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Home My WebLink AboutPermit Building 2008-4-10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2008-00489 ISSUED: 04/10/2008 APPLIED: 04/09/2008 EXPIRES: 10/10/2008 VALUE: $ 120,575.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5782 OBSIDIAN AVE ASSESSOR'S PARCEL NO.: 1802030008200 SPRINGFIETYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence- SAME AS COM2008-00157 1765 S 58th st Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing License 92208 172366 39237 142776 Contractor HA YDEN ENTERPRISES TOP NOTCH ELECTRIC INC PACIFIC AIR COMFORT INC DENNIS SCOTT EGGERS BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VB # of Stories: 1 Height of Structure 15,00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Energy Path: Path 1 Sprinkled Building No 2 I DEVELOPMENT INFORMATION I Residential Phone Number: 541-228-6935 Expiration Date 07/29/2009 09/29/2008 03/25/2010 05/05/2010 Phone 541-228-1081 541-317-1998 541-672-9510 541-459-0110 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,031 440 REQUIRED PARKING Frontyard Setback: 18,00 Overlay Dist: Total: 2 Side 1 Setback: 10,00 # Street Trees Rqd: 2 Handicapped: Side 2 Setback: 9,20 Paved Drive Rqd: Yes Compact: Rearyard Setback: 32,20 % of Lot Coverage: 24.40 \ w requireS yoU .t?t Solar Setbacks: 10.00 ON' Oregon a 0 egon Uti" V AiTEN~ . ~A"nted by t\i8 . . ~ MO c.et 10rth S'~~'f1f(~E:Vot Accepted l!!JBLIC IMPROVEM~~~.~tl~~-cen~~~16\~~;~.~~~OAR 9;~~OsU~~ Sfff~~iiFdY~nuSttlALL EXPIRE IF THE wd"R'K in OAR 95~~~p~:ples 01 t~\~p"'one . I sJd~h\fSQ~f~Qa~\}\g~R THIS PER~Nffl~ot:~ 0090., '(o~\DbW%~heJ' t ~~~~~ ~otlti~t~%~~~b~::t:r s;eGi~irI'hCSN~&..~~R IS ABANDONED FOR ca~~~r tor the.I(j'~~OO_332-2344). ANY 180 DAY PERIOD. nU center \$ 1- Notes: Storm water to curb & gutters Pae:e 1 of 4 .,- Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: cOM2008-00489 ISSUED: 04/10/2008 APPLIED: 04/09/2008 EXPIRES: 10/10/2008 VALUE: $ 120,575.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Dwelline:s Garae:e Tvpe of Construction V Wood Frame Garae:e $ Per Sq Ft or multiplier $105,00 $28,00 Square Footage or Bid Amount 1,031.00 440,00 Value Date Calculated Description Total Value of Project $108,255,00 $12,320,00 $120,575,00 04/0912008 04/0912008 ~ Fee Description Amount Paid Date Paid Receipt Number -Mech Iss 2+ Appliances- $40.00 4/10/08 2200800000000000428 + 10% Administrative Fee $132.46 4/10/08 2200800000000000428 + 12% State Surcharge $150,12 4/10/08 2200800000000000428 + 5% Technology Fee $81.30 4/10/08 2200800000000000428 2 Baths One or Two Family $280,00 4/10/08 2200800000000000428 Addressing Assignment $35,00 4/10/08 2200800000000000428 Appliance Vent $7,00 4/10/08 2200800000000000428 Building Permit $698,02 4/10/08 2200800000000000428 Curbcut Permit $85,00 4/10/08 2200800000000000428 Dryer Vent $7,00 4/10/08 2200800000000000428 Exhaust Hoods $10,00 4/10/08 2200800000000000428 Fire SF Fee - Residential $73,55 4/10/08 2200800000000000428 Furnace - up to 100,000 btu $14,00 4/10/08 2200800000000000428 Gas Outlets 1-4 $5,00 4/10/08 2200800000000000428 Plan Review Major - Planning $205,00 4/10/08 2200800000000000428 Plan Review Same As $220.00 4/10/08 2200800000000000428 Residence Wiring 1000 Sq Ft $117.00 4/10/08 2200800000000000428 Residence Wiring Ea Addtl 500 $21.00 4/10/08 2200800000000000428 Sanitary Sewer - Improvement $469,29 4/10/08 2200800000000000428 Sanitary Sewer - Reimbursement $617,17 4/10/08 2200800000000000428 SDC MWMC Administration $10,00 4/10/08 2200800000000000428 SDC MWMC Improvement $990,39 4/10/08 2200800000000000428 SDC MWMC Reimbursement $95,35 4/10/08 2200800000000000428 SDC Sanitary/Storm Admin $120,70 4/10/08 2200800000000000428 SDC Transpo Improvement $862,25 4/10/08 2200800000000000428 SDC Transpo Reimbursement $195.48 4/10/08 2200800000000000428 SDC Transportation Admin $73.65 4/10/08 2200800000000000428 Sidewalk Permit $85,00 4/10/08 2200800000000000428 Storm Drainage Impervious Area $647,06 4/10/08 2200800000000000428 Storm Sewer Each Addtll00' $16,00 4/10/08 2200800000000000428 Temp Power 200 amps or less $55.00 4/10/08 2200800000000000428 Vent Fan $21.00 4/10/08 2200800000000000428 WiIlamalane Single Family $2,513,00 4/10/08 2200800000000000428 Total Amount Paid $8,952,79 Pae:e 2 of 4 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00489 ISSUED: 0411012008 APPLIED: 04/09/2008 EXPIRES: 10/10/2008 VALUE: $ 120,575.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Planninf!" Review Public Works Review Structural Review 04/09/2008 04/09/2008 04/09/2008 I Plan Reviews, 04/09/2008 APP 04/09/2008 APP 04/09/2008 APP TAJ LKW DLM Storm to curb & gutters 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~nsoections I 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, Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed, Curbcut - Standard: After forms are erected but prior to placement of concrete, Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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, Pa!!e 3 of 4 CITY OF SPRINGFIELD - Status Issued Building/Combination Permit PERMIT NO: COM2008-00489 ISSUED: 04110/2008 APPLIED: 04/09/2008 EXPIRES: 10/10/2008 VALUE: $ 120,575.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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, c--'--~7-/2- ~ /'" r..__ ~ . '- -- Owner or Contractors Signature ;/P/il /0- O~ Date Pa2e 4 of 4 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER NAME OR COMPANY LOCATION TAX LOT NUMBER DEVELOPMENT TYPE NEW DWELLING UNITS 1 STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S F x COST PER S F CHARGE 187000 $0346 = , $64706 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S F I. x 1 COST PER S F I x DISCOUNT RATE o 00 I I $0 346 I 50% ITEM 1 TOTAL - STORM DRAINAGE SDC , $647.06 C0M2008-00489 Hayden Homes 5782 ObSIdIan 1802030008200 Smgle FamIly ReSIdence 1 BUILDING SIZE (SF: 1471 LOT SIZE (SF) 5781 100 ~ ~ o u ~ ~ ,E--< -.00 ...... o ~ $647.06 1070 $617.17 $469.29 x INEW TRIP FACTOR I 100 $195.48 DISCOUNT $000 2 SANITARY SEWER - CITY A REIMBURSEMENT COST NUMBER OF DFU's x 23 B IMPROVEMENT COST I NUMBER OF DFU's I x 1 23 I COST PER DFU $26 83 COST PER DFU $20 40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $1,086.46 3 TRANSPORTATION A REIMBURSEMENT COST I ADT TRIP RATE x I 957 NUMBER OF UNITS x I COST PER TRIP 1 I 2043 B IMPROVEMENT COST I ADT TRIP RATE x NUMBER OF UNITS x I COST PER TRIP I 9 57 1 I $90 10 ITEM 3 TOTAL-TRANSPORTATION SDC = I $1,057.73 4 SANITARY SEWER - MWMC A REIMBURSEMENT COST NUMBER OF FEU's x 1 ICOST PER FEU I $95 35 B IMPROVEMENT COST INUMBER OF FEU's x I 1 ICOST PER FEU 1 $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) = I 5 ADMINISTRATIVE FEE I SUBTOTAL x ADM FEE RATE $3,886 99 5% TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE $1,095.74 x INEWTRIPFACTOR/ I 100 I $862.25 1091 1092 ]093 1094 1054 1055 11054 I ]056 $3,886.99 CHARGE $194.35 = $95.35 I 11079 , 11078 Kaye Wilson 4/9/2008 = $990.39 $0.00 $10.00 12070 $73 65 PREPARED BY DATE TOTAL SDC CHARGES = I $4,081.34 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 2 0 3 = 6 I IDRINKlNG FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 1 0 3 = 3 ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 0 I MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG / WATER STATION / ETC 0 0 1 = 0 I RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK COMMERCIAL BAR 0 0 2 = 0 ISINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 I SINK- SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2 IURINAL, STALL/WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 *EDU (EqUIvalent Dwelling Urnt) IS a dIscharge eqUIvalent to a smgle fanllly dwelhng UI!!~pO DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 ]988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $498 $480 $463 $440 $4 07 $367 $322 $273 $225 $180 $1 59 $145 $125 $109 $092 $072 $048 $028 $009 $005 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 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0 00 x $5 29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0 00 x $5 29 TOTAL MWMC CREDIT = = , 2 2 1979 $000 o $000 SPRINGFIELD ~:1.'l~~ t.c::;AA'''''~'~~:J1q;~~J;J ""'~~ ~ ,'~""~ .~~~}}~~t. "'dl~~ /.1 ~~~l~ {~~t;.~}~~~~~~ ~ 7 ~ i 225 FIFTH STREET D SPRINGFIELD, OR 97477 D PH:(54l!)726-3753 D FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATIbN CIty Job Number COM ZCO 2'- 004lB 7 Date , I ... ~."I,.q ~""'Il'l'iW-.r.r.,'In.t\"j i;{ llfL~sr '\:w"~31+C<i"'v.~r ~1::"~~{,~"""4'1' 1"~4.nj"r'" ....<!r~-,..'T" r~'l"" 1'" -,/ T'f\fJP,,,, \"t' "rA~'-"~"'"' .'J.'\."" 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' ,,,~,t : '~ ,J~I.~.J~Ldj ~~f,;\ J' ~ t.L I~.~ lll~~ ,',"ijjh 1 LEGAL DESCRIPTION: 18020300 1 t I 08200 , . ServIce Included JOB DESCRIPTION. 1000 sq. ft or less I ) Each addItional 500 sq ft or J7t> c...L ~ ~ L-.J I tLt' I portion thereof PermIts are non-transferable and expire if work i~ Each Manufact'd Home or not started WIthin 180 days of issuance or ifwor~is Modular Dwelling ServIce or . _ _ _Suspended.JOl:-180-days-------- _ _____.___L______Fe.e,der---.-- _u'__ -'- I I I ( $117 00 $ 21 00 $55 00 2. " B."' tI" U \0 'Sli.l'~~tlt;"\t', -r ' J J Ii, ri JtAo,U' 'lo\,)\\\\\"f Electncal Contractor ..LJ)flv ~ fV;p ~ 0(\ i\ \O~OO Amps or less -N\\O~" ~~e ~ed 'O'l ~~u\e~ ate ~~Z.oO'\20 1 Amps to 400 Amps Address ;;2.0~ ~\\\~~: . ctlq(OS _'}(\" G>~~e ,U\eS ~1 Amps to 600 Amps \ '\Q~' . (,\:l\ \> () \\ \\,J- - 0' \\, Qt\9 g O~,\f\G'O.\\O'(\ ('\('\"\_00"\, CO?\eS'e"e\e?'ri _",;-:'1i01 Amps to 1000 Amps ~\\iI\\\ _ ^h?-VV ~~. f".__0i~ -CIty --'- e,.,.."...'{:~ ON'" "'~JR~0~~ '-. - uver iOOo-AIDpsIVolts---- oo90, ~ \\;\e Ce\\ OteqO(\ 0 ~ -'li Reconnect Only ca\\\'(\q 40~ \\;\e. ,\-'00013 De~ \ L~~ ' . Supervisor LIcense N~tPer ce~o) L( 5 c. $ 70 00 $ 83 00 $138.00 $180.00 -- -'-$~13~Oo-- $ 55 00 ExprratlOn Date {2n1 /7 '2 ~C?~ ~7 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Am s or 1000 V olts see "B" above $ 55 00 $ 76 00 $110 00 Constr. Contr Number Exprratlon Date . ~I ti ~l~ $ 48 00 $ 400 J!':~"C~ !QI.t~;11~~:lrpf.j,l'it~r~nlt~ ~ "'1l~T:\ ""'Uiir' f'" " f~~Y'~~~~VJl6~o...~ Pump or irrIgation $ 55.00 SIgn/Outline Lighting $ 55 00 Lumted Energy/ResIdenttal $ 28 00 Limited Energy/Commercial ------- $ 50 00 --------. Mimmum Electric Permit Inspection Fee is $50.00 + Surcharges OWNER INSTALLATION --rile mstallation is bemg made on propertY Town-{vlilcf - IS not intended for sale, lease or rent i Owners Signature. 4, - 12% State Surcharge 10% Adrnillistrative Fee 5% Technology Fee /9 ~ ~t)-() , - 2-3.16 / '2..10 '7.'- .) Inspection Request: 726-3769 TOTAL ;2;1<)/ Shared Dnve(T )IBUlldmg FormslElectncal PermIt ApphCallOIl 1-08 doc Job. No. ('~~-a{)1'-~? SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME: .&YVb\/ ~/:"f" PHONE: 7-2..~-(b93~ ADDRESS:24'61SIV t1WIg(CITYft"e7)H~/'A STATE~ZIP:JZ7Sc-' . ;1{, ~ LOCATION OF PROPOSED BUILDING SITE: Street Address: 5 7 ~-2- ~~I J/ A-A_) Plat Name: JAsb&< fJIM1>>ut:r Tax Lot Number: /~L/J'300 ~f:2.C;-t) . , - . 1. DEVE:LOPMENT TYPE (Check appropriate dwelling(s) Dwelling type definitions are on the back. ) A. Sinale-Familv Detached NO. OF UNITS I X $2,513 per unit = $ 25/3 B. Sinale-Familv Attached NO. OF UNITS X $2,726 per unit = $ C, Multi-Familv Aoartment NO. OF UNITS X $2,323 per unit = $ D. Sinale Room Occuoancv NO. OF UNITS X $1,162 per unit = $ E, Accessorv Dwellina Unit NO. OF UNITS X $1,257 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) $ 2b/l I I Development Services Department CitY of Springfield Date 5 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER NAME OR COMPANY LOCATION. TAX LOT NUMBER DEVELOPMENT TYPE NEW DWELLIN:G UNITS 1 STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S F x COST PER S F CHARGE 187000 $0346 = I $64706 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS SF x I COST PER SF x I DISCOUNT RATE I I 0 00 I $0 346 , 50% = I ITEM 1 TOTAL - STORM DRAINAGE SDC / $647.06 COM2008-00489 Hayden Homes 5782 ObSIdIan '1802030008200 Smgle FamIly ResIdence 1 BUILDING SIZE (SF~ [f) ~ Q o U ~ ~ E-< [f) ...... C ~ 1471 LOT SIZE (SF) 5781 DISCOUNT $000 11070 ,I $647.06 2 SANITARY SEWER - CITY A REIMBURSEMENT COST NUMBER OF DFU's I 23 B IMPROVEMENT COST NUMBER OF DFU's I 23 I COST PER DFU $26 83 x $617.17 1091 COST PER DFU $20 40 x , 1092 $469.29 = I ITEM 2 TOTAL - CITY SANITARY SEWER SDC $1,086.46 3 TRANSPORTATION A REIMBURSEMENT COST ADT TRlP RATE x 957 B IMPROVEMENT COST ADT TRlP RATE x 957 x INEW TRlP F ACTORI I 100 NUMBER OF UNITS I x I COST PER TRlP 1 I I 20 43 $195.48 1093 NUMBER OF UNITS I x COST PER TRIP 1 I $9010 x INEW TRIP FACTORI I 100 I $862.25 1094 ITEM 3 TOTAL - TRANSPORTATION SDC =/ $1,057.73 4 SANITARY SEWER- MWMC A REIMBURSEMENT COST INUMBER ~F FEU's I COST PER FEU I $95 35 x = / $95.35 1054 B IMPROVEMENT COST INUMBER OF FEU's I I COST PER FEU $99039 x = $990.39 1055 $0.00 1054 $10.00 1056 I Ii 120 70 11079 $73 65 1078 I ~, $4,081.34 I j 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 I ADM FEE RATE , $3,886 99 I 5% TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE Kaye Wilson 4/9/2008 TOTAL SDC CHARGES PREPARED BY DATE DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 2 0 3 6 IDRlNKlNG FOUNTAIN 0 0 1 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRIG / WATER STATION / ETC 0 0 1 = 0 RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 SHOWER, SINGLE STALL 0 0 2 = 0 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK COMMERCIAL BAR 0 0 2 = 0 SINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2 URINAL, STALL I WALL 0 0 5 = 0 I TOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET: PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 *EDU (Eqwvalent Dwelling Umt) IS a dIscharge eqUIvalent to a smgle famIly dwelling umt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 ]987 1988 1989 1990 1991 1992 1993 1994 1995 ]996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $498 $4 80 $463 $440 $407 $367 $322 $273 $225 $180 $159 $145 $125 $109 $092 $072 $048 $028 $009 $005 IS 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 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0 00 x $5 29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0 00 x $5 29 TOTAL MWMC CREDIT = 2 2 1979 = , $000 o $000 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 COM2008-00489 Payments: Type of Payment CredltCard cRecelOtl RECEIPT #: 2200800000000000428 Date: 04/10/2008 DescriptIOn Plan RevIew Same As Plan RevIew MaJor - PlannIng Curb cut PermIt SIdewalk 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 TransportatIOn AdmIn BUildIng PermIt AddressIng AssIgnment WIIlamalane SIngle FamIly 2 Baths One or Two FamIly Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu Vent Fan Apphance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 -Mech Iss 2+ Apphances- Temp Power 200 amps or less ResIdence Wmng 1000 Sq Ft ResIdence Wmng Ea Addtl 500 FIre SF Fee - ResIdentIal + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstrative Fee Paid By HAYDEN HOMES Item Total: Check Number AuthorizatIOn ReceIved By Batch Number Number How ReceIved NJM 092737 In Person Payment Total: Page 1 of 1 8:33:55AM Amount Due 220 00 205 00 8500 8500 647 06 61717 469 29 195 48 862 25 9535 99039 10 00 120 70 7365 698 02 3500 2,513 00 280 00 1600 1400 2100 7.00 10 00 700 500 4000 5500 117 00 21 00 7355 81 30 150 12 132 46 $8,952,79 Amount PaId $8,952 79 $8,952.79 4/10/2008 Job. No. CiJ>>1~-o01~? SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME: .&YfJb\! &1t1C:-r- PHONE: "'2-2.~ -(09 3~ ADDRESS:24'6f 5'IV Ut4c7!CITY /l?WA)".A;/t-STATE~ zIP:lZ.1'S- ~ ,-'{, LOCATION OF PROPOSED BUILDING SITE: Street Address:. '5 7 ~-2- C~/J'/A-A.-,) Plat Name: JAsj/t!;( >>/M1>>utI Tax Lot Number: J?rJ2/)~otJ ~~ . , . 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back. ) A. Sinale-Familv Detached NO. OF UNITS I X $2,513 per unit = $ 25/:3 B. Sinale-Familv Attached NO. OF UNITS X $2,726 per unit = $ C. Multi-Familv Aoartment NO. OF UNITS_ X $2,323 per unit =' $ D. Sinale Room Occuoancv, NO. OF UNITS X $1,162 per unit = $ E. Accessorv Dwellina Unit NO. OF UNITS X $1,257 per unit = $ WILLAMALANE SDC $ 2. soe CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval.) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED //"-\~----- ---...,,~ (if SDc--?~ced for cre. dit) / ~ ~ -' l ---~-- ( A/ "A' C:lr' /0 {/t:/ () ;;erapry"e'nt ~erVices Department Ity of Springfield L..' $ 2~/l -<I I / (J I ()~ Date 5