HomeMy WebLinkAboutPermit Field Test & Inspection Report 2005-04-04li c.o cA ?,c,os-oo tt3
- Pnesal
Building Pcr.mit #
tP /\tNo PttLq {Porqrs
I
II
t
I
I
1
ii
I
i
I
I
I
:.
!
!t
ii
+/'1, /0
Date
SPFIINGFIELD'CA/4 PL€V
:'r-o.!esl I;t:C
zoo s. 3zn J S+, SFR{lI^ft€+)roR q7'f78
Project Addrcss
Sp.cid Irl!Peclloo And T!!ting
fri""'6nirfroq *inJ"f.ag" in ut-d. lndingolthc lnfom.llon bytiSningbclow' rld rcturr lhi5 foEr lo th' Ciry'
BEFoRE ll PERMIT cAN BE IsliUED: Th. ownca or o$nc/, rcprc!.nhdyq on lhc .dyicc ofuc nipofl5ibh ltojccl E|lii6..r or Arc\il!t!, !h.ll comPlcL' ii8n, rnd 3ibmit
ro rh. Ciry for rlvicw .nd rpp,oY.l thii torm .omPLGd on both lhc frml rnd brek.
Th! owl|.r ind G...r.l corE !lor' *h'rc rpPli"bl', lhrll
'l!o 'ckttowlld8!
h' follo*i4 condllloN tDPtlclblo lo sP'cirl lllstcctlor lnd/or T'ltiry'
L Conrrr(ior k rclporiibl. tor Fop.r ioliic ion lb( lh. In3p..tlon or Tarting of it'm! liiGd'
2. T!!lh! lrbomro.y rtall l!k. qpropri.G limPl.t.nd mntPo( th.m lo dEir llbonlory for FoPrt 'vtluldon
ot l'rlin!'
. copi.s ci 0ll hbonbry rcPoll3 &d inlp.rdont lr! lo b.lanl lo lha City by lh' Tasting At'n'y'
l. qE.ir|Intr.ctior A3.tc, i5lo$bmil ntmcr.nd qu.lifieion3 ofon'til.Sr.ci.l lolP'cion to lh' Clly for Qpmv!|
.
4. Splchl lnsp.clor ihlll p.oyid. inlP.cdon r.podt to th. buildh! omci.l ofdl htpElioo tcdvfti.t'
l. Coitrr.tor i niponribl. 1o ,.vicw th. CiV +provad ph for .ddilion.l ilup.atio,, ot tsllnt .lquircm.tln ft.1 mry bc [olad.
SEFORE A CERTTFICATE OF OCCUPANCY W|LL 8E ISSUEDI Th. SpGci.l ltllprcdon Ag.!c' lhrll $brllll b dr Brilding ollicirl I sr.t flrlrl!ll.r.ll ilcmr .lqriring
p.oyirionr. Thot itcm, no! t srcd lndor in$Gc&d thll tr6 [orcd h Ur6 nrem.nt Th! r.?od it to bc albBit!.d to ti. Cily Prio! i. r rcqu.ta ror Dt.l inaPccnonl'
ACIfiOWLBDGMENTS E*av G,C,
0wncr amc (Printcd)Ocs. Contraclor Firm Namc (Printcd)Conracur Signaturc
?51
Enginecr or Architeo Firm or Archiuct Signaturc Specirl lnspection
Cily of Springfiold
Con::nu:ria': 3ul'i:rs DiYi:isir
225'Fifth Sucet
Springficld, OR 9747?
Tclcphonc: (54 l) 126-t7 59
Fox: (54 l) 726-1689
6\l
ol
Tcsting Laboratory Namc (Printcd)Lrboratory ignaturc Building Name d)
(Printcd)
Ofticirl
,i.
i
i
I
1l
j
;
alrol ,lhrnll6 lddf,rrCmIrdE-
Re
Oel
e*d Morlrrl
Prrta U?ro.r moel Colt r c lt:
!
=
=;<'oloN
E +s
B ,,b
a.s 9l -=Htsc(,/_,J..8
D H(,I.E
!')c
.{lN6(rl$oorOof:zalD461:
:D;\=-m:
=r7.!r):
a
r)
?
q
mJ{
H
5,.p+UF
(/)
&q)
UI
(l,
q)
!.
t.J
gPECTAL INSPECT1ON ANDTtssiINC SCflED'dLE
oTtrERTE"yr'&Form ?xt,
i
T
N
Sbtrtwtllmchorrililil;iaLldn rrb't
--vcFltiocriur of tnrn joir trb'
Slmdt atd lsil cnf,lP6stll
iJtmroo *oralry of rtool etcarr'ubr
TILL
Ebmr wlllmiUng hgtctlor
ral!rlr.,tcftr0aoct Za,fr;fi,6
VIOOD;
?cwuTt
l\be( ffra"l
T*ttt*t Dnv
F:ubUOr fmrl
llllphorroclu
SoilDadq
UoUlcttattrg
&ord vnilloltm
fhffmcrtr trPtclioo
Bd'ority lru
Tlrittuut tclt
hEFdhltAhg
l$u ldio I iltu]lailsn R'Yaloc'
rclt \ripstwrnrs
,PBOVIORSTNEfTGTH NSQUIBZD B? A ncflr6cr on tNorNErn oRcolnnAcT DOCI., fttSNf ut cATloN O F VALUES
(:
:
i(
((
(
pintortkre
ML flrltn.
Orrl !
tmrler I
Tmrlnn
(
Dir
I
ATTACHMENTA
CITY OF SPRINGFIELD SYSTEMS DE\ELOPMENT CHARGE WORKSHEET
JOURNALORJOBNLIMBER: COM2005-00113
NAMEORCOMPANY:SPRINGFIELD SPORTS COMPLEX - phase II
LOCATION:200 S. 32nd St
MAP & TAX I.,oT NI,MBER 17 02 3I OO OO5OO
NEW DEVETOPED AREA (S.F.):
E)(ISTTNG DEVELOPED AREA (S.F.):
TOTAL IMPERVIOUS SURFACE (S.F.):
CENTERPHASE II
40808
GAru(NG AREA PREVIOUSLY PAID)
X $ 0.3IO PER SF
(NO NEW UTILITIES)
ITE:
ITE:
l,oT SIZE (S.F.):
1. STORM DRAINAGE
IMPERVIOUS SQ, FT. 40950
2. SANITARY SEWER-CITY
A. REIMBURSEMENT COST:
NLJMBEROFDFU's
B. IMPROVEMENT COST:
NUMBER OF DFI-Is
(SEE REVERSE SIDE)
TOTAL STORMDRAINAGE
0
0
$ 18.30 PERTRIP
$ 80.72 PERTRIP
x $ 24.04 PERDFU
x $ 18.28 PER DFU
TOTAL LOCAL WASTf,WATER $
3. TRANSPORTATION
BLDGAREA TGSF x TRIP RATE x COST PERADT xNEW TRIP FACTOR
NEW
A. REIMBIJRSEMENT COST:
40.808 x 22.88
B. IMPROVEMENT COST:
40.808 x 22.88
E)ilSTING
A. REIMBURSEMENTCOST:
0.000 x
x
x
x
x
0.85 NTF $ 14,522.12
$ 64,064.210.85 NTF
NTFx $ 18-30 PERTRIP x
B. IMPROVEMENT COST:
0.000 x 0 x $80.72PERTRIP x 0 NTF
$92,OOO TRANS. CREDIT BROUGHT FORWARI)
$92,000-$82515.6e$9,484.34(AVATLABLE FOR PHASE IfD TRANSPORTATTON
4. SANITARY SEWER - MWMC
NEW:
A REIMBL]RSEMENT COST:
NUMBEROFFEU's
B. IMPROVEMENTCOST:
NUMBER OF FEU's
E)ilSTING:
A. REIMBURSEMENTCOST:
NIJMBER OF FEU's
B. IMPROVEMENTCOST:
NUMBEROF FEU's
MWMC CREDM IF APPLICABLE (SEE REVERSE)
TOTAL TRANSPORTATION REIMBURSEMENT
TOTAL TRANSPORTATION IMPRO\EMENT
$ 78,586.34
TOTALTRANSPORTANON $ 82,515.65
40.808 x $75.00 PERFEU
$79I,14 PERFEU
$ 3.060.61
40.808 x
0.000 x $0.00 PER FEU
PERFEU0.000 x $0.00 $
TOTAL MWMC REIMBURSEMENT
TOTALMWMC IMPROVEMENT
MWMC ADMIMSTRATWE
TOTALMWMC
SUBTOTAL (ADD ITEMS I, 2, 3, & 4)
48,049.92 x 5Yo
TOTAL TRANSPORTATION ADMINISTRATION FEE:
TOTAL SEWER A.DMINISTRATION FEE:
$ 35,355.42
5. ADMIMSTRATTVE FEES:
BASECHARGE(SUBTOTALABO\E) $
TRANSPORTATION ADMIN. AVOIDED 53929 32
Slevew W. :Zeaudrt4 Earwes 2t11/2005
:$
12$14
$
$ 3,060.61
$
-@
r-@
$
$
32,284.81I
)
$48
C&firE&Qfi?,HtEBF s coMpLEx pH ,, 2-- s. 3zRffiP
TOTALSDC CHARGES
1 JULY 2OO4
liil
049.92
ATTACHMENTA
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NIIMBER: COM2005-001 13
NAMEORCOMPANY:SPRINGFIELD SPORTS COMPLEX - phase II
LOCATION:200 S. 32nd St
MAP & TAX I.OT NI.IMBER 17 02 3I OO OO5OO
DEVELOPMENTTYPE
NEW DEVEIOPED AREA (S.F.):
E)CSTING DEVELOPED AREA (S.F.):
TOTAL IMPERVIOUS SI.IRFACE (S.F.):
RECREATIONAL CENTER PIIASE II
40808
(PARI(NG AXI,A PREI'IOUSLY PAID)
x $ 0.310 PER SF
(NO NEW UTTLITIES)
0
ITE:
ITE:
ror sIZE (S.F.):
495
I, STORM DRAINAGE
IMPERVIOUS SQ. FT. 40950
2. SANITARY SEWER-CITY
A. REIMBURSEMENTCOST:
NUMBEROFDFU's
B. IMPROVEMENTCOST:
NLIMBEROF DFtIs
(SEE REVERSE SIDE)
3. TRANSPORTATION
BLDCAREATGSF XTRIP RATE X COST PERADT XNEW TRIP FACTOR
NEW
A REIMBURSEMENTCOST:
40-808 x 22.88 x $ 18.30 PER TRIP x
B. IMPROVEMENT COST:
40,808 x @
E)ilSTING
A. REIMBTIRSEMENT COST:
0.000 x
x $ 80.72 PERTRIP x
$ 18.30 PERTRIP
B. IMPROVEMENT COST:
0.000 x $ 80.72 PERTRIP
TOTAI STORM DRAINAGE
x $ 24.04 PER DFU
x $ 18.28 PER DFU
TOTAL LOCAL WASTEWATER SDC:
x
0.85 NTF $ 14,522.12
0.85 NTF $ u,o64.21
NTF
NTF $
TOTAL TRANSPORTATION REIMBTIRSEMENT SDC
TOTAJ, TRANSPORTANON IMPROVEMENT SDC
TOTALTRANSPORTANON $ 82,515.65
$75.00 PERFEU $ 3,060.61
$791.14 PERFEU
$O.OO PER FEU $
0
x
x
x
x
$O.OO PER FEU $
$
$ 78,586.34
$ 35,3s5.42
$92,000-$82,515.66=$9,48434(AVAILABLE FOR PHASE III) TRANSPORTATION SDC:
4. SANITARYSEWER.MWMC
NEW:
A. REIMBURSEMENT COST:
NUMBER OF FEU's
B. IMPROVEMENTCOST:
NUMBER OF FEI.]'S
E)flSTING:
A. REIMBURSEMENTCOST:
NUMBER OF FELIS
B. IMPROVEMENTCOST:
NI.'MBER OF FEU'S
40.808
40.808
0.000
0.000
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES:
BASE CHARGE (SI.]BTOTAL ABOVE) $
TRANSPORTATTON ADMIN. AVOIDED S392932
,Slev ew W . eea ud'r 14 B a r wes
d&f,r6&eB?{ItF8Rrs coMPLEx PH rr, -
TOTAL MWMC REIMBURSEMENT FEE:
TOTAL MWMC IMPROVEMENT FEE:
MWMC ADMIMSTRATI\E
TOTALMWMC
STIBTOTAL (ADD ITEMS 1,2,3,&4)
48,049.92 x 50h 2,402.50
TOTAL TRANSPORTATION ADMIMSTRATION FEE:
TOTAL SEWER ADMIMSTRATION FEE:
2t1v2005
x
x
x
:$
$
$
.42
$0.00
$ 14,522j2
$ 64,064.21
$
$ 3,060.61@
10.00$
$ I rozs
50
32,284.81)
48,O49.92
S 32RfTF
TOTAL SDC CEARGES
0
S92,OOO TRANS. CREDTT BROUGHT FORWARJ)
1 JULY 2OO4