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Home My WebLink AboutPermit Building 2008-2-11 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2008-00134 ISSUED: 02/11/2008 APPLIED: 01/30/2008 EXPIRES: 08/11/2008 VALUE: $ 283,878.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2592 17TH ST ASSESSOR'S PARCEL NO.: 1703243103100 SPRINGFIETYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: SFR Residence Legacy Estates Lot 6 TYPE OF USE: New Residential I P~PROVEMENiM~ 'f~'IJO~~ " ~ S""a. @ ~J$J'\i' Fullv Imp~\9 FtR~' UNDER ,.t\\$ FE D f(f<< Type: A~~OR\Z.EOO OR \$ ~6~MDONg:ownspoutS/Drains: COMMEONCD~'l PER\OO. AN'l18 Owner: CRESCENT HOMES Address: 2210 COMSTOCK AVENUE EUGENE OR 97408 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Plumbing Contractor STEVE HAUCK COMFORT FLOW CUSTOM PLUMBING License 147618 460 I BUILDING INFORMATION. ~ w requires you 1Q # of Units: ATTENTI<i>N: orego~, a \~gon Utility 2 Primary Occupancy Group: 1olloW r~l~S adopten ~Wt~MM9rth 29.00 Secondary Occupancy GrouIMotl11CatlOO ce~~g~10i.hY69~"GM\952.op~ced Air Gas Primary Construction Type in OAR ~B-OO btain~6ts\6ffJl>&he rules ai' Gas Secondary Construction TypOO90.. YOU m~~ter.a _~,~phO~8 Gas # of Bedrooms: ca\lIng ~e the Ore ij4;\ilytN.9tificatiOft Path 1 numberC~~\er " 1 ~~fling n/a I DEVELOPMENT INFORMATION. Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 16.00 5.00 9.00 33.00 9.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: Notes: weep holes to curb and gutter Page 1 of 4 Phone Number: 541-344-2010 Expiration Date 04/09/2009 06/27/2009 Phone 541-221-2665 541-726-0100 Lot Size: Sq Ft 1st Floor: 1,707 Sq Ft 2nd Floor: 694 Sq Ft Basement: Sq Ft Garage/Carport 706 Sq Ft Other: Occupant Load: 2 No 31.00 REQUIRED PARKING To~l: 2 Handicapped: Compact: Setback 7' Curb and Gutter Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00134 ISSUED: 02/11/2008 APPLIED: 01/30/2008 EXPIRES: 08/11/2008 VALUE: $ 283,878.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I A.C. - Residen Dwellifil~S Gara2e Tvpe of Construction AC - Residential V Wood Frame Gara2e $ Per Sq Ft or multiplier $5.00 $105.00 $28.00 Square Footage or Bid Amount 2,401.00 2,401.00 706.00 Value Date Calculated Description Total Value of Project $12,005.00 $252,105.00 $19,768.00 $283,878.00 01/30/2008 01/30/2008 01/30/2008 ~ Fee Description Amount Paid Date Paid Receipt Number + 10% Administrative Fee $5.50 1/30/08 1200800000000000086 + 12% State Surcharge $6.60 1/30/08 1200800000000000086 + 5% Technology Fee $2.75 1/30/08 1200800000000000086 Plan Review Residential $833.01 1/30/08 2200800000000000125 Temp Power 200 amps or less $55.00 1/30/08 1200800000000000086 ~Mech Iss 2+ Appliances~ $40.00 2/11/08 1200800000000000125 + 10% Administrative Fee $212.99 2/11/08 1200800000000000125 + 12% State Surcharge $236.95 2/11/08 1200800000000000125 + 5% Technology Fee $119.48 2/11/08 1200800000000000125 3 Baths One & Two Family $337.00 2/11/08 1200800000000000125 Addressing Assignment $35.00 2/11/08 1200800000000000125 Appliance Vent $7.00 2/11/08 1200800000000000125 Boiler/Comp Up To 100,000 btu $14.00 2/11/08 1200800000000000125 Building Permit $1,281.56 2/11/08 1200800000000000125 Curbcut Permit $85.00 2/11/08 1200800000000000125 Dryer Vent $7.00 2/11/08 1200800000000000125 Exhaust Hoods $10.00 2/11/08 1200800000000000125 Fire SF Fee - Residential $155.35 2/11/08 1200800000000000125 Fireplace (Listed) $17.00 2/11/08 1200800000000000125 Furnace - up to 100,000 btu $14.00 2/11/08 1200800000000000125 Gas Outlets 1-4 $5.00 2/11/08 1200800000000000125 Overwidth Application Fee $40.00 2/11/08 1200800000000000125 Plan Review Major - Planning $205.00 2/11/08 1200800000000000125 Residence Wiring 1000 Sq Ft $117.00 2/11/08 1200800000000000125 Residence Wiring Ea Addtl 500 $105.00 2/11/08 1200800000000000125 Sanitary Sewer - Improvement $673.33 2/11/08 1200800000000000125 Sanitary Sewer - Reimbursement $885.50 2/11/08 1200800000000000125 SDC MWMC Administration $10.00 2/11/08 1200800000000000125 SDC MWMC Improvement $990.39 2/11/08 1200800000000000125 SDC MWMC Reimbursement $95.35 2/11/08 1200800000000000125 SDC Sanitary/Storm Admin $179.81 2/11/08 1200800000000000125 SDC Transpo Improvement $862.25 2/11/08 1200800000000000125 SDC Transpo Reimbursement $195.48 2/11/08 1200800000000000125 SDC Transportation Admin $67.91 2/11/08 1200800000000000125 Pa2e 2 of 4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00134 ISSUED: 02/11/2008 APPLIED: 01/30/2008 EXPIRES: 08/11/2008 VALUE: $ 283,878.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Sidewalk Permit Storm Drainage Impervious Area Storm Sewer Each Addtll00' Vent Fan Willamalane Single Family $85.00 $1,242.02 $32.00 $28.00 $2,513.00 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 1200800000000000125 1200800000000000125 1200800000000000125 1200800000000000125 1200800000000000125 Total Amount Paid $11,807.23 I Plan Reviews I PlanniOl:! Review Public Works Review 01/30/2008 01/30/2008 01/30/2008 01/30/2008 APP APP EMM LKW Structural Review 02/01/2008 02/04/2008 APP DLM Requested revisions to foundation for support of loads above Laundry area 2/1/08dlm. Received revised information 2/2/08dlm. 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. ~eouire<VnSDections I Temporary Electric: Approval required prior to Utility Company energizing pole. 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 - Overwidth: 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. Paee 3 of 4 CITY OF SPRINGFIELD - Status Issued Building/Combination Permit PERMIT NO: COM2008-00134 ISSUED: 02/11/2008 APPLIED: 01/30/2008 EXPIRES: 08/11/2008 VALUE: $ 283,878.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 mcluding 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. 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 ofany 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 constructio 2-//-B Date Pal!e 4 of 4 ~ WiHamalane ~ Park & Recreation ~istrict Job. No. 0$ 2LftJf9. -cJO /34- SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007 NAME: C/le:5CEV.r _~~ PHONE: 9S -4 - / .3 '/ L ADDRESS: 2.7..IO'~n~CITY ~ STATE:MzIP:_9'7~~ LOCATION OF PROPOSED BUILDING SITE: Street Address: 'J-5~:2-. / 7 ~ s- T/ . Plat Name: L&z:tAC-ILr-r~~ Tax Lot Number: Lbr 6 ( ~- , 1. DEVELOPMENT TYPE (Check appropriate dwelhng(s) Dwelling type definitions are on the back. ) A. Sinale-Familv Detached NO. OF UNITS 2-S13 X ~~n~ pQr unit = $ :2.)/~ B. Slnale-Famllv Attached NO. OF UNITS X $2,426 per unit = $ C. Multl-Famllv Apartment NO. OF UNITS X $2,032 per unit = $ D. Sinale Room Occuoancv NO. OF UNITS X $1.016 per Unit = $ E. Accessorv Dwelllna Unit NO. OF UNITS X $1,151.50 per unit = $ WILLAMALANE SDC $ 2. SDC CREDIT (If applicable) SOC payer must furnish proof of Willamalane Credit approval) $ / 3. TOTAL (if SO 2{ Date $ ~--I3- ;? { d.+- 5 DEVELOPMENT TYPE DEFINITIONS1 ~~" :~. ... ,~ ,_~IS- P3'ft'li'lJ..\~fached Dwelling Unit ' I -. \ ' j " . A b'ull<1ittg-or"8 pC5rtion 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. ~Tt\16 ~R~i1l.onffl~'~ manufactured housiu.g~. '. \ _ _ -- ". " ~ " l~"- ,.t~;\~,\ \~<}~~.:J-:,~\~~' J ~iQ.fJI.~~~ily A~ji;.hed Dwellin~ ~~it. Ow r:.'"A portior'l o'f a builCTr~~ conslsting'~8\~M,ore roorW~~~sm~P1tr~:cooking, : and plumbing facilities arranged and designed as permanent living quarters for one family or household; and which is attached to one or more dwelling units by one or more common vertical walls. This definitiA[.t als~c1udes, but is not limited to "duplex", "zero lot line dwelling", "townhouse", an~"rovV<hd~e~~ Vylth.t~~~rPJion of duplexes, Single Family Attached...~welling Units typically a~ sepa~alely owned. , C" \ \,3-~ '\ )"'i.~'-' .. '<",......1.. ~~ . .. ,-~~ c.... ,. \.~.)~,.... .. Multi-Family Dwelling Unit I "- 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 more ~'!lm.p~vertical walls. Typi~t~~~ units are In an apartment building or comprex, aftd 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 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 r dwelling units shall be charged at one-half the single family detached dwelling unit SDC rate. ~ " ... <::-., ( " ,.-1 ' ,. .- ~...) ..-' ... Updated 2120/07 1 From the WPRO Parks and RecreatIon SOC Resolution No. 06-07-6, October 10, 2006 6 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER COM2008-00134 NAME OR COMPANY Crescent Homes LOCATION 2592 17th Street TAX LOT NUMBER 1703243103100 DEVELOPMENT TYPE Smgle Farrllly ResIdence NEW DWELLING UNITS 1 BUILDING SIZE (SF 3107 LOT SIZE (SF) 1 STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS SF x I COST PER S F CHARGE 358945 I $0 346 = I $1,242 02 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS SF' x I COST PER S F I x I DISCOUNT RATE I , 0 00' $0 346 I 50% = I ITEM 1 TOTAL - STORM DRAINAGE SDC '$1,242.02 8034 len ~ Cl o U ~ ~ r-< en ...... o ~ DISCOUNT $000 $1,242.02 11070 I 2 SANITARY SEWER - CITY A REIMBURSEMENT COST , NUMBER OF DFU's x , 33 COST PER DFU $26 83 $885.50 1091 B IMPROVEMENT COST NUMBER OF DFU's I x COST PER DFU 33 $20 40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC $673.33 1092 =, $1,558.83 3 TRANSPORTATION A REIMBURSEMENT COST , ADT TRIP RATE I I NUMBER OF UNITS COST PER TRIP x I NEW TRIP FACTOR x x , 957 , 1 2043 , 100 $195.48 1093 B. IMPROVEMENT COST ADT TRIP RATE x , NUMBER OF UNITS x I COST PER TRIP x INEWTRIPFACTOR 957 I 1 , $90 10 I 100 $862.25 1094 ITEM 3 TOTAL - TRANSPORTA nON SDC =, $1,057.73 4 SANITARY SEWER - MWMC ,I A REIMBURSEMENT COST NUMBER OF FEU's x I COST PER FEU 1 , $9535 = $95.35 1054 B IMPROVEMENT COST INUMBER OF FEU's I x COST PER FEU I 1 I $99039 = , $990.39 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) = , $0.00 11054 MWMC ADMINISTRATIVE FEE = , $10.00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $1,095.74 -- . , SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I $4,954.32 5 ADMINISTRATNE FEE II 'SUBTOTAL x I ADM FEE RATE CHARGE I $4,954 32 I 5% $24772 TOTAL SANITARY ADMINISTRATION FEE 17981 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE $6791 1078 I Kaye Wilson 1/30/2008 =, \ TOTAL SDC CHARGES $5,202.04 PREPARED BY DATE - - DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 2 0 3 = 6 IDRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH I ETC 0 0 6 = 0 \LAUNDRY TUB 1 0 2 = 2 I CLOTIffiSW ASHER I MOP SINK 1 0 3 = 3 I CLOTIffiSW ASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG I WATER STATION / ETC 0 0 1 = 0 I RECEPTOR FOR COM SINK I DISHWASHER I ETC 1 0 3 = 3 ISHOWER, SINGLE STALL 1 0 2 = 2 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 I SINK. COMMERCIAL BAR 0 0 2 = 0 ISINK WASHBASIN/DOUBLELAVATORY 1 0 2 = 2 ISINK SINGLELAVATORY/RESIDENTIALBAR 3 0 1 = 3 IURINAL, STALL/WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 33 *EDU (EqUIvalent Dwellmg Urnt) IS a dtscharge eqUIvalent to a smgle famIly dwellmg urnt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$I,OOO ANNEXED ASSESSED VALUE IS LAND ELGlBLE FOR ANNEXATION CREDITI 2 r BEFORE 1979 $529 (Enter 1 for Yes, 2 for No) 1979 $529 IS IMPROVEMENT ELGlBLE FOR ANNEX CREDIT? 2 1980 $519 (Enter 1 for Yes, 2 for No) 1981 $512 BASE YEAR 1979 1982 $498 1983 $480 CREDIT FOR LAND (IF APPLICABLE) 1984 $463 VALUE I 1000 CREDIT RATE 1985 $440 $000 x $529 = I $000 1986 $407 1987 $367 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $322 VALUE I 1000 CREDIT RATE 1989 $273 $000 x $529 0 1990 $2,25 1991 $180 1992 $159 TOTAL MWMC CREDIT = $000 1993 $145 1994 $125 1995 $109 1996 $092 1997 $072 1998 $048 1999 $028 2000 $009 2001 $005 Date 7..QN I ''Tlf .. INJTIALS~' 'rJ~ DATE '2 - j I --0 K SOURCE f"'. r ~ 2.-lL- 8 ns fiFTH S'JlU\ET · SPJ/UNClfiIEl..o.OlU7477 " PIll:(S4J)7.zG-37$3 0 FAX: (541)726-3689 ELEu.;J.J1d~PERM1T APPLlCA170N City Job Number It'\M2fr'J X-- - C1J\. ~ L(- mJi~ll~a~~'""~IWIW'''i.I;O:~":~, .~ 3 ~~1mr~ 1. iil~\'l;~"ki.i;I""'~~~i~~~~M]jlI.~h~ . ~~~.<..'i."''''''''''''I'''''''''<l~"""",""l>Il:lIl~\o..'~''''' 'I/> Lor -#, L..-. Of (, or "'Et;./--k...s ' - . LEGAl; DESCRIPTION: I NeW S F-D JOB DESCRIPTION: 1tJ..J--s ~Sq2.. l1~; Permits are UDon-tnlllllfenble Bnd C)())ire Ihvork is not sblned within 180 days of i!lSUBn~C 011' if work is Suspended for 180 days. %. Electrical Contractor STEdE 4flud'- Addres.<: fo, B<J)( '7-1361 C/1Yo I r GvJ- Phone ~~ I - ~fpG.J City :.' , , Supervisor License Number 3S 1-=f S u ,. Expiration Date In- 1-)0 /Lf7&/R Lf-3o- 09 Con Sir. Contr_ Number Expiration Date S;Y"""E1_ Owners Name L...l'eSc. ~ -f. 1-/0'""--5 Address 2-2/'0 CD ""'S Ioc/c- ~ City E~~ 4U- Phone "34 '1-2.0 'L~ v OWNER INSTALLATION The installation is being made o~Pro erty I own which is ~ot intended rofzsaJe. 1ea.!7e ...,r.:.. Owners Signatutey. , ~-- .......- v Inllpec:tton Requellt: 726-3769 '\ I" .. A., Service Included JOOO sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder , ,~ ,,""~I \ $117.00 \ t 7- 3 $ 21.00 ~3 -$55.00 B. 200 Amps or I~T $ 70_00 AI ENTION. Or;;;:jc.i-, lavVJe~~ re;:, yuu iu 201 Amps to 4pJMOOPfules adO!3~BE! ~J' WeB ~ 19C;i U{,I,I, 401 Amps to ~~lt9d~'!1~lon Center. Those m sl~re-seH':'i-th 601 Amps to ~1>CW~!!)2...001-001 n thrnu~Wt1WR Q':'?-o.o.t.-- Over 1000 A~W:ol\bu may obtain COPI$t1UlA1arlJle~ b)L Reconnect On1lCalling the center (tiatP.~~I~,:, c. lInstallatiol1l, ADtemtiolll or RcloCllltiolll ' 200 Amps orless - $ 55.00 201 Amps~r,t~AilJ!S $ 76.00 401 AmpSlWI.ddkmjs jUll.oo.., Over60olM~Jlii~t,tl~~~ ,ot t'~E IFI HTE WORf,- D. E. $ 48.00 $ 4.00 .f- Pump or lnigation $ 55.00 Sign/Outline Lighting $ 55.00 Limited EnergylResidmtial ,,$ 28.00 Limited Energy/Commercial ~ ( . $ 50 00 MIDJiIllllUDD IElmrie Permit !uspedioo !Fee is $50.00 + SllrehaFglllll 4. 11Di ~,L., \ ~., ~'l:-~.......,,\~ r~M +.,vt.""'H to , ~ ..:> 12% State Surcharge I e :s.c. 10% Administrative Fee . / _~ ~c:> 5%,Technology Fee .I- J ~ S- T01' AI. lct 'f '3 ( Shan:d Onve(T )/bu,ildmg ~ onnlllElcetl'Ical Pcmllt ^pphcation 1-o8.<loc ) , /1' t If 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00134 COM2008-00134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00134 COM2008-00134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00134 COM2008-00134 COM2008-00134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00 134 COM2008-00134 COM2008-00 134 COM2008-00134 COM2008-00 134 COM2008-00134 COM2008-00 134 Payments: Type of Payment Check CredItCard cRecemtl RECEIPT #: 1200800000000000125 Date: 02/11/2008 DescriptIOn Plan RevIew Major - Plannmg Overwldth ApplicatIon Fee Curb cut PermIt Sidewalk PermIt Storm Dramage ImperVIOUS Area SanItary Sewer - ReImbursement SanItary Sewer - Improvement SDC Transpo ReImbursement SDC Transpo Improvement SDC MWMC ReImbursement SDC MWMC Improvement SDC MWMC AdmmIstratlon SDC SanItary/Storm Admm SDC TransportatIon Admm Buildmg PermIt Addressmg AssIgnment WIllamalane Single Family 3 Baths One & Two Family Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu BOller/Comp Up To 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 FIreplace (LIsted) ~Mech Iss 2+ Appllances~ FIre SF Fee - ResIdential Reslden-ce WIrIng 1000 Sq Ft ResIdence WIrIng Ea Addtl 500 + 5% Technology Fee + 12% State Surcharge + 10% AdmmlstratIve Fee Paid By CRESCENT HOMES INC MARC GRAS SAUER Item Total: Check Number AuthOrizatIOn Received By Batch Number Number How Received dJb dJb 6696 In Person o 1515c In Person Payment Total: '\ Page I of2 2:12:54PM Amount Due 205 00 4000 8500 8500 1,242 02 885 50 673 33 195 48 862 25 9535 99039 10 00 17981 6791 1,281 56 3500 2,513 00 33700 3200 1400 1400 2800 700 10 00 700 500 1700 4000 155 35 11700 105 00 119 48 236 95 212 99 $10,904.37 Amount Paid $1,50000 $9,40437 $10,904.37 2/1112008