HomeMy WebLinkAboutPermit Building 1997-4-22 (2)
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SPRINGFIELD
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Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 970309
225 North Fifth Street
springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 4022 FORSYTHIA ST
Assessors Map #: 18020500
Lot: 80 Block:
Tax Lot #: 03100
Subdivision: WYATT 2
Owner: COZY HOMES
Address: 1275 SOUTH 2ND STREET
Phone #: 747-8704
City/State/Zip: SPRINGFIELD, OREGON 97477
Describe Work: S.F. RESIDENCE
Contractor
Canst.
Contractor #
NEW
Expires Phone
06/10/97 747-8704
12/15/97 895-4575
12/23/97 747-7445
04/28/97 687-1851
General: COZY HOMES 0032947
1275 S 2nd Springfield OR 974770000
Plumbing: BMC MECHANICAL 0103570
648 W Oregon Ave Creswell OR 974260
Mechanical: MARSHALLS 0025790
4131 E St Springfield OR 974780000
Electrical: BILLS ELECTRIC 0021351
3170 W 11th Eugene OR 974020000
QUAD AREA: 3RSC
# OF UNITS: 1
CONSTR. TYPE: VN
WATER HEATER: E
SQ FOOTAGE: 1602
OFFICE USE --
LAND USE: 1111
ZONING CODE: MDR
# OF BDRMS: 3
RANGE: E
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: FE
INSUL PATH: SGC
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 ---
SITE - To be made after excavation but prior to setting forms.
FOOTING - After trenches are excavated.
FOUNDATION - After forms are erected but prior to concrete placement.
UNDERFLOOR MECHANICAL - Prior to insulation or decking.
UNDERFLOOR PLUMBING - Prior to 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.
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.
FINAL PLUMBING - When all plumbing work is complete.
FINAL MECHANICAL - When all mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is complete.
PRE BACKFILL: To verify site is clean of debris prior to final grading
and backfill.
FINAL BUILDING -
inspections have been a
House
Garage
N
10
Lot
Setbacks
S W
10 40
10
E
25
18
Item
Main
Garage
Total Value
BUILDING PERMIT
Square Feet x
1206
400
$/Square Feet
64.66
16.27
Building Permit Fee
Surcharge/Admin
TOTAL FEE
--- SYSTEMS DEVELOPMENT CHARGE (SDC) ---
and
From NPL: 10
= Value
77,980.00
6,508.00
84,488.00
388.00
31. 04
(A)
419.04
(B) 2,526.49
Systems Development Charge is due on all undeveloped properties within the City
limits and the Citys Urban Growth Boundry which are being improved.
PLUMBING PERMIT ---
Item
Residential Bath(s)
2
Plumbing Permit
Surcharge/Admin
TOTAL CHARGE
- -- MECHANICAL PERMIT ---
Furnace
Exhaust Hood
Vent Fan
Dryer Vent
2
Mechanical Permit
Issuance
Surcharge/Admin
TOTAL PERMIT
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
Sidewalk
Curb Cut
PLAN REVIEW FEE
ELECTRICAL PERMIT
WILLAMALANE SDC
TOTAL MISCELLANEOUS PERMITS
(E)
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUB
(A, B, C, D, and E combined)
Fee
160.00
160.00
12.80
(C)
172.80
6.00
4.50
6.00
3.00
19.50
10.00
1. 57
(D)
31. 07
0.00
13.00
12.40
60.00
167.40
1,000.00
1,252.80
4,402.20
SPRINGFIELD
~-
Job Number: 970309
Page 3
-- - BUILDING VALUB, 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.
Received By:
Plans Reviewed By: DON MOORE Date: 03/28/97
Building Site Reviewed By: LISA HOPPER
- - - ADDITIONAL COMMENTS
A & T ESTIMATE ONLY FOR SDC CREDIT PURPOSES
DRIVEWAY REQUIRED TO BE PAVED
Amount Received:
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 remai~Site at all times during construction. +,~~;I'~ ~
Signature \./ Dte /
--- VALIDATION
~~_~k7
4.11.C\1
,44\)1,1.0
'thWi). ~
Receipt Number:
Date Paid:
Received BY:./~
i _ 'IIIIf
.
.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
(RESIDENTIAL)
Name or Company: COZY
Location: 4022
Developement Type: R
HOMES
FORSYTHIA ST
Building Size:
Job No.: 970309
Lot Size:
1. STORM DRAINAGS
Impervious Sq Ft 3771 X 0.216 Per Sq Ft =
2. SANITARY SEWER - CITY
Number Of PFUs 18 X 44.75 Per PFU =
(see Page 2)
3. TRANSPORTATION
Number Of Units
1 X
X Trip Rate
1. 010 X
X
Cost Per Trip
451.26
$455.77
Transportation Total
4. SANITARY SEWER - MWMC
Number Of PFUs
18
Per PFU +
20.690 +
MWMC Admin Fee
10.00
X
X
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SUBTOTAL - (Add Items 1, 2, 3 & 4)
5. ADMINISTRATIVE FEES
Base Charge (Subtotal Above) X
0.50
TOTAL SDC
Reviewed By: DENNIS ERNST
Date: 03/27/97
Page 1
Sq Ft
$814.54
$805.50
$455.77
$382.42
$52.05
$330.37
$2,406.18
$120.31
$2,526.49
.1 . ~ ....
.
Job Number: 970309
.
FIXTURE UNIT CALCULATION TABLE
Fixture Type
Bathtub
Drinking Fountain
Floor Drain
Interceptors For Grease/Oil/Solids/Etc
Inteceptors For Sand/Auto Wash/Etc
Laundry Tub/C1otheswasher
Clotheswasher - 3 Or More
Receptor For Refrigerator/Water Station/Etc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial, Residential Kitchen
Urinal, Stall/Wall
Wash Basin/Lavatory, Single
Water Closet, Public Installation
Water Closet, Private
Miscellaneous
TOTAL FIXTURE UNITS =
Number of
New Fixture
2
o
o
o
o
1
o
o
o
o
o
1
o
2
o
2
o
Page 2
Unit
Equivalent
Fixture
Units
2
1
2
3
6
2
6
1
3
2
4
o
o
o
o
2
o
o
o
o
o
2
o
2
o
8
o
2
2
1
6
4
18
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1000)
Year Annexed: 1969
Credit For Parcel Or Land Only If Applicable:
Improvement (if after annexation date) :
15,000
X
3.47 =
52.05
o
3.47 =
x
0.00
CREDIT TOTAL =
$52.05
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)
.
.
~,.,. Willamalane
't..J,--""f' Park & Recreation District
".., SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME: lTlffi \_~ .. PHONE: l41.<61tr\
ADDRESS: \~~~ ~T A~STATE:0i2- ZIP: Q141.1
. Job. No..ib() ~\9\ .
LOCATION OF PROPOSED BUILDING SITE: .
. Street Address: ~\j) 0 - \[\{S,,\ \(\t\~ _ ')
.Plat Name~~ I Q.D'j._ Tax Lot~umber:. . .
1. DEVELOPME~ TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t
. ype definitions are on the back.)
A. Sinolp."F8milv Detached.
\ Single Family home
NO. OF UNITS
Manufactured home not in a park
X $1,000 per unit = $lDO-O ~
B. Sinale-F8milv Att8ched
NO. OF UNITS
X $~24 per unit - $
C. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
D. M8nllfl'lctllred Home P8rk,
NO. OF UNITS
WILLAMALANE SDC
X $699 peru nit = $
$ lO rf\ ,cD
JY"
$ U:CO ~
4 ilL 0\1
Date
$
I
2. SDC CREDIT (if applicable)".SDC-payer must fumish proof of .
Willamalane Credit approval. See sac Credit Wprl<sheet.
3. TOTAL WILLAMALANE NET SDC ASSESSED
< (if SDC reduced for Credit)
~ ~rul '
Develo-pm~er'v~- J:artmerit
City of Springfield ..
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The following project ElS slJbmittf:d h~3 tho fol:o\',ino
zoning, and does not roqlilre Spc.'Chlol;.nd u:;o
approval. .
~~DIJ ELECTRICAL PERMIT APPLICATION
97477 Zoningl~,t..-. (\
726-JY.6iJj'-1.2~7 City Job Number \Aln~
Authorized Signature ~M0I1PLE~'7 ",!':: SCHEDULE BELOII
1. LJJ..~13t~ INSTAL )
\ <tG6?_t%h(!JO~ ()~\Dn
~OBf\DESCRIPTI~ .f) 1/ 1\1@'
1,1 j l\ -r \~f) 1'(\ \' \ \lA..L ,
Perm are non-transferable and expIre
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
A. New Residential-Single or
Multi-Family per dwelling uni t.
Service Included:
Items Cost Sum
1000 sq. ft. or less $ 85.00 .85-
Each additional 500
sq. ft or portion A .10
the reo f $ 15.00
Each Manuf'd Home. or
Modular Dwelling -
Service or Feeder : $ 40.00
Il. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
2. CONTRACTOR INSTALLATION ONLY
Electrical contracto;~" I ( :S
zlcl
/j)t,;/ //~.. .
Phone arf 7 / ff; I
9C(jU S
Expiration Date / tJ -- / - c;t '?
Constr Contr. Number;) /.3/; /
Address :-317 0
Ci ty ~:/(/1
S . IL.'
upervlsor lcense
Number
Expiration Date 1/-;- 9? r
Si~ature of Supervising Electrician
-<::::R/Jl /J
~ -:;..--
Owners Name lO~ ~
Address---ll\'1.S~ 6lnd
Citll....~ Phone~
~r:sTALLATION
() r.:0
The installation is being'made on
property I own whi~h is not intended
for sale, lease or ren t.
O...ners' Signa ture:
~~~~~---------------,\:1J-~C(~--------.
RECEIPT #: _ ~ ~ \\0-
.RECEIVED BY: ~~J}...Y - .'.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'or less --l:-- $ 40'.00 .1(:L
201 amps to 400 amps . $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "Il" above
C.
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
0[' Feeder Permit
$ 35.00
$ 2.00
not included:
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
'TOTAL
40.00
40.00
20.00
36.00
$
~
,
$
$
I ~C:;~
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