HomeMy WebLinkAboutPermit Building 2006-5-1
./.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00401
ISSUED: 05/0112006
APPLIED: 04/05/2006
EXPIRES: 11/0112006
VALUE: $ 129,668.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4595 Camellia St
ASSESSOR'S PARCEL NO.: 1702324309800
TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single family residence, Lot 5, Andrew Acres
I PUBLIC IMPROVEMENTS I
"'. ATTFs~1~~k 9f~Q:on law requires you to
follow rules adopted by the Oregon Utility
Notifid?l~.~tP8iq~MPr~~~s.:ie rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Owner: MIKE BLANKENSHIP CORP
Address: 8063 THURSTONS ROAD
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
License
78966
87145
102455
110163
Contractor
MIKE BLANKENSHIP CORP
G MILLER ENTERPRISES INC
JUNG ENTERPRISES INC
DOUGS PLUMBINC INC
BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories: 1
Height of Structure 17.50
Type of Heat: orced Air Electric
Water Type: Electric
Range Type: Electric
Energy Path: Path 1
Sprinkled Building: nla
1
R-3
U
VB
3
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
18.00
12.50
12.00
11.00
0.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction: 'OOltl3d A\fO 08 ~ AN\!
tlOj 03NOON\f8\f SI tlO 03JN3lN\f\lOJ
iON SIiII/'Jtl3d SIHi tl30Nn 03ZItJOHlnV
>1tJOM 3Hl ::ll 3tJldX3 ll\fHS 11I/'JtJ3d SiHl
':!l "' fi ~ 111"
. .L \Y1 B ",,--.. t, : 1
Notes:
Pa2;e 1 of 4
Residential
Phone Number: 541-746-0194
Expiration Date
01/0912008
11/10/2006
10/04/2006
11/24/2007
Phone
541-912-4582
541-741-2596
541-741-0002
541-688-3385
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
5,412
1,200
418
REQUIRED PARKING
3
Yes
30.40
Total:
Handicapped:
Compact:
2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00401
ISSUED: 05/01/2006
APPLIED: 04/05/2006
EXPIRES: 11/01/2006
VALUE: $ 129,668.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description I
Dwellinl!s
Gara2;e
Tvpe of Construction
V Wood Frame
Gara2;e
$ Per Sq Ft
or multiplier
$99.00
$26.00
Square Footage
or Bid Amount
1,200.00
418.00
Value
Date Calculated
Description
Total Value of Project
$118,800.00
$10,868.00
$129,668.00
04/0512006
04/0512006
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $431.05 4/5/06 2200600000000000425
~Mechanical Issuance Fee~ $10.00 5/1/06 1200600000000000572
+ 10% Administrative Fee $117.02 5/1/06 1200600000000000572
+ 8% State Surcharge $93.61 5/1/06 1200600000000000572
2 Baths One or Two Family $254.00 5/1/06 1200600000000000572
Addressing Assignment $31.00 5/1/06 1200600000000000572
Building Permit $663.15 5/1/06 1200600000000000572
Dryer Vent $6.00 5/1/06 1200600000000000572
Exhaust Hoods $9.00 5/1/06 1200600000000000572
Furnace - up to 100,000 btu $12.00 5/1/06 1200600000000000572
Minimum/Adjustment Mechanical $6.00 5/1/06 1200600000000000572
Plan Review Major - Planning $150.00 5/1/06 1200600000000000572
Residence Wiring 1000 Sq Ft $106.00 5/1/06 1200600000000000572
Residence Wiring Ea Addtl 500 $38.00 5/1/06 1200600000000000572
Sanitary Sewer - Improvement $457.68 5/1/06 1200600000000000572
Sanitary Sewer - Reimbursement $601.68 5/1/06 1200600000000000572
SDC MWMC Administration $10.00 5/1/06 1200600000000000572
SDC MWMC Improvement $865.31 5/1/06 1200600000000000572
SDC MWMC Reimbursement $82.03 5/1/06 1200600000000000572
SDC SanitarylStorm Admin $125.24 5/1/06 1200600000000000572
SDC Transpo Admin $65.93 5/1/06 1200600000000000572
SDC Transpo Improvement $805.70 5/1/06 1200600000000000572
SDC Transpo Reimbursement $182.69 5/1/06 1200600000000000572
Storm Drainage Impervious Area $818.32 5/1/06 1200600000000000572
Storm Sewer Each Addtll00' $14.00 5/1/06 1200600000000000572
Temp Power 200 amps or less $50.00 5/1/06 1200600000000000572
Vent Fan $12.00 5/1/06 1200600000000000572
WiIlamalane Single Family $1,000.00 5/1/06 1200600000000000572
Total Amount Paid $7,017.41
I Plan Reviews I
Initial Review
04/06/2006
04/11/2006
APP LLH
Pa2;e 2 of 4
CITY OF SPRINGFIELD'
Status
Issued
Building/Combination Permit
PERMIT NO: COM2006-00401
ISSUED: 05/01/2006
APPLIED: 04/0512006
EXPIRES: 11/01/2006
VALUE: $ 129,668.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannin2; Review
04/11/2006
04/26/2006
APP
TAJ
Andrews Acres Plat recorded
3/29106. Plant street trees outside
the vision clearance triangles: 2 on
S 46th and 1 on Camellia, west of
the driveway.
PW cannot review until final plat is
recorded 4/11/2006 CAS
Plat recorded. LDAP ISSUED.
See Documents for plan review
comments by dim 4128/06
Public Works Review
04111/2006
WE
Public Works Review
Structural Review
04128/2006
04/11/2006
04/28/2006
04/25/2006
APP
APP
SB
RWC
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.
~eouire<UnSDections I
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
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.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Underfloor Mechanical. Prior to insulation or decking and including required testing.
Pa2;e 3 of 4
.'V'"".---~
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00401
ISSUED: 05/01/2006
APPLIED: 04/05/2006
EXPIRES: 11/01/2006
VALUE: $ 129,668.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
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 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
t;mesdu~i~ si/t-
Owner or Contractors Signature
Date
Pa2e 4 of 4
CITY OF S~"ti~GFIELD SYSTEMS DEVELOPMEN..;~,,~;)RKSHEET
JOURNAL OR JOB NUMBER: C0M2006-00401
NAME OR COMPANY: Mike Blankenship
LOCATION: 4595 Camellia
TAX LOT NUMBER: I7 02 32 43 Lot 5
DEVELoPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS I BUll.DING SIZE (SF: 1647.5 LOT SIZE :SF):
I, STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
IMPERVIOUS S,F, x I COST PER S.F. CHARGE
2533.50. I $0323 = I $818.32
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
IMPERVIOUS S.F, I x COST PER S.F. x I DISCOUNT RATE ,
0.00 I $0.323 I 50% I
ITEM 1 TOTAL - STORM DRAINAGE SDC I $818.32 I
;l, SANITARY SEWER - CITY
A REIMBURSEMENT COST:
I NUMBER OF DFU's' x
I 24
B. IMPROVEMENT COST:
I NUMBER OF DFU's x ,I
I . 24 I
COST PER DFU
$25,07
$19.07
DISCOUNT
$0.00
o
$818.32
$~OI.68
$457.68
--.
(/)
~-
o
o
u
~
~
r-<
(/)
,.....
CI
~
1070
1
1091
1092
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUN ALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY TIIE NET ADDmONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BA THTIJB ---.
2 0 3 = 6
IDRINKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE I OIL / SOLIDS I ETC. 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0 r
/LAUNDRY TIJB 0 0 2 = 0
"
ICLOTIIESW ASHER / MOP SINK 1 0 3 = 3 I
ICLOTIIESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 I
MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I
RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0
I RECEPTOR FOR COM. SINK I DISHWASHER / ETe. 1 0 3 = 3
SHOWER, SINGLE STALL 0 0 2 = 0
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
SINK: COMMERCIAL/RESIDENTlAL KITCHEN 1 0 3 = 3
SINK: COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2
ISINK: SINGLE LA V ATORY/RESIDENTlAL BAR 1 0 1 = 1
IURINAL, STALL / WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRlV ATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 24
*EDU (EQuivalent Dwelling Unit) is a discharge equivalent to a single family dwel1in7~t (20 DFD's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
1 CREDIT RATE/$I,OOO
_~~c~ESSED 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
2
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
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
=
$0.00
TOTAL MWMC CREDIT
225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH,(541)726-3753 . FAX, (541)726-3689 ~~~,_ ~~ \
~~~~~~~DfPLICATI~= 5/~/O~ ~~~
1. LOCA110N OF INSTALLAI10N 3. CO.M,PLETE .FEE SCHEDlJLE BELOll\!
~~l\S t\)S{\e1LL~
f~qAL DESCRIPTION t'QO \102.3"2. Ar 3> D4 \oO(.{. New Residential- Single or Multi-Family per dwelling unit.
-.ill\, :\. k\~{f'lc.") A(IJ'('5:::> S""icelodudcd \ \OI.o,oD
~0~~;;;:~~~~~~~? ti~o:~:~}~~~o:, :,0' ~ :',:: ~.Cf)
not started within 180 days of issuance or if work is Modular Dwelling Service or
Suspended for 180 days. Feeder
$50.00
B. Services or Feeders - Installation, Alterations or Relocation:
CONTRACTOR INSTALLATION ONLY
2.
Electrical Contractor C; t' v ('", v' d c 1-(: l..\
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
Address :3 '15',/ Jf~t...t d.l/V R., i<.c!
City)/) ,{- l d Phone '1"'; {"~2.5-(;{~
Supervisor License Number .' ] (~ ,5 -'i. S
C. Temporary Services or Feeders
G) f.I\
je -j -dill ~7
Installation, Alteration or Relocation \
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
D. Branch Circuits
5D ,00
Expiration Date
$ 50.00
$ 69.00
$100.00
Constr. Contr. Number ,? ? /.../ ')
Expiration Date J / -. / () ,{;; ~ C:~ .~
Signature of Supervising Electrician
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
~....}1 ('I.~ -'/ "._~C_\
~J .
ownerSN]' ~\k ~\r\f\'tro&hl?
Address O\o~ \n\~\~~
City ~M.c:-r...!~one "l~lo. O\Y.i-
\ -\\'tAX
OWNER INSTALLATION
$ 43.00
$ 3.00
E. JVliscellaneous (Service/feeder not included) -Each Installation
$ 50.00
$ 50.00
$ 25.00
$ 45.00
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited EnergylCommercial
The installation is being made on property I own which
is not intended for sale, lease or rent.
Minimum Electric Permit Inspection Fee is $45.00 + Surcharges
\C\'\:9D
\~. 5'2...
L\ .~o
'2}Lf) .u/~
4. SUBTOTAL OF ABOVE
Owners Signature:
7% State Surcharge
10% Administrative Fee
TOTAL
Inspection Request: 726-3769
Shared Drive(T: )/Building Fonns/Electrical Pennit Application 1-03,doc
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLIN'G UNITS
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
IMPERVIOUS S.F. x, COST PER S.F. CHARGE
2533.50 $0.323 = I $818.32
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. x I COST PER S.F. I x 1 DISCOUNT RATE I 1
0.00 I $0.323 I 50% I I
ITEM 1 TOTAL - STORM DRAINAGE SDC '$818.32 I
. .
CITY OF SINGFIELD SYSTEMS DEVELOPME~~RKSHEET
C0M2006-0040 I
Mike Blankenship
4595 Camellia
17 02 32 43 Lot 5
SINGLE FAMILY RESIDENCE
I BUILDING SIZE (SF: 1647.5
o
rfJ
~
Cl
o
u
~
~
,E-<
rfJ
>-<
o
~'
LOT SIZE (SF):
DISCOUNT
$0.00
$818.32
1070
2. SANITARY SEWER - CITY
A REIMBURSEMENT COST:
I NUMBER OF DFU's x
I 24
B. IMPROVEMENT COST:
1 NUMBER OF DFU's x
1 24
. :..
COST PER DFU
$25.07
$601.68
1091
$19.07
r
11092
$457.68
= ,
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
$1,059.36
3. TRANSPORTATION
A REIMBURSEMENT COST:
ADT TRIP RATE x NUMBER OF UNITS x I COST PER TRIP x I NEW TRIP FACTOR
9.57 I 1 $19.09 1 1.00 $182.69 1093
B. IMPROVEMENT COST:
I ADT TRJP RATE x I NUMBER OF UNITS x COST PER TRIP x NEW TRIP FACTOR
I 9.57 I I $84.19 1.00 $805.70 1094
ITEM 3 TOTAL - TRANSPORTA TION SDC = , $988.39
4. SANITARY SEWER - MWMC
A REIMBURSEMENT COST:
INUMBER OF FEU's x COST PER FEU
1 1. $82.03 = $82.03 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's x ICOST PER FEU
, I I $865.31 = $865.31 lOSS
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054
MWMC ADMINISTRATIVE FEE $10.00 1056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $957.34
SUBTOTAL (ADD ITEMS 1,2,3; & 4) = , $3,823.41
5, ADMINISTRATIVE FEE:
. SUBTOTAL x ADM. FEE RATE CHARGE
$3,823.41 5% $19L17
TOTAL SANITARY ADMINISTRATION FEE: 125.24 1079
TOTAL TRANSPORTATION ADMINISTRATION FEE: $65.93 1078
Steve Beaudry Barnes 4/28/2006 TOTAL SDC CHARGES =, $4,014.58
PREPARED BY DATE
.-
. .
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTIJRE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 2 0 3 = 6
IDRlNKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
IINTERCEPTORS FOR SAND I AUTO WASH / ETC. 0 0 6 = 0
ILAUNDRY TUB 0 0 2 = 0
ICLOTHESWASHER/MOP SINK 1 0 3 = 3
ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRIG / WATER ST AT]ON / ETC. 0 0 1 = 0
I RECEPTOR FOR COM. SINK / DISHWASHER I ETC. 1 0 3 = 3
ISHOWER, SINGLE STALL 0 0 2 = 0
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1
IURINAL, STALL / WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLAT]ON 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 24
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day ----"
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE J 979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$l,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
]S LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE 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
=
$0.00
TOTAL MWMC CREDIT
.. . ' f>
(':"v of Springfield Official Receipt
elopment Services Department
Public Works Department
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-00401
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
CO M2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
CO M2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
COM2006-0040 1
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
1200600000000000572
Date: 05/0112006
10:19:59AM
Description
SDC MWMC Improvement
SDC MWMC Administration
SDC SanitarylStorm Admin
SDC Transpo Admin
Building Permit
2 Baths One or Two Family
Storm Sewer Each Addtl 100'
Furnace - up to 100,000 btu
Vent Fan
Exhaust Hoods
Dryer Vent
Minimuml Adjustment Mechanical
~Mechanicallssuance Fee~
+ 8% State Surcharge
+ 10% Administrative Fee
Addressing Assignment
Willamalane Single Family
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Plan Review Major - Planning
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
Amount Due
865.31
10.00
125.24
65.93
663.15
254.00
14.00
12.00
12.00
9.00
6.00
6.00
10.00
93.61
117.02
31.00
1,000.00
106.00
38.00
50.00
150.00
818.32
601,68
457.68
182,69
805.70
82.03
$6,586.36
Paid By
MIKE BLANKENSHIP CORP
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
dIm
10137
In Person
Payment Total:
$6,586.36
$6,586.36
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