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Home My WebLink AboutPermit Building 2001-4-17 , " .. ',' '.'. ' '---;/>' '~ ~. ~. "c_'::>;;/";I!t-':-:~i " ,:. ,'.- :'";;'-":'" ' . -: 7fC 7ff'~:'>p~:/j~A!,TD /,u ~ nc..> a , ',',' ',' ~ . ""', //1. ,<..v--.:;, /"- ~e?J,'iv/~,<;~6 . ~' : J/~Q&l cQ't ~ -'tflU ,if II ' ~ , ,&';vv / Ijfl I T/f"/e S/~,.u },>J ~#f{kJ ~r~f ,()/fCVJ4)" ,"',,' ::::':, '.'.... ..:!.,:.>::,. I Job# 01-00334-01 I Page 1 of4 TRANS#:01-0004968 DATE :APR 17 2001 AHT RECD:2 $ 5501.72 CHANGE:$ 10.00 CASHIER: 003 225 North Fifth Street Springfield. OR 97477 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00334-01 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 759 Old Orchard Ln Spr Assessors Map#: 17032343 Lot: 108 Block: Addition:3RD Owner: '. Address: Scope Of Work: Single Family Residence Contractor FUTURE B HOMES PO BOX 7425. eUGENE, OR 97401 Electrical Contr Bob Fisher Electric Inc 96275 180 Kingsbury Ave, Eugene. OR 97404 Mechanical Contr Rolfs Heating 102455 PO Box 66, Dexter. OR 97431 Plumbing Contr Custom Plumbing 81994 3248 Kentwood Dr, Eugene. OR 97401 Contractor Type General Contr Quad Area: # Of Units: Constr. Type: Water Heater: Tax Lot #: 02102 Subdivision: River Glen FUTURE B HOMES PO BOX 7425 Phone Number: 541-744-2660 City/State/Zip: eUGENE, OR 97401 New Value: $171,307 SFR Registration # Expiration Date Phone 541-744-2660 1/25/2002 541-689-7973 10/1/2001 541-741-0002 5/6/2004 541-485-1146 5RNW 1 (VN) Wood Frame Office Use Land Use: Zoning Code: LDR Bedrooms: 3 Range: # Of Buildings: 1 Occupancy Group: Dwelling Heat Source: Sq. Footage: 2304 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 working day. Verify Ground Rod Footing Foundation Post and Beam Floor Insulation Ceiling Insulation Shear Wall Nailing Framing Wall Insulation Required Inspections I Buildin!! I -Install ground rod at footing. and call for inspection in conjuction with footing and/or foundation i -After trenches are excavated. - After forms are erected but prior to concrete placement. -Prior to floor insulation or decking, -Prior to decking, - Prior to cover. - Before covering sheathing with finish materials, - Prior to cover. - Prior to Cover , . Drywall Final Building Temporary Power Rough Electrical Electrical Service Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Stonn Sewer Line Final Plumbing Underfloor Mechanical Rough Gas Rough Mechanical Gas Service Final Mechanical SW-Setback CC-overwidth . . I Job# 01-00334-01 I Required Inspections Building I Page 2 of4 - Prior to taping, - When all required inspections have been approved and the building is complete. I Electrical I -Approval required prior to SUB energizing pole. - Prior to cover. - Must be approved to obtain permanent power. -When all electrical work is complete, I Plumbing - Prior to insulation or decking. - Prior to cover or placement of concrete, - Prior to cover. - Prior to filling trench, - Prior to filling trench, - Prior to filling trench, - When all plumbing work is complete, I Mechanical - Prior to insulation or decking, - Prior to cover, -After line is installed and line has been connected to a minimum of one appliance. Pressure tel -When all mechanical work is complete. I Public Works I -After forms are erected but prior to placement of concrete -After forms are erected but prior to placement of concrete Zoning: LOR Overlay District: FloodPlain? 0 Wetlands? 0 # of Street Trees: 2 Journal numbers 1: 2: 3: Comments Mistake: Tree Felling Permit not Required Planner: Ruth Klein Urban Growth Boundary?D Quantity Of Fill: Supplier: Drainage: Floodway FEMA: NA Construction Types:(VN) Wood Frame Occupancy Groups:Owelling # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? 0 rArea (Sq. Feet) I Main: 2304 Accessory592 Land Use: Pave Driveway? 0 Glenwood Area? 0 Additional Requirements: Tree Felling Permit Required Required Attachments: Source Locn: Material: Flood Plain FEMA: 1134 of 2975 Zone X Whit # Of Stories: 2 Height (feet): 27 Current Units: Proposed Units:1 Census Code: New SF - attached Total:2896 . . \ . Job# 01-00334-01 I Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check Residential Plan Check 04/06/2001 00047863 171,307 $386,75 Total Plan Check $386.75 Buildinll Building Permit 04/17/2001 4964 171,307 $595,00 State Surcharge For Building Permit 04/17/2001 4964 $41.65 Building Administrative Fee 04/17/2001 4964 $17,85 Total Building $654.50 Electrical Wiring Footage 1,000 Sq Ft or Less 1 $85,00 Wiring Footage Each Add'l 500 Sq Ft 4 $60.00 Temporary: 200 Amps or Less 04/17/2001 4964 1 $40,00 State Surcharge - Electrical 04/17/2001 4964 $2.80 State Surcharge - Electrical $10,15 Administrative Fee - Electrical 04/17/2001 4964 $1.20 Administrative Fee - Electrical $4,35 Total Electrical $203.50 Plumbinll Minimum Plumbing Permit Fee 04/17/2001 4964 $,00 Three Bathrooms 04/1712001 4964 1 $192,50 State Surcharge - Plumbing 04/17/2001 4964 $13.48 Administrative Fee - Plumbing 04/17/2001 4964 $5,78 Total Plumbing $211.76 Mechanical Hood and Exhaust 04/17/2001 4964 1 $4,50 One to Four Outlets 04/17/2001 4964 1 $2,00 Minimum Mechanical Permit 04/17/2001 4964 $,00 Administrative Fee - Mechanical 04/17/2001 4964 $,96 Less than 100,000 BTU 04/17/2001 4964 1 $6,00 Vent Fan to One Duct 04/17/2001 4964 4 $12,00 Gas Fireplace 04/17/2001 4964 1 $4,50 Dryer Vent 04/17/2001 4964 1 $3,00 Mechanical Issuance 04/17/2001 4964 $10,00 State Surcharge - Mechanical 04/17/2001 4964 $2,24 Total Mechanical $45.20 Public Works New Sidewalk 04/17/2001 4964 70 $65,00 New Curbcut 04/17/2001 4964 1 $65.00 2nd Driveway/Overwidth Appl Fee 04/17/2001 4964 1 $30.00 Multiple Permit Discount - 2nd Permit 04/17/2001 4964 1 $-30,00 Total Public Works $130.00 System Development Residential - Single Family - Storm 04/17/2001 4964 3,298 $893,62 Sanitary Sewer 04/17/2001 4964 29 $468,35 Residential Transportation 04/17/2001 4964 1 $656,02 Residential Sanitary MWMC 04/17/2001 4964 1 $285,91 Residential Improvement MWMC 04/17/2001 4964 1 $24,33 MWMC Administrative Fee 04/17/2001 4964 1 $10,00 Sanitary Sewer SDC Reimbursement 04/17/2001 4964 29 $616,25 SDC Administrative Fee 04/17/2001 4964 $154,61 ~ " , . Job# 01-00334-01 I Paid On Receipt# System Development 04/17/2001 4964 04/17/2001 4964 . Page 4 of 4 Value/Quantity Fee Amount I Fee Property Annexed 1998 Transportation SDC Reimbursement Total System Development 47 $-16.60 1 $154,27 $3,246.76 S,F, Residence - Wi llama lane Total Willamalane SDC Grand Total Willamalane SDC 04/17/2001 4964 1 $1,000,00 $1,000.00 $5,878.47 Plan Check Type Checked By Date Completed Comment Initial Review-Res Bob Barnhart Steve Templin Ruth Klein 04/06/2001 04/10/2001 04/12/2001 04/17/2001 Engineering-Res Planning-Res Structural-Res Tom Marx 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. Signature Date . , d has the tollowi , \ as subm,"a " ,nd usa Ttle_to\\Qw\ng 'Pl'o)e~ot rSQuire spect11C a toning. and doas {L; 225 FIFTH STREET wp.ova\' l-"b SPRINGFIELD, OREGON 97477, 7-oning\:i.._\1-0\ \ INSPECTION REQUEST: 726-3J.6.9 ----~ V-.Y:l OFFICE: 726-3?59. 'U 5.y"a."'" ~......I,.;JI;LICI 3. 1. LOCATION Of ;rNSTALLA}'IOli I C; q OM 1J~d.. I-. LEGAL DESCRIPTION /'J-f) S -'J,J'-.f'3 2- /(7 2- JOB DESCRIPTION /YEw J!F~lnpI-IGK , Permits are non-transferable and expire if vork is not started vi thin 180 days of issuance 'or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor f3asJ (,SIIt:-f'L Address City Phone Supervisor License Number Expiration Date Cons tr Con tr. Number q (). 75 Expiration Date / -')..5"-0'2-- Signature of Supervising Electrician Ovners Name Address Ci ty Phone OVNER INSTALLATION The installation is being made on property I own vhich is not intended for sale, lease or rent. Owners Signature: -----,----------'1--0------------------ DATE: 41/7 tJ / RECEIPT 11:, . . '1'7' C. ~ RECEIVED BY: -6~ ELECTRICAL PERMIT APPLICATION rH;JOb Number /JI - OrHflf--01 COMPLETE FEE SCHEDULE BELOII A. Nev Residential-Single or Multi-Family per dwelling unit. Service Included: 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular'Dvelling Service or Feeder B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only Items Cos t Sum ~ $ 85.00 ~ ~ $ 15.00 ~l) $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less ---I- 201 amps to 400 amps Over 401 to 600 amps Over 600,amps or 1000 volts D. Branch Circuits $ 40.00 40,Ob $ 55.00 $ 80.00 see fiB" above .' New, Alteration or Extension Per Panel One Circuit Each Additional Ci rcu'i t or vi th Service or Feeder Permit $ 35.00 $ 2.00 no t included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 7% State Surcharge 3% Administrative Fee TOTAL 40.00 40.00 20.00 36.00 $ $ $ $ .3MrD~ ~~ rJ ,{/ 'itI /9; :i,dO /2-/F .r; IT _ '20 3,::'-~ , . . CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET I JOURNAL OR JOB NUMBER: 01-00334-0 I NAME OR COMPANY: FUTURE B HOMES LOCATION: 759 OLD ORCHARD LANE TAX LOT NUMBER: 17.03-23-43-02102 ANNEXATION YEAR 1998 LANE COUNTY ASSESSED V ALOE (LAND) $47,439 DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE DWELLING UNITS: I BUILDING SIZE: 2896 SF LOT SIZE: 9850 SF ) ~TORM J)RATNMlE. 1 IMPERVIOUS S,F, 1,1 COST PER S,F, 1 3297,50 $0.271 I ITEM 1 TOTAL - STORM DRAINAGE SDC , ~ANITARV~I'WI'R _f:TTV =1 $893.62 1 =1 $893.62 JI /070 =1 $468,35 I IOn =1 $1.084.60 J I x I NEW TRIP FACTOR I ID93 LOO 1=1 $154,27 II I x I NEW TRIP FACTOR I /07'1 LOO 1=1 $656,02 =1 $810.29 .... A, REIMBURSEMENT COST: I NUMBER OF DFU's 1..1 COST PER DFU 1 29 $21.25 B. IMPROVEMENT COST: 1 NUMBER OF DFD's I..l COST PER DFU 1 29 $16,15 I ITEM 2 TOTAL - CITY SANITARY SEWER SDC ~AN~PORT~ A, REIMBURSEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP 1 9,57 I $16,12 B. IMPROVEMENT COST: I ADT TRIP RATE I' I NUMBER OF UNITS I x I COST PER TRIP 1 9,57 1 $68.55 I ITEM 3 TOTAL - TRANSPORTATION SDC 4 SANITARV~I'WI'R-MWMC. A, REIMBURSEMENT COST: 1 NUMBER OF FEU's I' I COST PER FEU I 1 $285,91 B. IMPROVEMENT COST: 1 NUMBER OF FEU's I 'I COST PER FEU I 1 $24,33 MWMC CREDIT IF APPLICABLE (SEE REVERSE) I MWMC ADMINISTRATIVE FEE lITEM 4 TOTAL -MwMC SANITARY SEWER SDC l SUBTOTAL (ADD ITEMS 1,2,3, & 4)- f'I5 A~:~~:T~l'll'l'~M'FEERATE 1 ~ $3,092,15 J 5% 1 sr- ~ 4/10/01 =1 $616.25 =1 $285,91 =1 =1 =1 =1 =1 I :i $303.64 I] $3.092.15~ $24,33 ($16,60) $10,00 =1 TOTAL SDC CHARGES =1 $154,61 $3,246.76 SDCCOORDlNATOR DATE 109/ 10-5:> I c> :>10 /e 7; . . , DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE " NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO, OF FIXTURES DRAINAGE ( # NEW # OLD ) x EO=ENT = FIXTURE FIXTURE TYPE UNITS BATHTUB ( 2 ) x 3 6 DRINKING FOUNTAIN ( ) x I 0 FLOOR DRAIN ( ) x 3 0 INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. ( ) x 3 0 INTERCEPTORS FOR SAND I AUTO WASH I ETC. ( ) x 6 0 LAUNDRY TUB ( ) x 2 2 CLOTHES WASHER I MOP SINK ( ) x 3 = 3 CLOTHESW ASHER - 3 OR MORE (EA) ( ) x 6 0 MOBILE HOME PARK TRAP (I PER TRAILER) ( ) x 12 0 RECEPTOR FOR REFRlG / WATER STATION / ETC. ( ) x I 0 RECEPTOR FOR COM, SINK / DISHWASHER / ETC. ( ) x 3 0 SHOWER, SINGLE STALL ( ) x 2 2 SHOWER, GANG (NUMBER OF HEADS) ( ) x 2 0 SINK: COMMERCIAURESIDENTlAL KITCHEN ( ) x 3 3 SINK: COMMERCIAL BAR ( ) x 2 = 0 SINK: DOMESTIC BAR ( ) x 1 0 WASH BASIN ( ) x 2 0 LAVATORY ( 4 ) x 1 = 4 URINAL, STALL / WALL ( ) x 5 = 0 TOILET, PUBLIC INSTALLATION ( ) x 6 0 TOILET, PRIVATE INSTALLATION ( 3 ) x 3 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU's. ( ) x 20 0 TOTAL DRAINAGE FIXTURE UNITS =1 29 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEP ARA TEL Y -1 YEAR CREDITRATEPER$I,OOO II YEAR CREDIT RATE PER $1,000 ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE 19790RBEFORE $4.74 1990 $1.96 1980 $4,65 1991 $1.55 1981 $4.59 1992 $U6 1982 $4,46 1993 $L23 1983 $4.30 1994 $1.05 1984 $4,14 1995 $0,90 1985 $3,93 1996 $0,75 1986 $3,63 1997 $0,57 1987 $3,26 1998 $0.35 1988 $2,85 1999 $0,15 1989 $2,40 CREDIT FOR LAND (IF APPLICABLE) CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE 47.439 X $0.35 =1 0,000 X $0.35 =1 TOTAL MWMC CREDIT =1 $16,60 $0,00 $16.60 . fl1\ _' ~ ~1''''Wdlamalane t\J""III Park & Recreation District Job No E\ I '- t'r-r\ ~ 2 II - . U Vl.J .IJ1-0/ SYSTEM DEVELOPMENT CHARGE WORKSHEET , ,,~ ,.~~~ " I :t, ~i '.:W " " .., ,'l~' I.A '; ~.. ; ;.r;.: , , '.} '''II~ '1'" , , ~.:" ,;: ~\ ;:;':1 'r /,',(, 'i~ -:::;- "'.1. ,.1 " , " :,] 'l '.:~ y. ,( . , . NAME: r.::vJ1,no., 61~~./ ADDRESS: to.~ 1/f-L'::- I PHONE: "7l..{L( ~ '2..(P~ cl STATE: oil ZIP: 0(1 LID 1 I . LOCATION OF PROPOSED BUILDING SITE: I Street Address: Plat Name: ~AI (~1A- (?'m\ _ Tax Lot Number: lIo::l, 1_ 3 tl:~ O.}IO)..-. 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). sac calculalions and dwelftrig t ype definitions are on the back.) , . ..~r. A Sinolp.-F::Jmilv Dp.t::J~hp.Q / Single Family home NO"OF UNITS Manufactured home not in a park X $1,000 per unit = $, Iboo - - I, ~' 'I' I .~ "1 :'j '11 . ~. ,'" ;~ . .~" .,.".~ ' \I~i: , ~ ii B. .si.w1p.-Fl'lmilv Aftl'l(~hp.ci NO. OF UNITS X $924 per unit ,- $ _ , , C. Multi-Familv AO::Jrtment NO. OF UNITS X $692 per unit = $ " i, D. .Ma.n.llfsIclIJrAcf HomA Pam. :', " " NO. OF UNITS X $699 per unit = $ $ \ o-e-o . " ~i WILLAMALANE SDC :, " ? '. ", " 2. SDC CREDIT (If applicable) SOc-payer musttumlsh proof of Willamalane Credit approval. See sac Credit Worksheet. $ a ( ... 3. TOTAL WtLLAMALANE NET SDC ASSESSED (If sac reduced (or Credit) $ 1fJrr1)' I " ~~,~ IlG~ Developl)lenfServices Department ~ City of Springfield "'" ......:.1.'..'... , " 10 ,"',' j Dat~ I 11 I 01 . ~...l .. """...~ . , , " ' .... ,....I ~.:':~: '~: '..fi, . \.,. ~ \ I . ",. .' I .' ". . \ I;' , I' t., ,;r . , ..( '.: ;', ','!; - ,"(1. " ~ '.. 225 North Fifth Street Springfield, OR 97477 . . I Job# 01-00334-01 I Page 1 of 4 TRANS#:01-0004968 DATE: APR 17 2001 AMT RECD:2 $ 5501.72 CHANGE:$ 10.00 CASHIER:003 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00334-01 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 759 Old Orchard Ln Spr Assessors Map#: 17032343 Lot: 108 Block: Addition:3RD Owner: Address: Tax Lot #: 02102 Subdivision: River Glen FUTURE B HOMES PO BOX 7425 Phone Number: 541-744-2660 City/State/Zip: eUGENE, OR 97401 New Value: $171,307 Scope Of Work: Single Family Residence Contractor Type General Contr Electrical Contr Mechanical Contr Plumbing Contr Quad Area: # Of Units: Constr. Type: Water Heater: SFR Contractor FUTURE B HOMES PO BOX 7425, eUGENE, OR 97401 Bob Fisher Electric Inc 180 Kingsbury Ave, Eugene, OR 97404 Rolfs Heating PO Box 66, Dexter, OR 97431 Custom Plumbing 3248 Kentwood Dr, Eugene, OR 97401 Registration # Expiration Date Phone 541-744-2660 96275 1/25/2002 541-689-7973 102455 10/1/2001 541-741-0002 81994 5/6/2004 541-485-1146 5RNW 1 (VN) Wood Frame Office Use Land Use: Zoning Code: LOR Bedrooms: 3 Range: # Of Buildings: 1 Occupancy Group: Dwelling Heat Source: Sq. Footage: 2304 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 working day. Verify Ground Rod Footing Foundation Post and Beam Floor Insulation Ceiling Insulation Shear Wall Nailing Framing Wall Insulation Required Inspections I Buildin!! I -Install ground rod at footing, and call for inspection in conjuclion with footing and/or foundation i -After trenches are excavated. -After forms are erected but prior to concrete placement. -Prior to floor insulation or decking, -Prior to decking, - Prior to cover. - Before covering sheathing with finish materials. - Prior to cover. - Prior to Cover Zoning: lDR FloodPlain? D Wetlands? D Journal numbers 1: 2: Comments Mistake: Tree Felling Permit not Required Planner: Ruth Klein Urban Growth Boundary?D Quantity Of Fill: Supplier: Drainage: Floodway FEMA: NA .' .. Drywall Final Building Temporary Power Rough Electrical Electrical Service Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Final Plumbing Underfloor Mechanical Rough Gas Rough Mechanical Gas Service Final Mechanical SW-Setback CC-Overwidth . . Page 2 of 4 I Job# 01-00334-01 I Required Inspections BuildinQ - Prior to taping, - When all required inspections have been approved and the building is complete, I Electrical I -Approval required prior to SUB energizing pole, - Prior to cover, -Must be approved to obtain permanent power. -When all electrical work is complete, I PlumbinQ - Prior to insulation or decking, - Prior to cover or placement of concrete, - Prior to cover. - Prior to filling trench, - Prior to filiing trench, - Prior to filling trench, - When all plumbing work is complete, I Mechanical - Prior to insulation or decking, - Prior to cover. -After line is installed and line has been connected to a minimum of one appiiance. Pressure te: - When all mechanical work is complete, I Public Works I - After forms are erected but prior to placement of concrete - After forms are erected but prior to placement of concrete Overlay District: # of Street Trees: 2 land Use: Pave Driveway? 0 3: Glenwood Area? D Additional Requirements: Tree Feliing Permit Required Required Attachments: Source locn: Material: Flood Plain FEMA: 1134 of 2975 Zone X Whit Construction Types:(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? D rArea (Sq. Feet) I Main: 2304 Accessory592 # Of Stories: 2 Height (feet): 27 Current Units: Proposed Units:1 Census Code: New SF - attached Total:2896 ,- w' . . Job# 01-00334-01 Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check I Residential Plan Check 04/06/2001 00047863 171,307 $386,75 Total Plan Check $386.75 Buildinll Building Permit 04/17/2001 4964 171,307 $595,00 State Surcharge For Building Permit 04/17/2001 4964 $41,65 Building Administrative Fee 04/1712001 4964 $17,85 Total Building $654.50 Electrical Wiring Footage 1,000 Sq Ft or Less 1 $85,00 Wiring Footage Each Add'l 500 Sq Ft 4 $60.00 Temporary: 200 Amps or Less 04/17/2001 4964 1 $40.00 State Surcharge - Electrical 04/17/2001 4964 $2,80 Slale Surcharge - Electrical $10,15 Administrative Fee - Electrical 04/17/2001 4964 $1,20 Administrative Fee - Electrical $4.35 Total Electrical $203.50 Plumbinll Minimum Plumbing Permit Fee 04/17/2001 4964 $.00 Three Bathrooms 04/17/2001 4964 1 $192,50 State Surcharge - Plumbing 04/17/2001 4964 $13.48 Administrative Fee - Plumbing 04/17/2001 4964 $5,78 Total Plumbing $211.76 Mechanical Hood and Exhaust 04/17/2001 4964 1 $4.50 One to Four Outlets 04/17/2001 4964 1 $2,00 Minimum Mechanical Permit 04/17/2001 4964 $,00 Administrative Fee - Mechanical 04/17/2001 4964 $,96 Less than 100,000 BTU 04/17/2001 4964 1 $6,00 Vent Fan to One Duct 04/17/2001 4964 4 $12,00 Gas Fireplace 04/17/2001 4964 1 $4,50 Dryer Vent 04/17/2001 4964 1 $3,00 Mechanical Issuance 04/17/2001 4964 $10,00 State Surcharge - Mechanical 04/1712001 4964 $2,24 Total Mechanical $45.20 Public Works New Sidewalk 04/1712001 4964 70 $65,00 New Curbcut 04/1712001 4964 1 $65,00 2nd Driveway/Overwidth Appl Fee 04/17/2001 4964 1 $30,00 Multiple Permit Discount - 2nd Permit 04/17/2001 4964 1 $-30,00 Total Public Works $130.00 System Development Residential - Single Family - Storm 04/17/2001 4964 3,298 $893,62 Sanitary Sewer 04/17/2001 4964 29 $468,35 Residential Transportation 04/17/2001 4964 1 $656,02 Residential Sanitary MWMC 04/17/2001 4964 1 $285,91 Residential Improvement MWMC 04/1712001 4964 1 $24,33 MWMC Administrative Fee 04/17/2001 4964 1 $10,00 Sanitary Sewer SDC Reimbursement 04/1712001 4964 29 $616.25 SDC Administrative Fee 04/17/2001 4964 $154,61 " .. . Job# 01-00334-01 . Page 4 of 4 Value/Quantity Fee Amount Fee Paid On Receipt# System Development 04/17/2001 4964 04/17/2001 4964 47 $-16,60 1 $154.27 $3,246.76 Property Annexed 1998 Transportation SDC Reimbursement Total System Development SF Residence - Willamalane Total Willamalane SDC Grand Total Willamalane SDC 04/17/2001 4964 1 $1,000.00 $1,000.00 $5,878.47 Plan Check Type Checked By Date Completed Comment Initial Review-Res Bob Barnhart Steve Templin Ruth Klein Tom Marx 04/06/2001 04/10/2001 04/12/2001 04/17/2001 Engineering-Res Planning-Res Structural-Res 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, 'f j, o!o I ~,~o (j ~ "'.. I