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HomeMy WebLinkAboutPermit Building 2007-11-7 Status Issued CITY OF SPRINGFIELD' ./'-v Building/Combination Permit PERMIT NO: COM2007-01638 ISSUED: 11/07/2007 APPLIED: 11/05/2007 EXPIRES: 05/07/2008 VALUE: $ 140,165.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5792 OBSIDIAN AVE SPRINGFIE TYPE OF WORK: Single Family Residence ASSESSOR'S PARCEL NO.: JASPER MDWS 5 ADD P TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - Jasper Meadows lot 211 Residential Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 Phone Number: 541-741-2572 Phone Number: 541-228-6935 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor HA YDEN ENTERPRISES M & W ELECTRIC INCORPORATED PACIFIC AIR COMFORT INC DENNIS SCOTT EGGERS License . 92208 67362 39237 142776 . Expiration Date 07/29/2009 06/19/2011 03/25/2010 . 05/05/2010 Phone 541-228-1081 541-754-6171 541-672-9510 541-459-0110 BUILDING INFORMATION' # of Units: 1 # of Stories: 1 Lot Size: Primary Occupancy Group: R-3 Height of Structure: 16.00 'Sq Ft Ist Floor: 1,235 Secondary Occupancy Group: U . Type of Heat: Forced Air Gas Sq Ft 2nd Floor: Primary Construction Type VB Water Type: Gas Sq Ft Basement: Secondary Construction Type: Range Type: Sq Ft Garage/Carport 480 # of Bedrooms: 3 Energy Path: Path 1 Sq Ft Other: Sprinkled Building: nla . Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 18.00 10.00 39.50 10.00 Over~ay Dist: # Street Trees Rqd: Paved Drive"Rqd: % of Lot Coverage: 4 Yes 24.20 Total: Handicapped: Compact: 2 . . Subdivision Not A~ION: Oregon law Lflqf.lJeIQIIMNWVEMENTS I S I J.Q{l.ow rules adopted by th VI tI\:jUII ULII"1 treet mprove,t:folification Center.Fih~tI~are set forth Sidewalk Type: Curbside T Storm Sewer A"RiGMi:952-001-0010through ~fl952-OO1. Downspouts/Drains: Curb and Gutter Special InstructOOOO. You may obtain copies of the rules by . NOTICE" calling the center. (Note: the telephone · . Notes: No fina~JGy ~~WfJ!t\ThIt'~V~P~to Public Wor.1.H~~~ ~J R~~kktEx.PJRE IF THE WORK Centeris 1-800-332-2344,. AUfI'1Ut1I~tU U1'JU1:tirA'(~ PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. .\: Paee 1 of 4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01638 ISSUED: 11/07/2007 APPLIED: 11/05/2007 EXPIRES: 05/07/2008 VALUE: $ 140,165.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Dwellin!!:s Garaee V Wood Frame Garaee $ Per Sq Ft or multiplier $103.00 $27.00 Square Footage or Bid Amount 1,235.00 480.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $127,205.00 $12,960.00 $140,165.00 11/05/2007 11/05/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $500.25 11/5/07 2200700000000001675 -Mech Iss 2+ Appliances- $40.00 11/7/07 1200700000000001377 + 10% Administrative Fee $142.94 11/7/07 1200700000000001377 + 5% Technology Fee $85.93 11/7/07 1200700000000001377 + 8% State Surcharge $107.49 11/7/07 1200700000000001377 2 Baths One or Two Family $280.00 11/7/07 1200700000000001377 Addressing Assignment $35.00 11/7/07 1200700000000001377 Appliance Vent $7.00 11/7/07 1200700000000001377 Building Permit $769.62 11/7/07 1200700000000001377 Curbcut Permit $85.00 11/7/07 1200700000000001377 Dryer Vent $7.00 11/7/07 1200700000000001377 Exhaust Hoods $10.00 11/7/07 1200700000000001377 Fire SF Fee - Residential $85.75 11/7/07 1200700000000001377 Furnace - up to 100,000 btu $14.00 11/7/07 1200700000000001377 Gas Outlets 1-4 $5.00 11/7/07 1200700000000001377 Plan Review Major - Planning $205.00 11/7/07 1200700000000001377 Residence Wiring 1000 Sq Ft $117.00 11/7/07 1200700000000001377 Residence Wiring Ea Addtl 500 $42.00 11/7/07 1200700000000001377 Sanitary Sewer - Improvement $469.29 11/7/07 1200700000000001377 Sanitary Sewer - Reimbursement $617.17 11/7/07 1200700000000001377 SDC MWMC Administration $10.00 11/7/07 1200700000000001377 SDC MWMC Improvement $990.39 11/7/07 1200700000000001377 SDC MWMC Reimbursement $95.35 11/7/07 1200700000000001377 SDC Sanitary/Storm Admin $125.77 11/7/07 1200700000000001377 SDC Transpo Admin $73.01 11/7/07 1200700000000001377 SDC Transpo Improvement $862.25 11/7/07 1200700000000001377 SDC Transpo Reimbursement $195.48 11/7/07 1200700000000001377 Sidewalk Permit $85.00 11/7/07 1200700000000001377 Storm Drainage Impervious Area $735.64 11/7/07 1200700000000001377 Storm Sewer Each Addtll00' $16.00 11/7/07 1200700000000001377 Temp Power 200 amps or less $55.00 11/7/07 1200700000000001377 Vent Fan $21.00 11/7/07 1200700000000001377 Willamalane Single Family $2,303.00 11/7/07 1200700000000001377 Total Amount Paid $9,193.33 Paee 2 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01638 ISSUED: 11/07/2007 APPLIED: 11/05/2007 EXPIRES: 05/07/2008 VALUE: $ 140,165.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plannine Review Public Works Review 11/05/2007 11/05/2007 I Plan Reviews I 11/05/2007 APP 11/05/2007 APP TAJ LKW No final occupancy approval shall be granted prior to Public Works approval for pump station Approved as noted on the plans. Structural Review 11/05/2007 11/05/2007 APP 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. l..ReouireCUnsnections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Setback: 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 andlor 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. Paee 3 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01638 ISSUED: 11/07/2007 APPLIED: 11/0512007 EXPIRES: 05/07/2008 VALUE: $ 140,165.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. 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. 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 times during construction. -Z/]J Owner or Contractors Sign~e //-0 7- 0 7 Date Paee 4 of 4 Willamalane Park & Recreation District Job. No.t'tJl#2(rJ.7-t'J/~.s6 SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007 NAME: ,.J-.!Ayj)t:;;Q >FiNr PHONE: ? 7.'0 - ~q 3'S : ADD,RESS:.l&f J)e1~CITY~ STATE:<<ZIP: ~~7S""~ LOCATION OF PROPOSED BUILDING SITE: Street Address: .C; 7'9 2- ~r~ /7) J AJV - . , . Plat Name:k2L/ JJ1.?IIl_~ItJ.s Tax Lot Number: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwellingtype definitions are on the back. ) A. Sinale-Familv Detached NO. OF UNITS / X $2,303 per unit = $ 2.~O: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$1,151.50perunit= $ 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) $ 2.~f):J 1{07 DAII'\ "t<OwLSr:s-y {( / [J8ve'lo'pmerit Services Department I Date City of Springfield 5 DEVELOPMENT TYPE DEFINITIONS1 ;i";. ~ ,~stngl~,f~RJtty'~~lt~'ched Dwelling Unit . . . . . . '''.J'--'-.~''bl:llldir;.g.J6r%'~h~c:m)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. Tl:1i? ~tgj.ti~rl.i~~~~. manufactured housing, __ .,,' -.:::~ .... ~ '. _-'~"' . t\) _ _..__.;. '\ \ r,.:t (" ~,._~t ',' I t. ." . - . \.... \ ,.-,--. "\ .\"~.._. " - \. \ '-!! " Si.3~@Ilily Att~~ed Dwellinij. Unit .. \. \ . \ ....... -. ~ . \ A po~& "of a builcirrt~ consisting o~}b~'7~'Il~~r~e roo~h~ip~ePie~Eooking, : and plumbing facilities arranged and designed as pef~~aQent living qua'rters for one family or household; .and which is attached to one or more dwelling units by one or .more common vertical walls,\, TJ1i~ qe~~lti~Q <i~9_~c1ude~, but i~not limited to "duplex", "zero lot line dwelling", "town M~;'\ar.td\:'toW:lllGlUSft". Wi.fu ~Ff!~\:~xc~1l,tion of duplexes, Single Family Attached Dwelling Units typically are s?J?,arately Qwned: , . . 1~~~~\~,~'t+-\. \\\'~"'.\ . . .. ,,". \~ \\..~ . Multi-Family Dwelling Unit \ 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~..cQ!:QCIlpQ. vertical walls. Typically, the units are in an apartment building or compl'~~(af,td"are not separately owned. \. . Single Room Occupancy Dwelling Unit A portion of a building consisting ot one or more rooms including sleeping facilities with' a shared or private bath, and shared cooking facilities and shared living/activity area. This definition al90 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 wrth a detached single.:.family dwelling. An accessory dwelling unit is subordinate in size, location, and appearance 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-half the single family detached dwelling unit SDC rate. ~ r~ ";0 r:-.. L \...) C -~"~ _,...e _'" \ ~.... :: r~ \ \ ~ . I .j i J ........... '"-, . .- -'. -,_ ../ I - -, ;' 1...'\ (.J ''v,'(') "') Updated 2/20/07 .. -,' ';"~L ~ r_ I ,'. \~. . 1 From the WPRD Parks and Recreation SDC Resolution No, 06-07-6, October 10; 2006 6 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: Com2007-01638 NAME OR COMPANY: Hayden Homes LOCATION: 5792 Obsidian TAX LOT NUMBER: Jasper Meadows 5th Add SL211 DEVELOPMENT TYPE: Single Family Residence NEW DWELLING UNITS 1 BUILDING SIZE (SF: 1777 LOT SIZE (SF): ' 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x; I COST PER S.F. CHARGE I 2-126.00 I $0.346 = I $735.64 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. x COST PER S.F. x I DISCOUNT RATE I 0.00 $0.346 I 50% = I' ITEM 1 TOTAL - STORM DRAINAGE SDC '$735.64 DISCOUNT $0.00 7076 r:rJ P-1 Q o u ~ P-1 t-< r:rJ ....... o ~ $735.64 1070 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's x 23 B. IMPROVEMENT COST: I NUMBER OF DFU's x I 23 COST PER DFU $26.83 COST PER DFU $20.40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, 3. TRANSPORTATION A. REIMBURSEMENT COST: ADTTRIPRATE x 9.57 B. IMPROVEMENT COST: I ADT TRIP RATE x I 9.57 $1,086.46 .1 ' NUMBER OF UNITS x I COST PER TRIP 1 I 20.43 NUMBER OF UNITS I x 1 I ITEM 3 TOTAL - TRANSPORTATION SpC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's x 1 = , ICOST PER FEU I $95.35 B. IMPROVEMENT COST: NUMBER 01 F FEU's I x ICOST PER FEU I $990.39 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINlSTRA TIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , SUBTOTAL (ADD ITEMS 1,2,3, & 4), = , 5. ADMINISTRATIVE FEE: SUBTOTAL x ADM. FEE RATE $3,975.57 5% TOTAL SANITARYADMINlSTRATION FEE:. TOT AL TRANSPORTATION ADMINISTRATION FEE: Kaye Wilson . 11/5/2007 ,PREPARED BY DATE x INEWTRIPFACTOR' I 1.00 COST PER TRIP $90.10 $1,057.73 x I NEW TRIP FACTOR I 1.00 $617.17 109] $469.29 1092 $195.48 1093 $862.25 ]094 / = $1,095.74 $3,975.57 ., = $95.35 1054 = $990.39 $0.00 $10.00 11056 ]055 1054 CHARGE $198.78 TOTAL SDC CHARGES , I 125.77 1079 $73.01 1078 I $4,174.35 I ,~ DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS I BATHTUB 2 0 3 = 6 I DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 1 0 3 = 3 ICLOTHESWASHER- 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG I WATER STATION I ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK I DISHWASHER I ETC. 1 0 3 = 3 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LA V ATORY 0 0 2 = 0 SINK: SINGLE LA V ATORY/RESIDENTIAL BAR 2 0 1 = 2 URINAL, STALL/WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET1 PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 'EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit ,\20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$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 ELGlBLE 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 o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE I 1000 CREDIT RATE $0.00 x $5.29 = I $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE 11000 CREDIT RATE $0.00 x $529 o = $0.00 TOTAL MWMC CREDIT -_, ..."" L..UU' \1 f'\l} 1(; IC %l..'l F'lFm S11U;F:I' · SP~u.LD. OR97477 . Ml:(541)'JU.3753 . FAX: (541)'tUi..31il1!1 ELE....J..KICAL PERMIT APPLICATION CityJobNumber ~7"O/h)~ 1 FIj;'.\~~~"':".!"':;'" . .." ,. /",: . .;,J,;j~~,l!l~" , 3. - SZ9.2 t'Jt5S/~/N J LEGAL DESCRIPTION: ~1or2;U J~~_H(~J' JOB DESCRIPTION: Sr.#es. <4~c_ vL-- OwncrsNamc flA-,~EN' ~G=S . Address '2 'ibc.r I 5 t,J G./ k.t WL ~L E. If- City 'M 1MD1A/~ Phone -;::2 ~ -b 7 J r . ~crmits an: Don-transferable and expire if work is not started within 180 days of issuance or ihv~rk is SUSpcaidcd for 180 days. Electrical Con1rnctor 1M f~l 't~~ Address ~<j(<i<~ HW-f ~~l City A\ huvv t( / Phone 7s:f-ltltl Supervisor .License Number f{~""'15 E..t':' ..~:on Date lfJ -I-toto Constr. Comr. Number (p / 5(PL /.,.1 -:)c.o~ Expiration Dale Signature of SUpervising ElectrieilUl - fA-- OWNER. INSTALLATION The installation is being made On property r own which is llat intended for sale. lease or renT. Owners Signature: In~t' ~~;';on Request: 726-3769' Date A.1I.dS!l~r Scrviec Included 1000 sq. ft. or less . Each additional SOO sq. ft. or , portion. thereof' . . _ $117.001J~~ 4-2-&aC / , "~ 2- . S21.oo Each Manumct'd Home or Modular Dwelling service or Feeder $55.00 ''B. 200 Amps or Jess 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1 000 Amps Over 1000 AmpsIV OilS Reconnect Only, $ 70.00 $ 83.00 , $138~OO $180.00 $413.00 , $ 55.00 lustaUation, Alteration or Relocation 200 Amps or Jess 201 Amps to 400 Amps 401 Amps to 600 Amps $ 55.00 $ 76.00 $110.00 ~H1 Over 600 Amps or ) 000 V olls see "B" above. D. ~!~~' New Alteration or Extension Per Panel ttne L;iiCuit Each Addilional Circuit or with Service or Feeder Permit . $ 48.00 $ 4.00 Pump or irrigation $ SS.OO Sign/Outline Lighting $ 55.00 Limited Energy/ResidentiaI $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Jl:lectric Permit Inspection Fee is $SO.OO + SUrcharges 4. .~." .""'.l..... ,..':~~., , ~ ...., I.L tJ4J ~~II ;r~ ~/~ 8% State Surcharge / 7 /1- 10% A~inistrativc Fcc "7:; "lO . 5% Technology Fee . , / n. 7p TOTAL '. ~ S 2... L ... -. I . Shared Ori~)JF.lullding FOrms/Electrical Pc:anit Application 7.{T1.doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-01638 COM2007-0 1638 COM2007-01638 COM2007-01575 COM2007-01575 COM2007-01575 COM2007-01575 COM2007-01575 COM2007-01575 Payments: Type of Payment CreditCard cReceint I RECEIPT #: 1200700000000001377 Date: 11/07/2007 Description Plan Review Major - Planning Building Permit Sidewalk Permit Curbcut Permit Storm Drainage Impervious Area 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 Addressing Assignment Willamalane Single Family Fire SF Fee - Residential 2 Baths One or Two Family Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 -Mech Iss 2+ Appliances- Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By HA YDEN ENT Item Total: Check Number Authorization Received By Batch Number Number How Received djb 048152 In Person Payment Total: Page 1 of I 11 :39:24AM Amount Due 205.00 769,62 85,00 85,00 735,64 617,17 469.29 195.48 862,25 95.35 990,39 10,00 125.77 73,01 35,00 2,303,00 85.75 280,00 16,00 14,00 21.00 7.00 10.00 7.00 5,00 40,00 117.00 42,00 55,00 85.93 107.49 142.94 117,00 84,00 55,00 12,80 20.48 25.60 $9,007.96 Amount Paid $9,007,96 $9,007.96 111712007