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Home My WebLink AboutPermit Building 1995-12-11SPR!i.GF!ELE, RESTDENTIAT PERMIT APPLICATION CITY OF SPRINGFIELD COMMI'NITY SERVICES DIVISION BUILDING SAFETY Page 1 ilob Number: 951559 225 North FifEh street Springfield, OR 97477 Location of Proposed Work: 1491 WIMBLEDON PL Assessors ttap #: L7033422 Lot: 13 Block: Office Inspection Line 726 -37 59 726 -37 69 Tax Lot #: 00815 Subdivision: OAKTREE CITY OF SPilNGFTELD, ONEGON OWNET: .TOHN PENUTE Address: PO BOX 5821 Describe Work: S.F. RESIDENCE Phone #: 744-09L6 city/state/ztp: EUGENE, OREGON 97405 NEW ConEractsor Conat. Contractor #Expires Lo/05/ss os/06/e6 05 /2s / e6 06/08/e5 Phone 7 44 - O9t6 485-LL45 34s-2838 7 47 - OSL1 General-: Plumbing: Mechanical: Electrical: QUAD AREA: 1RNW # OF UNITS: l- CONSTR. TYPE: VN WATER HEATER: G SQ FOOTAGE: 4L4O -- oFFrcE usE -- LAND USE: 111-l- ZONING CODE: LDR # OF BDRMS: 4 RANGE: G # OF BLDGS: 1 OCCY GROUP: R3 SECONDARY HEAT: FP INSUL PATH: Pl To requeat an inspection, cal-I the 24 hour recording aL 726-3769 A11 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. --- REQUTRED TNSPECTTONS --- SITE - To be made aftser excavation but prj-or to setting forms. FOOTING - After trenches are excavated. FOITNDATION - After forms are erecEed but prior to concrete placement ITNDERFLOOR PLITMBING - Prior to insulation or decking. ITNDERFLOOR IIECHAI{ICAL - Prior to insulation or decking. POST AI{D BE"AII - Prj-or to floor insul-aLion or decking. INSULATION - Floor; prior to decking Wal}/Ceiling; Prior to cover SAIiIITARY SEWER LINE - Prior Eo filling trench. STORM SEWER IJINE - Prior to filling trench. WATER LINE - Prior to filling trench. ROUGH PLUIIBING - Prior to cover. ROUGH DIECIIATiIICAL - Prior to cover. ROUGH ELECTRICAL - PTiOT EO COVET. FRAIIING - Prior to cover. INSUIJATION - Floor; prior to decking Wa11/Ceiting; Prior to cover DRYYiIALL - Prior to taping. ELECTRICAL SERVICE - Must be approved to obtain permanent power. ROUGH GAS - after line is instalfed and capped if not attached to an appliance FINAL GAS - When all gas work is complete. CITRBCIII - After forms are erected but prior to placement of concreEe SIDEWALK - AfEer excavation is complete, forms and sub-base material in pIace. SOVEREIGN BUILD 0086477 L318 Wimbledon Place SpringfieLd OR CUSTOM PLI]MB]NG 0081994 3248 KenEwood Dr Eugene OR 97401000 HOME COMFORT 0084154 85262 Peaceful- Valley Rd Eugene OR LH MORRIS OOO1838 PO Box 456 Eugene OR 974400000 SPRINGFIELD Job Number: 95L569 CITY OF SPilNGFIEI^D, ONEGON Page 2 FINAL PLUUBING - When all plumbing work is complete. FINAL MECIIANICAL - when all mechanical work is complete. FINAL ELECTRICAL - When all electrical work is complete. FINAL BUILDING - When all required inspections have been approved and the building is complete. Lot Faces: N Topography: 0 House Garage Lot Sq. Ft Lot Type: Setbacks swE 15. 25 5 : L2027. INTERIOR Lot Coverage: 34 Z N 5 Item Main Garage Total Value Building PermiE Fee Surcharge/Admin TOTAL FEE --- BUII.DING PERMIT --- Square Feet x 3588 552 $/Sguare FeeE s6.2 L4.t (A) Value 2Ot ,646 . OO 7,783.00 2O9 ,429 . OO 734 .95 --- SYSTEMS DEVEI.OPITENT CIIARGE (SDC) (B)3 ,04L.82 Systems Development Charge is due on all- undeveloped properties witshin the City limits and the Citys Urban Growth Boundry which are being improved. PI,I'MBING PERMIT --- ftem Fixtures Residential Bath(s) Sanitary Sewer WaEer Plumbing Permit Surcharge/aamin TOTAI, CHARGE 0 4 70 70 Fee 0.00 t92 .50 15.00 15.00 222 .50 17.81 240.3L(c) --- }TECIIAT{ICAI. PERMIT --- Furnace Exhaust Hood Vent Fan Wood Stove / tnsert /Fireplace Unit Dryer Vent Mechanical Permit Issuance Surcharge/Admin TOTAL PERMIT 5 7 .50 4.50 t-5.00 15.00 3.00 (D) 45.00 10.00 3.50 s8.50 --- IdISCELI.A}IEOUS PERMITS --- Surcharge/admin Sidewalk Curb Cut WILLAMA.LENE 0 13 13 1, 000 00 00 UU 00 TOTAI. UISCEI.I.A}iIEOUS PERMITS (E)1,025.00 580. s0 54 .45 SPRINGFIELD .fob Nunber: 951669 CITY OF SPilNGFIELD, ONEGON Page 3 (Excluding EIectsrica1 ) unlese otherwise noted --- TOTAL AI,TOI'NT DUE --- (A, B, C, D, and E combined)5, 101. 58 --- BUITDING VALUE, PLA.\I CHECK AIID BUIIJDING PERIIIT --- This permit. is granted on the express condition that Ehe said construction sha]I, in all respecUs, conform to the Ordinance adopted by the City of Springfield, including the Devefopment Code, regulating the construction and use of buildi-ngs, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. PIan Check Fee:. 442.33 Date Paid Received By: Pl-ans Reviewed By: DUAIiIE HUSSEY Date Building Site Reviewed By: LISA HOPPER LO /L7 / es L2/05/9s Receipt Number z 1-931-2 --- ADDITIONAL COMMEIITS --- DRIVEWAY REQUIRED TO BE PAVED By signature, I stsate and agree, thaE I have carefully examined the completed application and do hereby certify that afl informaEion hereon is true and correcL, and I furEher certify that any and aII work performed shall be done in accordance with the Ordinances of the City of Springfield, and Ehe Laws of Ehe State of Oregon pertaini-ng Eo the work described herein, and thats 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 701.055 wif] be used on Ehis project. I further agree to ensure that all required inspections are reguested at the proper time, that each address is readable from the sEreet, that the permit card is located aL Lhe front of the properEy, and the approved set of plans will remain on the site at all Eimes during consLructj-on. 2a /( 2{ s ure Date --- VAI.IDATION --. Receipt Number: Date Paid: AmounU Received: Received BY: 2 ?u G /?7' t SPRII\ICFI€LO 225 ETFTB SIREET SPRINGFIELD, oRBGoN 97477 INSPECTTON REQTIEST: OFETCE: '726-3759 1 LOCATION OP I,EGAI DBSCRTPTION JOB s not requii:e spocrfic iend uee A BTACTRICAL PERHIT APPIJCATION City Job Nunber SCEEDTTLE BBI.OV New Residentlal-Single or Hulti-Family per dvelling unit. Service Included:Items Cost $ Bs.oo The zoning, and approval. Authorlzed @ Sum 1000 sq.ft. or less Each additional 500 sg: ft or portion thereof. Each Manuf'd tsome or Hodular Dvelling Servlce or Feeder ts rable and expire if vork is not started vithin 180 days of lssuairce or lf vork is suspended for 180 days 2. CONTRACTOR INSTALI,ATION ONLY Electrical Contractor Address ct Phon"4#Z*72 B. Services or Feeders Installation, Alterations or Relocation: c. 200 amps or less 201 amps to 400 amps _401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect 0niy Temporary Services or'Feeders Installation, Alteration or Relocation ng_ v $ 15.00 $ 40.00 $100.00 $130.00 $300.00 $ 40.00 $ 50.00 $ 60.00 Supervisor L r Exp iration Date l(!- I - Constr Contr. Number )- ExP i'ration Date t'L 46 200 amps or less 201 amps to 400 amps _0ver 401 to 600 amps Over 600 amps or 1000 volt $40 $ss $80s see .00 .00 .oouB* a6i6Blectrician a ON The installatioh is beirig made on D.. Branch Circuits Nev, Alteration or Extension Per Panel one circuit s 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Puinp or irrigation Sign/0ut1ine Lighti Limited EnergY/Res 2e- Limited EnergY/Comm STIBTOTAL OT ABOVB 5Z State.surcharST* 22-* Orners Name Address cit ptoperty for saIe, -i))J I ovn vhich Phone is not intended nt.$ s $ s 40 40 20 36 00 00 00 00 6 o l 5 2 a & OgNER fizoppe, JVa- l/VaZiffi*fuvaW- /r?7* R *f zx /f :' /.a I /7 osot, 7*77 Uv ?6aA 5/ra7x7=m CITY SPrtINGFIELO 22.5 .YI,YIE' SIREE:T ipnrNcrlrlD, oREGoN 97477' nrsrsmroN nsOUEsI z 726-376 OFEICE: 726-3759 PBRHIT APPLICATION Ci ty Job Nurober 3. COHPI,ETE PEE SCtrEDI'flJ BELOS ingle or lti-Fam1IY Per dvelling unit' @ Service Included: I tgms 1000 sq.ft. or less I Each additional 500 sq. ft or Portionthereof +' Each Hanuf ''d Home or Hodular Dvelling it:.' 9' rovel, 26ning- F I,EGAL DESCRIPTION TION1. DESCRIPTION Pernl ts are non-transferable and lf vork ls not started'vithlri 180 s 'of lssuance or lf vork ls susPended fo '180 daYs 2. CONTRAC]OR INSTAII.ATION ONLY B' Electrlcal Contrac to, Lrt/' /Uopl6 t'lgf Address Ci ty PfnD,Phone 74?<O9// c. Services or Feeders fnstallation, Alterations or Relocation:. 200 amps or less $ l9'OO aoi u*i," to 600 amPs -- t199'99ooi u*'p" to 1000 amPs- $130'00 Temoorary Services or'Feeders inti"ffuiion, Alteration or Relocation 200 amps or less $ 40'00 ioi ;;; io qoo amps -- I ::'ooo;;r qbr to 6oo amps '= $ 8o'oo over 600 amPS ot fbOOGTfs'.see .Bn Branch Clr'cui ts e rf. Cos t $ Bs.oo $ 15.00 $ 40.00 s 3s.00 $ 2.00 Sum E . arrloLo aSoFSignature of Su lslng Elictilcian D I {-0nners Address clt OVNER -Each lnstallation Stgn/OutUqE Ligfrtlns Llmited EneigY/Res inone ? Nev, Alteration o'f Extension Per Panel '0ne Clrcui t .Each Addltional' Circui.t or vlth Ser.vice. E. Hiseellaneous (Service/feeder not included) 00 00 00 00 $40 $40 ,$ '20$so -- nefg: <-2 5. SUBTOTAL 0E"AB0VS 5/, 'State .Surch'arge TOTAL RECgIVED +3ob AAr,nrn lt-<LrO ' Supervisor Ltcen:e Number TooaS Expiration Date / O - /'( t Constr Contr . nunber O/33 ? Explratlo n Da\.e . L:'?-?.h -, The.installatloh is belrig nade on ;;;p;;iy.i-oun Yhich 1s not intended ior- sa1e, 'Iease or rent' Osners Slgnature: . . '.'. ,,. l. :l SPrrINGFI€LO h 225 .YTYTfl, STREEf, SPRINGPIBLD, oREGoN INSPBCTION REQI.IBST: OFEICB: 726-3759 e8'$&rni[e*bastha rquirosfficift+tF,i,+fl 'i, i;r;'.,,v,-,,t't city ELECTRICAL PERHIT APPLICATION Job Nunber COHPLETE PEE SCffiDI.IIJ BELOU 9 1.,ON OF INST I.EGAL JOB DESCSIPIION tv1 Zlz vl c A. Nev Resl a B. c dentlal-Single or mily per dvelling unit. Electrlcal contrac torJ, il, /ylup4tl t:lZf Serv cluded: I tEMS 1000 sq.ft. or }ess Each additional 500 sq. ft or Portlon thereof Each Hanuf'd Home or Hodular Dvelling Service or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amPs ' 401 amps to 600 amPs - 601 amps to 1000 amPs- 0ver 1000 amPs/volts - Reconnect 0nIY Cos t $ 8s.00 $ 1s.00 $ 40.00 $300. $ 40. $ 3s.oo $ 2.00 4o.oo 4o "L 80.00 ee rtBil aEF Sum Penoits are non-transferable and f i vort< ls not started vlthlri 180 oi i""runce or lf vork 1s susPend 180 daYs 2. CONTRACTOR TNSTAII..ATION ONLY d s ed for Address H e. cl Pro.Phone 4 Supervisor Llcense Number 3 oob-5 nxpiration Date l/o -t- q s Constr Contr . Nunber Ct t ?3{ Explration Date L-t-1 , s ture of suiervlstng Elictrician 0rners Nqne Address DATE: Temoorary Services or'Feeders installaiion, Alteration or Relocarion 50 60 100 130 $ $ $ $ 00 00 00 00 00 00 clty Pho".344% OVNER INSTALT,ATION The. installatloir is belrig srade on ;;;p;;ti-i-onn vhlch ls not intended tor iile,'Ieaie or rent' Onners SlSnature .. .,,. :, :1 D.. Branch Clrcuits Nev, Alteratlon o'f Extension Per Panel Each Additional' Circuit or vlth Ser.vice. E Hlscellaneous (Service/feeder not included) 200 amps or less + 201 amps tq 400 amPs Over 401 to 600 amPs - Over 600 amPs or 1000 volts -Each lnstalLation Stgn/OutIlnt l,ight lng l,Imi ted EneigY/fles t tmited En-ergYTgo*a "' $ $ $ s i $ 40.00 $ 40.00 ,$ ,20.90 s 36.00 40 '?5.- SUBTOTAL OP'ABoVE 5Z'State Sutcharge TOTAL ......, I :., z BREgEIVBD +iob Admrn tt-<-+T 'z-o -*tl II AUTHORTZATION TO PROCEED THIS AGREEUENT is entered into this SY d a1 ay of CITY OF SPRINGFIELD COHHUNITY SERVICES DTVISTOI,I BUILDTNG SAFETY e a ENT ora t ono t e S\to 0.3\ , tqs by and tate-6T oregon,betveen the City of Springfihereinafter ca1led City, and the Applicant.hereinafter calleti VIIEREAS, the applicant has applied to the City Community Services BuildingDivision for issuance of certai improvements to be located at o t c 1 ,o n rm ts f evelopmen t 0regon or r,'ithin the Cityrs Ur rovt Springfield, e CountyAssessor's Hap and Tax Lot number fl UHEREAS, -the applicant has asked the City to authorize the Applicant toimmediately commence development inprovements vithout " compllted plan reviev orsubsequent approval as required by the Springfield Building Safety CodeAdministrat.ive Code section 303(a). IEIR-EASr.the Applicant has submitted to the City a completed pernit application,3 (three) sets of construction dravings, specificationi, and other dati requiredfor the City to complete the necessary plan reviev of the proposed developmentimprovement. IIHEREAS, the intended development improvenent is of a nature that requires noother reviev approval from other State or local agencies and is exempt frorn thecriteria established by the Building Safety Division, attached as gxiribit A ofthis Agreernent. HHEREAS, the City has not revieved or approved the submitted materials for thedevelopment improvenent, the City is therefore unable to confirm at this timevhether the permit applicat!c:r subn:itted ui11 be approved, and vhether therequired construction permits can be issued. 1{tsEREAS, the applicant has requested the City to provide expedited authorizationto proceed vith-certain phases of construction prior to the completion of theCity's reviev of the permit application. VHEREAS, the City's fee for the administrative services rendered in providing q' expedited authorization is S150.00. NOU' THEREF0RE, in consideration of the foregoing recitals and of the mutualpromises contained herein, the City authorizes immediate commencement of thedevelopment improvement specified in the permit application subject to thefolloving terms and conditions: Authorization to Page 2. Proceed Agreement 1. City agrees that the Applicant may immediately commence vith the development improvements set forth in the permit application. city'sauthorization to proceed is conditioned hovever, upon Applicant's agreementthat the project vi1I be constructed as set forth in the attached iubmitteddravings and speeifications, except as may be modified by city, and vi11 comply vith all applicable lavs and ordinances. Applicant,s imnediate commencement of construct on is at cant's ovn risk. The Ci makes no assurErnce t t or construct ts a or cons truct on ts ter 2. City agrees to reviev Applicant's. permit application in the normal revievprocess and to thereafter: a) issue Applicant the appropriate construction permits; or b) advise Applicant of deficiencies in the proposed construction vhich must be remedied before permits can be issued; or c) advise Applicant of any statutes, ordinances or code provisions vithshich Applicant must comply vith beforg City can issue the pernit. 3. Applicant agrees that if City finds Applicant's permit application and submitted materials inadequate or deficient in any manner including but notlinited to' the application or the proposed construction do not comply vithall applicable statutes, ordinances or code provisions, Applicant vi11expeditiously cure the deficiencies so that the City may issue the requiredpernits. Should Applicant fail to expeditiously correct subtritted naterials,or should correction prove impossible, City may in it's discretion, take anyor all of the folloving actions: a) stop all further construction of the project in the manner prescribedin the Springfield Building Safety Code Administrative Code (BSCAC), sEcrroN 201 (d) b) order disconnection of serving utilities in a manner as prescribed'in BSCAC, SECTToN 201 (f) c) issue a N0TfCE }J.1 0!JE3, for rernoval of a1l- such ror!: ie a nanner asprescribed in BSCAC, SECTI0N 204. ABATEHEM OF UNSAFE, SUBSTAI.IDARD 0R, DAITGEROUS BUILDTNGS, STRUCTLTRES 0R BUILDTNG SERVICE EQUIPHEM. Uponreceipt of such notice, Applicant shall immediately remove the vork specified in the Notice and 0rder. Applicant agrees, if the issuance of the permit is denied: a) to remove, at the Applicant's sole cost and expense, all completedconstruction or improvementsl and b) to restore the site or structure to it's pre-agreement condition andfree of all hazards 4 Authorization Page 3. to Proceed Agreement that until Applicant,s permit application is approved,ot to p 5. Applicant agrees construction vi11 nby the City/s Build 0f roceed beyond the point of authorization approvedicial. Applica:rtrs Point of Authorization is 6. Applicant agrees thataceessible and exposed fOfficial nor City shaI1replacenent of any mater all vork performed under this agreement shall be :t llrp:"tion purposes and that neither the Buildingbe Liable for the expense entailed in the removal oiia1 necessary to aIlov inspection. 7' Applicant agrees that-any or all'deficiencies i<ientified during thenecessary inspections vi11-be promptly remedied, at Applicantfs sole costand expense before.proceeding yith'any i.;;t;; construttion. Appricant a1-.oagrees that these inspectioni do not ieplace the requii.d fr.n reviev nor dothey inply any approril of the submittei materials. B' Applicant agrees that no vork shall be done on any part of the buildingor structure beyond the point indicated in each succlriir" inspectionvithout first obtaining ihe approval of the Building official. such approvalshal1-be given only afier "t inspection has been made of each successivestep in the construction as intiitated on the attached Exhibit n. 9. Notvi thstand ing any other provisions of this Agreement, this AgreementshaIl terminate upon issuance of a buildi ng permit or thirty (30) days fromthe date of this Agreenent, vhichever fir st occurs. Ap t understands the City if this Agreement terminates p1i can i thoutthat all vork on the project sha11 immedi ately cease v any notice from re bui 1 pe it s1This agreetrent shall terrninate on 10. Applicant agrees to defend, indemnify andand all costs (including attorney fees)r-Iiabinature vhatsoever, for personal injury-and proApplicant,s early connencement of ionstruction comple ted . hold City harmless from anylity or damages of any kind orperty damage arising from the and the vork undertaken or 11' The terms of this Agreement shaI1 extend to and be binding upon theparties hereto and tl,eii heirs, successors and assigns .1,2- rf any suit, action or other proceeding, or an appeal therefrom, isinstituted to obtain, establishr. enforce, 3r compel any right or obligationresulting from. this Agreement, ih" pr"r"iti.,g party sha11 be entitled torecover from the adverse party, in iaaition io costs and disbursements, suchadditional sums as the courts, both triar-.ni .pp"11ate, h?y judge ,reasonable attorney fees Authorization to Proceed Agreement Page 4. BEFORE SIGNING THIS AGREEHENT, PLEASE READ AND TJNDERSTAND THE HEANING OF EACH PARAGRAPH OF TEIS AGREEHENT. IT AFFECTS YOTIR INTERESTS IN THE PRO?ERTY AND, INTHE EVENT OF DEFAULT, IT PLACES YOU PERSONALLY AT RISK AND TIIE SUBJECT PROPERTYAT RISK OF FORECLOSURE FOR COSTS AND EXPENSES INCTIRRED BY THE CITY IN ENFORCINGTIIE TERUS OF TETS AGREEHENT. TN THE EVENT THAT YOU DO NOT I.JNDERSTAND ANY TERHSOR CONDTTIONS OF THIS AGREEHENT, PLEASE SEEK ANY LEGAL OR OUTSIDE OPINIONS YOUHAY.DESIRE. crTr APPLICA}TT Ci 6 f_ Spri By: Building 0fficial Contrac tor Business Name Address CC Registration * T-AND/PROPERTY OSNER (s) IIAVE READ TBE ABOYE AUTEORTZATION TO PROCEED AGREEHENI . I/VE I.JNDERSTANDIT EXPRESSES AND THE RESPONSIBILTTIES IT PLACES UPON US AS THE AGREEHENT PERTY OVNERS. T/UE AGREE TO BE BOI.JND BY ALL TERMS AND CONDTTIONS OF THE Address ' EE\.'iii\','Il' [: ,4.irF;:CVE]t TC FCF.ir,a ]L r:-.At{.q t\ \trB tr:\Q!- T/VE l_,/.'ii::1"(a C:i:Fil! ajF CiTY A.TTOifl.iIY l-lr',-r. :- '. c..-..:.!,.:,:.=t:.:i n. .j\ EETBTT A Purpose The purpose of this agreement is to a1lov'certain development improvements tooccur prior to obtaining plan reviev approval from the Springfield Community Services Division. Scope The use of this agreement shal1 be l-imited to certain one and t'*o-familydvellings not complex in nature as determined by the Building Official and minor alterations or modifications to existing commercial and industrialbuil<iings vhich are of a non-structural't)'pe and do not adversely affect anystructural member of the building or any part of the building having fireresistant construction. One and tvo-family d'*eIling plans for structures that are complex in nature that have been prepared by an Oregon licensed architect or engineei and accompaniedby a letter of reviev prepared by said architect or engineer, stating thlt the submitted material is in compliance vith the One and Tvo-Family Dr.'e11ingSpeciarty code, may be considered eligible for- this agreement. The folloving iterus include but are not Iimited to certain conditions of development identified as ineligible for this agreement: a) development requiring site approval vhich has not been obtained; b) nev development located on land vith over six-percent slope; c) lots having expansive (clay) soil; d) development located vithin flood hazard areas; e) development located vithin vetland areas; f) pole buildings or other such type of structure that is not of conventionaiconstruction. EXHIBIT B Reguired Iospections To request an inspection, you must caII 725-3769. This is a 24 hour recording. A11 inspections requested before 7:00 a.m. rrrill be made the same working day, Inspections requested after 7:00 a.m. will be made the following work day. I K xx F ): 5 X & )< TeBporary Electric site - To be made after excavation, but prior to setting forms Footing - After trenches are excavated Foundatioa - After forms are erected but prior to concrete placement Underfloor Plunbing - Prior to filling trench Underfloor Mecbanical - Prior to ineulation or decking Post & Beaa - Prior to floor insulation or decking Underfloor Insulatioa - Prior to decking Sanitary Sewer - Prior to filling trench Storu sewer - Prior to filling trench Water Line - Prior to filling trench $WillamalanePaif-a R-ecreation District Job. No. t SYSTEM DEVELOPMENT CHARGE WORKSHEET PHONE:NAME: ADDRESS LOCATION OF PROPOSED BUILDING srArE: $L ,'r' \\o qAo^,.!1Street Add Plat Name:Tax Lot Number: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t ype definitions are on the back.) A. Single-Family Detached \ single Family home Manufactured home not in a park NO. OF UNITS X $1,000 Per unit = $ \ 0fnq) B. Single-Family Attached NO. OF UNITS X $924 per unit = $ C. Multi-Family Apartment NO. OF UNITS X $692 per unit D. Manufactured Home Park NO. OF UNITS WILLAMALANE SDC X $699 Per unit = $ 2. SDC CREDIT (il appticable) SDC-payer must fumish proof of Wiltamalane Credit approval. See SDC Credit Worksheet. 3. TOTAL WTLLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) $ \d)$ $ $ ,U OD I DateDevelo City of pme Sprir nt ngfield Department QsrtnlE