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Home My WebLink AboutPermit Building 2008-5-15 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00648 ISSUED: 05/15/2008 APPLIED: 05/08/2008 EXPIRES: 11/1512008 VALUE: $ 179,235,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1820 S 57TH PL ASSESSOR'S PARCEL NO.: 1802033209600 SPRINGFIETYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Single family residence- SAME AS COM2008-00211 5773 Obsidian Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 Phone Number: 541-228-6935 I CONTRACTOR INFORMATION I Contractor Type General Contractor HAYDEN ENTERPRISES License 92208 Expiration Date 07/29/2009 Phone 541-228-1081 BUILDING INFORMATION I # of Units: 1 # of Stories: 1 Lot Size: Primary Occupancy Group: R-3 Height of Structure 18.00 Sq Ft 1st Floor: 1,597 Secondary Occupancy Group: U Type of Heat: Forced Air Gas Sq Ft 2nd Floor: Primary Construction Type VB Water Type: Gas Sq Ft Basement: Secondary Construction Type: Range Type: Sq Ft Garage/Carport 480 # of Bedrooms: 2 Energy Path: Path 1 Sq Ft Other: Sprinkled Building n/a Occupant Load: I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 5.00 15.00 18.50 3.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 2 Yes 36.50 REQUIRED PARKING Total: 2 Handicapped: Compact: Subdivision Not Accepted Street Improvements: I PUBLIC IMPROVEMENTS I Sidewalk Type: Storm Sewer Available: Downspouts/Drains: Special Instruction: No final,occuJ!l!..nl;Y ap'prov.al shall be granted prior to Public Works approval for pump station. ATTENTION: Oregon aw reqUIreS- you to Notes: %eJ~Wlute~<dooilrlQh~~ Wt'uIows, it is the recomm~ndation to the Building Division.' by the City , ootIA'CRa9tI502n_OOe1~~~ij!&j t ~elJ ~ r (~s shall be made to samtary or storm H20 s):~tems, untIl the In s ga ~WJfJ e ,'i~ Council". ' '" ".- ,,- "rl/t"""Nf'U')lI 0090, You may 0 taln copies 0 e ru I If :r' :.~'_ -, '"_ ': . ' _ Ullf\ calling the center, (Note: the telep e h - I,: , . ! "~ NOT number for the Oregon Utility Notificimm c' - - 3, Center is 1-800-332-2344). ANY", , Paee 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Dwellinl!s Garal!e V Wood Frame Garal!e Fee Description -Mech Iss 2+ Appliances- + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee 2 Baths One or Two Family Addressing Assignment Appliance Vent Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fireplace (Listed) Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Plan Review Major - Planning Plan Review Same As PW Disc - 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Improvement SDC Transpo Reimbursement SDC Transportation Admin Sidewalk Permit Storm Drainage Impervious Area Storm Sewer Each Addtll00' Temp Power 200 amps or less Vent Fan I Valuation Descriotion I $ Per Sq Ft or multiplier $105.00 $28.00 Square Footage or Bid Amount 1,579.00 480,00 Total Value of Project ~ Amount Paid $40.00 $162.62 $182.79 $92.91 $280.00 $35.00 $7.00 $909.24 $85.00 $7.00 $10.00 $102.95 $17.00 $14.00 $5.00 $2.00 $205.00 $220.00 $-40.00 $117.00 $63.00 $489.70 $644.00 $10.00 $990.39 $95.35 $134.93 $862.25 $195.48 $71.94 $85,00 $850.17 $16.00 $55.00 $21.00 Date Paid 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 5/15/08 Pal!e 2 of 4 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2008-00648 ISSUED: 05/15/2008 APPLIED: 05/08/2008 EXPIRES: 11/15/2008 VALUE: $ 179,235.00 Value Date Calculated $165,795.00 $13,440.00 $179,235.00 05/08/2008 05/08/2008 Receipt Number 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 1200800000000000497 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00648 ISSUED: 05/15/2008 APPLIED: 05/08/2008 EXPIRES: 11/15/2008 VALUE: $ 179,235.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Willamalane Single Family $2,513.00 5/15/08 1200800000000000497 Total Amount Paid $9,551.72 I Plan Reviews I Planninl! Review Public Works Review 05/08/2008 05/08/2008 05/08/2008 05/08/2008 APP APP TAJ TSS No final occupancy approval shall be granted prior to Public Works approval for pump station. For this parcel in Jasper Meadows, it is the recommendation to the Building Division, by the City Engineer: "that no connections shall be made to sanitary or storm H20 systems, until the subdivision is accepted by City Council". Structural Review 05/08/2008 05/08/2008 APP DLM Stormwater directed to public system. 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, l..ReouirecUnsnections . 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. Pal!e 3 of 4 CITY OF SPRINGFIELD. Building/Combination Permit Status Issued PERMIT NO: COM2008-00648 ISSUED: 05/15/2008 APPLIED: 05/08/2008 EXPIRES: 11/15/2008 VALUE: $ 179,235,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. 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. -L..~ Owner or Contractors Signature Date Pae:e 4 of 4 ZON \..., D'/Z- 1N1TIALS N ~ DATE 5 -\(0 "0<"(" SOURC[~~ Date ()-'" , G ... CY' SPRINGFIELD w"~""~~ ,j t~' .4::'''1>- " I _I:fi. ~,-;f\ ...-<p ~I i--"" d.l!'f~~.'~ r"~'f'l[o\ ,,_~-,;~~..~~b~t~~;"f~ ?,~/)~;'f$:{J ~ '4;t'\!~t "TI';"';"'~ 'I ~ 1......1l..~~~ ~:s 225 FIFTII STREET. SPRlNGFIELD, OR 97477 . PH'(541)726-3753 . FAX (5~1)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (oAA l..oc> 8 - bob t{ B ,'" ~r.[lq'~..'l"i1+"i~!1~,"" Wq:~~g.~~Jl('1~V1lNj;W'Sf(,"~1 ~\n'~~-l~ ,l(...' I}i.~~/'r 1,.. h( ~ 1 ~ 1. ~~m'O,CA''FI6)NJ~ :\;I.NST~'I'ION::{"':"'~'l':.' ~, ~"'(""",." \.,,;:JfI'.!':"',.;",i;41,\~,t~',"\iir""'~"I;;.&!1,,'" '1~ ,"~I,"'. ",," ,.,j. 182-0 S . S7 PL LEGAL DESCRIPTION /802.0312 JOB DESCRIPTION: rfo"",-.s" . v l aL I TeM f' I Permits are non-transferable and expire If work IS not started within 180 days of Issuance or If work is Suspended. fOJ: 180-days_ - - -- - - - - - -- D ,600 Electncal Contractor -r;jJ)Jb!ci1 r-/ec Address ;;208-;9 ~ c+ ( 'Pnone 5"1! 3n -19'7'$ --- ~-Clty () / ,()~ ExprratlOn Date Lj 0:7 Lf 5 (2n1 /7 '2 j~~ ;}.ec; '1 Supervisor License Number Constr. Contr Number Exprratlon Date SIgnal Te of Supervilsmg ):<:lecmcian c?J;M " \ OwnersN~e j U-a1 L RlC ~rdJ Address ';l('Jcf77 ~ c + u City I!>~ Phone ,)4 ( 1qg ~n OWNER INSTALLATION The installation is bemg made onproperty I"own whIch - IS not intended for sale, lease or rent Owners SignahIre' Inspection Request: 726-3769 3. I'~ 'C6MPiEIE'm:s'CHEbliliEBEE0w,:;\~<;'~l':t";,~; F':~':'" ,',':: ~ IJ~~~_.. ~ _..~, ~"<.l,\'ft~~!L.f'~^'l1.~....,,,:lr'~~~:';.!\.J;:tj '~''':__':~J.'.<~''l:~'... ~.J~"__'__."'_~~'" ...._~... 'l'.1YN!:""~tl.~~7f,lijf"''',:rr:\I''i'''J'\~~'f~;<",;rt~,'{ ",TIti,';:!,"''' ,"/"><r-~~;'i-'Zffi ('I( <"I'_~wl'l fl<"l::, 'jl]I~Je~'b'brM'uiti~F~mjI~'iii~Mi~e'llin'~ ~l'ilj~~' ;'~ ~ ',i '..2r__..I~ 1'_.z;J,! ~ J..j, l.~\t.t',...,{' ~" .....11(." J t.J. ,~_ ,,_d.l J,:I _ 1 ServIce Included 1000 sq. ft or less Each additional 500 sq ft or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder _ I $11700 117,t!ro ,3 $ 21 00 --':,~~ $55 00 "" a I fl1J >' e , \\ Ow,if .., ',- o . C nter ~ r. ,,:'1.1 - Not'Ux~tlon e nr.:iO-hfC'-'9rIC~,'c.:~"'v, , O~'f\'~M--WijS l _.I'~ '\'J'0~\)'I ~oge9~fi\~ Sf&'O~~8i~l)~n~' \~\~pnol ,8_ camn~ ~g~~~ UtIlIty \-.jotltlC",.IUII n~~h:~~Wl~_~~32-2344J' Over 1000-AmpsNolts Reconnect Only ... "'b1~.....,., lh.... ~..:t.";-" "'1'1''''1 I .t';'ll....~.. ~.. .~lIIttF~IJ~~I(l6'~R'~ ~r'V'$]"W".;iI_"tt,-r~ ('! ,I) ~;bll(J4 onsq"or\ e oca IOn:"p', ~.l~tt.~.~lt~C~~~ ~1} ~ u~~':;:~~~l I j~ $ 70 00 $ 83.00 $138.00 $180.00 ---$Ll13~Oo- -- ~ $ 5500 1\..~t\':\ji11\.!'ml~1'" C drrV(I~;v:t:\"lil' . :t~~~~B'LI\~\ ,;' :i' tll \fll ~~'lllo; 1 ~~;II'(11 tj15W ,I " )~J!l':)1 ~ !:"'i!1 ~'~ ' InstaUation, Alteration or Relocation N OiiS or less --1 $ 55 00 ~ tJ-O '..J t' ,.t~~lfQ~IRE IF THE WOKI<$ 76 00 ~,'~~r~ 0, ott:l~IS PERMIT IS NU I $11000 em, ,"('I' ~ I/&B0\ijQQ~~~~ov~ "','iifi''':,'' I",. ',,,'i',,',,,, ' A r....1 ~ ~;'1l~ ~ill~~:I'J~,~ I:~'~i\t ~ ,~It 1;\ I,::" 11,' ,J ,i N 1 e.' 'I'~ 'tL:hriJj~ltl~L:i....L:.!),)~.:,~'l;lIJ\~' jI New Alteration or ExtenSIOn Per Panel One Circuit Each AddItional Crrcmt or wIth ServIce or Feeder PerIDlt $ 48.00 $ 400 ':"~""'r"""";"'"r.':M'ilf"...,r['"'I'II'.I""'j'" '"""""" "', "'P,,,.!' --''''''1'1'' E ~Lf~M ~lf I' t~~I\lrti'l<,lll/,j'{rjgil,t~ ~U~r 1;1 t,l~'" ~l[~S~"1 \/"'1;1 ~~I-dl11'\'~l.-tl"'~ r" ,...~l r{l 1 't~ \I .' '. Y:"l:'lI~C"., i1n,~'o1i's~(~ef.Y:j~e/'recO'~J;~;ITo1~nl'i:1ii' ',' j!.._.oll' '::Ud!.l1~~":;.1lJJMI ::'VWiI,~~li).H I !!!flllltll~r.t~lli~ !J.1lYl~'f.;m"'ILr6~~~l::I\~llil~ r.J!f. 1'01'''' ~ I:'] ""!, 11 j v " , Y"i~ht:t II" ,;,,Jd h'1"( J, ~ ~~tf,g11H~\t~JL~~~~ Pump or irngatlOn $ 55 00 Sign/Outline LIghting $ 55 00 LimIted Energy/Resldentml $ 28 00 Cillilted-Energylt.ori:iiiiercla'C" --~nb-Oo .- Mimmum Electric Permit Inspection Fee is $50.00 + Surcharges 4. I-i~'~" ~11~~Lz.3 S ~ Z~.,2,O 26,~e JI" 7r 2~~:~j Shared Dnve(T )/BUlldmg FonnslEleclncaI Pennlt ApplIcatIOn \-08 doc - 12% State Surcharge 10% Admmistrative Fee 5% Technology Fee TOTAL CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER COM2008-00648 NAME OR COMPANY Hayden Homes LOCATION 1820 South 57th Place TAX LOT NUMBER 1802033209600 DEVELOPMENT TYPE Smgle Family Residence NEW DWELLING UNITS 1 BUILDING SIZE (SF' 1989 LOT SIZE (SF) I STORM DRAlNAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS SF x 1 COST PER S F CHARGE 2457 00 1 $0.346 = $850 17 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUSSF I x I COSTPERSF x I DISCOUNTRATE o 00 I $0 346 I 50% ITEM 1 TOTAL - STORM DRAINAGE SDC '$850.17 if.J ~ ~ o I~ r/) ........ o ga 5317 DISCOUNT $000 $850.17 '. 11070 , 2 SANITARY SEWER - CITY A REIMBURSEMENT COST NUMBER OF DFU's 24 x COST PER DFU $26 83 $644.00 1091 B IMPROVEMENT COST NUMBER OF DFU's I 24 x COST PER DFU $20 40 $489.70 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $1,133.70 3 TRANSPORTATION A REIMBURSEMENT COST I 1 NUMBER OF UNITS x I - ADT TRIP RATE x COST PER TRIP x NEW TRIP FACTOR I 957 1 1 1 2043 .100 $195.48 1093 B IMPROVEMENT COST I ADT TRIP RATE x NUMBER OF UNITS x 1 COST PER 1R1P x INEW TRIP FACTOR 1 957 1 'I $90 10 I 100 $862.25 1094 ITEM 3 TOTAL - TRANSPORT A nON SDC = , $1,057.73 4 SANITARY SEWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's x COST PER FEU 1 I $95.35 = $95.35 1054 B IMPROVEMENT COST INUMBER OF FEU's x I COST PER FEU I I 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 =, $1,095.74 SUBTOTAL (ADD ITEMS 1,2,3, & 4) =, $4,137.34 5 ADMINISTRATIVE FEE 1 SUBTOTAL x ADM FEE RATE 1= CHARGE 1 $4,13734 5% I $206 87 TOTAL SANITARY ADMINISTRATION FEE 13493 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE $7194 1078 Todd Singleton 5/8/2008 TOTAL SDC CHARGES =1 $4,344,21 PREPARED BY DATE ~ -" - --,- , ~ DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXllJRES x UNIT EQUIVALENT = DRAINAGE FIXllJRE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC 0 0 1 = 0 RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 I SHOWER, SINGLE STALL 0 0 2 = 0 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 ISINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK COMMERCIAL BAR 0 0 2 = 0 SINK WASH BASIN/DOUBLE LA V A TORY 1 0 2 = 2 SINK SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 I URINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 24 *EDU (EqUIvalent DwellIng Urnt) IS a discharge eqUIvalent to a smgle family dwellIng umt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $498 $4 80 $463 $440 $407 $367 $322 $273 $225 $1 80 $159 $145 $125 $1 09 $092 $072 $048 $028 $009 $005 t IS LAND ELGTBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $000 x $5.29 = I $000 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0 00 x $5 29 o TOTAL MWMC CREDIT $000 = ~~ Willamalane t Park & Recreation District Job. No. {!{;)If2b!Jf> -DO (p 1-& SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME: /82-0 S~ ~7(} 1'1, PHONE: '22-~-b93S ADDRESS' 2!/t? 5U/ ~tAc/cit CITY t[)e;;H1L'A.! 0 STATE: C;(ZIP: '7775' ~C, /\ j " - . LOCATION OF PROPOSED BUILDING SITE: /~7 n c-<), ,'57-p, J1[, Street Address: Plat Name: \-1~Sjlt~ JtIM--~tJJV( Tax Lot Number: / eo2~3.1Z. Q}~r.J-O 1. DEVELOPMENT TYPE (Check appropnate dwelling(s). Dwelling type definitions are on the back ) A. Sinale-Familv Detached NO. OF UNITS / X $2,513 per umt = 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. sec CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval) C Y /' c.,J.... ',. 1~. CI..... '\)@-:".... /"0, (' ~3'.~'TOTAL WILLAMALANE NET SDC ASSESSED / ..,l q {"' ~ I.\c . ~ ( (If SDC reduced for Credit) (2. " ~ ~ ~ 3, Date $ 25/:3 $ $ $ $ $ $ $ Z-S/,"~ lfa 08 5 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 COM2008-00648 CO M2008-00648 Payments: Type of Payment CredltCard cRecemtl RECEIPT #: 1200800000000000497 Date: 05/15/2008 Description Plan Review Same As Plan RevIew Major - Plannmg SIdewalk Permit Curb cut PermIt PW DIsc - 2nd Permit Storm Dramage ImpervIous Area Samtary Sewer - ReImbursement Samtary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC ReImbursement SDC MWMC Improvement SDC MWMC AdmmlstratlOn SDC Samtary/Storm Admm SDC TransportatIOn Admm BUlldmg PermIt Addressmg Assignment WIIlamalane Smgle 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 Gas Outlets 4+ FIreplace (LIsted) -Mech Iss 2+ ApplIances- ReSidence WlTIng 1000 Sq Ft ReSIdence WlTIng Ea Addtl 500 Temp Power 200 amps or less FIre SF Fee - ReSidentIal + 5% Technology Fee + 12% State Surcharge + 10% Admmlstratlve Fee Paid By HAYDEN HOMES Item Total: Check Number Authorization Received By Batch Number Number How ReceIved IIh 094529 In Person Payment Total: Page 1 of 1 8:35:56AM Amount Due 220.00 205 00 8500 8500 (4000) 850 17 644 00 489 70 195 48 862 25 9535 99039 10 00 134 93 71.94 909 24 3500 2,51300 280 00 1600 1400 2100 700 10 00 700 500 200 1700 4000 11700 6300 5500 10295 9291 18279 162 62 $9,551.72 Amount Paid $9,551 72 $9,551.72 5/15/2008 \ ., ' l~l , , 08/08/2008 08 18 . 5033901275 GALE CONTRACTOR SVCS 9 ~r!2 AfMCa ---- "0 eo. 7:!'" ~aI.rT' r'" 07'0' OO~4 , ~:l. > . c 2r - (.,Lf'ff Hayden Enterpnses, Inc 2464 SW Glaclcr Place SUite 110 Redmond, OR 97756 RE: 1820 S 57'h St Spnngfield, OR Lot 235 To Whom It Moly Conceln Th,<,lcller" to venfy that G,lle Contractor Selvlcc~ m~tallcd 1575sqft Qf('erlollnTeed unfaced R 10X19 batt tn~L1lalIOn ~ecurcc1 with tWine and plumhlng l~ properly tn~L11a[cc1 tl~ contracted at the acidiC'S leferencecl ahove dr-~ Wayne Ru:;h Produ~ll()11 M ,1Ild gel Golle ('on/ractol Scnlcc' 503- 190- 1200 PAGE 02/05