98
RLiNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY ST
x
x x
ANDARDS
1. STORMDRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
$773.98ITEM l TOTAL. STORMDRAINAGE SDC
COST PER DFUNUMBER OF DFU's
.00$ 16.1520
NUMBER OF DFU's
20
COST PER DFU
$21.2s $425.00
B.IMPROVEMENT COST:
x
x
2. SAMTARY SEWER- CITY
A. REIMBURSEMENT COST:
$748.00ITEM 2 TOTAL. CITY SANITARY SEWER SDC
COST PER TRIP NEWTRIP FACTORADT TRIP RATE NUMBEROF UNITS
1.00 $6s6.02I9.57
ADT TRIP RATE
9.57
NUMBEROF UNITS
I
COST PERTRIP
$ 16.1 2
NEW TRIP FACTOR
L00 sts4.27
B. IMPROVEMENT COST:
xxx
xxx
3. TRANSPORTATION
A. REIMBURSEMENT COST:
$810.29ITEM3 TOTAL. TRANSPORTATION SDC
$10.00
NUMBER OF FEU's
I
COST PER FEU
$28s.91
NUMBEROF FEU's
I
COST PER FEU
s24.33 $24.33
$0.00
SUBTOTAL OF MWMC REIMBURSEMENT,IMPROVEMENT & CREDIT
MWMC ADMIMSTRATIVE FEE
$310.24
s285.91
B. IMPROVEMENT COST:
x
x
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
$320.24ITEM 4 TOTAL.IIYIWMC SANITARY SEWER SDC
5lSUBTOTAL (ADD ITEMS 1,2,3, &4)
SUBTOTAL ADM. FEE RATE
I 5%$132.63
5. ADMIMSTRATIVE FEE:
x
$2,785.14
617l0tttu4ck4l^l;r-
SDC COORDINATOR
TOTAL SDC CHARGES
DATE
a
IJ]coU
&r!Fa
O
IJ]&
1070
109 I
t092
1093
1094
1055
1056
1073
DRAINAGE f IURE UNIT CALCULATIC IABLE
NUMBER OF NEW FIXTURES x I.INIT EQUIVALENT = DRAINAGE FIXTURE UNITS
FOR CALCULATE ONLY THE NET ADDITIONAL
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
DRAINAGE
FIXTURE
UNITSFIXTURE TYPE (#NEW - #OLD )x UMT
EOUIVALENT
BATHTUB (
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
2-0
0-0
0-0
0-0
0-0
0-0
1-0
0-0
0-0
0-0
0-0
0-0
0-0
l-0
0-0
0-0
0-0
2-0
0-0
0-0
2-0
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
x
x
x
3 6
DRINKING FOLINTAIN I 0
FLOORDRAIN J 0
INTERCEPTORS FOR GRIASE I OIL /SOLIDS / ETC.x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
3 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC 6 0
LATINDRY TUB 2 0
CLOTHESWASHER / MOP SINK 3 3
CLOTHESWASHER - 3 OR MORE (EA)6 0
MOBILE HOME PARK TRAP (I PER TRAILER)t2 0
RECEPTOR FOR REI'@N / ETC.
RECEPTOR FOR COM. SINK / DISHWASHER / ETC'
I 0
J 0
SHOWER, SINGLE STALL 2 0
SHOWER, GANG AUMBEROF HEADS )2 0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN J 3
SINK: COMMERCIAL BAR 2 0
SINK:DOMESTIC BAR I 0
WASH BASIN 2 0
LAVATORY I 2
URINAL, STALL/WALL 5 0
TOILET PUBLIC INSTALLATION 6 0
TOILET, PRIVATE INSTALLATION J 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU's*
( 0 - 0 )x 20
TOTAL DRAINAGE FIXTIIRE UNITS
0
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
$0.00
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEPARATELY
CREDIT FOR LAND (IF APPLICABLE)
CREDIT FOR IMPROVEMENT (IF AFTERANNEXATION)
$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 $4.74 I 990 r.96
l 980 $4.65 199 I s1.55
198 I $4.59 1992 $1.36
1982 s4.46 I 993 s 1.23
1983 s4.30 1994 $1.0s
I 984 s4. l4 I 995 $0.90
1985 $3.93 1996 $0.75
I 986 $3.63 r997 s0.s7
I 987 $3.26 I 998 $0.35
I 988 $2.85 1999 $0. ls
l 989 $2.40
TOTAL MWMC CREDIT :
0.000 x $0.00
VALUE / IOOO CREDIT RATE
0.000 x $0.00
NO. OF FIXTLIRES
CITY OF OREGO'V
SPB. -,FIELO
DEV ELO P M ENT SERVI C ES D E PARTM ENT 225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
MANUFACTURED HOME LAND USE AGREEMENT
As required by the City of Springfield Development Code, I agree that the of
permits, one of the following manufactured homes will be at .z-
Springfield, Oregon, City Job Number
Type I Manufactured Home. A multi-sectional (double wide or wider) unit with an enclosed
floor area ofnot less than 1,000 square feet, that has a nominal roofpitch of3 feet in height for each 12
feet in width, that has no bare metal siding or roofing, and that has been certified by the manufacturer to
have an exterior thermal envelope meeting performance standards which reduce heat loss to levels
equivalent to the performance standards required of single family dwellings constructed under the State
Specialty Codes.
Type II Manufactured Home. A unit of not less than 12 feet in width with an enclosed floor area
of not less than 500 square feet, that has a nominal roof pitch of 2feet in height for each 12 feet in width
and that has no bare metal siding or roofing.
The manufactured home shall be placed on an excavated and back-filled foundation not to exceed 6
percent slope within l0 feet of the perimeter enclosure. The perimeter foundation wall surrounding the
home shall be constructed of stone, brick or other masonry materials, and with no more than24 inches of
the enclosing material exposed above grade.
I further agree to meet all land use and City Code requirements of the above mentioned parcel within 60
days of the date of issuance of the manufactured home set up permit. These requirements may include, but
are not limited to the items listed below. Specific land use requirements regarding your parcel are noted on
your approved set up plans and/or permit and your partition approval ifapplicable:
o Street Trees
. Paving Driveway
o Minimum 32 square foot storage structure
r Completion of partition approval
o Removal of any existing structures as noted on your partition approval
. Signing and recording of any required partition, easement, improvement agreements, etc
o Final lot grading
. City Sidewalk and curbcut installation
. Any outside agency approval as required i.e., Division of State Land approval.
By my signature below, I agree to complete the above mentioned land use requirements.
Owner Signature Date
6-zl-or
Contractor Signature Date
-