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Home My WebLink AboutPermit Building 2007-10-19 Status Issued CITY OF SPRINGFIELU Building/Combination Permit PERMIT NO: COM2007-01564 ISSUED: 10/1912007 APPLIED: 10/18/2007 EXPIRES: 04/1912008 VALUE: $ 210,727.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1283 S 41ST ST ASSESSOR'S PARCEL NO.: 1802064111600 SPRINGFIE TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence -Filbert Meadows lot 45 SAME AS COM2007-00590 4082 Filbert Meadows Residential Owner: BRUCE WIECHERT Address: 3073 SKYVIEW LN EUGENE OR 97405 Phone Number: 541-686-9458 I CONTRACTOR INFORMATION. Contractor Type General Contractor License BRUCE WIECHERT CUSTOM HOMES INC 101717 Expiration Date 09/16/2008 Phone 541-686-9458 BUILDIN~iION . . ..!.~_ law requires you to # f JpJlow.r~le8 adopted bith or~mp II !tV Ho. ~~WatIO_'l Center. Tho es e rth el~n~A~~!2'.~OO1Qtt1rt 0 ~.oor: . Typol7M!efJt;u may86tith'W oft tI E loor: Water~ the center. (No ~the t ent: Ran~ for the Oregon Uttfity N~ age/Carport Energy Path Center II 1-80~12344\q Ft Other: Sprinkled Building: n/a - . 6ccupant Load: 1,817 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VB 604 3 I DEVELOPMENT INFORMATION. REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 6.00 5.00 19.00 17.50 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 3 Yes 39.20 Total: Handicapped: Compact: 2 '''10~'/.. f ~\.\~ '1'1 -~ . I PUBLIC IMPROVEME~j ~\.. ~?\~Ti;. ~~~\1 \5 \'lV, ~{) \ ~\1 ~\\~ ~.\\~,,~ ~~ fO~ Fully Improved 1'~\5 ~t.~ c:D ~~ ~9:~O~ Curbside 5' Storm Sewer Available: Yes \ ~'nO~\t\. ~~~<fd'(s/Drains: To Storm Sewer Special Instruction: 7"P.U.E./Overwidth driveway approved~ ~W~i~~~er CO '\ ~\) ~~ Notes: Downspouts to weep holes in curb p..~'l Street Improvements: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line A.C. - Residen Dwellines Garaee AC - Residential V Wood Frame Garaee $4.00 $103.00 $27.00 Total Value of Project ~ CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01564 ISSUED: 10/19/2007 APPLIED: 10/18/2007 EXPIRES: 04/19/2008 VALUE: $ 210,727.00 1,817.00 1,817.00 604.00 $7,268.00 $187,151.00 $16,308.00 $210,727.00 10/1812007 10/1812007 10/18/2007 Fee Description Amount Paid Date Paid Receipt Number Plan Review Same As $220.00 10/18/07 1200700000000001317 -Mech Iss 2+ Appliances- $40.00 10/19/07 1200700000000001320 + 10% Administrative Fee $170.23 10/19/07 1200700000000001320 + 5% Technology Fee $100.06 10/19/07 1200700000000001320 + 8% State Surcharge $126.50 10/19/07 1200700000000001320 2 Baths One or Two Family $280.00 10/19/07 1200700000000001320 Addressing Assignment $35.00 10/19/07 1200700000000001320 Appliance Vent $7.00 10/19/07 1200700000000001320 Boiler/Comp Up To 100,000 btu $14.00 10/19/07 1200700000000001320 Building Permit $1,020.22 10/19/07 1200700000000001320 Curbcut Permit $85.00 10/19/07 1200700000000001320 Dryer Vent $7.00 10/19/07 1200700000000001320 Fire SF Fee - Residential $121.05 10/19/07 1200700000000001320 Fireplace (Listed) $17.00 10/19/07 1200700000000001320 Furnace - up to 100,000 btu $14.00 10/19/07 1200700000000001320 Gas Outlets 1-4 $5.00 10/19/07 1200700000000001320 Overwidth Application Fee $45.00 10/19/07 1200700000000001320 Plan Review Major - Planning $205.00 10/19/07 1200700000000001320 Residence Wiring 1000 Sq Ft $117.00 10/19/07 1200700000000001320 Residence Wiring Ea Addtl 500 $63.00 10/19/07 1200700000000001320 Sanitary Sewer - Improvement $571.31 10/19/07 1200700000000001320 Sanitary Sewer - Reimbursement $751.33 10/19/07 1200700000000001320 SDC MWMC Administration $10.00 10/19/07 1200700000000001320 SDC MWMC Improvement $990.39 10/19/07 1200700000000001320 SDC MWMC Reimbursement $95.35 10/19/07 1200700000000001320 SDC Sanitary/Storm Admin $96.58 10/19/07 1200700000000001320 SDC Transpo Admin $77.23 10/19/07 1200700000000001320 SDC Transpo Improvement $862.25 10/19/07 1200700000000001320 SDC Transpo Reimbursement $195.48 10/19/07 1200700000000001320 Sidewalk Permit $85.00 10/19/07 1200700000000001320 Storm Sewer Each Addtll00' $16.00 10/19/07 1200700000000001320 Vent Fan $21.00 10/19/07 1200700000000001320 Willamalane Single Family $2,303.00 10/19/07 1200700000000001320 Total Amount Paid $8,766.98 I Plan Reviews , Paee 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2007-01564 ISSUED: 10/19/2007 APPLIED: 10/18/2007 EXPIRES: 04/19/2008 VALUE: $ 210,727.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plannine Review 10/18/2007 10/18/2007 APP TAJ Plant street trees as shown on the attached street tree plan: species as shown, 2' caliper, leave name tag on until approved. Storm to weep holes in curb Same-as Plan review Public Works Review Structural Review 10/18/2007 10/18/2007 10/18/2007 10/18/2007 APP APP LKW DLM 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. ~eollireCUnsnections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Curbcut - Overwidth: After forms are erected but prior to placement of concrete. Sidewalk - Setback: 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 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. Paee 3 of 4 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-01564 ISSUED: 10/19/2007 APPLIED: 10/18/2007 EXPIRES: 04/19/2008 VALUE: $ 210,727.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Underfloor 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. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical 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. 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;m~dU'ZM wr . ! ~/Jr,;' 7- Owner orL:ontractors Signature Date Paee 4 of 4 ZON 1-\)(1 ~ INITIALS )-.j\,---"",- DATE \0- \ ~ - (; 1 SOURCE$\ ~-')r (~./ Date I C) ~ \ (1 -' O~ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54])726-3753 · FAX: (54])726-3689 ELECTRICAL PERMIT APPliCATION City Job Number COM ZoO 7 - 61 S"h c....( 1. LOCATION OF INSTALLATION: J 1. ~ 3 5~J/~t" LEGAL DESCRIPTION: J S'bZ Obl{( /I bDO JOB DESCRIPTION: COMPLETE FEE SCHEDULE BELOW 3. A. New Residential- Single or Multi-Family per dwelling unit. 5r.~.; 4'~~ Service Included 1000 sq. ft. orless Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. J ~ ~ -,~~ 2) / '7 t:rO $ 1'9:00-' U{ ':) . $50.00 2. CONTRACTOR INSTALLATION ONLY B. Services or Feeders - Installation, Alterations or Relocation: New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with OW' C 1..1..... . Service or Feeder Pennit Owners Name l:)Y$ L.e... ,e~"'v't- uS~ rjJ~'5 Address 3073 s Ie.. '1 V ~~ W E. Miscellaneous (Service/feeder not included) -Each Installation I jJOTtCE' Phone b Z6 - 1 L{ )' ~HIS p~lqr~.tXPIRE If THE WO~K $ 50.00 AUTHCWlt~@~(llighiJit8lS PERMIT \~ I\lU T $ 50.00 OWNER INSTALLATION COMrvm~~tR~BMi~QNED FUK $ 25.00 The installation is being made on property I own which ANY 18On[itu{:Elil~~'Mbmmercial $ 45.00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges / gc; .tn:) /4. 4' oJ ~ i90 , '"9. t!/;I? , . ro~ 22!~ Shared Drive(T:)/Building Fonns/Electrical Permit Application g-06.doc Electrical Contractor L 4-- e 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only Address q 2 <6 3 3 City \5 p y Je!- 'J Oh~5 t.:\-w~) Phone 6 l/ ... VI , 3 Supervisor License Number 11 / ) 'I - 5 I (j / (j 1/ 0 9 Constr. Contr. Number /0 S 't 7 ~ 3'/0 ~ f Signature of Supervising Electrician .;;\:'s. you to C. T elIlPorary .seryicei:1!t.JF~ijkW . . , ',_~i;:s are set forth in '}'~ ~>JtiSlMOOldb1:XR~~iHbif61- ~o~Oaqn 0080. You 2lO6YA@t~~1 'Y~qI?IGS of the ~rulesDJ .I'~ t~pentWr fM'O'fu: the telephone call1lg t6rt~~6WqJtmUJSNotiiioation "umberci~_~~44). Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits Expiration Date Expiration Date '\...." " l ) ,----,I '-".. y;;{ \...:x.. ~ \. ( (i. j. '1 City ~\JJ ~h. e-- Owners Signature: 4. SUBTOTAL OF ABOVE 8% State Surcharge 10% AdminiStnltive Fee 5% Technology Fee Inspection Request: 726-3769 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 Willamalane Park & Recreation ~istrict Job. No. ('~.. f)/ ~ 6 f SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007 NAME: \;../;EcII~_1 PHONE: (P~6 - Cj4- 5~ - ADDRESS: 3C)7~ io/'t!<<J:;ITY j::u4.Wc- STATE:~IP:_7.7~5- LOCATION OF PROPOSED BUILDING SITE: Street Address: J 2-~. ~ s. 4 ( ~ I 5/ ' Plat Name: fij;;atr ~j\ Tax Lot Number: -! ~tJ 2.. 0,,1/;/ &,tJt) . 1. DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type definitions are on the back. ) A. Sinale-Family Detached NO. OF UNITS I X $2,303 per unit = $ 2-3(93 B. Sinale-Family Attached NO. OF UNITS X $2,426 per unit = $ C. Multi-Family Apartment NO. OF UNITS X $2,032 per unit = $ D. Sinale Room Occupancv 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) ~~g Development Services Department City of Springfield $ Z ~tJ :5 /0 / /'7/ Date () I 5 DEVELOPMENT TYPE DEFINITIONS1 \, "', -.~ ,,$ing~~:~~'i!-wPet.a'c,hed Dwelling Unit, .., ""4;'~ \:" '. ... '.', 1\ ' '\ "." ~.,. >> \....~\... 'i1 \ . ~;.:...... ';A."Buildihg' ora po'rtlOA' of a building consisting of one or more rooms including sleeping, cooking, and plumbing facilities arranged and designed as permanent living quarters for one family or household; and not attached to any other dwelling .unit or building, ~Thts d.efinition 'in~ludesmanufactured housing. . \ (....-;, I. ..\.... "- .- \..~ < ::. <;,,,,:.1 ..- e" -... . .... . I ""-~" ~..~ ~.~ ... . ......' ....,. '\ ~,t-"" .\......,. '):__tt \ \ -.: ' "' ,- -, "c~~ \ ,,-. '-. ~ '\ ,.I\( Si;Jl,~!~\F.arnily A\.~Jahed Dwelli!!g('>UQit,: ";::". _.,,', '.';. ,_. )' . A p6rfio'h 'of a builalr,.~ consistingdf'6h~~6r':m~re r6o'iil$:~fiii~I~fr;J~ ~~~pi1it'g~' cooking, : and plumbing facilities arranged and designed as permanent living quarters for one family or household; and which Ls..attached to one or more dwelling units by one or more common vertical~wa.lI'S'::) This\a_efil1i~~g also;;ir'iclud~$, bJ.!,t i:s...pqt limited to "duplex", . "zero lot line dwelling", "to'Wrth'OLTse": .anb"row h0use". Wi.tH~.MJe:exc'~ption of duplexes; ,.,~$i-Q,~I~ '~Sl[Jljl:t..~tta.qt.l~ Qwelling Units typicallY_o:re sep'af:~teJY owne:d\ c~,.. \J ...\~.) \ ", " \, ~"'.~. '......." )1-5 \. . /""... \f~~,--:~'~'. ,.\.;\ '.-'~; ~\" ,\i~....\" .J ...1 "..1......\.....\,1 ~i, 'j~~"." \.~t,)'...1:. \ \ \ . Multi-Family Dwelling Unit . I "'.J A portion of a building consisting of one or more rooms including sleeping, cooking, and plumbing facilities arranged and designed as permanent living quarters for one family or household; and which is attached to two or more dwelling units by one or mor;~ y.Qn:!.I1l<;m..vertical walls. Typically, the units are in an apartment building or comfJle'x~(and':are not separately owned. .... . \ . Single Room Occupancy Dwelling Unit A portion of a building consisting of one or more rooms including sleeping facilities with a shared or private bath, and shared cooking facilities and shared living/activity area. This definition also includes, but is not limited to "assisted living facility." Single room occupancy dwelling units shall be charged at one-half the multi-family dwelling unit SDC rate. Accessory Dwelling Unit A secondary, self-contained dwelling that may be allowed only in conjunction with a detached single-family dwelling, An accessory dwelling unit is subordinate in size, location, and appea~ance to the primary detached single-family dwelling. An accessory dwelling unit generally has its own outside entrance and always has a separate kitchen, bathroom and sleeping area. An accessory dwelling unit may be located. within, attached to, or detached from the primary single-family dwelling. Accessory dwelling units shall be charged at one-halfthe single family detached dwelling unit SDC rate. . ~:,.. t-io:~ r~. ,-" t.,~. '-.,j 1::::'~~:....'~~._~ '\ .... -.. .. ,1', t ~ \ '-~ f'~ . \. 'v . r....... \ .....) \ ...<~.~ . ) " , "'... ...\ Upd~ted.. 2/20/07 1 From the WPRO Parks and Recreation SOC Resolution No. 06-07-6, October 10,2006 6 ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's' x I 28 COST PER DFU $26.83 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 28 I COST PER DFU $20.40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE x I 9.57 B. IMPROVEMENT COST: ADTTRIPRATE I 9.57 $0.00 $1,322.65 NUMBER OF UNITS x I COST PER TRIP 1 I 20.43 I NUMBER OF UNITS x I 1 x ITEM 3 TOTAL - TRANSPORTATION SDC =, 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's. x COST PER FEU I 1 $95.35 B. IMPROVEMENT COST: NUMBER OF FEU's 1 x. ICOST PER FEU I ,. $990.39 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , 5. ADMINISTRATIVE FEE: I SUBTOTAL x , ADM. FEE RATE I $3,476.12 I 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: COST PER TRIP $90.10 $1,057.73 $J,095.74 $3,476.12 CHARGE $173.81 DISCOUNT $0.00 . x I NEW TRIP FACTOR I 1.00 x NEW TRIP FACTOR 1.00 , _.. . on.. _---.J TOTALSDC CHARGES = I Kaye Wilson 10/18/2007 PREPARED BY . DATE 6553 $0.00 I $751.33 , . $571.31 $195.48 $862.25 $95.35 = $990.39 $0.00 $10.00 r:/) ~ ~ o u ~ ~ r:/) I-< o ~ 1070 1091 1092 i09] 1094 1054. 11055 1054 11056 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUNALENT UNITS IBATHTUB 2 0 3 == 6 I DRINKING FOUNTAIN 0 0 1 == 0 I FLOOR DRAIN 0 0 3 == 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 == 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 == 0 I LAUNDRY TUB 1 0 2 2 ICLOTIffiSW ASHER / MOP SINK 1 0 3 == 3 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 == 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 == 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 == 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 == 3 SHOWER, SINGLE STALL 1 0 2 == 2 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 == 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 == 3 SINK: COMMERCIAL BAR 0 0 2 == 0 SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 == 2 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 == 1 URINAL, STALL / WALL 0 0 5 == 0 TOILET, PUBLIC INSTALLATION 0 0 6 == 0 ITOILET, PRIVATE INSTALLATION 2 0 3 == 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 == 0 TOTAL DRAINAGE FIXTURE UNITS 28 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallollS per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$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 I 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 $0.05 225 Fifth Street Springfield; Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-0 1564 COM2007-01564 COM2007-01564 COM2007-0 1564 COM2007-01564 COM2007-0 1564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-0 1564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564' COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-01564 COM2007-0 1564 COM2007-01564 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200700000000001320 Date: 10/19/2007 Description Plan Review Major - Planning Overwidth Application Fee Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Curb cut Permit Sidewalk Permit Building Permit Addressing Assignment Wi1lamalane Single Family 2 Baths One or Two Family Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu Boiler/Comp Up To 100,000 btu Vent Fan Appliance Vent Dryer Vent Gas Outlets 1-4 Fireplace (Listed) -Mech Iss 2+ Appliances- Fire SF Fee - Residential Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By BWCH Item Total: Check Number Authorization Received By Batch Number Number How Received djb 03526B In Person Payment Total: Page I of 1 8:33:50AM Amount Due 205.00 45,00 751.33 571.31 195.48 862.25 95.35 990.39 10.00 96,58 77.23 85.00 85,00 1,020.22 35.00 2,303.00 280.00 16,00 14,00 14.00 21.00 7.00 7.00 5.00 17.00 40.00 121.05 117.00 63.00 100.06 126.50 170.23 $8,546.98 Amount Paid $8,546,98 $8,546.98 10/19/2007