HomeMy WebLinkAboutPermit Sidewalk 2001-6-26
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TRANS#~Ol-0005980
DATE:,JUN 26 200i
AMT RECD:2 $ 527.36
CHANGE:
CASHIER:004
Job# 01-00473-01
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00473-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 10 Beverly St Spr
Assessors Map#: 17032233
Lot: ' Block: Addition:
Tax Lot #: 00000
Subdivision:
Owner:
Address:
McKenzie-Willamette Hospital
1460 G Street
Phone Number: 541-726-4432
City/State/Zip: Springfield, OR 97477
New Value: $28,000
Scope Of Work: Paving
see also 01-00473 03
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Contractor Type Contractor Registration # Expiration Date Phone
General Contr Eugene Sand & Gravellnc 44524 2/23/2005 541-683-6400
Po Box 1067, Eugene, OR 97440-1067
Engineer Systems West Engineers Inc 541-342-7210
411 High Street, Eugene" OR
97401-2427
Quad Area: 2CNW
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
, Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
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. wjll be made the following
wo~ngday, '
Required Inspections
I Plumbing
- Prior to filling trench.
- When all plumbing work is complete.
Storm Sewer Line
Final Plumbing"
Rough Grading
Final Paving
I Permits w/o Srci1g I
-After gravel is in place but prior to placing concete.
-After paving is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
Fee
Commercial Plan Check
Additional Plan Check
Total Plan Check
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Storm Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
Impervious Surface Area - Storm
SDC Administrative Fee
Total System Development
Paving
Total Permits w/o Srchg
Grand Total
Plan Check Type
Checked By
Initial Review-C/I/P
Bob Barnhart
Engineering-C/I/P
Structural-C/I/P
Fire Marshal-C/I/P
Pam Ownby
Lome Pleger
AI Gerard
I Job# 01-00473-01
Page 2 of 2
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Paid On Receipt#
Plan Check
06/01/2001 5638 '
06/26/2001 0005980
Value/Quantity
85,000
, -133
Plumbing
06/26/2001 0005980
06/26/2001 0005980
06/26/2001 0005980
06/26/2001 0005980
System Development
06/26/2001 ' 0005980
06/26/2001 0005980
1,576
I
Permits w/o Srchg
06/26/2001 0005980
28,000
Date Completed
Comment
06/04/2001
06/25/2001
06/25/2001
06/07/2001
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state 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 atthe proper time, that the project 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.
? -
SignakJ'fe
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--
Fee Amount
$252.20
$-132.60
$119.60
9
$.00
$1.75
$25,00
$.75
$27.50
$427.10
$21.36
$448.46
$184.00
$184.00
$779.56
6/26~1
Date
ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER 01-00473-01
NAME OR COMPANY: MCKENZIE WILLAMETTE HOSPITAL
LOCATION: 10 BEVERLY STREET
MAP & TAX LOT NUMBER: 17-03-22-33 05919
DEVELOPMENT TYPE: PRIVATE STREET
USE # 1
NEW PAVEMENT AREA (S,F,)
EXIST PAVEMENT AREA (S,F,)
TOTAL DEVELOPED BUILDING AREA (SF)
6738,0
51620
ITE:
ITE
LOT SIZE (SF):
1. STORM DRAINAGE
IMPERVIOUS SQ, FT,
x $ 0,271 PER SF
TOTAL STORM DRAINAGE SDC: I $ 427,10
1576
2, SANITARY SEWER-CITY
A. REIMBURSEMENT COST:
NUMBER OF DFU's 0
B, IMPROVEMENT COST:
NUMBER OF DFU's 0
(SEE REVERSE SIDE)
x $ 21.25 PER DFU J$
x $ 16,15 PER DFU , $
TOTAL LOCAL WASTEWATER SDC: 1$
3, TRANSPORTATION
BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR
NEW
A. REIMBURSEMENT COST:
6,738 x 0 x $ 16,12 PER TRIP x
B, IMPROVEMENT COST:
6,738 x 0 x $ 65,55 PER TRIP x
o
NTF
o
NTF
TOTAL TRANSPORTATION REIMBURSEMENT SDC:
TOTAL TRANSPORTATION IMPROVEMENT SDC:
TOTAL TRANSPORTATION SDC:
4, SANITARY SEWER - MWMC
NEW:
A. REIMBURSEMENT COST:
NUMBER OF FEU's
B. IMPROVEMENT COST:
NUMBER OF FEU's
6,738
$0,00
PER FEU
x
6,738
$0,00
PER FEU
x
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL MWMC REIMBURSEMENT AND IMPROVEMENT FEE:
MWMC ADMINISTRATIVE FEE:
TOTAL MWMC SDC:
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
5 ADMINISTRATIVE FEES:
BASE CHARGE (SUBTOTAL ABOVE)
x 0,05
?~Y'-f}~~
SDC COORDINATOR
6/25/01 TOTAL SDC CHARGES
DATE
1$
1$
$
$
$
1$
1$
1$
$
$
, $
, $
I $ 21,35
1$ 448.45 I
DECEMBER 2000
DRAINAGE FIXTURE UNIT (DFU) CALCULA TION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNiTS
, (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN
INTERCEPTORS FOR GREASE/OIL/SOLIDS/ETe.
INTERCEPTORS FOR SAND/AUTOW ASH/ETe.
LAUNDRY TUB,
CLOTHES WASHER/MOP SINK
CLOTHES WASHER - 3 OR MORE (EA)
MOBILE HOME PARK TRAP (I PER TRAILER)
RECEPTOR FOR REFRIGERA TOR/W A TER ST A TlON/ETe.
RECEPTOR FOR COMMERCIAL SINK! DISHW ASHER/ETe.
, SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)'
SINK: COMMERCIAL"RESIDENTIAL KITCHEN
SINK: COMMERCIAL BAR
SINK: W ASI-fBASIN/DOUBLE LA V A TORY
SINK: SINGLE LA V A TORY /RESIDENTIAL BAR
URINAL, STALL/WALL
TOILET, PUBLIC INST ALLA TlON
TOILET, PRIVATE INSTALLATION
MISCELLANEOUS:
FIXTURES
NEW OLD
, NUMBER OF EDU'S*
UNIT
EQUIV ALENT
3
I
3
3
6
2
3
6
12
I
3
2
2
3
2
2
I
5
6
3
TOTAL DRAINAGE FIXTURE UNITS=
*EDU (Eq~ivaIentDweIJing Unit) is a discharge equi~alent to a single family dwelling (20 DFU) set at 167 gallons per day
,. \."':
DRAINAGE
FIXTURE
UNITS
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
0,
o
o
o
o
o
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXA TION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y
I, YEAR I RATE PER $1,000 I YEAR RATE PER $1,000
ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE
1979 or before $ 4,74 1990 $ 1.96
1980 '$ 4,65 1991 $ 1.55
1981 $ 4,59 1992 $ 1.36
1982 $ 4.46 1993 $ 1.23
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 PARCEL OR LAND ONLY IF APPLICABLE x $0,00
IMPROVEMENT (IF AFTER ANNEXATION DATE) x $0,00
CREDIT TOTAL I, $0,00
DECEMBER 2000