HomeMy WebLinkAboutPermit Building 2008-6-25
CITY OF ~t'K1NGFIELD'
Building/Combination Permit
Status
Issued
225 Filth Street, Spnngfield, 0 R
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn LlIle
PERMIT NO: COM2007-01223
ISSUED. 06/25/2008
APPLIED. 08/17/2007
EXPIRES 12/25/2008
VALUE. $ 136,475 00
SITE ADDRESS 4850 A ST
ASSESSOR'S PARCEL NO MEYER PARK SUB LOT
SPRINGFIETYPE OF WORK Smgle Family ReSIdence
TYPE OF USE
PROJECT DESCRIPTION SlIlgle family reSIdence
Owner
Address
SPFD EUGENE HABITAT FOR HUMANITY
PO BOX 488
SPRINGFIELD OR 97477
I CONTRACTOR INFORMA TION I
Contractor Type
Contractor
LIcense
BUILDING INFORMATION I
# of Units 1 # of Stones
PI Imary Occupancy Group R-3 HeIght of Structure
Secondary Occupancy Group Type of Heat
Pnmary ConstructIOn Type ." "'~I~l.bregon law'Yi!/fill~ou to
Secondary Construchon Type, _, adofJled by tRtJ'lllrelil:J?i'Utllily
# of Bedrooms , "" ,:cher Those&!l~g:a1'EJIY1Jl: forth
I'v ,11 ,)"d'()1.0010throtliWi'lYAfl'II~~g
'....... ...., "':...:-:::.' ~.-:r:,-~.!.J\':" :/:::= ~J
calling the cenld,rDr)tll~QIl~re'tilllllRORMATION I
number for the Oregon UlIIllY ,~oul:caugn
Center IS 1.800-332-2344\.
OVerlay'Dlst
500 # Street Trees Rqd
400 Paved Dnve Rqd
20 00 % of Lot Coverage
13 00
2
2500
Electnc
Electnc
Electnc
Path I
n/a
Frontyard Setback
SIde I Setback
SIde 2 Setback
Rearyard Setback
Solar Setbacks
I :UBLlC IMPROVEMENTS I
Street Improvements
Storm Sewer Avadable
Spec,all nstructlOn
New
ReSldenhal
Phone Nnmber 541-741-1707
ExpiratIOn Date Phone
Lot SIze'
Sq Ft 1st Floor 663
Sq Ft 2nd Floor 662
Sq Ft Basement
Sq Ft Garage/Carport
Sq Ft Other
Occupant Load
I
REQUIRED PARKING
Total 2
HandIcapped
Compact
S,dewalk Type
Downspouts/Drams
All storm and s1Ql"rrc~er connectIOns are to pnvate systems Dne to the nnnsual deSIgn of the pnvate sallltary
system, CIty M'lf'I.If.~'I*~M'I+~MWPNf,Wf~'ll!'~\~VfM~'lfon-standal d connectIOn
AUTHORIZED UNI]!I:t\ J MI:l t"1: IVII I l.'lIVU I
COMMENCED OR' ,'valuatIQR. _ tlOn
ANY 180 DAY PERum, Sq Ft S F t
Tv De of ConstructIOn )'-I'e It I quare 00 age
or IUU Ip Ief or Bid Amount
Notes
DescrmtlOn
Page I of 4
Value
Date Calculated
Status
Issued
225 F,fth Street, Sprmglield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 InspectIOn Lme
Dwelhnes
V Wood Frame
Fee DescriptIOn
Plan RevIew ReSidential
-Mech Iss 2+ Apphances-
+ 10% Admmlstratlve Fee
+ 12% State Surcharge
+ 5% Techuology Fee
2 Baths One or Two FamIly
Addressmg ASSignment
BUlldmg PermIt
Dryer Vent
Exhaust Hoods
FIre SF Fee - ResIdential
MInimum/Adjustment Mechanical
Plan ReVIew Major - Plannlllg
Sanitary Sewer - Improvement
Samtary Sewer - Reimbursement
SDC MWMC Admllllstratlon
SDC MWMC Impl ovement
SDC MWMC ReImbursement
SDC Sanitary/Storm Admm
SDC Transpo Improvement
SDC Transpo ReImbursement
SDC TransportatIOn Admm
Storm Drdmage ImpervIOUs Area
Temp Power 200 amps or less
Vent Fan
Wdlamalane Smgle FamIly
Total Amount PaId
Initial ReVieW
08/20/2007
PlilOOIng ReView
08/20/2007
Structural ReView
08/20/2007
Amount PaId
$49095
$40 00
$120 66
$136 84
$6727
$280 00
$35 00
$75530
$700
$1000
$6625
$1900
$205 00
$346 87
$456 17
$1000
$990 39
$95 35
$9481
$862 25
$195 48
$77 53
$490 31
$55 00
$1400
$2,303 00
$8,224 43
$103 00
Total Value of Project
Fpp(,',~
Date PaId
8/17/07
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
6/25/08
I Plan ReViews I
08/20/2007
APP NJM
08/23/2007
WE
09/10/2007
to
Paee 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01223
ISSUED: 06/25/2008
APPLIED 08/17/2007
EXPIRES: 12/25/2008
VALUE' $ 136,475.00
1,32500
$136,47500
$136,475 00
08/17/2007
Q
ReceIpt Number
2200700000000001304
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
1200800000000000692
TAJ
Waltmg untIl Plat IS recorded and
recorded copIes returned to
Planning I told Roddy Toyota thIS
on 8/23/07
LLH
Forwarded to Shawn Eaton WIth the
BUlldmg Department for revIew
under contract WIth the CIty of
Sprmgfield
CITY OF SPRINtiJ:<lJ!.LD .
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-01223
ISSUED: 06/25/2008
APPLIED 08/17/2007
EXPIRES. 12/25/2008
VALUE' $ 136,475.00
225 FIfth Street, Sprmgfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-3769 InspeetlOn Lme
Structural Review
09/10/2007
09/13/2007
APP LLH
Plans revIewed by Shawn Edton
WIth the BUlldmg Department under
contract wllh the CIty of Sprmgfield
Pubhc Works ReVIew
08/20/2007
05/1412008
APP TSS
All storm and sanitary sewer
connectIOns dre to private systems
Due to the unusual deSIgn of the
prlVdte Sdnltary system, CIty
Mamtenance Will not accept
responSlblhty for the lion-standard
connectIOn
Plannme: ReView
06/12/2008
06/12/2008
APP T AJ
Street tree to be located m front
yard of lot
ThiS meets cluster subdiVISIOn
deSign stdndards, coverage and
setbacks
To Request an inspection call the 24 hour recordmg at 726-3769 AllmspectlOns requested before 7.00
a.m. wIll be made the same working day, mspectlOns requested after 7:00 a.m. wIll be made the followmg
WOl k day
~ pr I" rp11 n < \1Pf'f.l.ll.lliJ
EroSIOII/Grddlng InspectIOn Prior to gl oUlld disturbance and after erosIOn measures are mstalled
Uler Electrical G.ound Instdll glOund rod at footmg and call for mspechon m conJunctJon WIth footmg and/or
foundation mspectlOll
Footmg After tJenchc~ dre excavdted
FoundatIOn After lorms dl e erected but p.lO. to concrete placement
Post and Bedm Prior to noOl IDsulatlOn 01 decklOg
Floor InsulatIOn Prlo. to deckmg
Shear Wall Ndlhng Belore LOvermg shedthmg WIth finish materials
Frammg InspectIOn Prior to cove. and after dll rough m mspectlOns have been approved
WalllnsulatlOn PrlOI to cove.
Ceiling InsulatIOn Prior to cover
Fmal BUlldmg After all requlI ed mspectlOns have been requested and approved and the bUlldmg IS complete
Underfloor Plumbmg Prior to msulatlOn or deckmg
Rough Plumbmg Prior to covel dnd mcludmg I eqUlred testmg
Water Lme PrlOI to Iilhng trench and mdudmg requIred testmg
SanItary Sewer Lme PrlOI to Iilhng trench and mcludmg required testmg
Pa2e 3 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO
ISSUED'
APPLIED
EXPIRES,
VALUE'
225 FIfth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
Storm Sewer Lme Prior to IiIhng tI ench
Fmal Plumbmg When all plumbmg work IS complete
Rough Mechanical P.lOr to Cover
Fmal Mechanical When all mechdnlcdl work IS complete
Temporary Electric Approv,Il, equlred prior to Utlhty Company energlzmg pole
Rough Electric Prim to Cover
Electric ServIce Approval requlI ed p.lO. to utlhty company energIZIng servIce
Fmal Electric Whell all elellrlcdl work IS complete
COM2007-01223
06/25/2008
08/17/2007
12/25/2008
$ 136,47500
By sIgnature, I state dnd agree, thdt I have carefully exammed the completed apphcatlOn and do hereby certIfy that all
mformatlOn hereon IS true and COl rect, alld I fUI the. certIfy that any and all WOI k performed shall be done m accordance wIth
the Ordmdnces 01 the CIty of Springfield and the Laws ot the State of Oregon pertammg to the work described herem, and
that NO OCCUPANCY WIll be made of dllY st. UCtUl e WIthout permISSIon of the Community Services DIvISIon, Buddmg Safety
1 further certify that only COlltl dctors alld employees who are m comphance wltb ORS 701 005 wdl be used on this project
I further agree to enSUle that all requlled mspoctlOns are requested dt the proper time, that each address IS readable from the
street, that the permit cal d IS located at the front of the property, and the approved set of plans will remdm on the sIte at all
times durmg constructIOn
o.",,",c""~A/
Date
(. ~ ZS -0 ~
Pa2e 4 of4
Date
\ill
INITIALS ~ 1------".
~ DATE(,p-7I.-.~D'i.
<fA" SOURCE~~
t~(QIZ5Io 't
ZON
225 FIFTH STREET. SPRINGFIELD. OR 97477 . PH (541)726-3753 . FAX (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number ~ fiY\') .Q"'\l 'J1 __ 0\ 'd'd.,:1.
Owners Nam~ b~ h +- k ~1.1Yt1b1 cizA
AddresPCJ \v:'O:>L 4B'e\\ J E
Clty~\ P A...~ Phon~41 -l,o-'
OWNER I~TALLATION
-
I LOCATION OF INSTALLATION
Ll<i\50 Pi ski?~
LEGAL DESCRIPTION
'\'N..CW2.- k\c....- SlJ..b 11Yl--?- \
/B DE~CRIPTION
l n rY\ A(l iJ1J,XJ.f) - / ~
- \
Permits are non-transferable and expire If work IS
not started withIn 180 days of Issuance or If work IS
Snspended for 180 days
2 CONTRACTOR INSTA1:LATION ONLY
Electncal Contractor
Addre~
~
Phone
/'
/
City
NOTICE:
THIS PERMIT SHALL EXPIR HE WORK
ALJTHO~~lEE1sB'NB'!:W'f~f81 ...':r I~ N8T
COMMENCED OR IS AS ONED FiJi(
^NY 1!f.tljjfp'J!lEff"
Constr 7r Number ~
Explf,atIon Date \
/~ture of SupervIsmg Electnclan
The Installation lS bemg made on property I own WhICh
IS not mtended for sale, lease or rent
Owners S~e t1 j / -h-,i
\7~ /
InspectIOn Request 726-3769
3 COMPLETE FEE SCHEDULE BELOW
A 1 N=-Vt~~:s]den~tI~I-&lDgl:or_I\lultI-Famll} per dwclhng Ulll! _ _
Service Included
1000 sq ft or less $11700
Each addlliOna1 500 sq ft or
portion thereof $ 21 00
Each ~1l1~<01tegon law reqUires you to
Modull'6aoolrI!lJe%eEt<l~ed by the Oregon Utility
Feed"NotlflCatlOn Center Thoo~ :~12: :.~.. ~'t8f\h
11:1 OAR ~2_00NlO1CHhrough OAR 952-001-
B Sero~b?r'lb'll''II1av-~t\l.\\'I~a$]tlfr\lt(j)D~I6iS1b\locatJon
callIng the center (Note the telephone
200 A'lIlifflll8\"for the Oregon Utility N(:$If)g~on
201 Amps to 40~ IS 1-800-332-2344$-8300
401 Amps to 600 Amps $13800
60 I Amps to 1000 Amps $180 00
Over 1000 AmpsNolts $413 00
Reconnect Only $ 55 00
C Temporar) SerVlces or Fee~er~
Installation, Alteration or Relocation
200 Amps or less r
201 Amps to 400 Amps
40 I Amps to 600 Amps
$ 55 00
$ 76 00
$11000
65
Over 600 Amps or 1009 Volts see "B" above
D Branch CirCUits
New Alteration or ExtenSion Per Panel
One Circuit
Each AdditIOnal ClfCUlt or with
Service or Feeder Penmt
$ 48 00
$ 400
MIScellaneous (Ser~lCe/feeder not mduded) -Each InstallatIOn
Pump or lITIgatIOn $ 55 00
Sign/Outline Llghtmg $ 55 00
Limited Energy/ReSldenlial $ 28 00
Limited Energy/CommefClaI $ 50 00
MIDlmum ElectriC Permit Inspection Fee IS $50 00 + Surcharges
. 55 ~
cI '1S
Y LjO
6 . c;;)
TOTAL G'l. Ca5
Shared Dnve(T )/Bulldmg Fonns/Electncal PenUlt ApphcatlOn 7 07 doc
4
SUBTOTAL OF ABOVE
8% State Surcharge
10% AdminIstratIve Fee
5% Technology Fee
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER C0M2007-01223
NAME OR COMPANY Habitat for lIumamtv
LOCATION 4850 A Street
TAX LOT NUMBER 17023241 (Tax Lot?)
DEVELOPMENT TYPE SINGLE F AMIL Y RESIDENCE
NEW DWELLING UNITS I BUILDING SIZE (SF 0 LOT SIZE (SF)
I STORM DRAINAGE
DlRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S F x [ COST PER S F CHARGE
[ 1417 00 [$0346 I ; [ $49031 [
RUNOfF ROUTED TO DRYWELL DCSIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPCRVIOUS S F I x I COST PER S F I, I DISCOUNT RATE I [
[000 I $0346 I I 50% ~I
ITEM I TOTAL - STORM DRAINAGE SDC $49031
2 SANITARY SEWER - r.lTY
A REIMBURSEMENT COS r
I NUMBbR Of DFU's [
I 17 I
x
COST PER DFU
$26 83
B IMPROVEMENT COST
[ NUMBER OF DFU's I
I 17 [
x
COST PER DFU
$20 40
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
=,
3 TRANSPORTATION
A REIMBURSEMENT COST
[ ADI TRJP RATE I x
I 957 [
B IMPROVEMENT COST
I ADT TRIP RATE I
I 957 I
I NUMBER OF UNITS I x [
[ I I [
I NUMBER OF UNITS I x I
I I [
~ ,
x
ITEM 3 TOTAL - TRANSPORTATION SDC
DISCOUNT
$000
$803 04
o
$49031
$45617
$346 87
1[.
Ir/J
~
P
o
U
c:<:
.1 ~
r/J
G
gj
11070
~
, 1091
1092
COSl PER TRIP
2043
x [NEW TRIP FACTOR[
I 100 I
COST PER TRIP
$9010
$1,05773
x INEW TRJP FACTORI
I 100 I ~ ,
4 SANITAR.Y SEWFR - MWMr
A REIMBURSEMENT COST
INUMBCR OF FEU's I
I I I
ICOST PER FEU
I $95 35
x
B IMPROVEMENT COST
[NUMBER OF FEU's I
I I
x
ICOST PER FEU
[ $99039
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I
$1,09574
11093
I
11094
I
.-----1
II
11054
I
$19548
$862 25
;
$95 35
"
,
11055
11054
1056
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ I
$3,446 82
;
$990 39
$000
$10 00
5 ADMINISTRATIVE FEE
[SUBTOTAL x I ADM FEE RATE [=
I $3,446 82 I 5% I
TOTAL SANITARY ADMINISTRATION FEE
TOTAL TRANSPORTATION ADMINISTRATION FEE
CHARGE
$172 34
Todd Smgleton
5/14/2008
TOTAL SDC CHARGES
11079
11078
-,
PREPARED BY
DATE
9481
$77 53
= I $3,61916 I
II
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT = DRAINAGE FIXTURE UNITS
(NOTE FOR REMODELS CALCULATE ONLY THE NET ADDmONAL FIXTIJRES)
NO OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
IBATH1lJB 1 0 3 = 3
IDRJNKlNG FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE / OIL / SOLIDS! ETC 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0
ILAUNDRY TUB 0 0 2 = 0
ICLOTHESW ASHER / MOP SINK 1 0 3 = 3
ICLOTIlESWASHER - 3 OR MORE lEA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRlG ! WATER STATION i ETC 0 0 1 = 0
I RECEPTOR FOR COM SINK / DISHWASHER / ETC 0 0 3 = 0
I SHOWER SINGLE STALL 0 0 2 = 0 !I
I SHOWER GANG (Nl}MBER OF HEADS) 0 0 2 = 0
I SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3
ISINK COMMERCIAL BAR 0 0 2 = 0
ISINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
ISINK SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2
IURINAL, STALL / WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 17
"'EDU (EqUivalent Dwellmg Ullit) 15 a discharge eqUivalent to a smgle fanuly dwelling urnt (20 OFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE
1- ~~D -,
I
I
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
]996
1997
1998
1999
2000
2001
CREDlTRATE/$I,OOO 1
A~~l'~~l'n VALUE
$529
$529
$519
$512
$498
$480
$463
$440
$407
$367
$322
$273
$225
$180
$159
$145
$125
$109
$092
$072
$048
$028
$009
$005
IS LAND ELGIBLE 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
1979
2
2
CREDIT FOR LAND (IF APPLICABLE)
VALUE / 1000 CREDIT RATE
$000 x $529
~ ,
$000
CREDIT FOR IMPROYEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$000 x $529 ~ ,
o
=
$000
TOTAL MWMC CREDIT
225 FIfth Street
Sprmgfield, Oregon 97477
541-726-3759 Phone
i(~
CIty of Sprmgfield OfficIal ReceIpt
Development ServIces Department
PublIc Works Department
Job/Journal Number
COM2007-0 1223
COM2007 -01223
COM2007-0 1223
COM2007-0 1223
COM2007-0 1223
COM2007 -0 I 223
COM2007-01223
COM2007 -0 I 223
COM2007 -0] 223
COM2007-0 1223
COM2007-0 1223
COM2007-0 1223
COM2007-0 1223
COM2007-0 I 223
COM2007-01223
COM2007-0 I 223
COM2007-01223
COM2007-0 I 223
COM2007-0 1223
COM2007 -0] 223
COM2007-0 I 223
COM2007 -01223
COM2007-01223
COM2007-0 I 223
COM2007-0 1223
Payments
Type of Payment
Check
cRecemtl
RECEIPT #.
1200800000000000692
Date' 06/25/2008
Description
Fire Sf Fee - ResidentIal
Temp Power 200 amps or less
Willamalane Smgle FamIly
Addressmg AssIgnment
Building Penn It
2 Baths One or I wo family
Vent Fan
Exhaust Hoods
Dryer Vent
Minimum/AdJustment Mechanical
-Mech Iss 2, Apphances-
Storm Dramage ImpervIOus Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Ilnprovement
SDC Transpo ReImbursement
SDC I ranspo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC AdminIstration
SDC Samtary/Stonn Admin
SDC 1 ransportatlon Admin
Plan RevIew Major - Plannmg
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative ree
Paid By
SPFD CUG HABITA r
Item Total
Check Number AuthOrizatIOn
Received By Batch Number Number How Received
dJb
1570
I n Person
Payment Total
Page I of I
10 II 52AM
Amount Due
6625
5500
2,303 00
3500
755 30
280 00
1400
1000
700
1900
4000
4903]
45617
346 87
19548
862 25
9535
990 39
1000
948]
77 53
205 00
6727
13684
12066
$7,73348
Amount Paid
$7,73348
$7,73348
6/25/2008
~~ Willamalane
t _ Park & Recreation Dlstnct
Job No ( PIYYll rTf), - 0 I d.- d.,3
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007
NAME\""'\(A___b~}-CL~ ~2/ 1\:~,Um(lJ'{\l'HONE i4'-j'-ct'),w
ADDRES~'O ~~ 4~~CITy{;pf\(L STATE@IP C(,'--ol
LOCATION OF PROPOSED BUILDING SITE
Street Address LI ~S 0
Plat Name
(l,
S-\-QS~-'<::-
Tax Lot Number
1 DEVELOPMENT TYPE (Check appropnate dwellmg{s) Dwelling type definitions are on the
back)
A Slnale-Famlly Detached
NO OF UNITS
B Slnale-Famlly Attached
NO OF UNITS
C Multi-Family Aoartment
NO OF UNITS
D Slnale Room Occuoancy
NO OF UNITS
E Accessory Dwelllna Unit
NO OF UNITS
WILLAMALANE SDC
X $2,303 per unit =
_~ U'O
$ 'd.-'3o s,
X $2,426 per unit =
$
o
X $2,032 per unit =
$
o
X $1,016 per unit =
o
$
X $1,151 50 per unit =
c)
~3 0 '3
su
$
$
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)
I~ QrYl;J I\. f6\Cu~X'O- cD-&
De\elopment'Servlces Department
I \
elt of Springfield
LJ
$
cJ
$ :;) 30 S
c;>J
b / Z)/ bY
Date
5