HomeMy WebLinkAboutPermit Building 2009-11-16
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CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01591
ISSUED: 11/16/2009
APPLIED: 10/29/2009
EXPIRES: 05/16/2010
VALUE: $ 158,464.00
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': p5 Fifth Str,eet;,Springfield, OR
'541-726-3753 pjj'o'rie)i";,;.y:;.. :::".-)'o ,~'
541 7263676 Fax '...,. .,.' :','.:;;,'0.';"
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541-726-3769 Inspection Line .",.' ,7
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SITE ADDRESS:: 2021 INLAND WAY Springfield TYPE OF WORK: Single Family Residence
, ASSESSOR'S PARCE(NO;i" iSO"i023308000
-i;'" 'i , TYPE OF USE: New Residential
.. ~ROJECT DESCRIPTI9N: Single family residence. Replacing existing manufllctured home- Radiant floor heat.
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Owner:
Address:
. -:';."';".-,,":,
V ALUSI>K LUCIUS" <(" ,".
2021INLANDWAY '. .'
SPRINGFIELD OR 97477 "
Phone Number: 503-780-8837
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l~:..~..~!~j:'/' ,~~:ff" I CONTRACTOR INFORMATION I
. <::ont..a~t()r )t~e,'l..;:::~ontractor ATTENTION: Oregon law requihif~fAo
General '. ,.,.,i""';"V OWNER :. follow rules adopted by the Oregon Utility
Electrical " OWNER'i" .. Notification Center. Those rules are set forth
Mechanica] OWNER In OAR 952-001-0010 through OAR 952-001.
Plumbing OWNER 009.0. You may obtain copies of the rules by
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1:' , ;;.,:C';'o'" ,;~ 'tt Center II HI00-332-2344).
# of Units: ;-"\ 1-',.. ' 'I # of Stories: 1
Primary Occnp~itcy,Gr~up: R-3 Height of Structure ]8.00
.. Secondary occupancy Group: ,. " Type of Heat:
Primary Constrnction Type;" .': ~. VB Water Type: Electric
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Secondary Construction Type: Rllnge Type: Electric
# of Bedrooms: 3 ,..' Energy Path:
" ,) Sprinkled Building:' n/a
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
8,712
1,432
525
(; Y~f": .~ '( ~~~m,F~r:T-:'~)p~RK
;;, : _ " AUTHORIZ~UNDER nils PERMIT IS NOT
Frontyard Seth~,cI{:" '~ .. 46'~OMMENC y 1'IiIV~isHANDONED f.(!)~n Fringe
, Side 1 Setback,"""-'-1,", ~;.,~ - ,;; "5.0 ~t11 M~s Rqd: .. -.: 1
Side 2 Setback: ',- 18. NY 180 D 'e~fB l~ Rqd: No
Rearyard Setback: 14.00 % of Lot Coverage: 22.46
Solar Setbacks: ~5.00 "
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
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Street Improvements:" ' ,
,
.. Siorm Sewer A vailab]e:;'.. ,
Special Instructi~n:;< . ~.". ';., to :.'
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Notes: Stormwater to curb and gutter
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
Downspouts/Drains:
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Status Issued
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2~5 Fifth Street,,~p~iogfiel<.l,' ()R3i:;~'~'/" iV:.
54,1-726-3753 P~o'rle};:~:;t~\~;~:~:!f"r-':q;'ipl)L < .
541-726-3676 Fax;'!! 1':" ',: , " ""
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CITY OF SPRINGFIELD
Building/Combination Permit
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, PERMIT NO: COM2009-01591
iSSUED: 11/16/2009
APPLIED: 10/29/2009
EXPIRES: 05/1612010
VALUE: $ 158,464.00
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, ..".",',...."., , ,': $ Per Sq Ft Square Footage
Description, <~:.;:;Jr~~~:~:~~G~,~~;~:~~:f8-?-~r ~.t;::;:or multiplier or Bid Amount
, Garaee/Misc!:;'i:~!U;YB iitilitV";'\' '$37.72 525.00 '
SF/Duplex:h,;~;:R:} VIll&2 Familv $96.83 1,432.00 '
',,' ' .:,J)~~~,~~;:~':j~:~:~;:i:, <~~~,> :.:l~ . f.. Total Value of Project
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F D .. ..'"" ~.:;", Amonnt Paid
ee escnptlOn~~_o 11..!t:.~~.; ".; .,.;~ ';-':':1"
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Plan ReVIew Res.denl1al,'. ,,: ',I. ![, .
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+':12% State Surcharge'
+:5% Technology Fee .
Temp Power 200 anips:or less",:. ;
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+'12% State Surcharge . , '~;;:
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+ 5% Technology' Fee
1st Appliance
21:Baths One or Two Family ,.:t"
Building Permit ' ,,';.' ,.,,:.:;lj~:~"!
'": :;~;-:~~:,.~:~!~~+ ,:~~'::-.:r.e :g;:.;:-;
Dryer Vent :~:".~ ~,P-;~ ..., '. ',,: 'I~' ,.
Exhaust Hoods' . I I' ... "
Fire SF Fee - Residential
Plan Review M~jor1[ Pianning '!'i" ;,
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Residence Wiring 1000 Sq Ft ::: i~
Residence Wiring Ea AddtI 500 .
SDC Sanitary/Storm Admin ..",
Storm Drainage Impervious Are~ "';.~~
Vent Fan _ ~t;:::].~~:;~,~.~:.:;;:.~~!:~~:i:;'
Total Amount Paid
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Initial Riwiew
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11/02/2009
Initial Review
11/03/2009" '
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Plan nine Review'" <,' ~:"r:
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StructuralRevlew . ,:. . ,'x." 11/02/2009
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Date Paid
$643.23
$7.56
$3.15
$63.00
$188.57
$89.12
$79.00
'$337,00
$922:42
$9,00
$13.00
$61.85
$211.00
$134.00
$50.00
$23.99
'$479,86
$27,00
10/29/09
11/12/09
11/12/09
11/12/09
11/16/0?
11/16/09
11/16/09
11/16/09
(i/16/09
11/16/09
11/16/09
11116/09
11116/09
11/16/09
.11/16/09
11116/09
11/16/09
11/16/09
$3,342.75
Plan Reviews I
11/02/2009 APP
LLH
11/03/2009
APP LLH
11/03/2009
WE DDK
11/03/2009
WE CJC
Paee 2 of 4
Value
Date Calculated
$19,803.00
$138,660.56
$158,463.56
11/03/2009
11/03/2009
Receipt Number
1200900000000001212
2200900000000001279
2200900000000001279
2200900000000001279
1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
,1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
1200900000000001259
Revised drawings forwarded to
Chris Carpenter
Scale on plot plan is not co....ect.
Need setback information/distances
and height of structure. Left
message for owner.
Plans incomplete
T!, Request an inspectiim call.the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m, will be ~'a!l~ (h! saine'~~rking day, inspections requested after 7:00 a.m. will be made the following
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work day. " '
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Status Issued:,
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, 22.5 Fifth Street;$pi:jiIgfi,eld"OR)" ,0)
541-726-3753 Phone ,,",,;' .'."'i!,i.""~t+.
541-726-3676 Fax, " .. ' ,'" ,'i:)!
541-726-3769 Inspection Line
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Structural Revi.eWliL,:. ,>,',\,:'J1/Q3/2009
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Planninl! Review, . 11/0512.0091,:
11 /03/2009
WE CJC
11/05/2009
APP DDK
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Structural Review",
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PublIc Works ReVIew y ."~ 'i ,
11/09/2009
APP TSS
11/02/2009
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- 11/1,0/2009
11/10/2009
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CITY OF SPRINli1'!J!;LD .
, Building/Combination Permit
PERMIT NO: COM2009-0159I
ISSUED: 11/16/2009
APPLIED: 10/29/2009
EXPIRES: 05/16/2010
VALUE: $ 158,464.00
Plans in'complete: Need 11001'
framing aud foundation plans, truss
doc's to match building plans and
euergy path and specific type of
radiant heating system.
Floodplain line must be staked and
marked in proximity to new buildin!
footprint. NO PART OF
STRUCTURE MAYBE IN THE
FLOODPLAIN. IF ANY PART OF
STRUCTURE IS IN THE
FLOODPLAIN A FLOODPLAIN
OVERLAY DISTRICT
APPLICATION WILL BE
REQUIRED. Existing street tree(s)
may be counted towards street tree
requirement.
Foudation /11001' framing plan,
e-option and 1100r heat type
recieved, still need revised truss
docs,
Spoke to homeowner about the scale
on plan set. He indicated on
11/6/2009 thatthe plans were on a
1/4 scale and that is what was used
to calculate rooftop impervious.
Floodplain certilicale included with
application.
Stormw'ater to curb and gutter.
As noted on plans and in review
letter
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
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Ufer Electrical Ground: Illstall ground rod at footing and call for inspection in conjunction with footing and/or
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loun atlOn IDspechoD." .. _1<-<: ~n:'
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Footing:4Aft;~ ;;enches ar~ e'xcavated.
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Foundation: 'After forms are erected but prior to concrete placement.
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CITY OF SPRINGFIELD'
Building/Combination Permit
'Status
Issued'
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225 Fifth Street, Springfiel~, OR ' ~,
541-726-3753 Phone . ,,- ,',..~,.,>~i,,;;
541-726-3676 Fa~;+ 'f':~~~;:',,!;!~'~?,~~'{j~~:; ~::
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PERMIT NO: COM2009-01591
ISSUED: 11/16/2009
APPLIED: 10/29/2009
'EXPIRES: 05/16/2010
VALUE: $ .158,464.00
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Floor Insuhition::;;,Prior ,to decking.
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Shear WallNailing: Before cov~ring sheathing with finish materials,
Framing Inspection: Prior to' cover and after all rough in inspections bave beeo approved.
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Wall Insulation: Prior,to.cover;.' 'j i;'
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Ceiling Insulation:' Prioi-'io 'cover,
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Drywall(Prior to taping.
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Final Building: Afte~ all required inspections have been requested and approved and the bnilding is complete.
. I . . .
Underslab Plu~bing: Prior to filling the trench and including required testing.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
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Rough Plumbing: Prior to cover and including reqnired testing.
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Water Link: 'Prior t(i'filling trimch and inclnding requircd testing.
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Sanitary'S~ewer Line, Prior to filling trench and including required testing.
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Line to S'eptic Tank: Prior to filling trench and reqnired testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Underslab Mechanical. Prior to insulation or decking and inclnding required testing,
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Rough ,Mechanical: Prior'to',Cover
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Final MechluiiCal: When all mechanical work is complete.
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Tempor"-ry,,~iect~ic:,,,APPI.~Y!,1 required prior to Utility Company energizing pole.
Rough Electric: Prior to Coyer,
Electric Service: Approval required prior to ntility'company energizing service.
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Final Electric: When all electrical work is complete.
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Tempor'1,ry)!;1~,~tri~;':App,r.o~al required prior to Utility Company energizing pole.
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By signature, I ~tate:"'nd agree, that 1 have carefully examined the completed application and do hereby certify that all
information her~'i>[ds tr'ue and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City'of Sp~ingfield and the Laws of the State of Oregon pert:tining to the work described berein; and
tbat 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 allre,quired inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located 'ai the front of the propcrty, and the approved set of plans will remain 011 the site at all
thites during co?str~'di~n. j';;':- .,.~,.'~' . .
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Owner or Contractors Signature! 'J
Date
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U,S, ')EPART:AENT OF HOMELAND SECURITY
Fe~eral Em'ergency Managemen(Agency
Na~ional Flood Insurance Program
ELEVATION CERTIFICATE
OMS No 1660-0008
Expires March 31, 2012
Important: Read the instructions on pages 1-9,
SECTION A . PROPERTY INFORMATION
A1,. Bl.!,i!ding Owner's Name LlJc.ius Vafusek
A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
2021 Inland Way ,
City Springfield State "OR ZIP Code 97477
A3. Property Description (Lot and B!ock Numbers, Tax Parcel Number, L~gal Description, etc.)
A~sessor's Map No. 18-03-02-3~, Tax Lot #8000, Lot 45, Block 2, Filbert Grove Fifth Addition, Book 66, page 4
A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 44.02607" Long, 123_022640 Horizontal Datum: D NAD 1927 [8J NAD 1983
A~. Attach at least 2 photograp~s of the building if the Certificate is being used to obtain flood insurance,
A7. Building Diagram Number 2-
A8, For ~ bUilding with a crawlspace or enclosure(s): A9. Fora building with an attached garage:
a) 'Square footage of crawlspace or enclosure(s) 720 sq ft a) Square footage of attached garage n/a sq ft
b) No. of pennanenfflood openings in the crawlspace or b) No. of permanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade n/a within 1.0 foot above 'adjacent grade n/a
c) Total net area of flood openings in A8.b n/a sq in c) Total net area of flood openings in A9:b n/a sq in
d) Engineered flood open,ings? D 'Yes [8J No d) Engineered flood openings? DYes [8l No
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP Community Name & Community Number
, Lane County, 415591
82. County Name
Lane
B3, State
OR
84. Map/Panel Number '
; 41039C1144
B5. Suffix
, F
B6, FIRM Index
Date
June 2, 1999
B7, FIRM Panel
Effective/Revised Date
Oct. 3, 2007
B8. Flood
Zone(s)
AE
B9, Base Flood Elevation(s) (Zone I
AO, use base flood depth)
451,3
B10.
Indicate the source. of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89.
[2] FIS Profile 0 FIRM 0 Community Determined 0 Other (Describe)_
Indicate elevation datum used for BFE in Item B9: [8J NGVD 1929 D NAVD 198,8 D Other (Describe)_
Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? DYes
Designa1ion Date _ 0 CBRS DOPA
[2] No
B11"
B12,'
SECTioN C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. .I Building elevations are based_on: D Construction Drawings.' D Building Under Construction" t8J Finished Construction
:; *A new.Elevation Certificate will be required when construction of the building is complete..
C2.: Elevations -Zones A1-A30, AE, AH, A (with BFE), VE;V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, AR/AH, AR/AO, Complete Items C2,a-h
,below according to the" building diagram specified.in Item A7, Use the same datum as the'BFE.
Benchmark Utilized See Comments Vertical Datum 1929
. Conversion/Comments nfa
a)
;;b)
c)
:,d)
',e)
f)
9)
h)
"
Top orlhe next higher floor
Bottom of the lowest horizontal.structural member f.Y Zones only)
Attached garage (top of s,lab)
Lowest, elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
Lowest adjacent (finished) grade next to building (LAG)
Highest adjacent (finished) grade next to building (HAG)
Lowest adjacent grade atlowest elevation of deck or stairs, including
structural support
454,;2
n/a._
n/a._
454,;2
Check the measurement used,
[2] feet 0 meters (Puerto Rico only)
[2] feet 0 meters (Puerto Rico only)
D feet D meters (Puerto Rico only)
D feet 0 meters (Puerto Rico only)
~ feet 0 meters (Pue.iio Rico only)
Top of bottom floor (il)clu.ding basement, crawlspace, or enclosure floor) 451.9,
451,,2
451,J!
n/a._
[gI feet 0 meters (Puerto Rico only)
[8l feet D meters (Puerto Rico only)
D feet 0 meters (Puerto Rico only)
SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Thi~ certincation is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
f u~derstimd that any false statement may be punishable by fine,or impriso'!ment under 18 U. S. Code, Section 1001.
[gI'Check here if comments.'areprovided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? [8J Yes D No
Adqress ;P:O. Box 7155
State 0 R
ZIP Code 97401
REGIS=ERED //'.
PROl!E;~~JO
LAND..S OR
'I ~!!!E I
OREGON
JULY. 15. 2003 ~}~1;
KENT BAKER.d
, ' #59885 ,'" ,
r,:"i":'" 12-~'-2"o "il
Certifier's.Name Kent Baker
License Number 59885
Title Vice President
Roberts Surveying, Inc.
Signature'
Telephone 541-34$-1112
FEMA Form 81-31, Mar 09
See reverse side for continuation.
Replaces all previous editions
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IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Stre~t Address (including Apt., Unit, Suite, and/or Bldg. No.) or P .0, Route and Box No.
2021 Inland Way .
City Springfield Stale OR ZIP Code 97477
~or~~rr&ncej~i,!n'~yJ:llir~~
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments Benchmark used: City ofSpringf d Sta.487, elevation"= 447.60'
Signature ~ . _____ Date 9/21/09
""'.T' ~ [3J Check here jf attachments
: SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AD and A (without BFb, complete Items E1-E5. If the Certificate.is intended to support a LOMA or LOMR~F request, complete-Sections,A, B,
an,d C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rito only, enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is~above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top' of bottom floor (including basement, crawlspace, or enclosure) is O"feet 0 meters 0 above orO below the HAG.
b) TO'p of bottom floor (including basement, crawlspace, or enclosure) is 0 feet 0 meters 0 above or 0 below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 andlor 9.(see pages-8-9 of Instructions), the next higher floor
(elevation C2,b in the diagrams) of the building is 0 feet 0 meters 0 above or 0 below the HAG.
E3, Attached garage (top of slab) is 0 feel 0 meters 0 above or 0 below the HAG,
E4, Top of platform of machinery and/or equipment servicing, the building is' 0 feet D meters 0 above or 0 below the HAG,
E5. Zo'ne AD only: If no flood depth number is available, is the top of the bottom floor elevated in accordancewith the community's floodplain management
ordinance? 0 Yes 0 No .0 Unknown, The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community~issued BFE)
or Zone AO must sign here. The statements in Sections A, a, and E are correct to the best of my knowledge.
Pr9perty Owner's or Owner's Authorized Represen~ative's Name
Address
City
State
;, ZIP Code
Signature
Date
Telephone
Comments
n Check here ifattachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The,local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E),
and G of this Elevation C::ertificate. ,Complete the applic~ble item(s) and sign below. Check the measurement used in Items GB and G9.
G1. '0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
II is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. 'b A community official completed Section E for a building located in Zone A (without a FEMA-issuedor community-issued BFE) or Zone AO.
G3. D The following. informatior) (Items G4-G9) is provided for community floodplain management purposes.
I G~: Permit Number I G5. DatePermit Issued I G6. Date Certificate Of qompliancelOccupancy Issued
G7. This permit has been issued for:' 0 New Construction 0 Substantial.lmprovem~nt
GB. , Elevation of as~built lowest floor (including basement) of the building: 0 feet 0 meters (PR) Datum
G9. I: BFE or (in 'Zone AO) depth oUlooding at the building site: _ _ . 0 feet D meters (PR) Datum _ -
G10/-Comrnunity's design flood elevation 0 feet 0 meters (PR) Datum _
Local Official's Name
Title
Community Name
. Telephone
Signature
Date
Comments
<
n Check here if attachments
FEMA Form 81-31, Mar 09
Replaces all previous editions
,-- ,T .
Building Photographs
, "See Instructions for Item A6.
No.) or P,Q. Route and Box No,
I Building Street Address (including Apt., Unit, Suite, and/orHldg,
2021 Inland Way ,
I City Springfield State OR ZIP Code 97477
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instruCtions for Item A6, Identify all photographs with: date taken; "Front View" and "Rear View':; and, if required, "Right
Side View" and "Left Side View," If submitting more photographs than will fit on this page, use'the Continuation Page on the
reverse. .
Front view taken on 9121/09:
Back view taken on 9/21/09,
~APPLICANT'S copy
SEPTIC INSTALLATION PERMIT
SP097242
Parcels 18-03-02-33-08000
Site:
2021 INLAND WAY SPR
'Applicant:
:v ALUSEK LUClUS
Owner:
V ALUSEK LUCIUS
2021 INLAND WAY
SPRINGFIELD OR
97477
2021 INLAND WAY
SPRINGFIELD OR
97477
Site Inspection Number:
Work Description: AUTH WITH SITE VISIT, City of Spfld BP.
System Type: AUTHSITE " STD
,
Issued Date: 10/19/20'09
ExpiI"ation Date: 10/19/2010
INSTALLATION REOUIREMENTS:
frojected Daily Flow:. 375 gallons
Drainfield Size: 0 ,feet
Special Conditions: 1 OOOga!. Tank pumped and inspected
By Royal Flush. 10-12-09.
Septic Tank Size: 1000 gallons
Trench Depth: in.
No evidence offailure, Limited repair
area. Alternative treatment if failure
occurs:
Setbacks met.
"
OTHER REOUIREMENTS:
1. Installation of an effluent pump requires and Electrical Permit.
2. Install disposal trenches on contour. The trench bottom shall be level within a tolerance of plus or minus one (1)
inch over the entire trench length.
3. Minimum of eight (8) inch fall from top of septic tank outlet to top of first header pipe leaving D-box.
4. New systems must meet setback requirements in Table I.
----. /'
_./} .
/ Y. '
/, ~~' /- --
-7/o//'~r ,;?"4~;?? ) -.,'
Jay M~thison, Environinentai Health Specialist
10/19/2009
Date
LANE COUNTY ON-SITE-SEW AGE OFFICE
125 E 8TH Avenue, Eugene OR 97401. PH: (541)682-3754, Fax: (541) 682-3947
,)~<". ,.
~-
Name'
/ Address
City
Notes:
,,.IUJ _...;__ _ __ _____
~-~-- - -- -----
----------.,- - ---- -------
===a=== = =.-= ==:i..==
--- '- - -- r'====,;::::
==.== ===== - ----------
__ 'lIII!!!!!!I' ...__ _ ~.... "IIIIIJ!!!!!I' ~~
,~ ~~~Ie ~ I~ g )~UVj $ ~~~ ~m ~i ~ I,In l~ *'~
DEQ UC. #37035 ' BOND #807002
P.O. BOX 67
CRESWELL, OR 97426
895-2072
SEPTIC TANK AND DRAINFIELD INSPECTION
L 0.. (' l'U,) VA LtA. ~ t<
:2 I?:J I """rA Ir.,^r\ l~ ')
-S ,f)..... \- V\..c, r.~,i,
I -
Date L 0 -'- 12.-
grpUmped o Not Pumped I9-1flspected
Approximate Age of System: L/ D yrs.
Approximate tank capacity: I oCfD gallons
Depth of Crust 0 inches Depth of Sludge D
. ~ptic tank is working at this time
Condition of Tank: , e-Good 0 Fair 0, Poor
I9--Oi'8infeldis working at present and see no problem
. \ .
Condition of Drainfield: B-GOOd' 0 Fair' 0 Poor
~ffles in place
Tank: Q--e6ncrete
o Metal
o Plastic
i.
inches
20 0<1
. ,
OH~~~adeco~
\ \ \ vV'< ~ .
, \
",:./ \\\
I \ \ \
\.
l' "'~+
\Y v
.yy
:S! ~
f~
J~~$~
-~
Royal Flush management and/or employees cannot be held liable for future septic problems.
We express no opinion beyond the test date. '
.f~~
.,
" REGISTE=ED "
PROFESSION, "
LAND SURV OR
,,~~
OREGON
JULY 15, 2003
KENT BAKER
" #59885 "
EXPIRES 12,31-2009
'.,
oi..,<
"
APPROX. EHOPERTYLINE"
}'r\-" \'" "\ ., \.
,,'" " '
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NOTES
[.i]
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1) BASE FLOOD ELEVATION DETERMINED
TO BE 451.3 FEET (NGVD 1929)
2) BENCHMARK USED: CITY OF
SPRINGFIELD BM #487,
, ELE'{ATIQN = 447.60 FEE} ,(NGVD 1929)
3) FLOOD ZONE LINE DETERMINED BY
RESeALING FIRM MAP AND OVERLAYING
IT O.NTO THIS MAP
/
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. :f5f'fiP. V'fj3.'M
30 ' 2cf '(10 Ih-O 20
. - -')...,
1 INCH = 20 FEET
40
I
40
I
,
EXISTING Co!NDITIONS SUR VEY
,
I
SW1/4 SECTJON2,T18S, RSW, W.M
2021 INLAND WA Y, SPRINGFIELD, OR
CLIENT: LUCIUS VALUSEK
^ DRAWN BY:, KB
I
CUL-DE-SAC
Roberts Surveying, Inc.
P.O. Box 7155
Eugene, Oregon 97401
Bus. (541) 345-1112
Fax. (541) 345,3464
DATE: OCTOBER 3, 2009
REVISION DATE:
JOB NO, 2009-TOPO-016
SHEET L OF ..L
.
;" ;;i~'" . . ;::.:..;:;~~~t::;:.;
225 Fifth Street:' .
Springfield, Oregon 97477
541":726-3759 Phone
~ 1
~! ,
" ,'i:Ji'j;iiit:iiillC'EIP$f#":'
1200900000000001259
..,,- .,;/. -,.
Job/Journal Number,: =. Qescript,ion
COMz009:0 1591 \K~t;;;'4:f}i~;SFJ~e;~~~sidential ,
COM2009,01591 ,"':',',2 Baths,O!:,e:or,Two FamIly
C0M2009-0159IResidence wirili'ibooO'Sq Ft
COM2009-01591 ',Residence Wiring Ea Addtl500
COM2009-0159IBuilding'Pennii:;:" ,', "
COM2009-0 1591 :),::. _;;:?l:~t-.Applf~n.c~;";m:~:",:::;j, ~..~
COM;2009~O 159"1 ~.:. ~i;;:!'~tJV~ti'Fcili'<""-1?~i;2/:.t>'::'{ .
COM2009-0 1591' ,"'ie"" ,'!EXhaust Hoods '
COM2009-0159.1 ;,:,i:i,.,\Dryer Vent ..
., ,!._ . ........" ;)~.:_.l ,~.,>'. ,. .' ;". .
COM2009-0 15~ 1"';,',:';'~Plap ~~yi<;'~ityl~jor, - Planning
COM2009~0 1591 Storm Driiimige~mpervious Area
COM2009-0 1591 SDC Sanitary/Storm Admin
COM2009'0 1591 + 5% Technology Fee "
C0M2009-01591 + 12%,State Surcharge
"\ 01 0:',.\ ~~, J-.:: ....;: ~0!f ;~~, ~.
PaYn!ents:
Type ~f Payment
CreditCard
'ii:"!I"; ,
':'Paid By
.. ~WG,IOIJ.S YAWSEK
Check Number
Batch Number
Received By
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Page I of I
cReceintl
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 11/16/2009
Item Total:
Authorization
Number How Received
047989 In Person
Payment Total:
1:52:32PM
Amount Due
61.85
337,00
134.00
50.00
922.42
79,00
27,00
13,00
9,00
211.00
479.86 '
23.99
89,12
188.57
$2,625.81
Amount Paid
$2,625.81
$2,625.81
11/16/2009