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Home My WebLink AboutPermit Building 2008-6-4 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2008-00774 ISSUED: 06/04/2008 APPLIED: 06/03/2008 EXPIRES: 12/04/2008 VALUE: $ 119,455.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5750 PUMICE PL ASSESSOR'S PARCEL NO.: 1802033209400 SPRINGFIETYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: Single family residence SAME AS COM2008-00140 1633 S 58th TYPE OF USE: New Residential Sidewalk Type: C b'd 7' ur SI e Downspouts/D~~'fMt 'NO~urb and Gutter tt01\C~:. ~ 5\-\~\..\. ~"\~~~R~\1 \5 ~Ol 1\-\\$ ~of:.~~io U\,\Of:.R ~~~~OO\'\t.o fOR M.\1\-\ l"\ nR \5 ,.. \julJ\\\\t \~O~- ~t.R\UU. I Valuation Descr~t,'8t o~'l Owner: HAYDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 I CONTRACTOR INFORMATION. Contractor Type General Contractor HAYDEN ENTERPRISES License 92208 BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: I Height of Structure 16.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: \ "OU 0 2 Ene.~~. , .\'~'/ Path 1 ;:11"4: O~~.~~:.~ ala 'O\\OV4 fU c'f~Y_~~ION. Not\fiCa\:~-O~U ~ in caples 01 ~ \epnone \n ~91GQ '((\aV ~e~ ~~PdJ. ~~O\\t\ca\\on o ~gdt\e ce e Ote'9sn-"~~ . d: I\\l~eo'ot \''c \& '\ rive Rqd: 16.80ti8n\e % of Lot Coverage: ..0.00 1 R-3 U VB - I PUBLlC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Fully Improved Yes Notes: Storm to curb & gutter Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Pa1!e 1 of 4 Phone Number: 541-228-6935 Expiration Date 07/29/2009 Phone 541-228-1081 Lot Size: Sq Ft 1st Floor: 1,031 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport 400 Sq Ft Other: Occupant Load: 2 Yes 17.90 REQUIRED PARKING Total: 2 Handicapped: Compact: Value Date Calculated Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00774 ISSUED: 06/04/2008 APPLIED: 06/03/2008 EXPIRES: 12/04/2008 VALUE: $ 119,455.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Dwellines Garaee V Wood Frame Garaee $105.00 $28.00 1,031.00 400.00 $108,255.00 $11,200.00 $119,455.00 06/03/2008 06/03/2008 Total Value of Project ~ Fee Description Amount Paid Date Paid Receipt Number -Mech Iss 2+ Appliances- $40.00 6/4/08 1200800000000000591 + 10% Administrative Fee $131.90 6/4/08 1200800000000000591 + 12% State Surcharge $149.69 6/4/08 1200800000000000591 + 5% Technology Fee $81.12 6/4/08 1200800000000000591 2 Baths One or Two Family $280.00 6/4/08 1200800000000000591 Addressing Assignment $35.00 6/4/08 1200800000000000591 Appliance Vent $7.00 6/4/08 1200800000000000591 Building Permit $694.44 6/4/08 1200800000000000591 Curbcut Permit $85.00 6/4/08 1200800000000000591 Dryer Vent $7.00 6/4/08 1200800000000000591 Exhaust Hoods $10.00 6/4/08 1200800000000000591 Fire SF Fee - Residential $71.55 6/4/08 1200800000000000591 Furnace - up to 100,000 btu $14.00 6/4/08 1200800000000000591 Gas Outlets 1-4 $5.00 6/4/08 1200800000000000591 Plan Review Major - Planning $205.00 6/4/08 1200800000000000591 Plan Review Same As $220.00 6/4/08 1200800000000000591 Residence Wiring 1000 Sq Ft $117.00 6/4/08 1200800000000000591 Residence Wiring Ea Addtl 500 $21.00 6/4/08 1200800000000000591 Sanitary Sewer - Improvement $469.29 6/4/08 1200800000000000591 Sanitary Sewer - Reimbursement $617.17 6/4/08 1200800000000000591 SDC MWMC Administration $10.00 6/4/08 1200800000000000591 SDC MWMC Improvement $990.39 6/4/08 1200800000000000591 SDC MWMC Reimbursement $95.35 6/4/08 1200800000000000591 SDC Sanitary/Storm Admin $122.69 6/4/08 1200800000000000591 SDC Transpo Improvement $862.25 6/4/08 1200800000000000591 SDC Transpo Reimbursement $195.48 6/4/08 1200800000000000591 SDC Transportation Admin $73.39 6/4/08 1200800000000000591 Sidewalk Permit $85.00 6/4/08 1200800000000000591 Storm Drainage Impervious Area $681.66 6/4/08 1200800000000000591 Storm Sewer Each Addtll00' $16.00 6/4/08 1200800000000000591 Temp Power 200 amps or less $55.00 6/4/08 1200800000000000591 Vent Fan $21.00 6/4/08 1200800000000000591 Willamalane Single Family $2,513.00 6/4/08 1200800000000000591 Total Amount Paid $8,982.37 I Plan Reviews I Plan nine Review Public Works Review Structural Review 06/03/2008 06/03/2008 06/03/2008 06/03/2008 06/03/2008 06/0312008 APP APP APP Paee 2 of 4 TAJ LKW DLM Storm water to curb & Gutter Approved as noted on the plans. Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00774 ISSUED: 06/04/2008 APPLIED: 06/03/2008 EXPIRES: 12/0412008 VALUE: $ 119,455.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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<UnsDection1J 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. 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. 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. Pal!e 3 of 4 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2008-00774 ISSUED: 06/04/2008 APPLIED: 06/03/2008 EXPIRES: 12/04/2008 VALUE: $ 119,455.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 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. 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. /----;-{) ~ r/ /~ ~ . Owner or Contractors Signat e ~-~-o~ Date Pae:e 4 of 4 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER COM2008-00774 NAME OR COMPANY Hayden Homes LOCATION 5750 Pumice TAX LOT NUMBER ~- - - - - -1802033209400 - DEVELOPMENT TYPE Smgle Farmly ReSidence NEW DWELLING UNITS 1 BUILDING SIZE (SF: 1431 LOT SIZE (SF) 7957 r:/) iJ.1 Q o u I~ ,E-< r:/) f-< o gz 1 STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS SF x COST PER S.F CHARGE 197000 $0346 = 1 $68166 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS 1 IMPERVIOUS SF I x I COST PER S F I x DISCOUNT RATE DISCOUNT 1 0 00 I I $0 346 I 50% $0 00 ITEM 1 TOTAL - STORM DRAINAGE SDC 2 SANITARY SEWER - CITY A REIMBURSEMENT COST I NUMBER OF DFU's 23 $681.66 $681.66 1070 x COST PER DFU $26 83 $617.17 :! 1091 B IMPROVEMENT COST I NUMBER OF DFU's I 23 x COST PER DFU $20 40 $469.29 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $1,086.46 3 TRANSPORTATION A REIMBURSEMENT COST I ADT TRIP RATE x NUMBER OF UNITS x I 957 1 COST PER TRIP 2043 x INEW TRIP FACTOR I 100 $195.48 1093 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 = 1 $1,057.73 4 SANITARY SEWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's I x , L , x !NEWTRIPFACTORI I 100 I $862.25 1094 I . COST PER FEU $95 35 $95.35 1054 B IMPROVEMENT COST INUMBER OF FEU's x I I I COST PER FEU I $990 39 PREPARED BY DATE = $990.39 1055 $0.00 1054 $10.00 1056 = , $1,095.74 --. '" =1 $3,921.59 1= CHARGE I $196 08 I 12269 1079 t $73 39 11078 I TOTAL SDC CHARGES =l $4,117.67 I - - --..-----....-- --~ - ~ - - ~...._....,._,- 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 i $3,921 59 1 5% TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE Kaye Wilson 6/3/2008 I DRAINAGE FIXTURE UNIT (~FU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQuiv ALENT ~ DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS, CALCULATE ONLY TIlE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 1 0 3 = 3 ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 I MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WATER STATION /ETC 0 0 1 = 0 I RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 ISHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK COMMERCIALIRESIDENTIAL KITCHEN 1 0 3 = 3 I SINK COMMERCIAL BAR 0 0 2 = 0 ISINK WASH BASINIDOUBLE LAVATORY 0 0 2 = 0 SINK SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 *EDU (EQUIvalent Dwellmg Umt) IS a dtscharge eqUIvalent to a smgle fanuly dwelhng urnt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $4 98 $480 $463 $440 $407 $367 $322 $273 $225 $180 $1 59 $145 $125 $109 $092 $072 $048 $028 $009 $005 IS LANB ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPRiOVEMENT 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 $0 00 =! CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $000 x $000 TOTAL MWMC CREDIT = 2 2 2005 $000 o $000 Job. No.-CM~'!)fb ,.C:0774- SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME: l-l-AYDb.I fiLr6t/l~/~~ PHONE: "2.7-fb "~~':5> ADDRESS:2~~ oW4lAct41CITY ,;(&NHt!)m STATEMZIP: 97?S't;, /~, LOCATION OF PROPOSED BUILDING SITE: J Street Address: f)7SfrJ _/C/P'~/C~ /L', Plat Name: -1AS.tL6< /t1~~ . Tax Lot Number: /.~bgg2- t> ~<ttrtJ ,. 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 ADartment NO. OF UNITS X $2,323 per unit = $ D. Sinale Room OccuDancv 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) $ 2-~/.~ bl C( I cY Date '-:-i-Z? . DevelopmenT Services Department CitY of Springfield 5 SPRINGF1ELD t...-..<!~~~SU} ~ A ~, t~ a _t~~ ~ !'>,,4:',;,;;.,~ ~:'~ J'tn~~~~ "-...J..JJ:.~~~ "..~-:;~~ ~~;~~tii, ~ ~v~~ ..., ....'" ION (C INI11ALS- JJ1l DATI: i.1?&-\.f/O /( SOURCE )J IV\.. 225 I'll 1 t1 STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FA)( (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number { Owf ZOo. 8" ... b 0 7 7 c...; SIgnal 'Ie of S~pervAsillg plectnclan , ~ { ~L -. 1.1 ~ -:J \:., : ' L~ ~e. ~ J~ New AIte~ation o~~tenslOn Per Panel ~ . One Crrc~~t.. ~Q i\ $ 48 00 Owners N~~(Y-:7~~ } R'h~~~f:, ~~~;~$~~~~~:~:~~~~~ili;\~8i:~~:~~;~~;~fi'i,g;i; Address "..k J () f Cnr-u c..~~ l" <<\:S\J. \) err.. ,l5' , ~i~\",:\JJ~,cll",!rli~!JJ,'ill;~L~,l,I:!i(.u:~~:!':'1~11':'I'f~g,1i:,::u.\~Ii.J\U/Ji:,\ll'h\,~,j~kl":ill(j,r:jt:,"j,}Jn,,~I,,_,j::,RJLJI.:~ c,.i!l:,ti: CIty 13~ Phone .f%~\~~~~~t."'\~p or lITlgahon $ 55 00 _ OJ\\'{ '\ rof:J \) SIgn/Outline LIghting $ 55 00 OWNER INSTALLATION ~~ Llll11ted Energy/Resldentlal $ 28 00 -TIle-installatIOn is beillg made-on prop-erty I -own -which - Cillli1ecCEnergy/CoriiI:llerclaC - ------ - -- $ )lHf()- IS not intended for sale, lease or rent MlDlmum Electric Permit InspectIOn Fee IS $50.00 + Surcharges ~~jIGlfJ1l' ':\'):' m / C) 7 4. t :;I~ '~:!',~ I ~ <& ~d ~:~ - 12% State Surcharge 23/b> 10% Administrative Fee 1'1.70 5% Technology Fee ., b r 2l{5 J- Shared Dnve(T )/BUlldmg ForrnslEleclncal Pemllt Application] -08 doc ;'~-~r,rnill~~H'1'{rZi:I:t\="~l..;"'J ~:1:~~1".I-:!l';:4-\i\! f<"i:FJ'';~~'''/ :'~tll: ~\l..,.t' ,~f-f.... > Ii\. :.' lill II '; l~... n1 f Ti 1. :;~'I';lil~JJIt(FLf8Y;Y;>Ei':fN$JfM.LA;TJ0N;','I: :',: I' :;~1~)j :!~\ 1,\ ,) ""~<~.,l" l'\'fulb. ~lr q"'IU\\\'~~U,_\'JIL'\II:'>MI/;:P~lh)'t\.;.- ,I" h I'll", \.:~ '... II '.. l ',..1:" Ii - ,> S7 SO 1:)v\.\IV\.\Le LEGAL DESCRIPTION 18020332 o 7l(OO JOB DESCRIPTION. I!V<A':>f' I'C#1tJ Permits are non-transferable and expIre If work is not started wIthin 180 days of issuance or if work is . _ _ _Suspende(ifOl:-180-days_- - - - - . - --- - - - -- - 2. ' ~~r.!l ...."....~"".,..?!l-!'ir, fl.,4)!;'-'f' ....j .Ill" ':ll>>k';I,',hl'i\i'iJ.llW ~'l;<'ll,1\"I,~~ ' CiXJJ .J.7\F1J~,1't r . ~ lPf~'fl'l ...t,,/f'r'., ~:lI, ~lt\~~L!'.lCS,J ll-<J1:,H'; '~...:. '.~ ,-l>....~l ExprratlOn Date ~7 Owners Slgnature InspectIon Request: 726-3769 Groll! () Y ( 'l Date 3. i':"tOM:P1illTE:msc'iJEbiiliEB'ELOw:~ >, .", ',1~' ", ",\ :-, I ~ ~ ~ >~\i101, 1ft,'!, l'~ !J~\","J,j(' ( :' J'..J>t....' , ,J~~'- ~t... ," If _,_.. ~ l ~ A. ',~:1ig~~ff~~1~~~~~t\~~$11I~li1~'~Mm~~~~~ii:?~~f;d~~ltilfg:" ri~1i:: "~ ):'; ,1'\\'U..n\P~\-11Llt<"\,~I:I;.-.:,.!,~'.i)l.(if~I.1"~_.j,..I<<'-1l<.'1~ t_-I!I"""'ct,~b.J~IJ\,I.\\' II' 'L..," , \11 {"!' . 1 ServIce Included 1 000 sq ft or less Each addItional 500 sq ft or portion thereof $117 00 1/7 21 I $ 21 00 Each Manufact'd Home or Modular Dwellillg ServIce or _ feeder _ ___ -- - '-- -- - --------- $55_00 ~I,I_"!I'''''-I~t'''r.'j'-'''''>''''l lh....... ....tbl<'"~.:i"..,..,. tal" l.'f........ ....... ...'JM;";'f.'''J';''.... ,'I ." '\,,~(~:~hj,11l~~'flr~'t\'~lt\~tJ /:'1' [i{,"vV~J~~:ll' 11; jP~~~r~"")~f~,',,;~'(h ..l~~t\~r/' I , atJonl'~:A1feraUOllS'(OnRelocatlOn':) '11~ 'Il~~ l"I'~"t'l'~',~ttJI-' ~'l'l';:>'}'h'~lj\.. ~\l':! ~')'N--;I '~'(11'< " ,t11~,~I~/lrl1:' . JJ ... _~ '\ 1....:_ ~ ~~ ""......'1Jl..x'oli.>:l ..... A (j ......"".l '~~~1.I.\> ,,l...... 1 . II _ ,h..., ~\. "':.11 , 200 Amps or less $ 70 00 $ 83 00 $138 00 $180.00 - $Ll13-00 $ 55 00 ',,1, It' )Jlll~ll' :.!Il , ;!(W~flil~J~f;1,~~l~: ;!~ [... II )~ t.... :....:::11.1t...::... Installation, Alteration or RelocatIon I $ 55 00 $ 76 00 $110 00 S~ 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above D ~j~~fo~1~~, (l,I'I,:1\,{Jl!II\]I~;/:i:fll~ '1;,,1 -I' [1"ll;I") I ,',' ; ;"'.olta ,\} 111'; I",,,h, 'I\Jllr,'II~,~r!' I' \<\I\'~ q,~ ,\,1 j . ~,~~'!t~1l.WJ~,1~1t, :tf:S~~:~~~l~l:I~:lli1~lr;:I;)~ t\ h~~~~'~;~~::J II~' TOTAL 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-0077 4 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 COM2008-00774 Payments: Type of Payment CredltCard cRecemt I RECEIPT #: 1200800000000000591 Date: 06/04/2008 DeSCription Plan ReVIew Same As BUlldmg PermIt Addressmg ASSIgnment WlIlamalane Smg1e Famlly 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- ResIdence Wmng 1000 Sq Ft ResIdence Wmng Ea Addtl 500 Temp Power 200 amps or less FIre SF Fee - ResIdential Curb cut PermIt SIdewalk 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 Plan ReVIew Major - Planmng + 5% Technology Fee + 12% State Surcharge + 10% AdmmlstratJve Fee PaId By HAYDEN HOMES Item Total: Check Number AuthOrizatIOn Received By Batch Number Number How Received dJb 022655 In Person Payment Total: Page 1 of 1 1l:06:50AM Amount Due 220 00 694 44 35.00 2,5 I3 00 280 00 1600 1400 2100 700 1000 700 500 4000 117 00 2100 5500 71.55 8500 8500 681 66 61717 469 29 195 48 862 25 9535 990 39 10 00 12269 7339 205 00 81 12 14969 13190 $8,982.37 Amount Paid $8,98237 $8,982.37 6/4/2008