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Home My WebLink AboutPermit Building 2006-10-20Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIED: 0711212006 EXPIRES: 06/0312007VALUE: $ 655,000.00 SITE ADDRESS: 1981 Mohawk Blvd ASSESSOR'SPARCELNO.: 1703251300500 PROJECT DESCRIPTION: Commercial Retail - Shell only and Paving Springfield TYPE OF WORK: Retail TYPE OF USE: New Owner: Address: M&M LAND LLC l0l E. BROADWAY, #l0l EUGENE OR 97401 PhoneNumber: 541-345-4860 License Expiration Date 0712u2007 03n4t2008 06t2712007 05n212008 Commercial Phone 503-225-9095 541-343-7143 541-687-5770 541-726-0100 s41-607-8879 Contractor Type C Architect General Electrical Mechanical Plumbing \s\l CONTRACTOR45539 104929 460 rNC 159425"iq SERVICE TION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: B M VB # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 6,340 Curbside 5' To Storm Sewer 30.00 Gas rt?9 Path 1 nla REQUIRED PARKING Total: Handicapped: Compact: Fully Improved Yes Sidewalk Type: Downspouts/Drains PUBLIC IMPROVEMENTS Notes: Page I of6 .J-\ t"' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIEDz 0711212006EXPIRES: 06/0312007YALUE: $ 655,000.00 Description Estimate Paving Type of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 480,000.00 175,000.00 7n0t06 7tr0t06 t0n3t06 r0n3t06 r0/13/06 10/13/06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20106 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10120106 10t20t06 10t20t06 10t20t06 t0t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20106 Value $480,000.00 $175,000.00 $655,000.00 Date Calculated 08/09/2006 08t09t2006 Total Value of Project Date PaidFee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety + l0o/o Administrative Fee + 57o Technology Fee + 87o State Surcharge Temp Power 200 amps or less -Mechanical Issuance Fee- + l0oh Administrative Fee + 5olo Technology Fee + 8olo State Surcharge Add, Alter, Extend Circ Ea Add Addressing Assignment Backflow Device Building Permit Curbcut - Additional Driveway Curbcut Permit Fire SF Fee - Non-Residential Fixture Furnace - more than 100,000 Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adjustment Mechanical Miscellaneous Plumbing Paving Perm Serv/Fdr 200 amps or less Perm Serv/Fdr 201 to 400 amps Plan Review Comm/Ind/Public Plan Review Fire & Life Safety PW Disc - 2nd Permit PW Disc - 3rd Permit Sanitary Sewer - lst 50 Feet Sanitary Sewer Each Addtl I00' SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Amount Paid $1,147.19 $705.96 $s.00 $2.s0 $4.00 $s0.00 $10.00 $399.31 $172.9s $203.97 $45.00 $31.00 $28.00 $1,800.65 $80.00 $80.00 $634.00 $182.00 $rs.00 $24.00 $4.00 $2.00 $45.00 $809.40 $63.00 $150.00 s392.92 $241.80 $-30.00 $-30.00 $4s.00 $28.00 $466.66 $9,333.16 $4s.00 Receipt Number 3200600000000000365 3200600000000000365 1200600000000001524 1200600000000001524 1200600000000001524 I 200600000000001524 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 220060000000000r471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 220060000000000147r 2200600000000001471 ['ees Paid Paee 2 of6 Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line SPRIN FIELD Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIEDz 0711212006EXPIRES: 06/0312007VALUE: $ 655,000.00 Storm Sewer Each Addtl 100' Water Line - lst 50 Feet + l0o/o Administrative Fee + 57o Technology Fee + 87o State Surcharge Water Line - Each Addtl 100' Total Amount Paid $28.00 $4s.00 $2.80 $1.40 s2.24 $28.00 10t20t06 10t20t06 u4t07 u4t07 u4t07 U4t07 2200600000000001471 220060000000000r471 2200700000000000017 2200700000000000017 2200700000000000017 2200700000000000017 $17,293.91 Plan Reviews Fire Department Review 0711712006 0811612006 OK GRG See attached comment for Fire Department Plans Review comments. WE. Received incomplete structural responses. Still waiting for items 7 and 9 (forms and contractor data). WI. Received forms and contractor data. Signed Development Agreement - 10112106. Needs completion of PIP project and Easement for 42" line before temporary occupancy is issued. Waiting for Final Site Plan submittal and Development Agreement Initial Review Plan Review Comments Plan Review Comments Planning Review Planning Review 07/12t2006 t0n2t2006 07n7t2006 07n2t2006 08/09/2006 10t05t2006 10n2t2006 APP IO APP WE LLH JMP JMP EMM IO Page 3 of6 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C:'- of Springfield Official Receipt L. elopment Services Department Public Works Department RECEIPT #: 2200700000000000470 Date: 0410212007 e:36:45AM Job/Journal Number coM2006-00865 Description Temp Occupancy Amount Due I,800.00 Item Total:$1,800.00 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check RICHARD L. HUNSAKER ddk t449 In Person Payment Total: $ 1,800.00 -im,mr ftst cReceint I flu \L./ Page I of I 41212007 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line CITY OF SPRIN Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIEDz 0711212006 EXPIRES: 06/0312007VALUE: $ 655,000.00 Public Works Review Public Works Review Structural Review Structural Review SUB Review SUB Review 07n7t2006 10nu2006 APP cJS 10n012006 10n0t2006 JLP LDAP Submitted. HOLD this permit for issuance of LDAP. SDCs added. Two curbcuts added. Fee for Encroachment permit added, however, APPLICANT MUST SUBMIT APPL.ICATION FOR ENCROACHMENT. LDAP issued 8/16 by B. Curtiss CJS 10t06t06 Called client (Chris at Concentric Architecture) to notify him of that an encroachment permit application needs to be submitted. He indicated that someone would be in to take care of this on Mon. (10/09) CJS 10t06106 Chris from Concentric Arch. called to ask if owner has to submit Encroachment Permit Application or if contractor can do this. Called Chris back and told him that the contractor can submit the application. l0/09/06 CJS Per D. Wright (via J. Prociw), no encroachment permit required. 10/11/06 cJS Per Denny Wright. Both (2) driveways were added to the PIP process. No Encroachment Permit needed. Deleted fee. Told Contractol - Unless unforseen issues Denny is unaware of, No Encroachment permit or fee's required.JlP Received final internal approval. Received 711712006. See attached documents for 12 structural comments faxed to Raymond R. Yancey. JMP called David to tell him that Bl and HVAC pass. David will see that the missing Lighting forms are sent soon. JMP JMP 10fizt2006 07fi2t2006 10t06t2006 07n712006 10n2t2006 07n8t2006 10t06t2006 07t24t2006 APP WE APP WE JF JF Page 4 of 6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIED: 0711212006 EXPIRES: 06/0312007VALUE: $ 655,000.00 Rerlrrired Insnecf 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. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Curbcut - Second: After forms are erected but prior to placement of concrete. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Exterior Lighting Temporary Electric: Approval required prior to Utility Company energizing pole. 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. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 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. Roofing: Prior to installing any roof covering. Masonry: Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Pase 5 of 6 i Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006APPLIED: 0711212006 EXPIRES: 06/0312007VALUE: $ 655,000.00 Roof Sheathing/llailing: Before covering sheathing with finish material. Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have bgen requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. 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. 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 atl required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the of the property, and the approved set of plans will remain on the site at all times du l*q-u ? Owner or Contractors Signature Date Page 6 of6 i 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone / , of Springfield Official Receipt r,cvelopment Services Department Public Works Department RECEIPT#: 2200700000000000017 Date: 0110412007 l:29:23PNl Job/Journal Number coM2006-0086s coM2006-00865 coM2006-00865 coM2006-00865 Description Water Line - Each Addtl 100' + 5% Technology Fee + 8% State Surcharge + l0o Administrative Fee Amount Due 28.00 1.40 2.24 2.80 Item Total:$34.44 Payments: Type ofPayment Paid By Received By Batch Number Number How Received Amount Paid Check MCKENZIE COMMERCIAL Jmp 67686 In Person Payment Total: $34.44 -S34-F cReceint I Page I of I I1412007 SPIII} 'ELD ZON INITIALS 1. LOCATION OFINSTALI,ATION: I ? 8 I lilot*Aw\q -E l" t 225 FIFTH STREET o SPRINGFIELD,OR97477 r PH:(541)726-3753 r FAX: (541)726-36E9 E LE CTRI CAL P ERMIT AP P LI CATI ON Ciry Job Number C(lM )oO(o-6aRb 5 Date to- B -ob 3.CAMPLETE FEE SCHEDT]LE BELO$T A. Nerv Residential - Single or Multi-Famlty per dwelling unit Service Included 1000 sq. ft. or less $106.00 Each additional 500 sq. ft. or portion thereof $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $s0.00 DATEIO-t?-2ec souRCE0I4f,EJCIS B. Services or Feeders - Installation, Alterations or Relocation: 7D3 ZSt 3lqoo too JOB DESCzuPTION S I So P Qdo.\ B\d Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1 City Electrical Contractor sg f.\r Ad&ess 4bZ3 :fsc.be \l<-<.\\h pnone b6)-s.-t I O 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps lling center, fio,xamsot less 201 Amps to 400 Amps 401 Amps to 600 Amps Pump or irrigation Sign/Outline Lighting Limited Energy/Res idential Limited Energy/Commercial 8% State Surcharge 10% Administrative Fee 5% Technology Fee $ 63.00 $ 75.00 $ 125.00 $ 163.00 $37s.00 $ s0.00 $ s0.00 $ 69.00 $100.00 s 43.00 $ s0.00 $ s0.00 s 2s.00 s 4s.00 sG oo Supervisor License Number "=l e-S 00eo- eal numbExpiration Date (o-\- ol Constr. Contr. Numb", ?-1 -:<El{'-1- \-08 -+xpi+atieOa*e CC3 to+q a? 3-\.{-08 Over 600 Amps or 1000 Volts see "B" above' Branch Circuits New Alteration or Extension Per Panel Electrician D. IIIOIIGE: IHIS PER HOR,Z Owners Name rt^tl Lo.'d tI Address City l)S.p -4gro OWNER INSTALLATION The installation is being made on prop-erfy I own which is not intended for sale, lease or rent. Owners Signature: Minimum Electric Permit Inspection Fee is $45.00 * Surcharges ItttutENc 180 ry 4. sunroratoFenow 50 ec ti "oI a,o" G l^5cInspection Request: 726-3769 TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application 8-06'doc LEGAL DESCRIPTION:I r &-tqewp. -------.1-- in OAB 9s2{l01 rules are f0IeS r,s iloT-$ 3.00 not included) -Each Installation y6rE- Status OK to Issue 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865 ISSUED: APPLIED: O7lt2l2$06 EXPIRESz 0411312007VALUE: $ 655,000.00 SITE ADDRESS: 1981 Mohawk Blvd ASSESSOR'SPARCELNO.: 1703251300500 PROJECT DESCRIPTION: Commercial Retail - Shell only Springfield TYPE OF WORK: Retail TYPE OF USE: New Owner: Address: Contractor Type Architect General Electrical Mechanical Plumbing M&M LAND LLC l0l E. BRoADWAY, #101 EUGENE OR 97401 Commercial PhoneNumber: 541-345-4860 Expiration DateContractor License CONCENTRIC ARCHITECURE MCKENZIE COMMERCIAL CONTRACTOR4ss39 JB ELECTRIC 104929 COMFORT FLOW 460 TOMS PLUMBING SERVICE INC 159425 07t2u2007 03n4t2008 06t27t2007 05n2t2008 Phone 503-225-9095 541-343-7143 541-687-5770 541-726-0r00 54r-607-8879 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: 1 isl Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: 6,340 PARKING Curbside 5' To Storm Sewer B M VB I 30.00 Gas Ih 'y t, law requi Sot$Ft Basement: REQUIRED Total: Handicapped Compact: t0 NO fffipffi"",,' Notes: Fullv I Page I of5 D U ll-l-rlt\ rJ 11\ I \rI(lYlA r IUI\ I DAY F Status OK to Issue 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865 ISSUED: APPLIED: 0711212006 EXPIRESz 0411312007VALUE: $ 655,000.00 Description Estimate Paving Type of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 480,000.00 175,000.00 7n0/06 7n0t06 10/13/06 10fi3t06 l0/13/06 l0/r3/06 Value $480,000.00 $175,000.00 $655,000.00 Date Calculated 08t09t2006 08/09/2006 Total Value of Project Date PaidFee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Temp Power 200 amps or less Total Amount Paid Amount Paid $1,147. I 9 $70s.96 $s.00 $2.50 $4.00 $s0.00 $1,914.65 Receipt Number 3200600000000000365 320060000000000036s 1200600000000001524 1200600000000001s24 120060000000000r524 r200600000000001524 tr'ees Paid Plan Reviews Fire Department Review 0711712006 08n6t2006 0K GRG 07fi2t2006 See attached comment for Fire Department Plans Review comments. WE. Received incomplete structural responses. Still waiting for items 7 and 9 (forms and contractor data). WI. Received forms and contractor data. Signed Development Agreement - 10112106. Needs completion of PIP project and Easement for 42" Iine before temporary occupancy is issued. Waiting for Final Site Plan submittal and Development Agreement Initial Review Plan Review Comments Plan Review Comments Planning Review Planning Review 07tr2t2006 08/09/2006 l0/0s/2006 10n2t2006 APP IO APP WE LLH JMP JMP EMM IO 10n2t2006 07n7t2006 Pase 2 of 5 Valuation Descrintion I Status OK to Issue 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865 ISSUED: APPLIED: 0711212006 EXPIRESz 0411312007VALUE: $ 655,000.00 Public Works Review Public Works Review Structural Review Structural Review SUB Review SUB Review 07n7t2006 10nU2006 APP CJS 10n0t2006 10fi0t2006 JLP LDAP Submitted. HOLD this permit for issuance of LDAP. SDCs added. Two curbcuts added, Fee for Encroachment permit added, however, APPLICANT MUST SUBMIT APPL.ICATION FOR ENCROACHMENT. LDAP issued 8/16 by B. Curtiss CJS 10t06/06 Called client (Chris at Concentric Architecture) to notify him of that an encroachment permit application needs to be submitted. He indicated that someone would be in to take care of this on Mon. (10/09) CJS 10t06t06 Chris from Concentric Arch. called to ask if owner has to submit Encroachment Permit Application or if contractor can do this. Called Chris back and told him that the contractor can submit the application. 10/09/06 CJS Per D. Wright (via J. Prociw), no encroachment permit required. l0/11/06 cJS Per Denny Wright. Both (2) driveways were added to the PIP process. No Encroachment permit needed. Deleted fee. Told Contractor - Unless unforseen issues Denny is unaware of, No Encroachment permit or fee's required.JlP Received final internal approval. Received 7/1712006, See attached documents for l2 structural comments faxed to Raymond R. Yancey. JMP called David to tell him that BI and HVAC pass. David will see that the missing Lighting forms are sent soon. JMP JMP 10n2t2006 07n2t2006 10t06t2006 07n7t2006 10t12t2006 07n8t2006 10t06t2006 07t24t2006 APP WE APP WE JF JF Page 3 of5 Status OK to Issue 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Frx 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865 ISSUED:APPLIED: 0711212006EXPIRES: 0411312007VALUE: $ 655,000.00 Reouired fnsnections 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. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Curbcut - Second: After forms are erected but prior to placement of concrete. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Exterior Lighting Temporary Electric: Approval required prior to Utility Company energizing pole. 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. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 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. Roofing: Prior to installing any roof covering. Masonry: Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Paee 4 of 5 Status OK to Issue 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865 ISSUED: APPLIED: 0711212006 EXPIRESz 0411312007VALUE: $ 655,000.00 Roof Sheathing/1.{ailing: Before covering sheathing with linish material. Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to Cify Building Inspector prior to placement. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. 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. 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 atl 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. Owner or Contractors Signature Date Page 5 of 5 T 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Ciq of Springfield Official Receipt L elopment Services Department Public Works Department RECEIPT #: 1200600000000001524 Date: 1011312006 l0:35:08AM Job/Journal Number coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 Description + 5% Technology Fee + 8% State Surcharge + l0%o Administrative Fee Temp Power 200 amps or less Amount Due 2.50 4.00 5.00 50.00 Item Total:$61.50 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check JB ELECTRIC INC djb t7512 In Person Payment Total:$61.50 $61 .s0 cReceint I Page I of I 10il3t2006 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIEDz 0711212006 EXPIRESz 0412012007VALUE: $ 655,000.00 SITE ADDRESS: 1981 Mohawk Blvd ASSESSOR'SPARCELNO.: 1703251300500 PROJECT DESCRIPTION: Commercial Retail - Shell only Springfield TYPE OF WORK; Retail TYPE OF USE: New Owner: Address: M&M LAND LLC 101 E. BROADWAY, #101 EUGENE OR 9740I CONTRACTOR45539 I u2007 lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Commercial Phone 503-225-9095 s4t-343-7143 541-687-5770 541-726-0100 541-607-8879 6,340 Curbside 5' To Storm Sewer PhoneNumber: 541-345-4860 License Expiration DateContractor Type Architect General Electrical Mechanical Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improyements: Storm Sewer Available: Special Instruction: 1r) 008 UMBING SERVICE INC #of Sprinkled o\ ,o $.? B M VB Ra I Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Fully Improved yes Sidewalk Type: Downspouts/Drains: PUBLIC IMPROVEMENTS Notes: Page I of6 {s.o nla L['Y Dl,UrlV[t N I t1\I \-rt(1vlA I tut\ Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIEDT 0711212006 EXPIRESz 0412012007VALUE: $ 655,000.00 Description Estimate Paving Type of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 480,000.00 175,000.00 Value $480,000.00 $175,000.00 $655,000.00 Date Calculated 08t09t2006 08t09t2006 Fee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety + lloh Administrative Fee + 57o Technology Fee + 8%o State Surcharge Temp Power 200 amps or less -Mechanical Issuance Fee- + l0o/o Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Addressing Assignment Backflow Device Building Permit Curbcut - Additional Driveway Curbcut Permit Fire SF Fee - Non-Residential Fixture Furnace - more than 1001000 Furnace - up to 100,000 btu Gas Outlets l-4 Minimum/Adj ustment Mechanical Miscellaneous Plumbing Paving Perm Serv/Fdr 200 amps or less Perm Serv/Fdr 201 to 400 amps PIan Review Comm/Ind/Public Plan Review Fire & Life Safety PW Disc - 2nd Permit PW Disc - 3rd Permit Sanitary Sewer - lst 50 Feet Sanitary Sewer Each Addtl 100' SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Amount Paid Total Value of Project Date Paid Receipt Number 3200600000000000365 3200600000000000365 120060000000000r524 r200600000000001524 1200600000000001524 120060000000000r524 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 220060000000000r471 2200600000000001471 220060000000000r471 2200600000000001471 2200600000000001471 220060000000000147r 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 2200600000000001471 $1,147.19 $705.96 $5.00 $2.50 $4.00 $50.00 $10.00 $399.31 $172.95 $203.97 $4s.00 $31.00 $28.00 $1,800.65 $80.00 $80.00 $634.00 $182.00 $1s.00 $24.00 $4.00 $2.00 $45.00 $809.40 s63.00 $150.00 s392.92 $241.80 $-30.00 $-30.00 $45.00 $28.00 s466.66 $9,333.16 $45.00 7n0t06 7n0t06 10/r3/06 t0n3t06 10/13/06 10/13/06 t0t20t06 10t20t06 r0t20t06 r0t20t06 r0t20/06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 10t20t06 t0t20t06 10t20t06 t0t20/06 10t20t06 r0/20t06 10t20t06 t0t20t06 t0t20t06 t0/20/06 10t20t06 r0t20t06 10t20t06 10t20t06 10120t06 t0t20t06 t0t20t06 10t20t06 10t20t06 Fees Pa Paee 2 of6 Valuation Descriotion I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-126-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 10/2012006APPLIED: 0711212006 EXPIRESz 0412012007VALUE: $ 655,000.00 Storm Sewer Each Addtl 100' Water Line - lst 50 Feet Total Amount Paid $28.00 $4s.00 $17,259.47 10t20/06 10t20t06 2200600000000001471 2200600000000001471 Plan Reviews Fire Department Review 0711712006 08n6t2006 OK GRG See attached comment for Fire Department Plans Review comments. WE. Received incomplete structural responses. Still waiting for items 7 and 9 (forms and contractor data). WI. Received forms and contractor data. Signed Development Agreement - 10112106. Needs completion of PIP project and Easement for 42" line before temporary occupancy is issued. Waiting for Final Site Plan submittal and Development Agreement Initial Review Plan Review Comments Plan Review Comments Planning Review Planning Review 07n2t2006 10n2t2006 07n7t2006 07n2t2006 08/09/2006 l0/05/2006 10112t2006 APP IO APP WE LLH JMP JMP EMM IO Paee 3 of6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006APPLIED: 0711212006 EXPIRESz 0412012007VALUE: $ 655,000.00 Public Works Review Public Works Review Structural Review Structural Review SUB Review SUB Review 07/17t2006 10nU2006 APP CJS t0n0/2006 10n0t2006 JLP LDAP Submitted. HOLD this permit for issuance of LDAP. SDCs added. Two curbcuts added. Fee for Encroachment permit added, however, APPLICANT MUST SUBMIT APPL.ICATION FOR ENCROACHMENT. LDAP issued 8/16 by B. Curtiss CJS 10t06t06 Called client (Chris at Concentric Architecture) to notify him of that an encroachment permit application needs to be submitted. He indicated that someone would be in to take care of this on Mon. (10/09) CJS 10t06t06 Chris from Concentric Arch. called to ask if owner has to submit Encroachment Permit Application or if contractor can do this. Called Chris back and told him that the contractor can submit the application. 10/09/06 CJS Per D. Wright (via J. Prociw), no encroachment permit required. l0/u/06 cJS Per Denny Wright. Both (2) driveways were added to the PIP process. No Encroachment permit needed. Deleted fee. Told Contractol - Unless unforseen issues Denny is unaware of, No Encroachment permit or fee's required.JLP Received final internal approval. Received 711712006. See attached documents for l2 structural comments faxed to Raymond R. Yancey. JMP called David to tell him that BI and HVAC pass. David will see that the missing Lighting forms are sent soon. JMP JMP 101t2t2006 07n2t2006 t0/06t2006 07/r7t2006 t0n2t2006 07fi8t2006 10106t2006 07t24t2006 APP WE APP WE JF JF Pase 4 of6 h* Status Issued 225 Fifth Street, Springfield, OR 541-126-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIED: 0711212006 EXPIRESz 0412012007YALUE: $ 655,000.00 Renrrired fnsnecf 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. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Curbcut - Second: After forms are erected but prior to placement of concrete. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following Cify Rough Mechanical inspection approval and prior to any cover. SUB Exterior Lighting Temporary Electric: Approval required prior to Utility Company energizing pole. 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. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 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. Roofing: Prior to installing any roof covering. Masonry: Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Pase 5 of6 T Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00865ISSUED: 1012012006 APPLIEDz 0711212006 EXPIREST 0412012007VALUE: $ 655,000.00 Roof Sheathing/l.lailing: Before covering sheathing with finish material. Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector, High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. 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. 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 Cify 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 properfy, and the approved set of plans will remain on the site at all times during construction. lO-z ct -c: e Owner or Contractors Signature Date Page 6 of6 I 225 FIFTH STREET . SPRINGFIELD,OP.97477 o PH:(541)726-3753 r FAX: (541)726-3689 E LECTRICAL P ERMIT APP LI CATION Ciry Job Number a Cr\ SP,III ELD ZON INITIALS U DATE SOURCE Date 3 COMPLETE FEE SCIIEDULE BELO'II' A.Nerv Residential - Single or Multi-Family per dwelling unit' c<> 1 1. LOCATION OF INSTALNNTTON: [-] oZ Z5 \Z fr>oo LEGAL DESCRIPTION:rqtl t\ o'ho r^i( JOB DESCRIPTION sh<. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 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 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps CONTRAC T A R IN STALIATTON ONLY1 Electrical Contractor Address 4bq6 a-<o V''o\Q S,+. \ A $s0.00 $ 63.00 (o1" " $ 7s.00 \ 56.o"t/ \$ 12s.00 $ 163.00 $ 43.00 U I,LJCityE.aQglae- Phone I U Supervisor License Number 3A1a - 3 Expiration Date 1(l- t -ol Over 1000 Amps/Volts Reconnecti{iitft. N i i t-r rul96 adoPted C. D. ccft:s Exeira*i€iDate loc{ Qr q 3- I q-ag Owners Name M0v"\A LLC Over 600 Amps or 1000 V New Alteration or Extension Per Panel olts see "B" above. T. Address D INSTALLATION The installation is being made on properry I own which is not intended for sale, lease or rent. Owners Signature: E PurddrM il:fi&0AY P E R I 0 t) Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial 4. SUBTOTALOFABOW 8% State Surcharge l0% Administrative Fee 5% Technology Fee Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 'lllol E. Ytc0 One Circuit E"dil 0.i1fi &i"l circuit or s".fiqppffiftfPgpfiL I&t'C,frur woHK q5,o" IT tS NO $ s0.00 $ s0.00 $ 2s.00 $ 4s.00 aSg.oo ao,b{ -===--fet.-jtr.:s Inspection Request: 7 26-37 69 TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application 8-06'doc fi(o B. Services or Feeders - Installation, Alteratiotrs or Relocation: Constr. Contr. Numb* 3?581 L l- l'CB $ 106.00 $ 19.00 Installation 9Plll NGFIELE! i i,'':.':,'i,,:l' IV\rVA r-*"b'lJt-. Orrncr Namc (Printcd) Fer or Architcct Firm (Printcd) TEsrrlr +-llgce Ciry of Springfield Com mun ity Scrviccs Division 225 Fifth Strcet Spring{ield, OR 97477 Te lephone (5 4l) 726-37 59 Foc (541) 726-3689 |\o(r^rto...b**"**r( Gen. Contractor Firm Nanre (Printcd) F Y.oiztr*tk- ( .e,*t Project Titlc I Addrcss o C' &, 19ooo o otI t, !{ tn- gt t aa ogl o6 I(') H2.N Itt oo EE'z() t- Speciel lnspection rnd Testing finishcd, ecknowlcdge an undersranding of thc information by signing bclow, and rehrrn this fontt to lhc City. City for rtview and apprcval this ibrm complelcd on bolh thc front nnd bach. Thc orrnsr arrd Gcncral Contractor, $hcrc applicable, shall also acknowledgcthc btlowing condilions rpplicable to Spccial lnspcction and/or'Icsting. l. Contractor is rcsponsiblc for propcr notification for thc lnspccrtion or Tcsting ofitems listed. 2. Testing labomtory shall takc appropialc samples and ttursport thenr !o lhrir labotatoty for propcr cvalralion or lcsting. o Copies of atl laboratory rcports and inspectiorx arc to bc sdrt lo thc City by the Tcsting Agcncy. 3- Spccial Iospcction Agcncy is to submit namcs and qualifications of on+ilc Speciil Inspectors to tlre City for approval. 4. Spccial lnspcctor shall provldc inspcction reports to the building oflicial ofall inspeclion activitics. J. Contractor is rosponribh to revicw the City approved plans for additionrl inspcction or testing requlrctnents tbat may be uoted. BEFTORB A CERTIFICATE OFOCCUPANCY WILL BE ISSUEDI Thc Spccial Inspection Agcncy shall submit lo thc Buildirg Ollicial a slatlmsnt that all items rcquiring provisions. Thosc items not tcstcd and,/or inspcctcd shall bc noted in thc sLtomcnt. The rcporr is to bc submincd to flc City prior to s request for fingl inspections. ACKNOWLEDGEMENTS Conlractor Sign. 6o€N C'c C'I Testing Laboratory Name (Printcd)ReP.Building Namc (Printod) Cot:!',zxv.'oo$uf l-t>zreu Building Permit # Date ) Concrctc Gunitc Groul Mortar AcransalcTcst of Mix De:icn Rcinficrcinr Tcst t'tix O.sign-rvclefia.G;a;rtj -x Continuous Barch Plmt Inspcct Placing Cast Samplcs Sarnolcs (PickuoiDe livercd) Comprcssion Tcstr Concrcb: Piles Post-Tcns Pre-'lens Chddinc AcsrtratE Tcsts Rcinforcinn Tcsts Tcndoo Test Mix Deslcns. Rainforcinr Placcmcnt Inscrt Placcmcot Concrctc Batchin{ Conc?cle Ptaccmenl lnslatlation lnsneclion Cost Scrnphs Pick.up Samrlcr Comprcssion Tcslr ADD!TION.d.L tNltRucTroNq oTHER TEST, & INSPECTIONS: SPECIAL INSPECTION AND TESTING SCHEDULE Form Complctcd Datc GRADING. EJ(CAVATION, AND FILL Acccplansr tostt +_PSF Ertablish final Fill placcmcnt Soll Dorsity gradc inr pcetlory'oonthruous STRUCTURAL STE EI.TWELIIING: Samplc and lcst (list spccific mcnrbers bclow) Shop matcrial ldentifioation (mill cen) X Wcldinspeoion I shop X fieU Ullrasonicimpec.tion___Shop Ficld Y - Hichstr$stlrBoltirrg Shoir7-fi.U- Al?5 l_N _XA{90 _N _X Mctal dcck wclding lnspcction Rcinforcing Sbel welding inspcction Rcinforcing stecl mill ccrtilicarc Mctrl stud wclding inspcction Concrclc inserl wclding inspcclion Momorl rcsisting stccl lruncs -F F STRUCTURAL IrYOOD: X Shearwnll nailing inspeoliou Shcsr wall anchors lnspcction ofGlu-lrm fab. ' T/C psi lnspeotiorr of truss joisl fnb. Sarple ond test components Fabricltion rvelding of steel ncccssorkls MASONRY Special inspection sresEs uscdr f m _fg Preliminary accrptrncc t€st! (rnarcnry units, wall prisos) Subsegucnl tcsts (morLr,Irout, field wall prismr) Plocement irrspection of uuils, and rcinforcemcnt Masonry, mortar, grout, and rcinforcing stecl certificalcs ) o It, Eooo 3otl tl b{ arr 'DH q u C' OrC'ot tao H2N It ootTtrtFo l- SMOKE CONTX,OL: Leskase testin[ _Control Vsrilicalion ROOFINGT FIREPROOFING: -Placcmcnt inspection _Dcnsity tcstl _Thicknes rests _luspcct batchlng instollatio.y'R-V aluer _Test sripYscams *PROVIDD, STRENGTH R.EQUIRED BY ARCHITECf OR ENGINEER OR CONTRACT DOCUMENT IOCATION OB VALUES 6o€qt c6 aJl lc. Crout anr ATTACHMENTA CITY OF SPRINGFIELD SYSTEMS DEVEIOPMENT CTTARGE WORKSHEET JOURNAL OR JOB NI.IMBER COM2OO6-00865 NAMEORCOMPANY I,OCATION: MOHAWK'CORNER" 198 I .WKBLVD MAP&TAXLOTNUMBER: 17 0325 13 00500 DEVEI,OPMENT TYPE:Sliell for Drive-thru bank and office./retail NEW DEVETOPED AREA (S.F.):3,083.00 drive-thru balk NEW DEYEI,oPED AREA (S.F.): 3259.00 Specialty Retail? TOTAL IMPERVIOUS SURFACE (S.F.):27 1. STORM DRAINAGE IMPERVIOUS SQ.FT.27,809 x $ 0.336 PER SF ITE: ITE: r.oT SZE (S.F.): E14 37635 $8,280.72 $36,525.68 NTF $2,146.24 s9,466.91 912 TOTAL STORM DRAINAGE SDC: $158.97 $1,676.87 16 2. SANITARY SEWER4ITY A REIMBURSEMENTCOST: NUMBER OF DFLIs B. IMPROVEMENTCOST: NUMBER OF DFU's (SEE REVERSE SIDE) &** rd A"..././ A*- SDC COORDINATOR WILL SUBMIT WITH TENANT INFILL x $ 26.03 PER DFU0 0 x $ 19.79 PER DFU $ 45.82 TOTAL LOCAL WASTEWATER SDC: NTF NTF 3, TRANSPORTATTON ESTIMATE - WILL SUBI\{IT WTTH TENANT INFILL BLDG AREA TGSF X TRIP RATE X COST PERADTXNEW TRIP FACTOR NEW A REIMBURSEMENT COST: 3.08 x 246.49 x $ 19.81 PERTRIP x Effiffir'reN"rcos-F- 3.08 x 246.49 x $ 87.39 PERTRIP x NEW (a A REIMBURSEMENTCOST: 3.26 x 44.32 x $ 19.81 PER TRIP x ElTilnovsr'svr cos:i- 3.26 x M.32 x $ 87.39 PERTRIP x 0.55 0.55 0.75 0.75 $ 107.20 NTF TOTAL TRANSPORTATION REIMBURSEMENT SDC TOTAL TRANSPORTATION IMPROVEMENT SDC 4. SANITARY SEWER - MWMC NEW: A REIMBI,JRSEMENT COST: NUMBER OF FEU's B. IMPROVEMENT COST: NL.IMBER OF FELIs NEW(2): A. REIMBIIRSEMENT COST: NIIMBER OF FELIs B. IMPROVEMENT COST: NLIMBER OF FEU"s 3.08 3.26 3.26 MWMC CREDIT tr APPLICABLE (SEE REVERSE) 5. ADMIMSTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) TOTAL TRANSPORTATION SDC : ESTIMATE -WILL SUBMIT WTTE TENANT INNLL 3.08 $s 1.56 PERFEU PER FEU x $543.91 $23.44 x s247.23 SUBTOTAL (ADD ITEMS I, 2, 3, & 4) $9,333. l6 x 814t2006 PER FEU PER FEU $76.38 TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMIMSTRATIVE FEE: I'OTALMWMCSDC 5% x x TOTAI TRANSPORTATION ADMIMSTRATION TOTAL SEWER ADMIMSTRATION DATE $0.00 $0.00 $0.00 $45,992.59 10.00 727.95 3.16 $466.66 $lr $ 466-66 s9,799.82 com20o5-00865, SHELL- MOHAWK CORNER, 1981 MOHAWK BLVD.xls TOTAL SDC CHARGES 1 JULY 2OM 1178 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Ci' - .f Springfield Official Receipt De' clopment Services Department Public Works Department RECEIPT #: 2200600000000001471 Date: 1012012006 l0:55:43AM Job/Journal Number coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 Description Addressing Assignment Fire SF Fee - Non-Residential Fixture Sanitary Sewer - lst 50 Feet Sanitary Sewer Each Addtl 100' Water Line - lst 50 Feet Storm Sewer - lst 50 Feet Storm Sewer Each Addtl 100' Backflow Device Miscellaneous Plumbing Curbcut Permit Curbcut - Additional Driveway PW Disc - 2nd Permit PW Disc - 3rd Permit Storm Drainage Impervious Area SDC Sanitary/Storm Admin Building Permit Paving Plan Review Comm/Ind/Public Plan Review Fire & Life Safety Furnace - up to 100,000 btu Furnace - more than 100,000 Gas Outlets l-4 M in imum/Adj ustment Mechanical -Mechanical Issuance Fee- Perm Serv/Fdr 200 amps or less Perm Serv/Fdr 201 to 400 amps Add, Alter, Extend Circ Ea Add + 5%o Technology Fee + 8% State Surcharge + l|oh Administrative Fee Amount Due 31.00 634.00 r 82.00 45.00 28.00 45.00 45.00 28.00 28.00 45.00 80.00 80.00 (30.00) (30.00) 9,333.16 466.66 1,800.65 809.40 392,92 241.80 24.00 l5.00 4.00 2.00 10.00 63.00 150.00 45.00 172.95 203.97 399.31 $15,344.82Item Total Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check Change MCKENZIE COMMERCIAL CONTRACTORS, INC. jmp 67056 In Person In Person Payment Total: $15,351.32 ($6.s0) $15,344.82 cReceint I Page I of2 1012012006 RECEIPT #: 120060000000000r471 e:1012012006 l0:55:43AM Job/Journal Number coM2006-0086s coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00E65 coM2006-00865 coM2006-0086s coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-0086s coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 coM2006-00865 Description Addressing Assignment Fire SF Fee - Non-Residential Fixture Sanitary Sewer - I st 50 Feet Sanitary Sewer Each Addtl 100' Water Line - lst 50 Feet Storm Sewer - lst 50 Feet Storm Sewer Each Addtl 100' Backflow Device Miscellaneous Plumbing Curbcut Permit Curbcut - Additional Driveway PW Disc - 2nd Permit PW Disc - 3rd Permit Storm Drainage Impervious Area SDC Sanitary/Storm Admin Building Permit Paving Plan Review Comm/Ind/Public Plan Review Fire & Life Safety Furnace - up to 100,000 btu Furnace - more than 100,000 Gas Outlets l-4 M inimum/Adj ustment Mechanical -Mechanical Issuance Fee- Perm Serv/Tdr 200 amps or less Perm Serv/Fdr 201 to 400 amps Add, Alter, Extend Circ Ea Add + 5olo Technology Fee + 87o State Surcharge + l|Yo Administrative Fee Amount Due 31.00 634.00 182.00 45.00 28.00 45.00 45.00 28.00 28.00 45.00 80.00 80.00 (30.00) (30.00) 9,333.16 466.66 1,800.65 809.40 392.92 241.80 24.00 I 5.00 4.00 2.00 r 0.00 63.00 150.00 45.00 172.9s 203.97 399.31 $15,344.82Item Total Payments: Type of Payment Paid By CheckNumber Authortzatton Received By Batch Number Number How Received Amount Paid Check Change MCKENZIE COMMERCIAL CONTRACTORS, INC. jmp 67056 In Person In Person Payment Total: $15,351.32 ($6.s0) $15,344.82 cReceint I Page 2 of 2 1012012006