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Home My WebLink AboutPermit Building 2008-5-9 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00636 ISSUED: 05/09/2008 APPLIED: 05/07/2008 EXPIRES: 11/09/2008 VALUE: $ 119,455.00 Status Issued 225 Fifth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Lme SITE ADDRESS' 5798 PUMICE PL ASSESSOR'S PARCEL NO 1802033208800 SPRINGFIETYPE OF WORK Smgle FamIly Residence TYPE OF USE New REQUIRED PARKING Overlay Dlst. Total. 2 # Street Trees Rqd 3 Handicapped Paved Dnve Rqd Yes Compact % of Lot Coverage 02{16QJ requires you to ATTfNTION Orqg 1 1<:1. 'he Oregon utIlity I ,,- ,~"I",,~ adoptl?d by t. \~" orA c:;et forth I PUBLIC IMPRO~EN\FS\cetg~~~\~~;;~9h-OAR 95~-OO~y ~i,Q~IkE:..ovements. In j-\r\ vv- OOY-SUf~HP~les of th,e r~~~e '1<) PER'MIT SHALL EXPIRE IF 1l1f~'\'W)PtIf(lved 0090 YO~~~ep.ter (NotJllrre te ~Ihcatlon CurbSIde 5' Storm,~z_~rt)'mm!~ THIS PERMIT IS NOT Yes ca~~~r for th~e1f~~U~~3~~)' Curb and Gutter SpecIal n\~F.~5tIaYi 'S ABANDONED FOR nu Center \s 1-800-33 Notes' St'o'~.it;i&rt~be directed to weep hole III curb PROJECT DESCRIPTION' Smgle famIly reSIdence SAME AS COM2008-00490 1533 S 57th Owner HA YDEN ENTERPRISES Address 2622 SW GLACIER PL #110 REDMOND OR 97756 I CONTRACTOR INFORMATION I Contractor Type General Electncal Mechamcal Plumbmg Contractor HA YDEN ENTERPRISES TOP NOTCH ELECTRIC INC PACIFIC AIR COMFORT INC PLUMBING PLUS INC License 92208 172366 39237 90482 BUILDING INFORMATION' # of Vmts Pnmary Occupancy Group Secondary Occupancy Group' Pnmary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms' 1 R-3 U VB # of Stones 1 HeIght of Structure 1600 Type of Heat Forced AIr Gas Water Type. Gas Range Type Energy Path. Path 1 Spnnkled BuIldmg n/a 3 I DEVELOPMENT INFORMATION I Frontyard Setback Side 1 Setback Side 2 Setback. Rearyard Setback Solar Setbacks 18.00 1290 900 24.00 10 00 Pal!:e 1 of 4 ReSIdential Phone Number 541-228-6935 Expiration Date 07/2912009 09/2812008 03/25/2010 05/10/2009 Phone 541-228-1081 541-317-1998 541-672-9510 541-926-3190 Lot S,ze Sq Ft 1st Floor. Sq Ft 2nd Floor' Sq Ft Basement Sq Ft Garage/Carport Sq Ft Other. Occupant Load 1,031 400 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00636 ISSUED: 05/09/2008 APPLIED: 05/07/2008 EXPIRES: 11/0912008 VALUE: $ 119,455.00 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541- 726-3769 Inspection Lme I Valuation Descriotion , Dwelhnl!s Garal!e Tvpe of Construction V Wood Frame Garal!e $ Per Sq Ft or multIpher $10500 $28.00 Square Footage or BId Amount 1,031.00 400.00 Value Date Calculated DeSCription Total Value of ProJect $108,25500 $11,200 00 $119,45500 05/0712008 05/07/2008 ~ Fee DeSCriptIOn Amount Paid Date PaId ReceIpt Number -Mech Iss 2+ Apphances- $40 00 5/9/08 2200800000000000635 + 10% AdmmlstratIve Fee $131.90 5/9/08 2200800000000000635 + 12% State Surcharge $149 69 5/9/08 2200800000000000635 + 5% Technology Fee $79 62 5/9/08 2200800000000000635 2 Baths One or Two FamIly $280 00 5/9/08 2200800000000000635 Addressmg ASSIgnment $3500 5/9/08 2200800000000000635 Apphance Vent $700 5/9/08 2200800000000000635 BUlldmg Permit $694 44 5/9/08 2200800000000000635 Curbcut Permit $85.00 5/9/08 2200800000000000635 Dryer Vent $700 5/9/08 2200800000000000635 Exhaust Hoods $1000 5/9/08 2200800000000000635 Fire SF Fee - ReSidential $71 55 5/9/08 2200800000000000635 Furnace - up to 100,000 btu $14.00 5/9/08 2200800000000000635 Gas Outlets 1-4 $500 5/9/08 2200800000000000635 Plan ReView Major - Planmng $205 00 5/9/08 2200800000000000635 Plan ReView Same As $220.00 5/9/08 2200800000000000635 PW DISC - 2nd PermIt $-30 00 5/9/08 2200800000000000635 ReSIdence WIrIng 1000 Sq Ft $11700 5/9/08 2200800000000000635 ReSidence WIrIng Ea Addtl 500 $21 00 5/9/08 2200800000000000635 Samtary Sewer - Improvement $469 29 5/9/08 2200800000000000635 Samtary Sewer - Reimbursement $61717 5/9/08 2200800000000000635 SDC MWMC AdmmlstratIon $10.00 5/9/08 2200800000000000635 SDC MWMC Improvement $990.39 5/9/08 2200800000000000635 SDC MWMC ReImbursement $95 35 5/9/08 2200800000000000635 SDC Samtary/Storm Admm $12037 5/9/08 2200800000000000635 SDC Transpo Improvement $862 25 5/9/08 2200800000000000635 SDC Transpo Reimbursement $195.48 5/9/08 2200800000000000635 SDC TransportatIOn Admm $73 69 5/9/08 2200800000000000635 Sidewalk PermIt $85 00 5/9/08 2200800000000000635 Storm Dramage ImpervIOUs Area $641 18 5/9/08 2200800000000000635 Storm Sewer Each Addtll00' $1600 5/9/08 2200800000000000635 Temp Power 200 amps or less $55 00 5/9/08 2200800000000000635 Vent Fan $21 00 5/9/08 2200800000000000635 WIllamalane Smgle FamIly $2,513 00 5/9/08 2200800000000000635 Pal!e 2 of 4 Status Issued CITY OF SPRINGFIELD I Building/Combination Permit PERMIT NO: COM2008-00636 ISSUED: 05/09/2008 APPLIED: 05/07/2008 EXPIRES: 11/09/2008 VALUE: $ 119,455.00 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon Lme Total Amount PaId $8,908.37 I Plan Reviews I Plannm!! RevIew PublIc Works RevIew Structural RevIew 05/0712008 05/07/2008 05/0712008 05/07/2008 05/07/2008 05/07/2008 APP APP APP TAJ BRC DLM SDC Worksheet Attached 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. ~eouirecUnsnections I EroslOn/Gradmg InspectIon Pnor to ground dIsturbance and after erosIOn measures are mstalled SIdewalk - CurbsIde 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 footmg and call for mspectIon m conjunctIon wIth footmg and/or foundatIon mspectlOn Footmg After trenches are excavated FoundatIOn After forms are erected but pnor to concrete placement Post and Beam Pnor to floor msulatIOn or deckmg, Floor InsulatIOn. Pnor to deckmg Shear Wall Nadmg Before covermg sheathmg wIth fimsh matenals Frammg InspectIon Pnor to cover and after all rough m mspectlOns have been approved Wall InsulatIOn Pnor to cover Cedmg InsulatIon PrIor to cover Drywall PrIor to tapmg Fmal Buddmg After all reqUIred mspectIons have been requested and approved and the buddmg IS complete Hold Downs Installed SpecIal InspectIon performed pnor to placement of concrete ProvIde report to CIty BUlldmg Inspector Underfloor Plumbmg. Pnor to msulatIon or deckmg Underfloor Dram PrIor to cover or placement of concrete. Rough Plumbmg. Pnor to cover and mcludmg reqUIred testmg. Water Lme Pnor to fillIng trench and mcludmg reqUIred testmg Samtary Sewer Lme Pnor to fillIng trench and mcludmg reqUIred testmg Storm Sewer Lme. Pnor to fillIng trench Pa!!e 3 of 4 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2008-00636 ISSUED: 05/09/2008 APPLIED: 05/07/2008 EXPIRES: 11/09/2008 VALUE: $ 119,455.00 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Lme Fmal Plumbmg When all plumbmg work IS complete Underfloor Mechamcal Pnor to msulatlOn or deckmg and mcludmg reqUired testmg. Underfloor Gas After line IS mstalled and required testmg and capped If not attached to an appliance Rough Gas After line IS mstalled and reqUired testmg and capped If not attached to an appliance Gas Service After line IS mstalled and line has been connected to a mmlmum of one appliance mcludmg reqUired testmg Presure test done at this pomt. Rough Mechamcal Pnor to Cover Fmal Gas' When all gas work IS complete. Fmal Mechanical When all mechamcal work IS complete. Temporary Electnc Approval reqUired pnor to Utility Company energlzmg pole Rough Electnc Pnor to Cover Electnc Service. Approval reqUired pnor to utility company energIZIng service Fmal Electnc When all electncal work IS complete. By signature, I state and agree, that I have carefully exammed the completed application and do hereby certify that all mformatIon hereon IS true and correct, and I further certify that any and all work performed shall be done m accordance with the Ordmances of the City of Sprmgfield and the Laws of the State of Oregon pertammg to the work descnbed herem, and that NO OCCUPANCY Will be made of any structure without permission of the Commumty Services DIvIsion, BuIldmg Safety I further certify that only contractors and employees who are ID compliance with ORS 701 005 wIll be used on this project I further agree to ensure that all required mspectIons 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 remam on the site at all times dunng construction \ - ~. a~, Owner or Contractors Signature gS-7-o{. Date Pae:e 4 of 4 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER COM2008-00636 NAME OR COMPANY Hayden Homes LOCATION 5798 Pumice TAX LOT NUMBER 18-02-03-3208800 DEVELOPMENT TYPE Smgle Family Residence NEW DWELLING UNITS I BUILDING SIZE (SF 1853 LOT SIZE (SF) I STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS SF x I COST PER S F CHARGE 185300 I $0346 ::: I $641 18 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S F x I COST PER S F x I DISCOUNT RATE I o 00 I $0 346 I 50% ~ I ITEM 1 TOTAL - STORM DRAINAGE SDC '$64118 2 SANITARY SEWER - CITY A REIMBURSEMENT COST NUMBER OF DFU's I x 23 I B IMPROVEMENT COST I NUMBER OF DFU's x / 23 $469 29 1092 '/ I $195 48 11093 $862 25 1094 5182 DISCOUNT $000 $641 18 COST PER DFU $26 83 $61717 COST PER DFU $20 40 ~, ITEM 2 TOTAL - CITY SAN IT ARY SEWER SDC 3 TRANSPORTATION A REIMBURSEMENT COST I ADTTRIPRATE x I 957 B IMPROVEMENT COST I ADT TRIP RATE x I 957 $1,086 46 NUMBER OF UNITS I x I I I I COST PER TRIP 2043 I x NEWTRIPFACTOR I 100 I NUMBER OF UNITS' x I I ~, COST PER TRIP $90 IO $1,057 73 x NEW TRIP FACTOR 100 ITEM 3 TOTAL - TRANSPORTATION SDC 4 SANITARY SEWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's I x COST PER FEU I I I $95 35 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC B IMPROVEMENT COST NUMBER OF FEU's x I ::: $95 35 ICOST PER FEU I $990 39 ::: $990 39 $000 $10 00 ~ , = , $1,095 74 SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) 5 ADMINISTRATIVE FEE I SUBTOTAL x ADM FEE RATE I $3,881 I I 5% TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE $3,881 11 CHARGE $194 06 12037 $73 69 Billy CurtiSS TOTAL SDC CHARGES PREPARED BY 5/7/2008 = I $4,07517 DATE r/) ~ Ci o u ~ ~ t-< r/) >-< o ~ 1070 1091 1054 11055 1054 /1056 i 1079 I 11078 I DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXllJRES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXllJRES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBA THTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 1 0 3 = 3 ICLOTHESWASHER- 3 OR MORE (EA) 0 0 6 = 0 I MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 IRECEPTORFORREFRIG/WATER STATION /ETC 0 0 1 = 0 IRECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 I SINK COMMERCIAL BAR 0 0 2 = 0 I SINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 *EDU (EqUIvalent Dwelhng Umt) IS a dIscharge eqUIvalent to a smgle famIly dwellmg UnIt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE. BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$I,OOO ANNEXED ASSESSED V ALOE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2 BEFORE 1979 $529 (Enter 1 for Yes, 2 for No) 1979 $529 IS IMPROVEMENT ELGlBLE FOR ANNEX CREDIT7 2 1980 $519 (Enter 1 for Yes, 2 for No) 1981 $512 BASE YEAR 1979 1982 $4 98 1983 $480 CREDIT FOR LAND (IF APPLICABLE) 1984 $463 V ALOE 11000 CREDIT RATE 1985 $440 $000 x $529 = I $000 1986 $4 07 1987 $367 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $322 V ALOE / 1000 CREDIT RATE 1989 $273 $000 x $529 = I 0 1990 $225 1991 $180 1992 $1 59 TOTAL MWMC CREDIT = $000 1993 $145 1994 $125 1995 $109 1996 $092 1997 $072 1998 $048 1999 $028 2000 $009 2001 $005 Date ZON IN1TlALS N ~ , DATE 5::l2.'06 SOURer: ~/ S}t1)O't( SPRINGFIELD O~"."- L~ ~ f. ~~"';>-~ ~ d~~ .."'~~'l,.,... ~'f p"1.fi !~~~\ ~ "''''.,../~~J''.-1.:r'''~ :L 'n~'l> ~ ~,""~ ;l.l{l~~:~;~ YjIJ'J1 't\t 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FA,X (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number C C>rlA t.>> 0 8'- DO b-:J b rr;J:ESCRJJ>TION 1000 sq ft orless I Each addltJOnal 500 sq ft or A> f::' c."" I fl..e r ~ f' pomon thereof Permlts are non-transferabl{and explre lfwork IS Each Manufact'd Home or not started wlthm 180 days of lssuance or If work IS Modular Dwelhng Servlce or _ _ __Suspended-for.:-180-days------------------ - -- - __Feeder________ 1 ....<.~,.fl<ll-t'J 'T'~1:..;.'j n~<"h. ..q l~mtD~'FI I Ii ~.z; )nll,f.. ~ll<.h.'lf .1-1 1'~t.l1 S7C;B LEGAL DESCRIPTION /80z.0112- c:>j? F"O c:> :;1~: 1~ ;}l{ 2 l./1Im~II~~lr..::l,~.(~ r~ , QN'eJV;,uJfi~ll (",I' ~I,.~~~{j.tl~:: t ~ ~1 Electncal Contractor -r;"f?)J~1v0 2:/ec 200 Amps or less $ 70 00 /1 AT~t:~I~ ~~otWrPP8,^, renIJ1re-s--.ysl:.! t~ $ 83 00 Address ;;logiC; ~ (t- fo4,Q,l,A1nps t9.&P~lAw~j the ulegon UTJ:Jty $13800 ( Notll:WMnpsct6t1bOO A!mp'S8 rules are set forth$180 00 Phone 5o/1--3n79<j3---1A~~~r:} 00W~N5lt~t-t-OA~ ~~~.uU-+--$4 n-ou OO~<;::ro.w.tt1~ Qpcatn copies of th~ I ul~:> L~ fuS5 00 callJl1gthe cerner N~ \1~rWl~~nw\ 1 I I'll nu \~ t,'~I']M4h\t1 :r" \, "J \ C l"1\{11'lO ~1)\~'l~lt~ltJI1JI"'jllIJ I t ~J~(t.:'~~1!!\l\~'t~I~~lti~~ C'-'{l\:o ,,~ r'r" Not\1\CaMn v "\ (, --n)'..wh O~, \ 0 bY InKt~~l\ip?J;i:i\Jt~tatlgq oi\~~~s~trnfdhe rules m ' ayOJt8'\\C~, pj phone 20(bOOBJls~\i~cen',er l}-lDle ~he ~l~a~~A-OO .;:;.~ ~ 201 ~W:bt~r 18P~~(egon Uti ~~i3~4), $ 76 00 401 JillWs to~@(j.~ 1_800-332 $110 00 CIty J:J f/yJT/ ExplfatJOn Date LfoY'/ 5 an"! /7 2 ~~~ {2~i SupervIsor Llcense Number Constr Contr Number Explfatlon Date Slgna1 re of SupervjJsmg; plectnclan ~ ,-- h' , I.. "1 III "! 1 I\.t.f-h {l~~n>t I '~.I'~ .:1; ~1;i'...t.(~....1r;,\....\ '-'J" 1'" ~1.1J ~{..\l)"l~ -,lt1r 'tt"~l I J \.\ 3 ~ CO.MRLET,E:FEE;SCEIEDtriJE- BELO}W, \ ,"~ /' ,~ '~':I -,,; ,~:' ' I; ~ '-- (! '< I Ii! I I A f i ~,~ J II': .. I-ill\. 1 u j ,\....l."" J. .: I ,,1 f 'l- I ~ l._.... ~, .:...i' ~ ... ~ I ! f '~<".$~rEl :~\~JIJ\ljrl~J~~'Uf.~'lP;l~"lCl~\,..f;-qt~J\ rif""r.ll~ ~~"'I)'t""d'('0hl;;t,,:."\i"~ (1)\1 '";.t ly....<.t1."~1...~r.:1 f71 ~~'-i~f.::' I~w \Y ~ A I "ijg\XtI~:f,sioent1ntL!i;-S)ngle,di-~MultIL'Fam)ly I'hi+'dwelling UDlt'" \~Y\1 M. l.lt t J {l"l....~ll dl.......; t.IJ1u...lr .ir_ 1. '...~h I ( J 1\ I N~ .I. II -. Iffl I .....n...L <J._ t. _dl Jlr <. \"' 1 Servlce Included / / $11700 LlJ,#O $ 2100 Z/. tttJ $55 00 ". 1'" ,'"" I "rt ~Ltl~ r!i~l ~ ,\I 1 jllirf1lf!~ ~i }u,~ B ~,I Den,lces or;' ~ r~\lllt ..:d\n...;-;..ft~...:......rI~1.~-lIUt.t~t~WJ ~r~\rl~~~ ~ & ,;\~X;)1 ~j~r~";~;Q1~~~t~KI~~;~;I~ ~ nsmllatlOu eran r~RelocatlOn'>\r\;l, -!!WL"'I/..tl1 j~:" ~~~ i-tl..,_ J...~bJ!~..:.ftl~"I ~ 1 I' 11\;U "'~'UiL ~'tJ( \I.l.. I. ~\.~'-L.~I~rl h. :~\ ,tIft-ill ;1 t il l Vr1 (H 1 J Ii ~ ,1\ rll'~~l 1~1 \t'\ i\l\ l~~ \ l~l\l ~ m\.jlJfo.~li.L kl.!J~.t.:l~ It I \ i jl Ne\y MWri!tJ01t9r{l]f~nH~t€P~~~fT IS NOT One CrrCUL'1(rrj 0R 12 f\8ANDOI\IFfl r-OR $ 48 00 Each AddItJO;nal t:lTowt jl3r wlth Servlce or Feeder Pe~t $ 400 OwnersN~e j U-atj L RlC ~rdJ Address ';2 (J67 '7 c?~ c + Clty 13~ Phone .)"4 ( '/tlg ~77 E ~~r21 ~J1Inlee't'II~r;~1\1~lS lfl~l!ll'~11 fl1~ } ~~ 9fl"...l:jl;'d\~~I~I~\I\ \1 ~~IJU: lJ~J 1)iU;I; d~ (1 ~~hbt:~/~ \ 1~ lUll !I~! ~~l ~,~ J~ I , l' ~~s.c~) <t'iif ~ehh!ieh ec ~lN.wti'mcl'ude JJe--:-'1'ach~T:o.stllll~tlonl i-lJPiilt..lrU\llh lIL"Jdl..r/h1i u.l1n m1ilf;lil{~ll!Jllt(iit~{fft41i.0:I;;~r~.i}<'iIlu.l\1!I~~rlItl" k, ~(J/JQll~MJ ,,"ili:~i1W~n..!l;u...~~,..1!!: Pump or llTIgahon $ 55 00 Slgn/Out1me Llghtmg $ 55 00 Lillllted Energy/Resldentml $ 28 00 LUl11ted-Energy/Commerclal- - -- ------ :$ 50 00 ------ - - MlDlmum Electnc PermIt InspectIon Fee IS $50 00 + Surcharges 4 If tli~: ~;;;:~~ lri :lll \/r~~i::~ [I F"tll~~'!r'~J/ II fa..) IJ<) r l\tl1INlltjl}~I\lUU!J1 -/, · -12% State Surcharge 2 "J.I~ 1 0% AdrrumstratJVe Fee / '1. ~ 5% Technology Fee 9,t;f' r '2.4-6: H Shared Dnve(T )/BUlJdmg forms!Eleclncal Permit ApplicatIOn ]--08 doc OWNER INSTALLATION -The mstallatJOn lS bemg made onproperfY I -own whIch lS not mtended for sale, lease or rent Owners Slgnature ----- InspectIon Request 726-3769 TOTAL 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone CIty of Sprmgfield Official Receipt Development ServIces Department Public Works Department Job/Journal Number COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 COM2008-00636 Payments Type of Payment CredItCard cRecelOtl RECEIPT #: 2200800000000000635 Date: 05/09/2008 DescrIptIOn Plan ReVIew Same As SIdewalk PermIt Curb cut PermIt PW DISC - 2nd 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 AddtI 100' Furnace - up to 100,000 btu Vent Fan ApplIance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 -Mech Iss 2+ ApplIances- Residence Wifing 1000 Sq Ft Residence Wifing Ea Addtl 500 Temp Power 200 amps or less Plan ReVieW Major - PlannIng Fire SF Fee - ResIdentIal + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstrative Fee Paid By BRETT WILSON Item Total Check Number AuthOrIzation Received By Batch Number Number How Received nJm 05141c In Person Payment Total Page 1 of 1 9 23 55AM Amount Due 220 00 8500 8500 (30 00) 641 18 61717 46929 195 48 862 25 9535 99039 10 00 12037 7369 694 44 3500 2,51300 280 00 1600 1400 21 00 700 10 00 700 500 4000 11 7 00 2100 5500 205 00 7] 55 7962 ]4969 131 90 $8,908 37 Amount Paid $8,90837 $8,90837 5/9/2008 Willamalane Park & RecreatIon Dlstnct Job No ~ ~~ -19CJ~;r ~ SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME /f*'(/'OtJ J2p~//~/S-~ PHONE 7 " ~ -/~~:?) ADDRESS u'i4 ,J/Ut.t"~~,CITY~ STATE~ZIP ~7.(2? LOCATION OF PROPOSED BUILDING SITE Street Address S7?~ tJu JHIC!..C /(, , Plat Name -'....JA{'/1d< fi1L~1J Tax Lot Number / kJZt>~ ~2.... -~~O 1. DEVELOPMENT TYPE (Check appropriate dwelllng(s) Dwelling type definitions are on the back ) A Smale-Famllv Detached NO OF UNITS / B Smale-Famllv Attached NO OF UNITS C Multl-Famllv Aoartment NO OF UNITS D Smale Room Occuoancv NO OF UNITS -' /. E Accessorv Dwelhna Unit NO OF UNITS WILLAMALANE SDC X $2,513 per Unit = $ ZDJ3.~ X $2,726 per Unit = $ X $2,323 per unrt = $ X $1,162 per Unit = $ X $1,257 per Unit = $ $ 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) Development Services Department City of Springfield $ 2'f) I 3 , l!t::;:J I I Date 5