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Home My WebLink AboutPermit Building 2008-4-29 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00573 ISSUED: 04/29/2008 APPLIED: 04/24/2008 EXPIRES: 10/29/2008 VALUE: $ 131,740.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5785 PUMICE PL ASSESSOR'S PARCEL NO.: 1802030013300 SPRINGFIETYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: Single Family Residence TYPE OF USE: New Residential 18.00 5.00 5.00 33.90 0.00 f~I;~;';~;~~~~~;~l~~.I~E[~MIT SHALL EXPIRE IF THE WORK Street Improvements: ~otification Center. Those rules are set forthAUTHORffi8&WWlJ5fleTHIS PERMIT IS MOT . In OAR 95~9tJY-fm'D<t~ugh OAR 952-001- CittlJSlde 7' Storm Sewer Available: 0090. You may obtain ~ples of the rules byCOMME~~t\:.~/I~,IM\NPONEDcf.Qij and Gutter Special Instruction: calling the center. (Note' the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Notes: Storm to curb & gutter Center is 1-800-332-2344). Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 I CONTRACTOR INFORMATION. Contractor Type General Electrical Mechanical Plumbing Contractor HA YDEN ENTERPRISES L & E ELECTRIC INC PACIFIC AIR COMFORT INC PLUMBING PLUS INC License 92208 105475 39237 90482 BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R3 U VB # of Stories: 1 Height of Structure 16.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Energy Path: Path 1 Sprinkled Building No 3 I DEVELOPMENT INFORMATION. Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Pae:e 1 of 4 Phone Number: 541-228-6935 Expiration Date 07/29/2009 03/30/2010 03/25/2010 05/10/2009 Phone 541-228-1081 541-933-2653 541-672-9510 541-926-3190 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,148 400 1 Yes 30.90 REQUIRED PARKING Total: 2 Handicapped: Compact: Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00573 ISSUED: 04/29/2008 APPLIED: 04/24/2008 EXPIRES: 10/29/2008 VALUE: $ 131,740.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Dwellines Garaee Tvpe of Construction V Wood Frame Gara!!:e $ Per Sq Ft or multiplier $105.00 $28.00 Square Footage or Bid Amount 1,148.00 400.00 Value Date Calculated Description Total Value of Project $120,540.00 $11,200.00 $131,740.00 04/24/2008 04/24/2008 ~ Fee Description Amount Paid Date Paid Receipt Number ~Mech Iss 2+ Appliances~ $40.00 4/29/08 1200800000000000408 + 10% Administrative Fee $138.88 4/29/08 1200800000000000408 + 12% State Surcharge $157.37 4/29/08 1200800000000000408 + 5% Technology Fee $84.32 4/29/08 1200800000000000408 2 Baths One or Two Family $280.00 4/29/08 1200800000000000408 Addressing Assignment $35.00 4/29/08 1200800000000000408 Appliance Vent $7.00 4/29/08 1200800000000000408 Building Permit $737.40 4/29/08 1200800000000000408 Curbcut Permit $85.00 4/29/08 1200800000000000408 Dryer Vent $7.00 4/29/08 1200800000000000408 Exhaust Hoods $10.00 4/29/08 1200800000000000408 Fire SF Fee - Residential $77.40 4/29/08 1200800000000000408 Furnace - up to 100,000 btu $14.00 4/29/08 1200800000000000408 Gas Outlets 1-4 $5.00 4/29/08 1200800000000000408 Plan Review Major - Planning $205.00 4/29/08 1200800000000000408 Plan Review Same As $220.00 4/29/08 1200800000000000408 Residence Wiring 1000 Sq Ft $117.00 4/29/08 1200800000000000408 Residence Wiring Ea Addtl 500 $42.00 4/29/08 1200800000000000408 Sanitary Sewer - Improvement $469.29 4/29/08 1200800000000000408 Sanitary Sewer - Reimbursement $617.17 4/29/08 1200800000000000408 SDC MWMC Administration $10.00 4/29/08 1200800000000000408 SDC MWMC Improvement $990.39 4/29/08 1200800000000000408 SDC MWMC Reimbursement $95.35 4/29/08 1200800000000000408 SDC Sanitary/Storm Admin $123.63 4/29/08 1200800000000000408 SDC Transpo Improvement $862.25 4/29/08 1200800000000000408 SDC Transpo Reimbursement $195.48 4/29/08 1200800000000000408 SDC Transportation Admin $73.27 4/29/08 1200800000000000408 Sidewalk Permit $85.00 4/29/08 1200800000000000408 Storm Drainage Impervious Area $698.10 4/29/08 1200800000000000408 Storm Sewer Each AddtI 100' $16.00 4/29/08 1200800000000000408 Temp Power 200 amps or less $55.00 4/29/08 1200800000000000408 Vent Fan $21.00 4/29/08 1200800000000000408 Willamalane Single Family $2,513.00 4/29/08 1200800000000000408 Total Amount Paid $9,087.30 Paee 2 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00573 ISSUED: 04/29/2008 APPLIED: 04/24/2008 EXPIRES: 10/29/2008 VALUE: $ 131,740.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review Structural Review 04/24/2008 04/24/2008 I Plan Reviews I 04/24/2008 APP 04/24/2008 APP LKW DLM Storm to curb & gutter Approved as noted on the plans. Plannine: Review 04/24/2008 04/25/2008 APP T AJ Survey required because of minimum side setbacks. 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. ~(((]uiredJnsnections 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. 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. 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Pae:e 3 of 4 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2008-00573 ISSUED: 04/29/2008 APPLIED: 04/24/2008 EXPIRES: 10/29/2008 VALUE: $ 131,740.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. 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. 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. Owner or Contractors Signature Date Pal!e 4 of 4 225 FlFTII STREET. SPRINGFIELD, OR 97477~";1l'(~rl)726-3753 . FA)( (541)726.3689 ELECTRICAL PERMIT APPLICATION CIty Job Number ~f'b - S 7 J New AlfAr7a}tlFtfJf}r ExtensIOn Per Panel One Cl!ftJli:bW rU/~ON: OregO $ 48 00 Each !il@ltii~iJ!.ft~lr1;&Hklm~tf~/aVv reqUires servbDliMF~~dr:!-()trflh'cr. Th Y the ()r~ _ $o1lt~ ""<t 090, ...v - 01-0 ,aseru/ ,,'-"~un Utili 1';\(' U", -I!~t,li;~~i ~r~;''!'1.~l- ....;:~,!lf.'-' E. 'ji,/ .b~l\'i'$.:ttill~ tio~ ..t.!it-'!i:;w'i,rl:1Tft '!!~J!Njl'\:'JC,llD r for the O' ute' th e ru/ . Pump or iITl@~&r 1 regOn Ut;/. e, te/eQbd(.,~PMJ SIgn/Outline Lightm~ 1-800-332_i;~:Otitjca~~ 00 OWNER INST ALbA-TION LImIted EnergyfResIdentlal ). $ 28 00 Yfielnsrnllat(oj':(J~emg made on propertY rownlWJiich-- LimIted Energy/CommerclciC n ------ -. $ 50 00 - ---- -.- IS not irity1{1F&cff~Rf~lF;lease or rent I Mimmum Electric Permit Inspection Fee is $50.00 + Surcharges M JTHO I SHALL EXPIRE I [~];r.' / owners,~I@a~ZED UNDER THIS P IF TH~ WORK 4. Ir\1 Z,!-'f'1N IJJ:V/MfNCED 0 ERMI7iI IS NO ' ftll'" , R IS 4BANDOfr T -12% State Surcharge 2t;; " e, "'V I I C:5U DAY PERIOD. tv HOR 10% Administrative Fee '?...{,!fO 5% Technology Fee 1/)_70 . L 57~S LEGAL DESCRIPTION /g,02 (:),1 ~ /3 3c!J tJ JOB DESCRIPTION. ;). P. ~C;j. ; C~~ PermIts are non-transferable and expire lfwork IS not started within 180 days of Issuance or If worr is _ _ . __ _Suspended_for-.180.days_ --- ---- - ---- - - --- - ElectrIcal Contractor -r;,jJ))~fci1 E"/ec , Address ;;20879 ~I" C~f I I Phone 5*;1-~79'Jg _0 / ---- ---CIty D~?( Exprrabon Date Lf 0:5- 11 5 {2n1 /7 2 ~ tRc:. SuperVIsor LIcense Number Constr Contr Number Exprratlon Date b2e1Jr SIgnal 'Ie of SupervJsmg F:lectncIan ~~ ' r " '-----' I I Owners N~e - iJayqeY\ ./h.-V'" &'5_, Address :24.& Y. 5 c,.y s(&t-Ct'ti fL I . I (j I CIty I?e fA rYlt'l1 of Phone .x; <(- -&q '3 S- InspectIon Request: 726-3769 SPRINGFIELD t.P.5:!""'~~ ~ ,\ _"":.,,, f,\ ~ -J.~~ "~;-r'ri>f!",~r.~~'t ~~(3 l....r:;~l~~ .....:1~~> ~~\<~~;Jt ~"~\(ftA~f{~~.l~~ a ~ r, "'4.;~':-~::r ~:..:u~~~ ~ / ~~ ZON lN1TlALS DATE SOURCE Date hi I' ;I~~T.' \ fl~" ~ J ':-J ! 'J I '1.."'1 I~I~ "~~, +l~i '<'\~"!:"11' ''I I" ~'! 1 't;17!l~rl'':..J.~~C' 'l.~f"" ~f" '<:'41;'1 'l'':'lfl}J ?~ ..,..,~ll il'1;;"i\l'") ,- 17,!," 3 ~;k C'D1l1FEErElFP~! '$ CiIED miE 1JlfJ.j'(f) T4z:~;,~t~!i\ g~r?~;~~~~,1 i'~li'; f~t'l~>~{i!~~i;: ! I \~ '-,l-. ~ ~~_-. l.:,~' ~ ,~,lIirt'~i, l"l-~l,~"'\~ .r;,')>..., ~,~r \,I>jrr.t::/' .~l\.:'.i~~J.I(.';:'+..-i,~\,~",).!..'~,'~ ~tl~,H:'~I l"~; ~t~.,~,~';:,~ :1 ~ "l 1, ~,W{gltTI~:llt...\\j~,~,~-'tC<I:i'f~i~1~~~~'>:'j~"1 ~lI~tl:~HlliJ~""'-1:r~\ ;t.t"lj~')J~'i'~~-;;' ~~~;.'i;;~I"} ;1"rm Ifrp;~roo/~~fF I ~> "lfj,: A. f"l~rrw"J{esio'eil dftt\~"S)llgJeio'r,'$1:ufl'i;F~l'm)i~';'Re~ :dwelliii'gtJ . jl~h' ~".Ill~ 'G~ ~,~ ttll\l II! t" ;;-'1 L ,i):'~;&.. ,~' ,.,!. if.. '_ 1.."~ M i .> :J,,,-.1 , l~, ~'l' ~'\l..tl ,_, l;......" ~t d 1" ~ ,~};'].\d~ t-~!'~:.:.>-.' 1l1...J, l;.~ 1\ L~II:- Service Included 1000 sq ft or less Each addItIOnal 500 sq ft or portIon thereof Each Manufact'd Home or Modular Dwellmg ServIce or _ ___Fe_eder ______~_ ____.____ / Z $11700 /17,01> $ 21 00 ~2... .. $55.00 - - '"",'.", ""'"'-''''1' <e.' ""{,, ,," t \>t~..1Ni'i111 'I,~lr ~,,}, t11' \\1,rr~~,~J:ll 'h'~:~ln B. \~SrelWi~&)io'FjF:ee'oe ~j~1&~\ II~h' 't.~:'22':: .~~ 1111 /~r ~/~~;ll ~.......-!tufl1!~ '1.'''~":\'' z..~~''''''I!';'''-''''rll-'I:J'''''1 I!~ll" "II 'II I".... m' "'nil~ r.ml I,,' "!r I .T!J1J~{t'ltl,'n'" ti'~~w.:'~lh~./IIPlt!,'1 \7~{. ,l'lIS ,~, a o,n,\:, " er,a. l!.1!,rlll~) Jl~!;.,.1:''':.:.U",:'J~~:b.:iL. ~~t~~Ji'l' 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over TOOO-ArripsNo!ls Reconnect Only $ 70 00 $ 83 00 $13800 $180 00 ---$"413-00 $ 55 00 c Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 V olts see "B" above J ,~\'hl UfjrA ,II~.' $ 55 00 $ 76 00 $110 00 ~ / TOTAL m "" Shared Dnve(T )/BUlldmg FonnsfElectncal Pennlt Application 1-08 do~ Job. No. ('.tJlttMrJ~ -~() 573 SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME: ' l:7r PHONE: , . v ADDRESS:zM 5W4"kt>( CITY R'~J STATE:~ZIP:~7 "'-'S6 LOCATION OF PROPOSED BUILDING SITE: Street Address: ~ 1 ~ ,<, "Pt4 M / CC ~I, Plat Name: J Jt-~O( /11t!:tf1iJk!.r Tax Lot Number: / gtJ 2L.?3 (;)0 I nerO 1. DEVELOPMENT TYPE (Check appropnate dwelling(s). Dwelling type definitions are on the back. ) A. Sincle-Familv Detached NO. OF UNITS / X $2,513 per unit = $ 2-r;(j B. Sincle-Familv Attached NO. OF UNITS X $2,726 per unit = $ C. Mu/ti-Familv Acartment NO. OF UNITS X $2,323 per unit = $ D. Sincle Room Occucancv NO. OF UNITS X $1,162 per unit = $ E. Accessorv Dwellinc Unit NO. OF UNITS X $1,257 per unit = $ WllLAMALANE sec $ 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval.) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED ~\K\S~\C~;;;U De~elOpment ~ervice\D8partment City of Springfield $ 25/;] L\: I Jf1 () fJ Date 5 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER NAME OR COMPANY LOCATION TAX LOT NUMBER DEVELOPMENT TYPE NEW DWELLING UNITS I STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S F x COST PER S F CHARGE 201750 $0346, = I $69810 , RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S F x COST PER S F x I DISCOUNT RATE I I o 00 $0.346 I 50% I = I ITEM 1 TOTAL - STORM DRAINAGE SDC '$698.10 I COM2008-00573 Hayden Homes 5785 Pumice o SmgIe Family Residence I BUILDING SIZE (SF 1548 2 SANITARY SEWER - CITY A REIMBURSEMENT COST I NUMBER OF DFU's x 1 23 B IMPROVEMENT COST NUMBER OF DFU's I x 23 I r COST PER DFU I $26 83 COST PER DFU $20 40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $1,086.46 3 TRANSPORTATION A REIMBURSEMENT COST I ADTTRIPRATE x I 957 I NUMBER OF UNITS x I I I I COST PER TRIP 2043 B IMPROVEMENT COST r ADT TRIP RATE x I NUMBER OF UNITS x I COST PER TRIP I 9 57 I I I $90 10 ITEM 3 TOTAL - TRANSPORTATION SDC = , $1,057.73 4 SANITARY SEWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's I x I I I LOT SIZE (SF) DISCOUNT $000 x I NEW TRIP FACTOR I 100 x INEW TRIP FACTOR I 100 5000 $698.10 $617.17 $469.29 $195.48 $862.25 I~ ~ o u ~ ~ r/) ...... c.:; ~ , 1070 1091 1092 i 11093 1094 I COST PER FEU I $95 35 B IMPROVEMENT COST. NUMBER OF FEU's x I 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 I ADM FEE RATE CHARGE I $3,93803 I 5% $19690 TOTAL SANITARY ADMINISTRATION FEE. $1,095.74 $3,938.03 = $95.35 1054 I = $990.39 11055 $0.00 11054 $10.00 I 1056 TOTAL TRANSPORTATION ADMINISTRATION FEE 123 63 $73 27 Kaye Wilson 4/24/2008 1079 11078 PREPARED BY DATE TOTAL SDC CHARGES $4,134.93 - --- -" DRAINAGE FIXTURE UNIT (DJFU) CALCULATION TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT = DRAINAGE FIXTIJRE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTIJRES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUNALENT UNITS BATHTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC 0 0 1 = 0 RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 I SINK COMMERCIAL BAR 0 0 2 = 0 ISINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 ISINK SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2 IURINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 MlSCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 *EDU (EQUIvalent Dwellmg Urnt) IS a discharge eqUIvalent to a smgle famIly dwe1hng urnt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $4 98 $4 80 $463 $440 $407 $367 $322 $273 $225 $180 $159 $145 $125 $109 $092 $072 $048 $028 $009 $005 IS LAND ELGIBLE FOR ANNEXATION CREDIT7 (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX CREDIT7 (Enter I for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATE $0 00 x $5 29 = , $000 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0 00 x $5 29 o TOTAL MWMC CREDIT $000 = 225 Fifth Street o Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 COM2008-00573 Payments: Type of Payment Cred ItCard cRecelOtl RECEIPT #: 1200800000000000408 Date: 04/29/2008 DescriptIOn Storm Drainage ImpervIOus Area Samtary Sewer - ReImbursement Samtary Sewer - Improvement SDC Transpo ReImbursement SDC Transpo Improvement SDC MWMC ReImbursement SDC MWMC Improvement SDC MWMC AdminIstratIon SDC Samtary/Storm Admin SDC TransportatIOn Admin Curbcut Permit Sidewalk Permit Plan ReView Same As BUIlding PermIt AddreSSing ASSignment WIllamalane Single FamIly 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 Fire SF Fee - ResIdentIal Plan ReVIew Major - Planning + 5% Technology Fee + 12% State Surcharge + 10% AdminIstrative Fee Paid By HA YDEN HOMES - TIM D Item Total: Check Number AuthorizatIOn ReceIVed By Batch Number Number How ReceIved llh 026877 In Person Payment Total: Page 1 of 1 8:17:27AM Amount Due 698 10 61717 469 29 195 48 862 25 9535 990 39 10 00 123 63 7327 8500 8500 220 00 73740 3500 2,51300 280 00 1600 1400 2100 700 10 00 700 500 4000 11700 4200 5500 77 40 205 00 8432 157 37 13888 $9,087.30 Amount Paid $9,08730 $9,087.30 4/29/2008