The URL can be used to link to this page

Home My WebLink AboutPermit Backflow Test 1999-3-23 '. - BPRINCr-IELD BACKFLOV PREVENTION DEVICE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION ~ OFFICE: 726-3759 INSPECTION LINE: 726..3769 225 FIFTH STREET SPRINGFIE::.D OR 97477 ------~--------~--------------------7-------------------------------______.._____ '..... JOB LOCATION: " ASSESSORS MAP D: :f"Yjj-- x--~~'='-':" / iD323Lf3 cA"--<-J ;- TAX LOT D: & / 0 0 .1 I 1 OVNER: .::F-.-re.-k H~T}/~ K/19,/ .. ADDRESS: 25).. (l)R.d.Q,f, fJJexxf.. 1)(; (L PHONE D: CITY: f; ( AOJ ~V1L rJ STATE: f'JL.. f t:b~- tS"/<J-2 ZIP/1;L( 0 cj BACKFLOV PERMIT IS $15.00 + $.75 (STATE SURCHARGE) + $.\4~1(~OMmNYO~~) a $16.20 goO aVi 00 U\ii1l'f p-i\E.N.nON~:eted bY the ?:'~Ie set lort~ CONTRA,CTOl'i: )./t.LNI-<-.-f' rrl"'A'lq4/F..""'\~?~~~f~IU~952..00~,J " " ' .. Notilicauup - - 1 _0010 tll,v,,:if' , -I the IU\\N ADDRESS: _.2.....1'"' ')..J C . ~~dff!-A'/(. I Z"" MR\!52.-00 ~"tfllH0Ne\~~~ ...~tf'l3 ~,.IJ- - 'gO 'IoU \"~' tNote:'{\ tilica\IVP CITY: J/<. ~'~F?!1- OO~iI(.I1BJthe~~~nol111ti\iW~~\ ZIP: 97Ya--? - bellO' ",- - 800-~~",-2- ' CONSTRUCTION CONTRACTORS REGISTRATION *:"U~/~~i51- EXPIRES:~-~~-~)? BY SIGNING THIS PERMIT/APP~~C~TION, I AGREEJDc,~~L~FFDR AN INSPECTION ONCE THE BACKFLOV PREVENTION DEVICE HAS BEEN .INS'i'JnILEDIAND'IS\lIISIBLE FOR INSPECTION (726-3769). I ALSO STATE THAT<~At~~INFORMATION~ON3THI5 PERMIT/APPLICATION IS CORRECT. .' \,,,r:- "'-\-\1::, :\~D rOR ' i\NDO".. ,-, I r'tP.\O"- ~I~"'" 3-.z 3~ :? 57 DATE s FOR OFFICE USE ::~:-::-:;::::::~:::~-:~li~7qq------------------------:::-:~q7Dij~~- RECEIPT h (j ~3 r2~ r ISSUED BY: yj - fM.iA.A--- TOTAL AHCiUNT COLLECTED: If I . 2-0 ---------.- ----------------------------~---------------------- -----------_.. ------ , , S.pRINGFIE!LD NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERfI!.ln\€H~\!HIAL PERMIT APPLICATION COMMENCED OR IS ABANDONED F"SITY OF SPRINGFIELD CO~ITY SERVICES DIVISION ANY 180 DAY PERIOD. BUILDING SAFETY Page 1 Job Number: 980485 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location of Proposed Work: 848 MCKENZIE CREST Assessors Map #: 17032343 Lot: 86 Block: DR Tax Lot #: 06100 ~ Subdivision: RIVER GLEN 2 Phone #: 689-5192 City/State/Zip: EUGENE, OREGON 97404 Owner: JACK HATHAWAY Address: 252 WEDGEWOOD DRIVE Describe QUAD AREA: 2RNW #'OF UNITS: 1 CONSTR. TYPE: VN WATER HEATER: G SQ FOOTAGE: 4389 Work: S. F. RESImqlEllJTlON:Oregon law requires you to NEW fnllow rr,'"q "dopted by the OrG~OR 8ti:;::, Notification Center. Those rufiffi'.~lr'irsEtt forth Contractolfl OAR 952-001-0010thr8ogIH~fi;,~952_00f-xpires 0090. You may obtain copies of ,the rules by OWNER calling the center. (Note: the telephone number for the Oregon Utility Notification ~.anto.ri~ Lp00 32~ ~?~~). OFFICE USE -- LAND USE: 1111 ZONING CODE: LDR # OF BDRMS: 3 RANGE: E Phone General: # OF BLDGS: 1 OCCY GROUP: R3 HEAT SOURCE: FG INSUL !lATH: P1 To request an inspection, call the 24 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. ;". REQUIRED INSPECTIONS --- FOOTING - After trenches are excavated. FOUNDATION - After forms are erected but prior to concrete placement. ROUGH GAS - after line is installed and capped if not attached to an appliance UNDERFLOOR PLUMBING - Prior to insulation or decking. UNDERFLOOR MECHANICAL - Prior to insulation or decking. POST AND BEAM - Prior to floor insulation or decking. INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover WATER LINE - Prior to filling trench, SANITARY SEWER LINE - Prior to filling trench, STORM SEWER LINE - Prior to filling trench, ROUGH PLUMBING - Prior to cover. ROUGH MECHANICAL - Prior to cover, ROUGH ELECTRICAL - Prior to cover. _ELECTRICAL SERVICE - Must be approved to obtain permanent power, SHEAR WALL NAILING - Before covering sheathing with finish materials. FRAMING - Prior to cover. INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover DRYWALL - Prior to taping, CURBCUT - After forms are erected but prior to placement of concrete. SIDEWALK - After excavation is complete, forms and sub-base material in place. GAS SERVICE - After line is installed and line has been connected to a minimum of one appliance. Pressure test done at this point. FINAL PLUMBING - When all plumbing work is complete, FINAL MECHANICAL - When all mechanical work is complete. FINAL ELECTRICAL - When all electrical work is complete., FINAL BUILDING - When all required inspections have been approved and the building is complete, SPRINGFIELD Job Number: 980485 Lot Faces: SW Topography: 2 Solar Approved: Y N House 59 Garage Item Main Garage BONUS RM, Total Value Building Permit Fee Surcharge/Admin TOTAL FEE Item Residential Bath(s) Plumbing Permit Surcharge/Admin TOTAL CHARGE Furnace Exhaust Hood Vent Fan Dryer Vent GAS LINE & W/H GAS F.P Mechanical Permit Issuance Surcharge/Admin TOTAL PERMIT Surcharge/Admin Sidewalk Curb Cut WILLAMALANE SDC CITY SDC Lot Sq, Ft.: 13248 Total Height: 30 Lot Type: INTERIOR Setbacks S W E 5 6 13 BUILDING PERMIT --- Square Feet x 3380 672 337 PLUMBING PERMIT --- 4 --- MECHANICAL PERMIT --- 6 --- MISCELLANEOUS PERMITS --- TOTAL MISCELLANEOUS PERMITS (Excluding Electrical) unless otherwise noted Page 2 Lot Coverage: 22.64\ Setbk From NPL: 40 $/Square Feet 64.66 16.27 64.66 (A) (C) (D) (E) TOTAL AMOUNT DUE (A, B, C, D, and E combined) Value 218,551. 00 10,933.00 21,790.00 251,274.00 775.00 62.00 837.00 Fee 192.50 192.5,0 15.41 207.91 6.00 4.50 18.00 3.00 5.00 4,50 41.00 10.00 3,28 54,28 0.00 24.40 36,00 1,000.00 3,618.55 4,678.95 5,778.14 Job Number: 980485 Page 3 --- BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT --- This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: Received By: Plans Reviewed By: DON Building Site Reviewed 503.75 Date Paid: 04/24/98 Receipt Number: 29544 MOORE Date: 06/08/98 By: LISA HOPPER --- ADDITIONAL COMMENTS MAXIMUM HEIGHT OF STRUCTURE CANNOT EXCEED 30'. SEPARATE ELECTRICAL PERMIT IS REQUIRED; PATH 1 MAX. DRIVEWAY WIDTH IS 24 FT. DRIVEWAY REQUIRED TO BE PAVED 3 STREET TREES REQUIRED 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 approved set of plans will remain on the site at all times during construction. ~77 p7'""' r > ~ ~A?_.,,>~?,- _.-"~ C7 :>J--r;.b'- 9t? Date --.. VALIDATION Date Paid: ()3/1'19 't /1-5 /~ f 5 :/7'8'< I~ JtJM/I , Receipt Number: Amount Received: Received By: !:. JOB NO, q&') 4 er , - ... ATTACHMENT A ... CITY OF S~NGFIELD SYSTEMS, DEVEL~MENT CHARGE WORKSHEET NAME OR COMPANY: ,-C;r~ 4 (' Hal<- 'f' /lJE /-IA TNA WA <,/ 848 /1t"_I!EN';1..IE: ('/2~<'f' . LOCATION: DEVELOPMENT TYPE: <::;~~, BUILDING SIZE LOT SIZE SO, Ft, 1. STORM ORA HIP-GE, IMPERVIOUS SO FT, 5jL2...c; 2, SANITARY SFi,FR-CTTY NO, OF PFU'S 3"2..- (See Revecse Side) 3. TRANSPORTFTiIiN x $0,226 PER SO, FT, $ 1.181,7f""' , x $46,86 PER PFU $ 1.4 en .!J-z- 'NO OF UNITS X' TRIP RATE X COST PER TRIP X I , 0 l X $472,49 $ 477, 2.J x x $472.49 $ x X $472. 49 $ 4, SANITARY SFWFR-MWMC pLl'') NO. OF FEtt"3 I' X Z)77r."PER FEU + $10 MWMClADM FEE $ Z~7.7c:;'. MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ ,TOTAL-MWMC SOC $ -z.f57,76 SUBTOTAL (ADD ITEMS 1.2.3 & 4) $. .~4fb. z.t 5, ADMINISTRATIVE FFFl BASE CHARGE (SUBTOTAL ABOVE) X .05 $ 172, ",/ i~. Date :-.5- Ul-'1B SDC Coordinator TOT~L SDC $: 3,&'18 .sS- I . ,-,^, vnL: VIII" vMLvVLM'"VIII I J-\DLC; Number 01 New Fixtures X Unit Equivalent = Fixture Units (NOTE: For remodels, calculate ani.' NET additional fixtures) . ' NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub......,'..,..,..,.,..""'.,.,.".,."."""'..,., ,.,.,",."....,... Drinking. Fountain.,...."".""."".,."."."."."...".."".".. Floor Drain, ,.,..:,.,.".,."."".,.,.,..,.,.,.". '...,..,., ...".."...,. Interceptors For Grease/Oil/Solids/Etc................, Interceptors For Sand/Auto Wash/Etc........:......... Laundry Tub/Clotheswasher,.,.".,..,.".., '.'.,..,..."..", Clothes washer - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).......,.......... Receptor For Refrigerator/Water Station/Elc..,...., Receptor For Commercial Sink/Dishwasher/Etc,. Shower, Single Stall.................,.,............................. Shower, Gang"."., ,.,',.,.,..,"',.""",.."."",.",'.",'.",.., Sink: Bar, Commercial, Residential Kitchen........................ Urinal, Stall/Wall,.."".,.,.",..,.,."..,."., '.".'..,..".",..".., Wash BasiniLavatory, Single....,....,......................... Toilet, Public Installation'.. ....,.. ......., ......................, Toilet, Private.......,..............,...., ,... ....................... Miscellaneous: 7-- 2 1 2 3 6 2 6 6 1. 3 4 i/Head 2 2 1 6 4 'Z.... 4 t TOTAL FIXTURE UNITS = 4- <- 4- "2- 4 /h. 32- CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table, calculate credits separates, Year Annexed Rate per $1,000 Assessed Value Year Annexed 1979 or before 1980 1981 1982 1983' 1984 1985 1986 $3.97 . 3.89 3,83 3.70 3.55 3.39 3,20 2.91 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 Credit for Parcel or Land Only If Applicable X $ '(Rate X Assessed Value) X $ . (Rate X Assessed Value) = Improvement (if after annexation date) = CREDIT TOTAL = $ RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) fie sid entia I. ,,:.,...,........... ...... 0.4 Commerical.............,.......,... 0.9 Industrial............................ 05 Governmental...................... 0.5 IMPERVIOUS AREA. = TOTAL LOT SIZE X RUNOFF COEFFICIENT II Rate per $ 1,000 Assessed Value $2.56 :' 2.17 1.73 1.31 0,92 0.74 0.61 j 0.45 0,31 0.17 H . .-. . . Job. No. m~ .. I \, SYSTEM DEVELOPMENT CHARGE WPlRKSHEET NAME:J.\t~t-~~~\S-~(\O t\ ONE: \lJ~q.~\q~ ADDRESS: _A~~ \uQ~i)1)r6 ' ATE: BfLzIP: itI1fr1- LOCATION OF PROPOSED BUILDING SITE: Street Address: PAS Ji~ f\B Q, 0 ~ tAJ\-, t\i\ Q9/ Plat Name: ~\.\\~r {1\" ~ Tax Lot Num;er: ~?1 O~ I (f) 1. DEVELOPMENT TYPE (Check appropriate dwelling(s), SDC calculations and dwelling t ype definitions are on the back,) . A. SinnlA-Familv DAtachAd L , NO. OF UNITS l Manufactured home not in a park X $1,000 per unit = $ I rfJJ ~ Single Family home B. SinnIA'-Familv A.ttached NO. OF UNITS X $924 per unit = $ C. Multi-Familv A.partment NO. OF UNITS X $692 per unit = $ D. Manufactureci HnmA Padi NO. OF UNITS X $699 per unit = $ $ \n[t) pO ~ $lDro~ 'f~ $ WILLAMALANE SDC 2. SDC CREDIT (if applicable) SDC-payer must furnish proof of Willamalane Credit approval. See SDC Credit Worksheet. X I '1---) I Date _:;;