HomeMy WebLinkAboutPermit Building 2004-12-8
Status
Issued
CITY OF SPRINGFIELJ) .
Building/Combination Permit
PERMIT NO: COM2004-01403
ISSUED: 12/08/2004
APPLIED: 11/12/2004
EXPIRES: 06/08/2005
VALUE: $ 22,176.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6989 C ST
ASSESSOR'S PARCEL NO.: 1702353200204
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Addition
Residential
PROJECT DESCRIPTION: Additiol1 to existing SFR
Owner: BRIAN KING
Address: 6989 C ST SPRINGFIELD OR 97477
Phone Number: 541-736-8722
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Contractor License
V ANDERVIES CONSTRUCTION INC 1~4~1C)""\\.
BEAR MOUNTAIN ELECTRIC LLC. ~\P-t. \t ~~~9,fb ~C)\
",,\r.'IlUJIf.~~~~iiloN'flJ?-
~v t-.\\\'I' ~ \J ~~\JV\ '
,\\\S \' C)\\\1t're~~~i.es<P ~'O
R-3 f\~\\\-l\'t.~~~ 8f.~~ture
CC)~ ~(J;'W~'hrHeat:
VN \\~"{ \ UWater Type:
Range Type:
Energy Path:
Sprinkled Building: .
Expiration Date
02/19/2005
08/06/2005
Phone
541-914-8249
541-953-6747
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
REQUIRED PARKING
Overlay Dist: ~.I:
# Street ~rees Rqd: ~\"f!/!J 'I ' ; capped:
Paved Dnve Rqd: ''a~ "eO: ~e9Jo(\ ~:
% of Lot Coverage: Of.e9P(\ r4 ~e 0 ~'(e ~ r/,...oO'-
...-<~~1\\O~.~d09\e~ose ~~~~ :~\es '01
I PUBLIC IMPRq~~<le~\~O'\~ ~t~~~s 0'\ ~~\e~:'O~~<\
~ r;~~'\ n..'la.\~ ~J'f\e ...\O~\\~
Street Improvements: Fully Improved ~ O~~ 9~\}.1'<'e.'1 ~:f.~ "\:~ \S\~\'I \~). Curbside 5'
Storm Sewer Available: Yes \~~9()':O \,<\0 cli>'o~~~s: Curb and Gutter
Special Instruction: Ca.\\\f\9 1. \Of. \,<\e 's \-~<J
\}.~'Oe ef\\0f. ~
Notes: Storm Drain into existing to curb face per Martin VandervThs 11/17~004 CAS
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
6.00
27.10
0.00
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!e 1 of 3
Status
Issued
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: COM2004-01403
ISSUED: 12/08/2004
APPLIED: 11/12/2004
EXPIRES: 06/08/2005
VALUE: $ 22,176.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Dwellines
V Wood Frame
$92.40
240.00
$22,176.00
$22,176.00
11/12/2004
Total Value of Project
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $135.72 11/12/04 1200400000000001613
-Mechanical Issuance Fee- $10.00 12/8/04 1200400000000001711
+ 10% Administrative Fee $34.48 12/8/04 1200400000000001711
+ 7% State Surcharge $24.14 12/8/04 1200400000000001711
Add, Alter, Extend Circ $43.00 12/8/04 1200400000000001711
Add, Alter, Extend Circ Ea Add $3.00 12/8/04 1200400000000001711
Building Permit $208.80 12/8/04 1200400000000001711
Minimum/Adjustment Mechanical $45.00 12/8/04 1200400000000001711
Minimum/Adjustment Plumbing $45.00 12/8/04 1200400000000001711
Plan Review Minor - Planning $59.00 12/8/04 1200400000000001711
SDC Sanitary/Storm Admin $4.33 12/8/04 1200400000000001711
Storm Drainage Impervious Area $86.65 12/8/04 1200400000000001711
Total Amount Paid $699.12
I Plan Reviews I
Initial Review 11/15/2004 11/15/2004 APP SKG
Plannine Review 11/15/2004 11/29/2004 APP TAJ
Public Works Review 11/15/2004 11/17/2004 APP CAS Storm drainage into existing to curb
face 11/17/2004 CAS
Structural Review 11/15/2004 12/01/2004 OK RJB
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.
l..Reouirerunsnections.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Floor Insulation: Prior to decking.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Final Building: After all required inspections have been requested and approved and the building is complete.
Storm Sewer Line: Prior to filling trench.
Underfloor Mechanical. Prior to insulation or deeking and including required testing.
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Paee 2 of3
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2004-01403
ISSUED: 12/08/2004
APPLIED: 11/12/2004
EXPIRES: 06/08/2005
VALUE: $ 22,176.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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 insp,ectitms are requested at the proper time, that each address is readable from the
street. that the perndy:(r77at the'f,ront, the property, and the approved set of plans will remain on the site at all
ttmeSd~D'fi/~ /clJrft~
p ,
tors Signature Date
Pa2e 3 of3
'.
CITY OF S";~GFIELD SYSTEMS DEVELOPMEN'1~ORKSHEET
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:"
NEW DWELLING UNITS
1. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I. IMPERVIOUS S.F. x COST PER S.F.' 'I. CHARGE'
I 279.50 $0.310 = , $86.65
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. x I COST PER S.F. x I DISCOUNT RATE
I 0.00 I $0.310 I 50%
ITEM 1 TOTAL - STORM DRAINAGE SDC '$86.65
COM2004-0 1403
Brian King
6989 C St
'1702353200204
o
BUILDING SIZE (SF'
2. SANITARY SEWER - CITY
A REIMBURSEMENT COST:
1 NUMBER OF DFU's x
1 0/
COST PER DFU
$24.04
B. IMPROVEMENT COST:
1 NUMB~ROFI)FU's I.'x . .....,., ...
I . ....'0 ,". I'~ ...,' .$I8:2~~'= -
_. _t-'''''';.o _ . '.. .....,.:~.~, ......,..:. _ ':-
ITEM 2 T,o.!,~L. ~ <;.rr.y SANIT ARY SEWE~ S?C~,. = ,
$0.00
3. TRANSPORTATION
, *'. ,;
A. REIMBURSEMENT COST:
ADT TRIP RATE x
9.57
, NUMBER OF UNITS I x
I 0 I
COST PER TRIP
$18.30
B. IMPROVEMENT COST:
1 ADT TRIP RATE x NUMBER OF UNITS x I COST PER 1:'RIP
I 9.57 0 I $80.72
ITEM 3 TOTAL - TRANSPORTATION SDC = I $0.00
4. SANITARYSEWER-MWMC
A REIMBURSEMENT COST:
INUMBER OF FEU's I x
I 0 I
ICOST PER FEU
1 $82.03
B. IMPROVEMENT COST:
INUMBER OF FEU's
I 0
x
COST PER FEU
$865.31
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, $0.00
SUBTOTAL (ADD ITEMS 1, 2,3, & 4) =, $86.65
5. ADMINISTRATIVE FEE:
I SUBTOTAL x ADM. FEE RATE . CHARGE
I $86.65 5% $4.33
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
-- -..
'-'"
246
I'
LOT SIZE (SF):
DISCOUNT
$0.00
x I NEW TRIP FACTOR
1 1.00
x INEW TRIP FACTOR
1 1.00
6887.5
$86.65
$0.00
=',
$0:00
r:/)
p:.1
c:l
o
u
~
p:.1
E-<
r:/)
I-<
o
~
1070 '
, 1091
]092
1093
11094
II
1054
r
11055 .
1054
1056
11079
) 1078
i
Cheryl Slaymaker
11/17/2004
TOTAL SDC CHARGES
PREPAREDBY .
DATE
$0.00
$0.00
=
.$0.00 .
=
$0.00
$0.00
$0.00
4.33
$0.00
=,
$90.98 /
-,~...~
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET AvUIII0NAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUlV ALENT UNITS
I BATHTUB 0 0 3 = 0
I DRINKING FOUNTAIN 0 0 1 = 0
IFLOOR DRAIN 0 0 3 = 0
I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
ILAUNDRY TUB 0 0 2 = 0
CLOTHESW ASHER / MOP SINK 0 0 3 = 0
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
SHOWER, SINGLE STALL 0 0 2 = 0
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0
- I
SINK: COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 I
SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = 0
URINAL, STALL/WALL 0 0 5 = 0
TOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 0 0 3 = 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 0
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at ] 67 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
]979
]980
]98]
]982
]983
]984
]985
]986
]987
]988
]989
]990
]99]
]992
]993
]994
]995
]996
]997
]998
]999
2000
200]
CREDIT RATE/$I,OOO
ASSESSED VALUE
$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
$1.59
$1 .45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
IS LAND ELGIBLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE /1000 CREDIT RATE
$0.00 x $5.29
= ,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
o
TOTAL MWMC CREDIT
$0.00
=
225 Fifth Street .
Springfleid;Oregon 97477
541-726-3759 Phone
Job/Journal' Number
COM2004-0 1403
COM2004-01403
COM2004-0 1403
COM2004-0 1403
COM2004-01403
COM2004-01403
COM2004-01403
COM2004-0 1403
COM2004-0 1403
COM2004-0 1403
COM2004-0 1403
Payments:
Type of Payment
Check
12/8/2004
+y of Springfield Official Receipt
vevelopment Services Department
Public Works Department
RECEIPT #:
1200400000000001711
Date: 12/08/2004
2:35:45PM
Description
Storm Drainage Impervious Area
SDC Sanitary/Storm Admin
Building Permit
Minimum! Adjustment Plumbing
Minimum! Adjustment Mechanical
-Mechanical Issuance Fee-
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Plan Review Minor - Planning
Amount Due
86.65
4.33
208.80
45.00
45.00
.10.00
43.00
3.00
24.14
34.48
59.00
$563.40
Paid By
V ANDERVIES CONSTR
Item Total:
Check Number Authorization
Batch Number Number How Received
Amount Paid
Received By
djb
2312
In Person
Payment Total:
$563.40
$563.40
Page I of 1
'8; f.Yi::1:1 ?\",'::;: P::,~ 2i:....;O
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (5411726-3689
~ .~
ELECTRICAL G~~~'~~ICATION "0,(01)0/10
, ~ . ~
City Job Number ... ~ Date 'I t-<?/ <?I)ey &>,0
~ 7;: ""0 0,
~,t9 ~ (\l~-'tb
3. COMPLETE.v'P,EE~cifflpr]L'BJjJ:tLOlV
""" . &> '" <S'.::-
(\l", ',~, 6>9, <)0
\5' '" "', 0", "tt.
"9 ",' 6J ~ 6>ey
A. New Residential- Si1fgJ,.,c O'r.M~'-F~l~~"~ dwelling unit.
c- " ~'0
" C' /; <9
Service Included . , '''~ ~ <?l)eyl'olo
" ' ~5h.~
1000 sq. ft. or less __, ~ Q-,,~106.1'IV1('
Each additional 500 sq. ft. or ~-{~
portion thereof .00
,
Each Manufact'd Home or ""'<"
Modular Dwelling Service or
Feeder
,
OwneffiName~. ~
Address \ (~~\~ 9\' Q.. Sirfli~
City- ~'rl\V'l1~\.c.l Phone l~. ~ Pump or irrigation $ 50.00
, ~ \ Sign/Outline Lighting $ 50.00
OWNER INSTALLATION "-..' "\'1"[:' ~Limited EnergylResidenti.~I, $ 25.00
!he in.stallation is being made on property I own WhiCh;\~~~ '~;0~?mife~~p~rg~~~~tlial, " $ 45.00
IS not mtended for sale, lease or rent. J,U '\'\1RwmItri):t.eoti'ie.:P.~~~ ~$pec,tj~n Jf~e is $45.00 + Surcharges
Ownm S;gnature: ~~~)j\"i~;?[~&f1i~~V . 4W rJ;
7% State Surcharge tp J ?/'I/
10% Administrative Fee 'i'..:t. .' ~1l
TOTAL ~ ~J~
1. LOCATION OF W'WfATI~N
\A~C\. (' A ~\\Pe:~
-. . -
LEGAL DESJi~~ I'\M f'"'Li
f)O'L~b l"t JlJ.J \
~hcD~ ?QlJ\de~
Permits are non-transferable and expire if work is
. not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
CONTRACTOR INSTALLATION ONLY
;. ' . 1I1,/t-";7,/
// if "
/ ~.,\' /' "t - 1/ ~1
;.~./J;, .. (4. J ,../ 'l" L ,_C .:~_
Electrical Contractor
/'
;".'.
.' _/ / j
Address l L .'
""'
City
//7 .
\ ' i" .~.,~_,../i"'" '/
",-
/:.--;
///7
.' --,'
/'
/
Supervisor License Number
Expiration Date
--..
-(/
Constr. Contr. Number ,
'"
....,./
',.,
... /'
/-
/'
Expiration Date
...,
Sign",t1.# of Supervi.sing Ete~trician
I' .. I i/
, . .'A ,. i .
,( ,(,/:...-.1
/ ./,,-1
,---'
Inspection Request: 726-3769
$50.00
B. Services or Feeders- Installation, Alterations or Relocation:
\res yOU to
200 Amps or les~ iegon laW feqU - \1 'JtMy.OO
20~~T6Q~ 0 d 'o'i the Ofe~~t~G~O
4~~~%it ~~ "{hose ru\e~~R 95~oM60
6~ttg~98e~iO thrO~gh 01 the fU_Y.~O
O\l'&~~lcrffia'9qttstain COP\~~rlJ ,p.\ep~ .00
R~.t 8~e center. tNOt~t":W No@cSUl~~O
c~\\\ng r or the qreQon .. .... ~_~~4).
C. >Te~~yJ;n~~ft\~dr~~s
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
$ 50.00
$ 69.00
$100.00
Over 600 Amps or 1000 Volts see "B" above.
D. Branch Circuits
New Alteration or Extension Per Panel
One Circuit \
Each Additional Circuit or with \
Service or Feeder Permit
~%
$ 43.00
$ 3.00
E. Miscellaneous (Service/feeder not included) -Each Installation
Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03,doc