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Home My WebLink AboutPermit Building 2005-4-20 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00320 ISSUED: 04/20/2005 APPLIED: 03/21/2005 EXPIRES: 10/20/2005 VALUE: $ 41,472.00 SITE ADDRESS: 1146 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1703234403300 . Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Room addition Owner: MEYERS RONALD B JR & GERI K Address: 1146 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 Contractor Type General Electrical Mechanical Contractor License OWNER ...... requITeS you to OWNER ATTENTION: Oregon ,a.. on Utility OWNER follOW ~es ~~?~~~~~~ set forth "'uu"....~r..' ~ 0.. ~b1iff-uU ,- In OAR "lWffilPDmlllll ~ V.J!I WoW. as by 0090. You may c.."" . ......phone ...A!I' thett:sfltl!llr~the~ I R-~ for~Qli8tt6li1itl NotiflCClll~90 . "'6nM'f&~t332-2344)ueat Pump VN -Water Type: Range Type: Energy Path: Sprinkled Building: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bcdrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Overlay Dist: 22.00 # Street Trees Rqd: 32.00 Paved Drive.Rqd: "K ~\01ICE' ~- ,0 -rql"\i,un " q.qy 5\1I\LL E).."(o\otucit Coverage: 1 1\1.'~ ~!'~f~ \ INOER 1\1\5 p~~~~\~tll~U COMMENCED 01,piLBiic"iMPROVEMENTS I I\N'< 180 01\'< Pt",-_. Fullv Improved Yes Phone Number: 541 747-0429 I CONTRACTOR INFORMATION I Expiration Date Phone Path 1 nla Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 432 I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: . Urban Fringe Sidewalk Type: DownspoutslDrains: Curbside 5' Curb and Gutter Notes: Strom drainage to existing piped to curb face on Debra 3/24/2005 CAS Paee 1 of3 _~G?I!I:~!;I!I!-I?; , . , ' , - . .....-.:;-. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Description Tvpe of Construction Dwellin!!s V Wood Frame Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Building Permit Minimum/Adjustment Electrical Miscellaneous Mechanical Plan Review Minor - Planning SDC Sanitary/Storm Admin Storm Drainage Impervious Area Plan ReviewlResidential Hourly Total Amount Paid Initial Review Plannin!! Review Public Works Review Structural Review . 03/2212005 03/23/2005 03/23/2005 03/23/2005 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00320 ISSUED: 04/20/2005 APPLIED: 03/21/2005 EXPIRES: 10/20/2005 VALUE: $ 41,472.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $96.00 Square Footage or Bid Amount 432.00 Value Date Calculated Total Value of Project $4 I ,472.00 $41,472.00 03/21/2005 )?pp<. PlWLJ Amount Paid Date Paid Receipt Number 2200500000000000320 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 2200500000000000497 $21 0.50 $10.00 $41.39 $28.97 $43.00 $323.85 $2.00 $45.00 $59.00 $6.70 $ 133.92 $45.00 3/21/05 4120/05 4120/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/27/05 $949.33 I Plan Reviews I 03/23/2005 APP LLH 04/0812005 APP TAJ 03/2412005 APP CAS 04/1912005 APP DLM Storm drainage to existing piped to Debra 3/24/2005 CAS Incomplete information for lateral bracing. Contacted owner 4/8/05 dim. Met owner at counter, resolved lateral bracing & clarified otehr questions 4/15/05 dIm. To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. ~",np,..tillln\l Footing: After trenches are excavated. Floor Insulation: Prior to decking. Pa!!e 2 of3 . . Lit t' OF ~l"K1J~GFIELD Status Issued Building/Combination Permit PERMIT NO: COM2005-00320 ISSUED: 04/20/2005 APPLIED: 03/21/2005 EXPIRES: 10/20/2005 VALUE: $ 41,472.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover 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 coustruction. @~ /YJr 4k7kor>r owner or Contractors Signature Date Pa!!e 3 of 3 225 Fifth Street Springfi~ld, Oregon 97477 541~726-3759 Phone . ~. .,.ity of Springfield Official Receipt .evelopment Services Department Public Works Department \ ., I$J OlIil '\lJbb/Journal Number ~ COM2005-00320 RECEIPT #: 2200500000000000497 Date: 04/27/2005 8:46:02AM ' Description Plan Review/Residential Hourly P'ilyments: Type of Payment CreditCard Paid By RONALD MEYERS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 777910 In Person Payment Total: Amount Due 45.00 $45.00 Amount Paid $45.00 $45.00 \ I ; 4 1~1 tn . , 1 i ~ \ I~ t~ l . f \ \ l I~, "9 It 'h 1 I .. , 4/27/2005 Page I of I . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00320 ISSUED: 04/20/2005 APPLIED: 03/21/2005 EXPIRES: 10/20/2005 VALUE: $ 41,472.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line , SITE ADDRESS: 1146 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1703234403300 Springfield TYPE OF WORK: Single Family Residence ) TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Room addition , ~ Owner: MEYERS RONALD B JR & GERI K Address: 1146 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 Phone Number: 541747-0429 Contractor Type General Electrical Mechanical Contractor OWNER OWNER OWNER , CONTRACTOR INFORMATION I ~"mON' oregon law reqtRnUim~ Expiration Date 1.. I ~n' ., by the oregon Utility follO\\l rules adopted sa rules are set forth Notification Center. Tho "'h OAR 952-001- - r~ nMJln1nthroug 1 ~_. 'O~'~BUI~'rf\~rJ~h;;;' calling ~;~~on Utility Notificatlor R-3 number&.fiG!\lief1>tWCt;};!,?-2S44). 14.90 "Type of Heat: Heat Pump Water Type: Range Type: Energy Path: Sprinkled Building: Phone # of Units: , Primary Occupancy Group: , . Secondary Occupancy Group: Primary Construction Type . Secondary Construction Type: . # of Bedrooms: VN Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 432 Path I n/a I DEVELOPMENT INFORMATION I . Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: . 22.00 32.00 11.00 0.00 Overlay Dist: . Urban Fringe # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: . . REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: ) St~rm Sewer Available: , Special Instruction: .-r~' fLU.l.!.:...... ... - 'RE n. 1111: V<V"" . I P~HLl(;JMPROV,~I\:lENWs-'. MIi IS NOT "". - UNUtti I nh.l PER ""ruORIZED Sidewallf.1Type' Fully Improv~\11 OR IS ABANDO\,,_u'\ V' '. tesMMENCtD peRIOD DownspoutslDrains: ANY 160 DAY" . Curbside 5' Curb and Gutter , 'Notes: Strom drainage to existing piped to curb face on Debra 3/24/2005 CAS , Pa!!e I of3 Status Issued : 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax , 541-726-37691nspedion Line Description Dwellines Tvpe of Construction V Wood Frame Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee " + 7% State Surcharge Add, Alter, Extend Circ Building Permit Minimum/Adjustment Electrical Miscellaneous Mechanical Plan Review Minor - Planning SDC Sanitary/Storm Admin Storm Drainage Impervious Area Total Amount Paid Initial Review Plannine Review Public Works Review Structural Review . 03/22/2005 03/23/2005 03/23/2005 03/23/2005 . CITY OF ~rKll~ul'lJ!,LD Building/Combination Permit PERMIT NO: COM2005-00320 ISSUED: 04/2012005 APPLIED: 03/21/2005 EXPIRES: 10/20/2005 VALUE: $ 41,472.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $96.00 Square Footage or Bid Amount 432.00 Value Date Calculated Total Value of Project $41,472.00 $41,472.00 03/21/2005 Fpp< PIilLI Amount Paid Date Paid Receipt Number $210.50 $10.00 $41.39 $28.97 $43.00 $323.85 $2.00 $45.00 $59.00 $6.70 $133.92 3/21/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 4/20/05 2200500000000000320 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 1200500000000000480 $904.33 I Plan Reviews I 03/23/2005 04/08/2005 03/2412005 APP LLH APP TAJ APP CAS Storm drainage to existing piped to Debra 3/24/2005 CAS Incomplete information for lateral bracing. Contacted owner 4/8/05 dIm. Met owner at counter, resolved lateral bracing & clarified otehr questions 4/15/05 dim. 04/19/2005 APP DLM To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. Rrrr-lIirl~lrI Ulm"'tr;rn~, I Footing: After trenches are excavated. Floor Insulation: Prior to decking. Paee 2 00 . . LH f OF SPKll'\jljt<1~LU Building/Combination Permit PERMIT NO: COM2005-00320 ISSUED: 04/20/2005 APPLIED: 03/21/2005 EXPIRES: 10/20/2005 VALUE: $ 41,472.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Walllnsulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Epoxy Anchors: To be done by Certified Spciallnspector. Provide Inspection results to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover 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 construction. o..6):.d::/':{4.:' ",!ko/7~' Pa2e 3 of3 -. .... l ". .' '. ." . .' . Construction 'Contractors Board 700 Summer St NE Suite 300 PO BO:l14140 Salem OR 97309-5052 Pbone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: co"""- A)- 00'"32.0 Ill.{ b 1+A-y~C7Y' 'Br'l. ~d Address: Issued by: '1--6 Date: L{ - 2.0 -0 )' Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constroction permit applicants who are not licensed with the Constroction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits, Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the app.up.:ate blanks and initial boxes I and 2, and either box 3A or 3B: ~ 1. I own, reside in, or will reside in the completed structure. ~ 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. D 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~ 3B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. Ifl change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I herehy certify that the above information is correct and that I have read and do understand tbe Information Notice to. Property Owners about Construction Responsibilities on the reverse side of this form. fii? /!4~/'J. I 4l~fiX)r \..----' (slratuftlot"permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property-owner.doc 06-01-04 ... . A~~nlID~ ~~ 1( @MJr'OWIID G~IID~Jr'~n C([J)IID~Jr'~~~iIJiJr'? ': INFORMATION' NOTICE'TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES ., . ., NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. lEmjpHoyer ReSjpOinsilbfilities You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposeS' on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined nwnber for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsuav.htmll for the at'P&....t'I~ate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' c4.ut'_Usation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one 'ofyour employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages-:--" You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their web site at W\vw.irs.l!ov. Otlhler ReSjpOllnsilbillW.es amll Areas 011' COllncerIIlls Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. . . " ~. " ,,' \ ~( Time: Make sure you have sufficient time to supervise your employees. , , , , . . Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the apI" VI" ;ate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner.doc 06-01-04 , . CITY OF SINGFIELD SYSTEMS DEVELOPMEaORKSHEET JOURNAL OR JOB NUMBER: COM2005-00320 NAME OR COMPANY: Ron Mevers LOCATION: 1146 Hayden BridRe Rd TAX LOT NUMBER: 1703234403300 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 0 BUILDING SIZE (SF: 432 LOT SIZE (SF): I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I 432.00 I $0.310 1 = I $133.92 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I I 0.00 I I $0.310 I I 50% = I DISCOUNT $0.00 ITEM I TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - crr'( A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 0 I $/33.92 11070 COST PER DFU $24.04 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 0 I $18.28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $0.00 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x I 9.57 I I NUMBER OF UNITS I x I I 0 I I COST PER TRIP $18.30 x INEW TRJP FACTORI I 1.00 I B. IMPROVEMENT COST: 1 ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP I 9.57 I I 0 I I $80.72 ITEM 3 TOTAL - TRANSPORT A nON SDC = , $0.00 4 SANITARY SEWER - MWMC x I NEW TRIP F ACTORI I 1.00 I A. REIMBURSEMENT COST: INUMBER OF FEU's I x I 0 I B. IMPROVEMENT COST: INUMBER OF FEU's I x I 0 I ICOST PER FEU I $82.03 ICOST PER FEU I $865.31 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: so.oo 8880 $133.92 $0.00 $0.00 SO.OO $0.00 = $0.00 'j en I~ o U 0:: ~ en a ~ 11091 I '11092 11093 1094 J 1 1054 I 11055 11054 11056 I J $133.92 I SUBTOTAL x I ADM. FEE RATE 1= I $133.92 I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: CHARGE $6.70 Cheryl Slaymaker 3/24/2005 TOTAL SDC CHARGES PREPARED BY DATE = so.oo so.oo so.oo , 6.70 I $0.00 = I $140.62 1079 11078 . . , , . DRAINAGE FIXTURE UNI'!:.{DFU) CALCULATION TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUIV ALENT ~ DRAINAGE FIXTIJRE UNITS (Nom FOR REMODELS. CALCULATE ONLY TIlE NET ADDITIONAL FlXTIJRES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 0 0 3 = 0 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 0 0 3 = 0 CLOTIffiSW ASHER - 3 OR MORE lEA) 0 0 6 = 0 MOBILE HOME PARK TRAP.(1 PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRJG / WATER STATION / ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETe. 0 0 3 = 0 ISHOWER. SINGLE STALL 0 0 2 = 0 ISHOWER. GANG (NUMBER OF HEADS\. 0 0 2 = 0 ISINK: COMMERCIALlRESIDENTIAL KITCHEN .0 0 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LA V A TORY /RESIDENTIAL BAR 0 0 1 = 0 IURINAL. STALL / WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INSTALLATION 0 0 3 = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 :1 ~EDU (Equivalent Dwelling Unit) is a disct!arRe equivalent to a single family dwelling unit (20 DFU's) set at 167 wlI10ns per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE l YEAR CREDIT RATE/$I,OOO I ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2 1 BEFORE 1979 $5.29 (Enter I for Yes, 2 for No) I I 1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 2 1 1980 $5.19 (Enter I for Yes, 2 for No) ,I I 1981 $5.12 BASE YEAR 1979 , 1 1982 $4.98 II 1 1983 $4,80 CREDIT FOR LAND (IF APPLICABLE) 1 1984 $4.63 VALUE 11000 CREDIT RATE I 1985 $4.40 $0.00 x $5.29 ~ , $0.00 I 1 1986 $4.07 I. 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $3.22 VALUE /1000 CREDIT RATE 1989 $2.73 $0.00 x $5.29 0 ! 1990 $2.25 1991 $1.80 1992 $1.59 TOTAL MWMC CREDIT = $0.00 1993 $1.45 1994 $1.25 1995 $1.09 1996 $0.92 1997 $0.72 1998 $0.48 1999 $0.28 2000 $0.09 2001 $0.05 225 Fifth Street ,. S(1I'ingfitlld, Oregon 97477 541-726-3759 Phone' . SPiftI.IlUI'Cll!J- . 1It--. ___m.'. --- . ~ -.- "". ' .,....-... , '; ; , ~.. 0 . "~~ l $'.wli... ~1 '~~"'" .....; ...,.....-. .. ~ty of Springfield Official Receipt .velopment Services Department Public Works Department Job/Journal Number COM2005-00320 COM2005-00320 COM2005-00320 COM2005-00320 COM2005-00320 COM2005-00320 . , COM2005-00320 COM2005-00320 COM2005-00320 COM2005-00320 Payments: Type of Payment CreditCard .( '( ./ ./ 4/20/2005 RECEIPT #: 1200500000000000480 Date: 04/20/2005 Description Add, Alter, Extend Circ Minimwnl Adjustment Electrical Storm Drainage Impervious Area SDC Sanitary/Storm Admin Plan Review Minor - Planning Building Permit Miscellaneous Mechanical -Mechanical Issuance Fee- + 7% State Surcharge + 10% Administrative Fee Paid By RONALD MEYERS Item Total: Check Number Authorization Received By Batcb Number Number How Received djb 740415 In Person Payment Total: Page I of! 2:4I:42PM Amount Due 43,00 2.00 133.92 6.70 59.00 323.85 45.00 10.00 28.97 41.39 $693.83 Amount Paid $693.83 $693.83 GPAINQPIELD - 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)72WIj'::rc1 ~ o &8~~~" ELECTRICAL~~'PLICATION "I" <'011' 0", /.V()~ "/ ~'11J. 69;."1i!, City Job Number . , Date VIl,o,>:9 '-.. V/;." $!J"(f 1,,, - <'6/"7' .......... 9". $~I) " I LOCArrON~s~rrON _ J ,. I COMPum;FEESCH~"""'~~ \\A-\ 0 t 1\. ~~ A7)-,e . """ ~'iI/, LNOIt ~i/n. ,. 4:} -~ ",-,. I LEGAL DESCRIPTION 03D A. I\i(/~~fritiat~ingle or Multi-Faml. er ding moil. \\(')~l\4- [). ~eA>~~Cf/,'n:::'~~Of)faw ~ v'.ll~ .q;;-''1:;9f)t e(j 6 I'&q/Jf-. JOB DESCRIPTION ~.sll; lY.~ et; 1'ho ~ the O.c"0J8 Jrou$106.00 C'. _ 0 ~ ~..1.1\..tr-! _^ Hlw.W"WIi,Iltlg\?o(?qqCf\\<Jjfe'llfe -1i0f) lJt'.CO Y1I\ W,} J \ \ ~l I 1lrl9l1b"~lleu:~~06taif) c rOugh ~ are St>.;tvI9.00 Each ~fil6Nr&'~nf~\!r~:!es 01 th; 9S~-oo'J" Modur.!'l~~~{~!fe ilt ~he te!. 'lIfeS 6....50 00 Feeder '-Bon...,':!.ll!lh... .Jl,n.,- ,., -Vij;J 'T 'yo"" vole 2 br.;;-'fJIC\!, B. I Services or Feeders - Instaliiflen, Aff2qtions or Relocation: CITY OF SPRINGFIELD, OREGON -~: Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. I CONTRAcrORINSTALLATIONONLY I City 200 Amp.or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts NO r, c ~econnect Only THIS P l:: . AUr/iO ~?~iFeP1Porary Services or Feeders fvUM/t RIlED ~f'/lJ,lll!'" ANi-' 7 1ENCtlnst'lIttion, AItFiallon.or Relocation 80 U OQ ." /HI . '. '''-1'1' OA zoo 'Am'fs or"less~ P/jf/4 riG W@~ 2OtfK~p~7J14'o'd{A.wr~tJ!lf Is Nfj'lf( 40 I Amps to 600 Amps ffjfl r Over 600 Amps or 1000 Volts see "B" above. D. I Branch Circuits New Alteration or Extension Per Panel One Circuit \ Each Additional Circuit or with e ice or Feeder Pennit Phone Expiration Date Owners Name ~r.~ r\..t, E\qx\ Address \ W~- Phone ~ \. $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 ! 4~fjJ E. I Miscellaneous (Service/feeder not included) -Each Installation I Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric PermiUnspection Fee is.f45.00) Surcharges 4.1 SUBTOTAL OF ABOVE I ~qO :-\. \ ~ 4.S) 'dL.loS City The installation is being made on property I own which is not intended for sale, lease or rent. @:'1; 1_- ,~ 7% State Surcharge 10% Administrative Fee Inspection Request: 726-3769 TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application 1-03.doc