HomeMy WebLinkAboutPermit Building 2001-11-14Job# 01-01170-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 3of1
SPRINGFIELD
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 2524 00031st St Spr
AssessorsMap#: 17021933
Lot:1200 Block: Addition:
Job Number: 01-01 170'01
Office:726-3759
lnspection Line: 726-3769
Tax Lot #: 01200
Subdivision:
ctTY oF SPRTNGFIELD, OREGOTV
Owner: Scott Adair
Address: 2524 31sl Street
Scope Of Work: Garage
Phone Number:
City/State/Zip:
New
541-953-1 195
Springfield, OR 97478
Value: $16,934
Detached garage
Contractor Type
GeneralContr
Contractor
MetalClad Builders lnc
514 N 5Th, Creswell, OR 97426
Registration #
94679
Phone
541-895-2786
complete.
To request an inspection call the 24 hour recording at 726-3769. All
a.m. will be made the same working day, inspections requested after 7
working day
Footing
Foundation
Shear Wall Nailing
Framing
Final Building
Storm Sewer Line
Drywell
1111 sl
\$!t'
Required
-After trenches are excavated.
-After forms are erected but prior to
-Before covering sheathing with finish
- Prior to cover.
-When all required inspections have been
-Priortofillingtr"#
-Engineered Drywell is required.
\6
r$'{
Zoning: LDR
FloodPlain? [ Wettands? [
Journal numbers
1:
Comments:
2:
Planner: Sam Gollah
Urban Growth Boundary?!
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA: X-White
Overlay District:
# of Street Trees:
Job# 01-01170-01 Page 2 of 3
Land Use: Single Family Dwelling
Pave Driveway? V
Glenwood Area? [
5
Additional Requirements
Required Attachments:
Source Locn:
Material:
Flood Plain FEMA:1153 of 2975
Construction Types:
Occupancy Groups:Accessory Structure
# Of Buildings: 1
# Of Bedrooms:
Handicap Access?
(Sq.F
Main Accessory864
# Of Stories: 1 Height (feet): 1B
Current Units: Proposed Units:
Gensus Code: Does not apply
Total:864
Fee Paid On Receipt# Value/Quantity Fee Amount
Plan Check
Residential Plan Check
Total Plan Check
10t2312001 7056 16,934 $105.30
$105.30
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
Building
1111412001
11t1412001
11114t2001
7248
7248
7248
16,934 $162.00
$11.34
$12.96
$186.30
Plumbing
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Storm Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
11t14t2001
111142A01
11114t2001
1111412001
7248
7248
7248
7248
30
$.00
$3.15
$4s.00
$3.60
$51.75
2nd Driveway/Overwidth Appl Fee
Total Public Works
Public Works
1111412001 7248 1 $30.00
$30.00
System Development
Residential- Single Family - Storm
SDC Administrative Fee
Total System Development
11t14t2001
11t14t2001
7248
7248
201 $305.76
$15.29
$321.05
Planning
1Planning Plan Review
Total Planning
$50.00
$50.00
Grand Total
11t1412001 7248
$744.40
3:
Job# 01-01170-01 Page 3 of 3
Plan Check Type Checked By Date Completed Comment
lnitialReview-Res Lisa Hopper 1012412001
Engineering-Res Steve Templin 1012612001
Planning-Res Sam Gollah 1110112001
Structural-Res Tom Marx 1012612001
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state 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 the project address is readable from the street, that the permit card
is located at the front of the property,and the a set of plans will remain on the site at all times
//z /-rs/
re Date
s
T
97 177
TION
A.
LEGAL DESCRIPTIONr70L I 733
Multi-Family per drvelling unit.
Service Included:
ft. or less
500
Drvelling
Service or Feeder
$ 106.00
Z7---2,03
JOB DESCRIPTION
Permits are
if work is not started
2. CONTRACTOR INST
Electrical'
Address
B
$ 50.00
Superr ising Electrician Oler
Over
22,
"8" abo\re
$50.00
$2 5.00
Limited EnergylComm $+5.00
l\Iinimum Electric Permit Inspcction Fee is S-15.00 + Surcharges
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energl./Res
4. SUBTOTALOFABO
7oh Stfie Surcharge
8%o Administrativc Fee
TOTAL 1*E
I
of issuance or if work is
180 days. ,'
Supervisor License Number
Expiration
Constr Contr
Expiration
(' )/ / /'
orvners No*eJ<'cff ilCk t*?
b-t
OWNER INSTALLATION
The installation is being tttade on
propert)' I olvn u'ltich is not intended
[or sale. lease or rent.
ELEL .,dCAL PERMIT APPLICATION
City Job -o/t
ft
Home or
200 arnps or less
201 amps to 400 amps
-l0 i anrps to 600 amps
601 amps to 1000 amps
Over i000 arnps/volts
Reconnect Only
C. Tcnrporitrl' Scn'ices or Fcctlcrs
Installation, Alteration or Relocation
D. Branch Circuits
Nerv Alteration or Extension Per Panel
One Circuit
I
_ $ l9.oo
--
,r /-( s o:.oo -b)
$ 125.00
c-rt
Each Additional Circuit or rvitlt
or Feeder Pennit
t'K
$3.00 Zg
Signature.
:l
(
CITY OF SPRINGFIE-.T SYSTEMS DEVELOPMENT CH. .]E WORKSHEET
O BUILDING SIZE: O SF LOT SIZE: O SF
JOURNAL OR JOB NUMBER: 0l-01170-01
NEW DWELLING UNITS:
NAME OR COMPANY:ADAIR
LOCATION:2524 3 IST STREET
TAX LOT NUMBER:r7-02-t9-33-01200
DEVELOPMENTTYPE: GARAGE
DISCOLINT RATEIMPERVIOUS S.F.COST PER S.F
s0%000.00 $0.273
IMPERVIOUS S.F
l120.00
COST PER S.F
s0.273 $305.76
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
x
x x
I. STORMDRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
$305.76ITEM I TOTAL - STORM DRAINAGE SDC
NUMBER OF DFU's COST PERDFU
$0.00$16.240
NUMBER OF DFU's
0
COST PER DFU
$2r.37 $0.00
B.IMPROVEMENT COST:
x
x
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
COST PER TRIP NEW TRIP FACTORADT TRIP RATE NUMBER OF UMTS
1.00 $0.009.57 0 $68.94
ADT TRIP RATE
9.57
NUMBEROF UNITS
0
COST PER TRIP
$ 16.21
NEW TRIP FACTOR
1.00 $0.00
B.IMPROVEMENT COST:
x xx
xxx
3. TRANSPORTATION
A. REIMBLIRSEMENT COST:
ITEM 3 TOTAL - TRANSPORTATION SDC
$0.00
NUMBER OF FEU's
0
COST PER FEU
$332.86 s0.00
NUMBER OF FEU'S
0
COST PER FEU
$34.83 $0.00
$0.00
SUBTOTAL OF MWMC REIMBURSEMENT, 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 .]VTWMC SANITARY SEWER SDC
76SUBTOTAL (ADD ITEMS l, 2, 3, & 4)
SUBTOTAL ADM. FEE RATE
$1s.29765%
5. ADMIMSTRATIVF FEE:
x
$321.0st01261200rt|r,uoT.4,l;"-
SDC COORDINATOR
TOTAL SDC CHARGES
DATE
a
rrl
O
&trlFa
trl&
1070
l09l
t092
1093
1094
1055
1056
1073
lrt u
NUMBER OF NEW FIXTURES X IJNIT EQUIVALENT: DRAINAGE FIXTURE LTNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
FIXTLIRE
UNITSFIXTURE TYPE (#NEW - #OLD )x UNIT
EQUTVALENT
BATHTTIB (
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
0-0
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 FOUNTAIN I 0
FLOORDRAIN J 0
INTERCEPTORS FOR GREASE / OTL / SOLIDS / ETC 3 0
INTERCEPTORS FOR SAND / AUTO WASH IETC.6 0
LAUNDRY TUB 2 0
CLOTHESWASHER / MOP SINK 3 0
CLoTHESWASHER - 3 OR MORE (EA)6 0
MOBILE HOME PARK TRAP (I PER TRAILER)12 0
RECEPTOR FOR REFRTG / WATEB qATrqNllfq-
RECEPTOR FOR COM. SINK / DISHWASHER / ETC.
I 0
J 0
SHOWER, SINGLE STALL 2 0
sHowER, GANG OIUMBER OF HEADS)2 0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN J 0
SINK: COMMERCIAL BAR 2 0
SINK: DOMESTIC BAR I 0
WASH BASIN 2 0
LAVATORY t 0
URINAL, STALL / WALL 5 0
PUBLIC INSTALLATION 6 0
TOILET, PRIVATE INSTALLATION J 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU's*
( 0 - 0 )x 20 0
TOTALDRAINAGE FIXTIIRE UNITS =
*EDU (Equivalent ttwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
0
DRAINAGE F^ URE UNIT CALCULATIOT. .,ABLE
MWMC CREDIT 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
$0.00
YEAR
ANNEXED
CREDIT RATE PER $I,OOO
ASSESSED VALUE
YEAR
ANNEXED
CREDIT RATE PER $I,OOO
ASSESSED VALUE
I979 OR BEFORE $4.92 1990 s2.06
I 980 s4.83 t99t $ 1.64
198 I $4.77 t992 $1.4s
1982 s4.64 1993 $1.31
I 983 $4.47 1994 s l.l3
I 984 $4.30 I 995 $0.97
I 985 $4.09 1996 $0.82
r 986 $3.78 r997 $0.63
1987 $3.41 I 998 $0.41
$0.22r 988 s2.98 t999
I 989 $2.s2 2000 s0.04
TOTAL MWMC CREDIT =
0.000 $0.00x
VALUE / IOOO CREDIT RATE
0.000 x $0.00