HomeMy WebLinkAboutPermit Building 2007-10-5
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2007-01501
ISSUED: 10/0512007
APPLIED: 10/04/2007
EXPIRES: 04/05/2008
VALUE: $ 161,518.00
SITE ADDRESS: 5363 I ST
ASSESSOR'S PARCEL NO.: 1702283402700
SPRINGFIE TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single famliy residence-Thurston Place subd lot 19
Owner: CUMMINS INVESTMENTS LLC
Address: 31221 OSPREY RD
LEBANON OR 97355
Residential
Phone Number: 541-401-5272
I CONTRACTOR INFORMATION.
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor License Expiration Date
DAVIS CONSTRUCTION SERVICES LLC 160347 06/14/2008
EASTSIDE ELECTRIC INC 117770 10/04/2009
MARSHALLS INC 25790 12/23/2009
JOHNS PRECISION PLUMBING LLC 158279,_ " ,~1/13/2008
BU (Q)E'{1~ \b ~~g~~uti\ity
n\\O}N, rules a 0 ose rules are set 10rth
',1/ RJ~~center. "~hrOugh OAR 9521AA~ze:
r~~g~e.1C~\~ C9'pies~,d09 ru'~r 911st Floor:
o ~ 'If>DentW obta 'lNa~tVt~8dft)~ph~r~ 2nd Floor:
lt1U\g~:cente~~ on Uti\it~WPti1\~~ ~asement:
~\)~: \h8,O 1lo0-332-~). ~~.ftfGarage/Carport
tnergy IGifi\\8I 8 Path 1 Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
1
R-3
U
VB
3
I DEVELOPMENT INFORMA nON I
Phone
541-350-2060
541-915-9828
541-747-7445
541- 736-8690
1,400
434
REQUIRED PARKING
2
Overlay Dist: Total:
# Street Trees Rqd: 2, Handicapped:
Paved Drive Rqd: Yes, Compact:
% of Lot Coverage: 23.10 / ~ \NO"\(.
Ul),.\rl~~ _"'~' ~'''~ ~~;~,. \S ~01
. I PUBLIC IMPRov.rl>'l-J\'~ tNtlER 11\\'0 ~ONEtl fOR
~U \,\u~1.E Rv\S~~N.
Fully Improved W\W\t.NCt.~iQ \OO.ype. Curbside 5'
Storm Sewer Available: Yes CO ~&O O~cP~pouts/Drains: Drywell- Provide
Special Instruction: For this parcel in Thurston Place, it is thAA~ommendation to the Building Di~liIyHhgi(ilitying
Engineer: "that no connections shall be made to sanitary or storm H20 systems, until the
Notes: Storm water rouNd>dh6.ciemt~cf}t City Council".
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
20.00
5.00
6.50
10.00
0.00
Subdivision Not Accepted
Street Improvements:
Pa2e 1 of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Ac - Residential
V Wood Frame
Gara!!:e
A.C. - Residen
Dwellin!!:s
Gara!!:e
Fee Description
-Mech Iss 2+ Appliances-
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
2 Baths One or Two Family
Addressing Assignment
Appliance Vent
Building Permit
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Furnace - up to 100,000 btu
Gas Outlets 1-4
Heat Pump
Plan Review Major - Planning
Plan Review Residential
PW Disc - 2nd Permit
Residence Wiring 1000 Sq Ft
Residence Wiring Ea AddtI 500
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Sidewalk Permit
Storm Drainage Impervious Area
Vent Fan
WiIlamalane Single Family
I Valuation Description I
$ Per Sq Ft
or multiplier
$4.00
$103.00
$27.00
Square Footage
or Bid Amount
1,400.00
1,400.00
434.00
Total Value of Project
~
Amount Paid
$40.00
$145.35
$84.84
$108.94
$280.00
$35.00
$7.00
$844.80
$85.00
$7.00
$10.00
$91. 70
$14.00
$5.00
$14.00
$205.00
$549.12
$-40.00
$117.00
$42.00
$489.70
$644.00
$10.00
$990.39
$95.35
$123.26
$73.32
$862.25
$195.48
$85.00
$644.46
$21.00
$2,303.00
Date Paid
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
10/5/07
Pa!!:e 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01501
ISSUED: 10/05/2007
APPLIED: 10/04/2007
EXPIRES: 04/05/2008
VALUE: $ 161,518.00
Value
Date Calculated
$5,600.00
$144,200.00
$11,718.00
$161,518.00
10/0412007
10/04/2007
10/04/2007
Receipt Number
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
2200700000000001553
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01501
ISSUED: 10/05/2007
APPLIED: 10/04/2007
EXPIRES: 04/05/2008
VALUE: $ 161,518.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Amount Paid
$9,182.96
Plan Reviews I
Plannin2 Review 10/04/2007 10/04/2007 APP TAJ Street trees may be reduced to 1 if
there is not room on the east side.
Public Works Review 10/04/2007 10/04/2007 APP TSS Storm water routed to engineered
drywell.
Structural Review 10/04/2007 10/04/2007 APP DLM Approved as noted on the plans.
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.
l....Reouh..eCUnsoections I
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
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.
\
Underground Plumbing: Prior to filling the trench and including required testing. \
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
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.
Pa2e 3 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-01501
ISSUED: 10/05/2007
APPLIED: 10/04/2007
EXPIRES: 04/05/2008
VALUE: $ 161,518.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
Hold Downs Installed: Special Inspecti,on performed prior to placement of concrete. Provide report to City
Building Inspector.
Drywell: Engineered Drywell is Required.
Undertloor Gas: After line is installed and required testing and capped if not attached to an appliance.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point.
Final Gas: When all gas work is complete.
Undertloor Mechanical. Prior to insulation or decking and including required testing.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical 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
times during construction.
I
(0/r:;/111-:
. .
~ftl\c
Owner or Contracttlrs Signature
Date
Pa2e 4 of 4
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSH~ET
JOURNAL OR JOB NUMBER: COM2007-01501 I
NAME OR COMPANY: Cummins Investments I
LOCATION: 5363 I Street I
TAX LOT NUMBER: 17-02-28-34-02700 I
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE .1
NEW DWELLING UNITS 1 BUILDING SIZE (SF: 0 LOT SIZE (Sr):
o
ifJ
~
.~
o
u
~
~
E-<
ifJ
.......
o
~
I .
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. xl I COST PER S.F. CHARGE
I 640.00 I I $0.346 :::: I $221.45
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS.
I IMPERVIOUS S.F. xl I COST PER S.F. x I DISCOUNT RATE I
'2445.00 I $0.346 . I 50% = I
,
I. STORM DRAINAGE
DISCOUNT I
$423.01 I
;'
I
ITEM 1 TOTAL - STORM DRAINAGE SDC
I
2. SANITARY SEWER - CITY
$644.46
$644.46
11070
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 24 I
B. IMPROVEMENT COST:
I NUMBER OF DFU's
I 24
COST PER DFU
$26.83
)
$644.00
1091
x
COST PER DFU
$20.40
$489.70
1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
I
= I
$1,133.70
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRlPRATE x I NUMBER OF UNITS I x I COST PERTRIP ,. x I NEW TRIP FACTOR
I 9.57 I I I 20.43 I I 1.00 I $195.48 ,1093
B. IMPROVEMENT COST: \
I ADT TRIP RATE I x I NUMBER OF UNITS I x COST PER TRIP x NEW TRIP F ACT0R
I 9.57 I 1 I' $90.10 1.00 I $862.25 1094
ITEM 3 TOTAL - TRANSPORTATION SDC = I $1,057.73
I
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
NUMBER OF FEU's x ICOST PER FEU
1 I $95.35 :::: $95.35 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 1 I $990.39 :::: $990.39 I 1055
I
MWMC CREDIT IF APPLICALLE (SEE REVERSE) $0.00 I 1054
I . 111056
MWMC ADMINISTRATIVE FEE $10.00
I
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $1,095.74
I
I
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) =1 $3,931.63
I
5. ADMINISTRATIVE FEE:
I SUBTOTAL x ADM. FEE RATE CHARGE
I
I $3,931.63 I 5% $196.58
I
TOTAL SANITARY ADMINISTRATION FEE: 123.26 11079
I i 1078
TOTAL TRANSPORTATION ADMINISTRATION FEE: $73.32
-
Todd Singleton /0/1//6:]- TOTAL SDC CHARGES =, $4,128.21
PREPARED BY DATE
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 1 0 3 = 3
I DRINKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
!INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
ILAUNDRY TUB 1 0 2 = 2
ICLOTHESW ASHER / MOP SINK 1 0 3 = 3
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 = 3
SHOWER, SINGLE STALL 1 0 2 = 2
SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LA V ATORY/RESIDENTIAL BAR 2 0 1 = 2
IURINAL, STALL/WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 24
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
I YEAR CREDIT RATE/$I,OOO
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2
BEFORE 1979 $5.29 (Enter 1 for Yes, 2 for No)
1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 2
1980 $5.19 (Enter 1 for Yes, 2 for No)
1981 $5.12 BASE YEAR 1979
1982 $4.98
1983 $4.80 CREDIT FOR LAND (IF APPLICABLE)
1984 $4.63" VALUE/1000 CREDIT RATE
1985 $4 .40 $0.00 x $5.29 = , $0.00
1986 $4.07
1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
1988 $3.22 VALUE / 1000 CREDIT RATE
1989 $2.73 $0.00 x $5.29 0
1990 $2.25
1991 $1.80
1992 $1.59 TOTAL MWMC CREDIT = $0.00
1993 $1.45
1994 $1.25
1995 $1.09
1996 $0.92
1997 $0.72
1998 $0.48
1999 $0.28
2000 $0.09
2001 $0.05
Date
fUN '-TY"
rrITIALS "f'::rvv... 0
DATE I;()--OS -CJf
I
SOURCE 'CYl:{)"; r~ ~
l ~JoB 10,
I
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689
I 0
ELECTRICAL PERMIT APPLICATION '
City Job Number ~ 20-07 - 0/ '5'0/
200 Amps or less
, 20 I Amps to 400 Amps
Address 31la.S'3 f3OS(AGf (,.10' SPRD ,401Ampst0600Amps
VI"..E 601 Amps to 1000 Amps,
Phone ~.l'-Vty)f9: Orel)Jo(Q)fawI~t!I_;Y8llSt
~I\;o tidopted~_I(!)Qcl.v.. 0
'Notification Centel Thos n:I\:IUn Utifity
L I -In.0IA~~2~~;-00'1o.t ~ra.seHort
Supervisor License Number, 1 (odgl!S. obt ~~ 1I.,~~
, Calling th aln c las of the rules bv
) 0 - / - 0 ~umber 4...~ 2.enoter. (~Qf&~.I~ttel9~_ t)r Relocation
'W--U/e regO~.IV^tif' .
Center is 1-80 s'Q'M9slCation $ 55.00
.constt..Contr. Number { /777 0 0 m 0 1M Amps $ 76.00
I (] ~ / _ 09 0 401 Amps to ,600 Arrips II $110.00
Expiration Date 0 "
,I or 1000 Volts see HB abo,ve.
Signature of Supervising Electrician D.
, .' I,'
'~J4 ~
~ .1 I . '
OwnersName .ttV/H/Hld /j(j~
Address ? /-22.-1, C>5dAlY~.1
1 - I r';
City .. 'ksMJQ)1 Phone Pump or irrigation__,. ' $ 55.00
I Sign/Outline Lighting ! $ 5:5.00
, OWNER INSTALLATION NOT'CE~ Limited Energ~~l~~WliHE W~Q~ $ 28.00
The in,stallation is being ~ade on property I own whin.\IS PERMg;iS~-Ne~\tH~Err \S N01 $ 50.00
IS not mtended for sale, lease or rent. AUTH'0lill~Q ij~~~lJIA'r ij '0 is $5Q.,!l0 + Surcharges
Owners Signature: COMME~i~li~~So "OJ'! , / 5)' ~'
" ANY 180 M~. tate.surch;rge J /_ _"t...
10% Administrative Fee '/ 1::; tfJO
5% Technology Fee .. """ "or
I .
TOTAL, J j~ >7
Shared Drive(T:)/Building Fonns/Electn;al Pennil ApplicaliJi\7-07,doc
1.
LEGAL DESCRIPTION:
17n2- z.'~~,~ CJ 2. Tt:TO
. ---
JOB DESCRIPTION:
, I'
s;e RCJ: I ~~~
Permits are non-transferlble and expire if work is
not started within 180 daYs of issuance or ,if work is
Suspended for 180 days. '
2.
Electrical Contractor
E' (~S151 fj{2
(LfCTf( I (.
City
5P\-co
Expiration Date
">,
Inspection 'Request: 726-3769
'. . i
3.
A.
Service Included
, 1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
, Each Manufact;d Home or
Modular Dwelling SerVice Or
Feeder
I ' $11}.00 1(7
~ $ 2t.00 ~'2-,
.,
I $55.00
B.
$ 70.00
$ 83.00
$138.00
$180.00
$413.00 '
$ 55.00
, New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit '
$ 48.00
$ 4.00
E.
.~
~:,..:r'
225 Fifth Street
Springfield;Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-0 150 I
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-0 150 I
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-01501
COM2007-0 150 I
COM2007-01501
Payments:
Type of Payment
CreditCard
cReceiotl
RECEIPT #:
2200700000000001553
Date: 10/05/2007
Description
Sidewalk Permit
Curb cut Permit
PW Disc - 2nd Permit
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Reimbursement
SDC Transpo Improvement
Plan Review Major - Planning
Plan Review Residential
Building Permit
Addressing Assignment
Willamalane Single Family
2 Baths One or Two Family
Furnace - up to 100,000 btu
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlyts 1-4
Heat Pump
~Mech Iss 2+ Appliances~
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Fire SF Fee - Residential
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
SCOTT DAVIS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 02943C In Person
Payment Total:
Page I of I
9:06:27 AM
Amount Due
85.00
85.00
(40.00)
644.46
644.00
489.70
95.35
990.39
10.00
123.26
73.32
195.48
862.25
205.00
549.12
844.80
35.00
2,303.00
280.00
14.00
21.00
7.00
10.00
7.00
5.00
14.00
40.00
117.00
42.00
91.70
84.84
108.94
145.35
$9,182.96
Amount Paid
$9,182.96
$9,182.96
10/5/2007
Willamalane
Park & Recreation District
Job. No. Q14I'JJlJ7-0/50!
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007
NAME: (!tlJhd/hf/.{ //V~ PHONE:
. ADDRESS:!1/22/ tJ~W:TYk~) STATE:.1{ZIP: 9'7U.r
LOCATION OF PROPOSED BUILDING SITE:
Street Address: ?3 ~ .~ I J T, '
Plat Name:]dHA_or.l3t' ,.P'~ Tax Lot Number: j 7 /J~ 2!JJef tJZ,1~
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the
back.)
A. Sinale-Familv Detached,
NO. OF UNITS I
X $2,303 per unit =
$ 2-'3~s
B. Sinale-:-Familv Attached
, NO. OF UNITS
X $2,426 per unit =
$
C. Multi-Familv Aoartment
NO. OF UNITS
X $2,032 per unit =
$
D. Sinale Room Occuoancv
NO. OF UNITS
X $1,016 per unit =
$
E. Accessorv Dwellina Unit,
NO. OF UNITS
X $1,151.50 per unit = $
WILLAMALANE SDC
$
2. SDC CREDIT (If applicable) SDC payer must furnish proof of
Willamalane Credit approval.)
$
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
$J5t?:?
~~
Development ServiCe's Department
City of Springfield
/D / 5" I 07
Date
5