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Home My WebLink AboutPermit Building 2006-06-20Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00540ISSUED: 0612012006 APPLIED: 05i0912006 EXPIRES: 1012012007VALUE: $ 19,404.00 SITE ADDRESS: 1176 S 34th Pl Springfield TYPE OF WORK: Single Family Residence ASSESSOR'S PARCEL NO.: 1802062401200 TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Sunroom additon to existing single family residence Phone Number: 541-747-4882Owner: Address: Contractor Tvpe General Electrical RON HIEBENTHAL 1176 S 34TH PL SPRINGFIELD OR 97477 Contractor F FRENCH & COMPANY INC OWNER License 136594 Expiration Date 09/01/2008 Phone 503-910-3104 TION nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: A Overlay Dist:Urban Fringe Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: o ication ca N\Jfi \ng the rber tor rh Drywell - Provide Drywell Engineering Notes: Storm into existing drywell Cen,ter is Page I of3 No't Type: Range Type: Energy Path: Sprinkled Building: torth ru\es Or rcation Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line FIELD Building/Combination Permit PERMIT NO: COM2006-00540ISSUED: 0612012006APPLIED: 05/0912006 EXPIRESz 1012012007VALUE: S 19,404.00 Description Dwellings Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 196.00 Total Value of Project Amount Paid Date Paid Value $19,404.00 $19,404.00 Receipt Number 1200600000000000619 120060000000000091 I 120060000000000091 I I 20060000000000091 I 120060000000000091 I r20060000000000091 I 120060000000000091 1 120060000000000091 I 2200700000000000s60 2200700000000000560 2200700000000000560 2200700000000000560 2200700000000000s60 Date Calculated 05/09/2006 Fee Descrintion Plan Review Residential + l0oh Administrative Fee + 87o State Surcharge Building Permit Fire SF Fee - Residential SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet + llY" Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid $120.51 $24.02 $18.43 $18s.40 $9.80 $1.82 $36.34 $45.00 $4.s0 $2.2s $3.60 $43.00 $2.00 5t9t06 6t20t06 6t20t06 6t20t06 6t20t06 6t20t06 6t20t06 6t20t06 4t20t07 4t20t07 4t20t07 4t20t07 4t20t07 s496.67 ees Paid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 0sn0t2006 05n0t2006 0s/r0/2006 05/10/2006 05/10/2006 05t24t2006 0sn2t2006 APP APP APP SKG TAJ CAS 0st26t2006 OK RWC To Request an inspection call the24 hour recording at 726-3769. 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 work day. Footing: After trenches are excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. Storm Sewer Line: Prior to filling trench. Page 2 of3 Insneefions Valuation Descrintion I No Planning issues. Storm drainage into existing drywell 5/1212006 CAS Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00540ISSUED: 0612012006APPLIED: 05/0912006 EXPIRESz 1012012007VALUE: $ 19,404.00 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 701.005 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 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. Owner or Contractors Signature Date Page 3 of3 Kffir Construction Contractors Board Permit *: (OrAZr- -)6- OoSt O 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: ry$!g!4! s. sqL /tAddress: Issued by:N Date:61 F" Statement: lnformation Notice to Property Owners About Gonstruction Responsibi Iities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensedwith the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38 It \ t. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the sfructure is sold or offered for sale before or on completion. tr 3A. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR 38. I will be my own general contractor If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. at #-,20-d 2 (Date) (White copy to issuing agency permilfile, pink copy to applicant.) Property_owner. doc 06-0 I -04 Acting as r our Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION H,HSPONSIBILITIES If y<lu are acting as ysur own sontractor to conskuct horn* *:r'make a substantiai irnprov*rn*nt to an exrsnrlg structure, you cafi prevent rnany problans by being aware of the following responsibilities and cilncems" Employer Responsibilities You will, in rnost inslances, be ruied to be an o'employer" and the contractors you conilact with wiil be'jemployees" if you {fie sontractors not licensed with the Construction Contractr:rs Board to do iabor in constr"ucting or to assist in the conskuction or improvement of a re$idential sfructure. As the employer, you must eomply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time empioyees are paid. You will be liable for the tax payments even if you don't actually withhold the tax fiom your employees. For more information, call the Departrnent of Revenue at 503-3784988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemploynrent insrrance purposeg < on the wages of all employees. For more informafion, call the Oregon Employment Department *t 503-947-1488. -T.-!. is a ecrnbined number for both Oregon Withholding and 5 03 -945-S09 1 or y1pr,"<1g1.Slat"q.,"$:g#f *Crn5gAy.h&:tll f*r the Y\' The Oregon Business Identification Nurnber €fN) Unemployment Insurance Tax. To file for a BIN, call appropriate forms. Workersl Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subjec[to penalties and be lidbie for all claim costs ifbne ofyour eqrployees is injured on the job. For more infarmation, call the Workers' Compensation Dirrision at the Deilartment of Consumer and Business Services at 503-947-78 i 5. U.S, Internal Reven** Seryice: As an employer, you must w'ithhold federal income tax from ernplbyees' *.ige*> Y$:r $/ill be iiable far the tax payment even if you didn't actually'"vithhold the tax. For a Federal EIN number, call the IRS;at l-8ffi;829-4S33 or visit'their i*rcb site at wir,rv.irs.sov ', . tll, , Other Responsibilities and Areas of Concerns . i Code Compliance: As the permlt holder for this project, you are responsible for resnlving any failure to meet eode requirernents that nmy be brought t* yolr attenlion through instrrections".iir'"" . t: i Liabitity anel Praperty Damage'fnsnranee: Contact your insurance agent to'see if you tial.d adequate iirstrancr' coverage for accide*ts and omissions such as falling tools, paint over spray, r.vater damage liom pipe punctures, {ire or work that must be redone . \ Time: Make sure you have suihcient time to supervise your *mplmyees. . ,' ,t,' , - ' '1\ '''' ;-' r-u Expertise: Make sure you have ihe skills to act as your'own general contractbr, to coordinate the work of rough-in and finish trades, ar:d to notify building officials as the appropriare times so they can perform the required inspections. If you have additi*na} qu*stior:s caltr the Consh:ueti** Contracte;rs B*ard (503-37SdS2l) rr write the agency at IIO ISox 14140, Salem, SR 97309-5052. Propert-v-ownel.doc 06-0 1 04 fVOfEj This lnformation Natice to Propefty Ourners about Construction Responsibi/rties lvas developed by the Canstruction Contractors Board in accordance with ORS 701.055(5i, passed by the 1989 Qregan Legislature. SPRI]VGFI ELD .: :, I ,:' :.@' zoN INITIALS DATE SOURCE $37s.00 see "B" above. $ s0.00 $ 69.00 $100.00 $ 43.00 q 3 $ 3.00 50.00 50.00 25.00 45.00 * Surcharges j50 -qe_ l. tl 225FlF-THSTREET o SPRINGFIELD,OR97477 o PH:(5'll)726-3753 rFAX:(541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (Ovt-1.z006 - c) o s15 Date Z o o J COMPLETE FEE SCHEDWE BELO\I/LOCATION AF II,{STALLATI'16 S . 3q+L LEGAL DESCRIPTIONCZO6Z\OIZO O JOB DESCzuPTION C c fcv,-.+ City Phone Supervisor License Number Expiratiou Date "^/ Constr. Contr. Number IHIS PE AN Owners Name Address City puone 7/6- 76R? OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Over 1000 Amps/Volts Recomect OnlY Installation, Alteration or Relocation 200 Amps or less u0TtSE' 2ol F4'Hf /'U / .101 Expiration Date R IZED Signature of Superv'ising Electrician D.GO Nerr'Y 180 DAY Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit 8% State Surcharge I0% Administrative Fee 5% TechnologY Fee E. I.Iiscellaneous (Service/feeder not illcluded) -Each Installatiorr Pump or irrigation _- $ Sign/Outline Lighting - S Limited EnergY/Residential - S Limited EnergY/Commercial Minimum Electric Permit Inspection Fee is1$4fu 4. SWTOTAL OF ABO\'E t{ t- --F- -9575Inspection Request: 726-37 69 TOTAL Shared Drive(T:)/Building Forms/Electrioal Permit Application 8{6 doc A. Neu'Residential - Singte or l\Iulti-Famil-v per dwelling unit. Service Included 1000 sq. ft. or less $106.00 Each additional 500 sq. ft. or portion thereof $ 19.00 Each Manufact'd Home or 60i s 75.00 $ r 2s.00 $ 163.00 Pt- I Permits are non-transferable and expire if work is not started within 180 days of issuance or if Suspended for 180 daYs. 'l C O NT Id-4CT O R IN S T ALIAT I O N Electrical Contractor 009u . You Address calling C. Temporary Services or Feeders V.,J0RK 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Cifr, of Springfield Official Receipt L._- :lopment Services Department Public Works Department RECEIPT #: 2200700000000000560 Date: 0412012007 8:3e:l8AM Job/Journal Number coM2006-00540 coM2006-00540 coM2006-00s40 coM2006-00540 coM2006-00540 Description + 5olo Technology Fee + 8% State Surcharge + l0oA Administrative Fee Add, Alter, Extend Circ M inimum/Adj ustment E lectrical Amount Due 2.25 3.60 4.50 43.00 2.00 Item Total:$s5.3s Payments: Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Check WAYNE HIEBENTHAL djb 2365 In Person Payment Total: s55.3 5 -ffi cReceintl Page I of 1 412012007 *rrffiil*fr} City of Springfield 225 Fifth Street, Springfield, OR97477 54l-726-3759 Phone 541-726-3676 Fax January 10,2007 HIEBENTHAL RON 3501 GARDEN AVE SPRINGFIELD Job Number: Location: oR 97478 coM2006-00540 1176 S 34th Pl Project:Sunroom additon to existing single family residence Dear Permit Holder: The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid, the work which has been authorized by the permit must begin within 180 days of the date of issuance, and an inspection must be requested at least every 180 days. According to our records, you obtained a permit for a project at ll76 S 34th Pl which is set to expire on 113112007. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notify you that your permit(s) will be expiring shortly. If you are ready to request an inspection for your project, please phone the inspection line at 541-726-3769. If you do not request an inspection prior to the expiration date, your permit(s) will expire and additional permit fees will be required in order to complete your project. If you have any questions, please feel free to phone me at 541-726-3790. Sincerely, Lisa Hopper Building Safety Management Analyst Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00540ISSUED: 0612012006APPLIED: 05/0912006EXPIRES: 1212012006VALUE: $ 19,404.00 SITE ADDRESS: 1176 S 34th Pl Springfield TYPE OF WORK: Single Family Residence ASSESSOR'S PARCELNO.: 1802062401200 TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Sunroom additon to existing single family residence Owner: Address: Contractor Type General RON HIEBENTHAL 35OI GARDEN AVE SPRINGFIELD OR 97478 Contractor F FRENCH & COMPANY INC License Expiration Date Phone 136594 09/0il2006 503-910-3104 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Fronfyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: R-3 35.10 2.50 Partiallv Improved No # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor:. Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VN nla Notes: Storm into existing drywell Sidewalk Type: Downspouts/Drains Drywell - Provide Drywell Engineering $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Paee I of3 Value Date Calculated f:r'a Number:541-747-4882follow rrrl jsd You may obtain coo ng the center. (Note: the tr ne rules by It u tLL,t 1\ u l1\ r (rr(lYrry..] Overlay # Street Paved oh of Lot PARKINGL ZED Compact: Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00540ISSUED: 0612012006 APPLIED: 05/0912006 EXPIRESz 1212012006VALUE: $ 19,404.00 Dwellings V Wood Frame Fee Description Plan Review Residential + l0oh Administrative Fee + 87o State Surcharge Building Permit Fire Fee - Residential SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Total Amount Paid $99.00 196.00 Total Value of Project Date Paid $19,404.00 $19,404.00 Receipt Number 1200600000000000619 12006000000000009r I 120060000000000091 I 120060000000000091 I r20060000000000091 I 12006000000000009r I r20060000000000091 I 120060000000000091 I 05/09/2006 Amount Paid $120.s1 s24.02 $18.43 $185.40 $9.80 $1.82 $36.34 $4s.00 $441.32 5t9t06 6t20t06 6t20t06 6t20t06 6t20t06 6t20t06 6t20t06 6t20t06 tr'ees Pn Plan Reviews Initial Review Plannins Review Public Works Review Structural Review 05n0t2006 0s/10/2006 05/r0/2006 05n012006 0st2412006 05n2t2006 APP APP APP SKG TAJ CAS No Planning issues. Storm drainage into existing drywell 5/r212006 CAS 0sn0t2006 0st26t2006 0K Rwc To Request an inspection call the 24 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. Footing: After trenches are excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. Storm Sewer Line: Prior to filling trench. Reouired Insnections Page 2 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00540ISSUED: 0612012006 APPLIED: 05/0912006 EXPIRESz 1212012006VALUE: $ 19,404.00 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 Springlield 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 701.005 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 street, that the permit card is tocated at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Page 3 of3 I .F JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING T]NITS I. STORM DRAINAGE DIRECT RI,INOFF TO CITY STORM SYSTEM CITY OF Sl-,<INGFIELD SYSTEMS DEVELOPMEN TORKSHEET coM2006-00540 Ron Hiebenthal I 176 S 34th Place 1802062401200 SINGLE FAMILY RESIDENCE 0 BUTLDTNG SIZE (SF. 196 LOT SIZE (SF):15114 RLNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. x 0.00 NUMBER OF DFU's 0 B. IMPROVEMENT COST: NUMBER OF DFU's 0 ADT TRIP RATE 9.57 B. IMPROVEMENT COST: ADTTRIP RATE 9.57 x COST PER S.F $0.323 COST PER S.F $0.323 COST PER DFU $25.07 $19.07 NUMBEROF UNITS 0 NUMBER OF TNITS 0 ADM. FEE RATE 5% CHARGE $0.00 DISCOUNT RATE 50Yo $36.34 DISCOUNT $36.34 IMPERVIOUS S.F 22s.00 ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: x x x x x x TTEM 2 TOTAL - CITY SANITARY SEWER SDC 3. TRANSPORTATION A REIMBURSEMENTCOST: $0.00 COST PER TRIP $ 19.09 COST PER TRIP $84. I 9 $0.00 xx xx NEW TRIP FACTOR 1.00 NEW TRIP FACTOR L00 ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NLIMBER OF FEU's 0 x B. IMPROVEMENT COST: NUMBER OF FEU's 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMTNISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBToTAL (ADD rrEMS l, 2, 3, & 4) 5. ADMINISTRATIVE FEE: SUBTOTAL $36.34 $0.00 $36.34 CHARGE $r.82 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: CherylSlaymaker 5/1112006 COST PER FEU $82.03 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 1.82 $38.16 1070 l09l 1092 I 093 1094 I 054 r 055 I 054 1056 079 r 078 a rr.1noO & IJ.]Fa o IJ.]& I@ COST PERFEU $865.31 PREPARED BY DATE TOTAL SDC CHARGES x DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEW FXTURES x LINTT EQUTVALENT: DRAINAGE FXTURE UN]TS FOR CALCULATE ONLY THE NETADDITIONAL NO. OF FIXTT'RES L'NIT ryPE NEW OLD AI,ENT MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FXTURE UNITS lsa toa unit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COI]NTY ASSESSED VALUE 20 DRAINAGE FIXTTIRE LINITS 0 +EDU IS LAND ELGIBLE FORANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND OF APPLICABLE) 0 BEFORE 1979 1979 '1980 1982 l 983 '1984 I 985 I 986 1987 1988 1989 I 990 l99l 1992 1993 1994 I 995 1996 1997 r 998 1999 $5.29 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4,07 $3.67 $3.22 $2.73 $2.25 $1.80 0 l98l 1979 VALUE / IOOO $0.00 CREDIT RATE $5.29x CREDIT FOR IMPROVEMENT (IF AFTERANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 0 0 3 0 DRINKING FOLNTAIN 0 0 1 0 FLOOR DRATN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 6 0 LAT]NDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CL0THESWASHER - 3 OR MORE (EA)0 0 b 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0 SHOWER" SINGLE STALL 0 0 2 0 sHowE& GANG NUMBER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 0 SINK: COMMERCIALBAR 0 0 2 0 SINK: WASI] BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0 URINAL, STALL / WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 o 0 TOILET, PRIVATE INSTALLATI ON 0 0 3 0 0 YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALUE 0 $0.00 2000 2001 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C;^, of Springfield Official Receipt L elopment Services Department Public Works Department RECEIPT#: 1200600000000000911 Date: 06/2012006 9:48:46AM Job/Journal Number coM2006-00540 coM2006-00540 coM2006-00540 coM2006-00s40 coM2006-00540 coM2006-00540 coM2006-00540 Description Fire Fee - Residential Storm Drainage Impervious Area SDC Sanitary/Storm Admin Building Permit Storm Sewer - lst 50 Feet + 8% State Surcharge + l0o/o Administrative Fee Amount Due 9.80 36,34 1.82 185.40 45.00 18.43 24.02 Item Total:$320.81 Payments: Type of Payment Paid By Received By Batch Number Check Number Authorization Number How Received Amount Paid Check FRED'S AWNINGS & SOLAR SCREENS ddk 4617 In Person Payment Total: s320.81 $320.81 cReceint I Page I of I 6t20/2006 rFffifiaarrstl ,.- SEPTIC INSTALLATION PERMIT (-trrr,, sP997056 Parcel Number: 18-02-06-24-0 I 200 Applicant: SHARP RAY 2495 DEYON AVENUE EUGENE, OR 97408 Site Inspection Numberz 98-9129 Work Description: install septic system System Type: INSTALL ' RED Applied Date: OltP+itggg Approved Date:'03/l I I 1999 Issued Date: 0512611999 Expiration Date: 0512612000 INSTALLATION REOUIREMENTS: Projected Daily Flow: 450 gallons Drainfield Size:225 feet Site: hwy 105 east to 42ndright to I 164 S 34TH PL SPR Owner: WHITE JAY 36670 BRAND S SPRINGFIELD, OR 97477 NNAU OCCUPANC-Y I= @"ENDANT AN FZrefiY D€Dta+'(toM AFID WJe gtetf PEfirov^(- -THFP)g * GorrlY - G*e:ctt wrr4 wcHS bercte€:QtJbttcFt xrtu @U%I'JCY Septic Tank Size: 1000 gallons T-HA,NrS Maximum Depth of Drainfield: 30 in. Special Conditions: INSTALL REDI-INDANT DRAINFIELD *SEE ATTACHED OAR 340-71-285 (2) DESIGN CRITERIA SANITATION SETBACK REOUIREMENTS: From drainfield to property lines and structures: 10 feet From drainfield to well: 100 feet From septic tank to property lines and structures: 5 feet From septic tank to well: 50 feet s'e6-fl DEQ Agent Date This permit will expire after one year unless the system has been inspected. To obtain an inspection, make a drawing of the system as installed on the form provided. Submit the completed form to this office and the inspection will be scheduled. Final inspection for sewase systems cannot be reouested by telephone. LANE COIJNTY ON-SITE.SEWAGE OFFICE 125 E 8TH Avenue. Eugene OR 97401. Ph: (541) 682-3754. Fax: (541) 682-3947 Lane Countg -7TO: SEWAGE DISPOSAL SYSTEMS PERMIT APPLICANTS FROM: LANE COUNTY ENRIVONMENTAL HEALTH SERVICES You are required by law (OAR 340-71-160)to be in possession of a permit authoriz- ing installation of sewage disposal system before construction of your septic sys- tem can begin. ln addition, the law specifies that all work on said system must be performed by the owner or contract purchaser or his regular employees or a person licensed with the State Department of Environmental Quality to per- lorm sewage disposal services. You should read carefully all the specifications on the.installation permit before starting any digging. lf you have any questions rggarding installation procedures or specifications or the approved area, call your aida sanitarian at 687-4051 and they will be glad to assist you. lf you intend to hire someone to do the work for you, you should make sure that the person is licensed with the State Department of EnvironmentalOuality to per- lorm such work. This protects you, as the consume( as each licensed installer has to post a bond and is liable lor the work performed. To check the licensing of an individual you can call Lane County Environmental Health Services at 687-4051 and we will check for you to see if the individual or contractor you have chosen is licensed. A file on each licensed installer is available for review upon request in this office. ln addition, the law requires the installer to deliver to each person for whom he performs sewage disposal services, prior to completion ol such services, a written notice of the name and address of the surety company which has executed the bond and of the rights of the recipient of such services as provided by subsection (2) or ORS 454.705. We uroe you to request this from the installer or contractor you have chosen prior to hiring them. Do not hesitate to contact Lane County Environmental Health Services if you have any questions. LANE COUNTY ENVIRONMENTAL HEALTH SERVICES 125 E. 8th Avenue I Public Service Building / Eugene, Oregon 97401 it55-9E O7,lgt (503) 687-40s1 When the construction of your septic system is complete and before you backfill it is necessary to have the system inspected. To obtain an inspection, make a drawing of the system as installed on the form provided. Submit the completed form to this office and the inspection will be scheduled. Final inspection for sewaoe svstems cannot be reouested bv telephone. DEPARTMENT O F ENW RONMENTAL QAALITY Watcr Qlolit! Progmm o o 340-7 I.285 REDTJNDANT SYSTEMS.I (l)Criteria for Approval. Construction installation permits may be issued by the Agent for redundant disposal field systems to serve single family dwellings on sites that meet all the following conditions: (a) The lot or parcel was-created prior to January 1, 1974; and (b) There is insufficient area to accommodate a standard system. (2) Design Criteria: (a) Each redundant disposal system shall contain two (2) complete disposal fields; (b) Each disposal field shall be adequate in size to accommodate the projected daily sewage flow from the dwelling; (c) A minimum separation of ten (10) feet (twelve (12) feet on centers) shall be maintained between disposal trenches designed to oPerate simultaneously, and a minimum separation of four (4) feet (six (6) feet on centers) shall be maintained between adjacent disposal trenches; (d) The system shall be designed to alternate between the disposal fields with the use of a diversion valve or other method approved by the Agent. i:. S ? Er U -lrd -lF Poo r qit+irr\{6^OcE S! aFE frl E;ad > rrl3oFu, r?E sE <) {sq T. 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