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Home My WebLink AboutPermit Building 2001-05-24Job# 01-00457-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of4 SPRINGFIELD 225 Fifth Street Springfield, OR97477 Location Of Proposed Site: 951 00004th St Spr AssessorsMap#: 17033521 Lot: 10 Block:s Addition: Job Number: 01 -00457-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 07800 Subdivision:Dera Park crTY oF SPRTNGFTELD, OREGON Owner: David Seamans Address: 319 Broadway Scope Of Work: Single Family Residence Contractor Type GeneralContr Electrical Contr Plumbing Contr Phone Number: City/State/Zip: New 541-747-2364 Springfield, OR97477 Vatue: $132,440 SFR w/ separate garage. Address change approved on 6125101, new placard mailed 6125101 with letter/lh Contractor Registration # Expiration Date Phone David Seamans 59283 31112002 541-747-2364 319 Broadway, Springfield, OR 97477 David Seamans 59283 31112002 541-747-2364 319 Broadway, Springfield, OR 97477 Chapin Enterprises lncorporated 81994 51612004 541-485-1146 3248 Kentwood Dr, Eugene, OR 97401 Quad Area: # Of Units: Constr. Type: Water Heater: 1 RNW 1 (VN) Wood Frame Gas Office Use - Land Use: Zoning Code: LDR Bedrooms: 3 Range: Electric # Of Buildings: 1 Occupancy Group: Dwelling Heat Source: Forced Air Gas Sq. Footage: 1748 To request an inspection call the 24 hour recording at726-3769. 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 working day. Required lnspections Building Site Verify Ground Rod Footing Foundation Post and Beam Floor lnsulation Ceiling lnsulation Shear Wall Nailing Framing Walllnsulation Drywall -To be made after excavation but prior to setting forms. -lnstall ground rod at footing, and call for inspection in conjuction with footing and/or foundation ir -After trenches are excavated. -After forms are erected but prior to concrete placement. - Prior to floor insulation or decking. -Prior to decking. -Prior to cover. -Before covering sheathing with finish materials. - Prior to cover. -Prior to Cover -Prior to taping. FinalBuilding Temporary Power Verify Ground Rod Rough Electrical Electrical Service Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line Final Plumbing Underfloor Mechanical Rough Gas Rough Mechanica! Gas Service FinalGas FinalMechanical Sidewalk Zoning: LDR FIoodPIain? [ Wetlands? [ Journal numbers 1: 2: Comments: Overlay District: # of Street Trees: Job# 01-00457-01 Page2of 4 Required lnspections Building -when all required inspections have been approved and the building is complete Electrical -Approval required prior to SUB energizing pole. -lnstall ground rod at footing, and call for inspection in conjuction with footing and/or foundation ir - Prior to cover. -Must be approved to obtain permanent power. -When all electrical work is complete. Plumbing -Prior to insulation or decking. -Prior to cover or placement of concrete -Prior to cover. - Prior to filling trench. -Prior to filling trench. - Prior to filling trench. -When all plumbing work is complete. Mechanical - Prior to insulation or decking. -After line is installed and capped if not attached to an appliance. - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure tes -When all gas work is complete. -When all mechanical work is complete. Public Works -After excavation is complete, forms and sub base material is in place Planner: Liz Miller Urban Growth Boundary?[ Glenwood Area? [ Quantity Of Fill: Supplier: Drainage: Floodway FEMA: Zone X White Land Use: Pave Driveway? Additional Requirements: Required Attachments: Source Locn: Material: Flood Plain FEMA: Panel1142 of 2975 3: Construction Types:(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? [ Area (Sq # Of Stories: 2 Height (feet): 27 Current Units: Proposed Units:1 Census Gode: Does not apply Main: 1748 Accessory5B4 Total2332 Job# 01-00457-01 Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check Residential Plan Check Total Plan Check 05/03/2001 s153 132,440 $329.71 $329.71 Building Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 0611812001 06t18t2001 0611812001 5847 5847 5847 132,440 $507.25 $35.51 $15.22 $557.98 Electrical Wiring Footage 1,000 Sq Ft or Less Wiring Footage Each Add'l 500 Sq Ft Temporary: 200 Amps or Less State Surcharge - Electrical Administrative Fee - Electrical Total Electrica! 0611812001 0611812001 06t18t2001 06118t2001 06t18t2041 5847 5847 5847 5847 5847 1 3 1 $85.00 $45.00 $40.00 $11.90 $5.1 0 $187.00 Plumbing Minimum Plumbing Permit Fee Three Bathrooms State Surcharge - Plumbing Administrative Fee - Plumbing Total Plumbing 0611812001 06t1812001 06t18t2001 06t1812001 5847 5847 5847 5847 1 $.00 $192.50 $13.48 $5.78 $211.76 Mechanical Hood and Exhaust One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct ApplianceVent (Not Covered in Schedule Woodstove Dryer Vent Mechanical lssuance State Surcharge - Mechanical Total Mechanical 0611812001 06118t2001 06118t2001 0611812001 0611812001 0611812001 06t18t2001 0611812001 0611812001 06t18t2001 06t1812001 5847 5847 5847 5847 5847 5847 5847 5847 5847 5847 5847 1 1 $4.50 $2.00 $.00 $1.41 $6.00 $12.00 $4.50 $15.00 $3.00 $10.00 $3.29 $61.70 1 4 1 ,0002 1 Public Works 05t24t2002 9225Sidewalk Repair Total Public Works $10.00 $10.00 System Development Residential- Single Family - Storm Sanitary Sewer Residential Transportation Residential lmprovement MWMC MWMC Administrative Fee Sanitary Sewer SDC Reimbursement SDC Administrative Fee Property Annexed 1979 or Before Residential Sanitary MWMC Transportation SDC Reimbursement Total System Development 0611812001 0611812001 06t1812001 06t18t2001 06/1 8/2001 0611812001 06t18t2001 0611812001 0611812001 06t1812001 5847 5847 5847 5847 5847 5847 5847 5847 5847 5847 $783.73 $436.05 $656.02 $24.33 $10.00 $573.75 $139.83 $-127.55 $285.91 $154.27 $2,936.34 2,992 27 1 1 1 27 27 1 1 1 Job# 01-00457-01 Page 4 ot 4 Fee Paid On Receipt# Value/Quantity Fee Amount Willamalane SDG S.F. Residence - Willamalane Total Willamalane SDG 06118t2001 5847 1 $1,000.00 $1,000.00 Grand Total Plan Check Type lnitial Review-Res Engineering-Res Planning-Res Structural-Res of Ghecked By Bob Barnhart Steve Templin Liz Miller Don Moore the Date Completed 0610412001 0611212001 0512512001 0611212001 $5,294.49 Comment MUST SIGN IMPROVEMENT AGREEMENT, DEDICATE RIGHT OF WAY & UTILITY EASEMENT, AND SUBMIT RECORDING FEES PRIOR TO PERMIT ISSUANCE. Need structural analysis of beams, girders, headers, joists, and pier footings - owner contacted 611lO1 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 701.055 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 the permit card is located at the front of the property, and the site at alltimes during construction. 5'eq,o3-- Signature Date c-rl I>tse*fi" 3 --l*{ r::,:7.I :t:i -{ :e r-rr ffl t:':r- ", &*r:r:{ ", I LEGAL DESCRIPTION Multi-Family per drvelling unit. Service Included: Items Cost\1 3q0_r cn qEs N Thc Anthorized Qiana+, rrr 1000 sq.ft. or less rF itt6/i Etrheddfiimgt Soo sq: ft oDpodion thereof Service or Feeder -l- sffu.oo 3-slf,oo :] Permits are and if work is tarted within 180 of issuance 180 days. if work is C City ALLATION ONLY,B. Services or Feeders Installittion, Relocation: 200 amps or 201 amps to 401 amps to 1 an'rps Over ,,B" a D. Branch E 1\[inimum ,1. SUB 7'/t S 3ffz, eomini or $ 50.00 Per or with S ncluotNI ection Fee is 545.00 + Supervising Ele TOTAL & D EV ELO P M ENT S E fl V I C E S u t: PA Ri t',1 E: N' t w i25t-il iltstnLLl SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-s689 November 27,2001 David Seamans 319 Broadway Springfield, Oregon 91477 Dear Mr. Seamans: Yesterday, Electrical Inspector Dave Gadomski, informed our office that you are performing the electrical wiring at 951 4th Street, Springfield, Oregon. ln order to maintain accurate records for the property, we need you to sign the enclosed electrical permit form indicating you performed the electrical installation as the owner. There are no fees due, just the signature. I am enclosing a pre-stamped envelope for you to return the form to me. Thank you and if you have any questions, please feel free to phone me at 726-3790 Sincerely, Lisa Hopper Bui lding Safety Supervisor rvrsrnge e dent LEGAL DESCRIPTION Multi-Family per drvelling unit. Service Included: Items Cost\1n3Aci0 r D-ttlncr B qES N Permits are and ifrvork is sta(ed within 180 days of issuance 180 days. work is suspended for ALLATION ONLY Add Supervi iln B. Ser-vices or Feeders Insttllation, Alt Relocrtion: 200 amps or 201 irnrps ro 400 401 anrps to I amps 1000 sq.ft. or less Each'adclitional 500 sq. ft or portion thereof Each Manufd Home or Modular Drvelling Service or Feeder ,5I stte.oo j-slioo $ s0.00 ,. I Over D. Branch or Feeder n or n,ith not in ON .:.: E. _s _$45 lVlinimum 4. SUB 7Y" zx^ TOTAL Fee is 545.00 + & City J . rl,: ob ,,- SPRTNGFIELD 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: Assessors Map#: 17033521 Lot: 10 BIock:S Job# 0f -00457-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety o nx' 5\ 00004th St Spr Addition: Page '1 of 4 Job Number: 01-00457-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 07800 Subdivision:Dera Park ctTY oF SPRINGF7ELD, OREGO^' SFR w/ separate garage Phone Number: City/State/Zip: New 541-747-2364 Springfield, OR97477 Value: $132,440 Gontractor Type GeneralContr ElectricalContr Contractor David Seamans 319 Broadway, Springfield, OR 97477 C&SElectriclnc Po Box 1482, Springfield, OR 97477-0189 Registration # 59283 Expiration Date 3t1t2002 Phone 541-747-2364 541-741-2236384991112002 Quad Area: # Of Units: Constr. Type: Water Heater: 1 RNW 1 (VN) Wood Frame Office Use - Land Use: Zoning Code: LDR Bedrooms: 3 Range: # Of Buildings: 1 OccupancyGroup: Dwelling Heat Source: Sq. Footage: 1748 To request an inspection callthe 24hour recording at726-3769. 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 working day. Required lnspections Bui Site Verify Ground Rod Footing Foundation Post and Beam Floor lnsulation Ceiling lnsulation Shear Wall Nailing Framing Walllnsulation Drywall FinalBuilding -To be made after excavation but prior to setting forms. - lnstall ground rod at footing, and call for inspection in conjuction with footing and/or foundation i -After trenches are excavated. -After forms are erected but prior to concrete placement. -Prior to floor insulation or decking. - Prior to decking. - Prior to cover. -Before covering sheathing with finish materials. - Prior to cover. -Prior to Cover -Prior to taping. -When all required inspections have been approved and the building is complete. Owner: David Seamans Address: 319 Broadway Scope Of Work: Single Family Residence - Verify Ground Rod Rough Electricat Electrical Service Final Electrical Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line FinalPlumbing Underfloor Mechanica! Rough Gas Rough Mechanica! Gas Service Wood Stove FinalGas FinalMechanical Job# 01-00457-01 Page 2 of 4 Required lnspections Electrica! - lnstall ground rod at footing, and call for inspection in conjuction with footing and/or foundation i - Prior to cover. -Must be approved to obtain permanent power. -When all electrical work is complete. Plumbing -Prior to insulation or decking. - Prior to cover or placement of concrete. - Prior to cover. - Prior to filling trench. -Prior to filling trench. -Prior to filling trench, -When all plumbing work is complete. Mechanical - Prior to insulation or decking - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure tet -After installation. -When all gas work is complete. -When all mechanicalwork is complete. I Zoning: LDR FloodPlain? [ Wetlands? [ Journal numbers 1: Comments: Overlay District: # of Street Trees Land Use: Pave Driveway? Panel 1142ot2975 2 3 Planner: Liz Miller Additional Requirements: Urban Growth Boundary?[ Glenwood Area? ! Required Attachments: Quantity Of Fill: Source Locn: Supplier: Material: Drainage: Floodway FEMA: Zone X White Flood Plain FEMA: Gonstruction Types(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: 3 Handicap Access? ! # Of Stories: 2 Height (feet): 27 Current Units: Proposed Units:1 Census Code: Does not apply (Sq. Feet) Main: 1748 AccessoryS84 Total2332 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check Residential Plan Check Total Plan Check 0510312001 5153 132,440 $329.71 $329.71 Buildin Building Permit 06/18/2001 5847 132,440 $507.25 Job# 01-00457-01 Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Buildinq State Surcharge For Building Permit Building Administrative Fee Total Building 0611812001 06t1812001 5847 5847 Electrical Wiring Footage 1,000 Sq Ft or Less Wiring Footage Each Add'l 500 Sq Ft Temporary: 200 Amps or Less State Surcharge - Electrical Administrative Fee - Electrical Total Electrical 0611812001 0611812001 0611812001 0611812001 0611812001 5847 5847 5847 5847 5847 1 3 1 $85.00 $45.00 $40.00 $11.90 $5.1 0 $187.00 Plumbing Minimum Plumbing Permit Fee Three Bathrooms State Surcharge - Plumbing Administrative Fee - Plumbing Total Plumbing 0611812001 06t18t2001 06t18t2001 06/1 8/2001 5847 5847 5847 5847 1 $.00 $1e2.50 $13.48 $5.78 $211.76 Mechanical Hood and Exhaust One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct ApplianceVent (Not Covered in Schedult Woodstove Dryer Vent Mechanical lssuance State Surcharge - Mechanical Total Mechanical 0611812001 0611812001 0611812001 06t1812001 06t18t2001 0611812001 06t18t2001 0611812001 0611812001 06t18t2001 06/18/2001 5847 5847 5847 5847 5847 5847 5847 5847 5847 5847 5847 1 1 $4.50 $2.00 $.00 $1.41 $6.00 $12.00 $4.50 $15.00 $3.00 $10.00 $3.29 $61.70 1 4 I ,0002 1 System Development Residential- Single Family - Storm Sanitary Sewer Residential Transportation Residential Sanitary MWMC Residential lmprovement MWMC MWMC Administrative Fee Sanitary Sewer SDC Reimbursement SDC Administrative Fee Property Annexed 1979 or Before Transportation SDC Reimbursement Total System Development 0611812001 0611812001 06t18t2001 06t18t2001 06t18t2001 06/1 8/2001 06/18/2001 06t18t2001 06t18t2001 06/1 8/2001 5847 5847 5847 5847 5847 5847 5847 5847 5847 5847 2,892 27 1 1 1 1 27 27 1 $783.73 $436.05 $656.02 $285.91 $24.33 $10.00 $573.75 $139.83 $-127.55 $154.27 $2,936.34 S.F. Residence - Willamalane TotalWillamalane SDC Willamalane SDC 06t18t2001 5847 1 $1,000.00 $1,000.00 Grand Tota! Plan Check Type lnitial Review-Res Checked By Bob Barnhart Date Completed 0610412001 Comment $5,284.49 $35.51 $15.22 $557.98 Plan Check Type Engineering-Res Planning-Res Structural-Res Checked By Steve Templin Liz Miller Don Moore Job# 01-00457-01 Date Completed 06t1212001 0512512001 06t1212001 Page 4 of 4 Comment MUST SIGN IMPROVEMENT AGREEMENT, DEDICATE RIGHT OF WAY & UTILITY EASEMENT, AND SUBMIT RECORDING FEES PRIOR TO PERMIT ISSUANCE. Need structural analysis of beams, girders, headers, joists, and pier footings - owner contacted 611101 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 701.055 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 that the permit card is located at the front of the property, and the set of S on the site at alltimes during construction. Signature Date kt/- o) NO. OF FIXTURES DRAINAGE FIXTURE UMTSFIXTURE TYPE ( +xew - +oro ) *UNIT EQUIVALENT BATHTUB ( 2 - 0 )x ( 0 - 0 )* ( 0 - 0 )x ( 0 - 0 )x( 0 - 0 )x ( 0 - 0 )x ( I - 0 )x ( 0 - 0 )x ( 0 - 0 )x ( 0 - 0 )x( 0 - 0 )x( I - 0 )x ( 0 - 0 )x ( I - 0 )x( 0 - 0 )x( 0 - 0 )x ( 0 - 0 )x ( 4 - 0 )x ( 0 - 0 )x ( 0 - 0 )x( 3 - 0 )x J 6 DRINKING FOUNTAIN I 0 FLOORDRAIN 3 0 INTERCEPTORS FOR GREASE / OIL I SOLIDS / ETC.3 0 INTERCEPTORS FOR SAND / AUTO WASH /ETC.6 0 LAUNDRY TUB 2 0 CLOTHESWASHER / MOP SINK J J CLOTHESWASHER - 3 OR MORE (EA)6 0 MOBILE HOME PARK TRAP (I PER TRAILER)t2 0 I 0 3 0 2 2 SHOWER, GANG (NUMBER OF HEADS))0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN J J SINK: COMMERCIAL BAR 2 0 SINK: DOMESTIC BAR I 0 WASH BASIN 2 0 LAVATORY I 4 URINAL, STALL/WALL 5 0 TOILET, PUBLIC INSTALLATION 6 0 TOILET PRIVATE INSTALLATION J 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'SX ( 0 - 0 )x 20 0 TOTAL DRAINAGE FD(TT'RE I.JNITS : *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day 27 DRAINAGE (TURE UNIT (DFU) CALCULATIP\ TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIX^ -(E UNITS FOR CALCULATE ONLY THE NET ADDITIONAL MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE $127.55 IF IMPROVEMENTS OCCURRED AFTERANNEXATION DATE, CALCULATE CREDIT SEPARATELY CREDIT FOR LAND (IF APPLICABLE) CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) $127.s5 $0.00 YEAR ANNEXED CREDIT RATE PER $I,OOO ASSESSED VALUE YEAR ANNEXED CREDIT RATE PER $1,OOO ASSESSED VALUE I979 OR BEFORE $4.74 I 990 $1.96 r 980 s4.65 I 991 1992 s1.55 lgSl $4.s9 s1.36 1982 $4.46 I 993 $r.23 1983 I 984 $4.30 $4.14 $3.93 t994 I 995 1996 s l.0s s0.90 I 985 1986 t98',7 r 988 $0.7s $3.63 1997 I 998 $0.s7 s3.26 $2.85 s2.40 $0.35 t999 $0.15 l 989 TOTAL IVTWMC CREDIT : 0.000 x 54.74 VALUE / IOOO CREDIT RATE 26910 x $4.74 RECEPTORFORREFRIG / WATER STATION/ ETC. RE-CEPTOR FOR COM. SINK / DISHWASHER / ETC. SHOWER, SINGLE STALL CITY OF SPRINGFIELT 'YSTEMS DEVELOPMENT JOURNAL OR JOB NUMBER: 0 I -00&7--0 I NAME OR COMPANY:SEAMANS LOCATION 949 4TH STREET TAX LOTNUMBER:l7-03-35-2 l-07800 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS: ] WORKSHEET I BUILDNG SIZE: 2332 SF LOT SIZE: 0 SF IMPERVIOUS S.F.COST PER S.F 0.00 $0.271 $0.00 IMPERVIOUS S.F. 2892.00 COST PER S.F. $0.271 $783.73 RUNOFF ROUIED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS DISCOUNTRATE 50% x x x I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM $783.73ITEM I TOTAL - STORMDRAINAGE SDC NLIMBER OF DFU's COST PER DFU 27 16. l5 $436.05 NUMBER OF DFI-l's 27 COST PER DFU $2r.25 $573.7s B. IMPROVEMENT COST: x x 2. SANITARY SEWER- CITY A. REIMBURSEMENTCOST: .80ITEM 2 TOTAL - CITY SANITARY SEWER SDC ADT TRIP RATE NUMBER OF UMTS COST PER TRIP NEWTRIP FACTOR 9.57 I $68.ss 1.00 $6s6.02 ADT TzuP RATE 9.57 NLIMBER OF UNITS I COST PER TRIP $ r 6.12 NEW TRIP FACTOR 1.00 $ts4.27 B. IMPROVEMENT COST: x x x x x x 3. TRANSPORTATION A. REIMBURSEMENT COST: $810.29ITEM 3 TOTAL - TRANSPORTATION SDC $ 10.00 NUMBER OF FEU's I COST PERFEU $285.91 $285.91 NUMBER OF FEU's I COST PER FEU $24.33 SUBTOTAL OF MWMC REIMBURSEMENT,IMPROVEMENT & CREDIT MWMC ADMIMSTRATIVE FEE $182.69 127.55 B.IMPROVEMENT COST: x x MWMC CREDIT IF APPLICABLE (SEE REVERSE) 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: $192.69ITEM4 TOTAL -IVTWMC SANITARY SEWERSDC 796.51SUBToTAL (ADD ITEMS 1,2,3, & 4) SUBTOTAL 796.51 $139.83 ADM. FEE RATE s% 5. ADMINISTRATIVE FEE: x $2,936.34Slr,uoTur"+l;* SDC COORDINATOR 6l6l0t TOTAL SDC CIIARGES DATE 1070 l09l r092 1093 1094 1055 1056 1073 ar!ao(-) &HFa oH& q Willamalane Park & Recreation District \*a \SYSTEM DEVELOPMENT CHARGE woRrcSueEr .t$r-ro..r,,A,PHONE: -1 \.l-.{ -I appropriate dwelling(s). SDC calculations and dwelling t Job. No.6 ADDRESS:3 \1 R' .:rr*.J,^**, srATE:On zrp'1.t --sLOCATTON OF PROPOSED BUILDING SITE: Street Address:\\ Ptat Name: \'1 O j 35 &!l Tax Lot Number:D? NAME D 1 DEVELOPMENT TYPE (check ype definitions are on the back) A Single-Family Detached P Single Family home NO. OF UNITS t Manufactured home not in a Park X $1,000 per unit = $ B. Single-Family Attached NO. OF UNITS X $924 Per unlt C. Multi-Family Apartment NO. OF UNITS X $692 per unlt D. Manr{ac{trrecf Home Park NO. OF UNITS X $699 Per unlt WILLAMALANE SDC 2. SDC CREDIT ([ applicable) SDC,payer must (umlsh proof of Willamalane Credit approval. See SOC Credit Wodahoot. 3. TOTAL WILLAMALANE NET SDC ASSESSED (l( SDC reduced for Credit) ('a \ CJtr) $ $ $ j, t-/d t Ol $ $ $ City of epartment Date t approval Zoning ft Date G -o 225 FIFTB STR.EET SPRINGFIELD, OREGON 97 417 Aurrtorized Sighature INSPECTION REQLTESTz 726-3769 OFFICE:6-3759 1 I.,EGAL DESCRIPTION/7D3 slL/ 07902 JOB Permits are non-transferable and expirelf vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY ELectrical Contractor S 7L SI GFTELO require specific land use PERHIT APPLICATION City Job Number 3. COHPLETE FEE SCBEDULE BELOS A. Nev Residential-Single or ON Hulti-Famil Service Inc y per dvelling unit. luded: ^0 Cost Sum s Bs.oo g5 s 1s.00 s 40.00 I tems 1000 sq.ft. or less L- Each additional 500 sq. ft or portion thereof 7 Each Manuf'd Home. or - Modular 'Dve1ling Sertice or Feeder Services or Feeders Installation, Alterations or Relocation: f .B Address 7c: fux lt/g) c] tY ,n",. 1Vl-D1 Super-.visor License Number tb?t3 Expiration Date constr contr. Number )C )L/C Expiration Date )c-l-ct S ture of Supervising Electrieian 200 amps or less 201 amps to 400 amps 401 amps to 600 amps -501 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0nly 00 00 00 00 00 00 50. 60. 100 130 300 40 s s s s $ $ $ $ $ s C D. Branch Circuits SUBTOTAL OF ABOVE 7% State Surcharge 3Z Admini.strative Fee TOTAL Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"or less L- 201 amps to 400 amps -Over 40L to 600 amps -Over 600 amps or 1000 voTfs 40.00 55.00 80.00 & ee r?Brr aEovE- 0 rs Name Address .7/2 *em)az- Ci ty OVNER INSTALLATION Tire installation is being made on property I ovn vhich is not intended for sale, lease or rent. qi ;,".-2i=,sa/ Nev, Alteration or Extension Per Pane1 One Circuit S 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Iliscellaneous (Service/feeder not included) -Each ins tallation Pump or irrigation sign/ou tline Lighting- Limited Energy/Res Limited Energy/Comm iilu :,fififidti$ Signa ture : ' 1ni iLii :i'i $ 40.00 $ 40.00 $ 20.00 s 36.00 /;t a,M hr.+.i Y/.rfl7 'rUUtJ L'l03 crib f, i:i1-'11H ll"lu 5 rt* a RECEIVED -77-r )O - l-cl t, I: