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Home My WebLink AboutPermit Building 2007-01-18Status 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: COM2006-01538ISSUED: 0111812007APPLIED: 1210112006 EXPIRES: 08/2812007VALUE: $ 48,162.00 SITE ADDRESS: ll35 6TH ST ASSESSOR'S PARCEL NO.: 1703351204000 PROJECT DESCRIPTION: Remodel and garage conversion TYPE OF WORK: Garage Conversion TYPE OF USE: Addition Residential Phone Number: 726-5368 License Expiration Date Phone 8331 I 02n7t2008 541-726-9854 Springfield Owner: Address: Contractor Type General Mechanical Plumbing GOSSWILLER NEIL 1136 6TH ST SPRINGFIELD OR 97477 Contractor OWNER OWNER BARNES HIGH TECH PLUMBING INC # 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: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: UU trr utir-.y settor -00 Notrt ication Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: t7 Wall Heat Electric Path 1 nla ,<, 10.00 38.00 Fu REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Curbside 5, Downspouts/Drains: Curb and Gutter NOTICE: THIS PERMIT SHALL EXPIRE IF THE WO AUTHORIZED UNDER THIS PERMIT IS N COMMENCED OR IS ABANDONED FOR ANY l BO DAY PERIOD lrl{'\lt \'Yurr Special Instruction DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: rules adopteu 344) Page I of4 11\r(rruYtAr[rl\ | lIUlIJLrlt\rJ 11\rtrI(lYlA I l(rl\ | F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax S4l-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-0r538ISSUED: 0111812007APPLIED: 1210112006 EXPIRES: 08/2812007VALUE: $ 48,162.00 Description Type of Construction Dwellings V Wood Frame Garage Conver. Garage Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Building Permit Fire SF Fee - Residential Fixture Minimum/Adj ustment Mechanical Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Vent Fan + l0o/o Administrative Fee + 57o Technology Fee + 87o State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid Total Value of Project Date PaidAmount Paid $ Per Sq Ft or multiplier $99.00 $73.00 Square Footage or Bid Amount 2s2.00 318.00 Value $24,948.00 $23,214.00 $48,162.00 Receipt Number 2200600000000001645 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 r200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 120070000000000004r 1200700000000000041 1200700000000000221 1200700000000000221 1200700000000000221 1200700000000000221 Date Calculated 12t0u2006 12t0u2006 s237.12 $r0.00 $52.34 $25.s4 $40.86 $364.80 $12.60 $s6.00 $39.00 $118.74 $1s6.16 $17.97 $84.s8 $45.00 $6.00 $6.30 $3.15 $5.04 $63.00 t2nt06 ut8t07 Ut8l07 ut8l07 ut8t07 Ut8t07 ut8t07 u18t07 ut8l07 ut8/07 Ut8l07 ut8l07 ul8t07 Ut8t07 ut8l07 3nt07 3/u07 3/u07 3nt07 $1,344.20 Fees Peid Plan Reviews Initial Review Planning Review Public Works Review 12t0512006 12t05t2006 12t05/2006 12t05t2006 12t2U2006 12n812006 IO LLH No Planning issues. Sanitary line location ok'd by building division & storm H2O tied to exisiting approved sytem Per owners wife by telephone @ 726-5368 in the am l2ll9|2006,JLP Plans sent to Building DePartment for review under contract with the City of Springfield. APP APP APP SKG TAJ JLP Structural Review 12t05t2006 0u1u2007 Page 2 of4 Valuation Description F 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: COM2006-01538ISSUED: 0111812007 APPLIEDz 1210112006 EXPIRES: 08/2812007VALUE: $ 48,162.00 Structural Review 0U1u2007 0u17t2007 APP LLH Plan review completed by The Building Department, Shawn Eaton, under contract with the Cify of Springfield To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Reorrired Insnections Page 3 of4 ila b.iil 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: COM2006-01538ISSUED: 0111812007APPLIED: 1210112006 EXPIRES: 08/2812007VALUE: $ 48,162.00 By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Prse 4 of 4 J I. LOCATION OFINSTS.II,ATION: siPF EIELEI Date Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Hom6 or Modular Dwelling Service or Feeder SOURCE $ 106.00 $ 19.00 $50.00 InstaUation, .l Alterations or Rekrcrtion: zoN INITIALS DATE?fi, 22SFIFTHSTREET o SPRINCFIELD,oRgT{?7. PH:(S;ll)72G3753 oFAX:(541)726-3689 ELECTRICAL TION Ciry Job Number ,) 3 n3 ;oL A.LECAL DESCRIPTION \4 0n {{DD JOB DESCzuPTION (b, Permits are non-transferable and expire if rvork is not started within 180 days of issuance or if work is Suspended for 180 days. 7 CotrrnecrQnrNS,TALLrTroN.oNLY B., lerui1es 9ITlaut Electrical Contractor tuil eL(t)200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Anps 601 Amps to 1000 Amps Over 1000 AmpsiVolts Recomect Only Address 2Gq City ,\ ?,0 a O/*Lk u'l krno," "'? q'fqaf Expiration Date I Constr. Contr. Number zu -Lclct ( Expiration Date io 0 0 Signature of Supervising Electrician f Installation, Alteration or Relocation 200 Amos or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs Over 600 Amps or 1000 Volts see "B" above. l New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit E. $ 63.00 $ 75.00 s 125.00 s l 63.00 $375.00 s 50.00 Supervisor License Number 3dob -f /l,L q $ 50.00 $ 69.00 $ 100.00 s 43.00 s 3.00 Owners Name \LeO Ciry t bS I ath p6,,"1)lor\3W OWNER INSTALLATION The installation is being made on properly I own which is not intended for sale, lease or rent. Owners Signature Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45'00 + .. I4. SWTOTALOFABOW: ' ,'. :. 8% State Surcharge I0% Administrative Fee 5% TechnologY Fee Surcha TOTAL Shared Driv(T: )i Building Forms/Electrical Pennit Application b.\. ( (Service/feeder not included) -Each Installation $ 50.00 $ 50.00 s 25.00 s 45.00 Inspection Request: 726-3769 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C of Springfield Official ReceiPt Development Services Department Public Works Department RECEIPT #: 1200700000000000221 Date: 0310112007 l1:03:55AM Job/Journal Number coM2006-01538 coM2006-01538 coM2006-01s38 coM2006-01538 Description Perm Serv/Fdr 200 amps or less + 5% Technology Fee + 8% State Surcharge + l|Yo Administrative Fee Amount Due 63.00 3,15 5.04 6.30 Item Total:$77.49 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid CreditCard CAMPBELL ELECTRIC ilh 096058 In Person $77.49 Payment Totat: -572f cR aeeint I Paee I of I 31U2007 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2006-01538ISSUED: 01118/2007 APPLIED: 1210112006 EXPIRESz 0711812007VALUE: S 48,162.00 SITE ADDRESS: 1135 6TH ST ASSESSOR'SPARCELNO.: 1703351204000 PROJECT DESCRIPTION: Remodel and garage conversion Springfield TYPE OF WORK: Garage Conversion TYPE OF USE: Addition Residential Phone Number: 726-5368 License Expiration Date Phone 8331 I 02n7t2008 541-726-9854 Owner: Address: Contractor Type General Mechanical Plumbing GOSSWILLER NEIL 1136 6TH ST SPRINGFIELD OR 97477 Contractor OWNER OWNER BARNES HIGH TECH PLUMBING INC CONTRACTOR INFORMATION BUILDING # 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: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 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: 252 Curbside 5' Curb and Gutter l7 Wall Heat Electric Path I nla REQUIRED PARKING Total: Handicapped: Compact: 10.00 38.00 Fully Improved yes Sidewalk Type: Downspouts/Drains: DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: Storm H2O will tie to existing approved system.JlP Page I of3 OF 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: COM2006-01538ISSUED: 0111812007APPLIED: 1210112006EXPIRES: 0711812007VALUE: $ 48,162.00 Description Tvpe of Construction Dwellings V Wood Frame Garage Conver. Garage Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0oh Administrative Fee + 57o Technology Fee + 8%o State Surcharge Building Permit Fire SF Fee - Residential Fixture Minimum/Adj ustment Mechanical Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Vent Fan Total Amount Paid Total Value of Project Date Paid Receipt Number 2200600000000001645 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 1200700000000000041 r200700000000000041 Amount Paid $ Per Sq Ft or multiplier $99.00 $73.00 $237.12 $10.00 $s2.34 $25.54 $40.86 $364.80 $12.60 $56.00 $39.00 $118.74 $156.16 s17.97 $84.58 $45.00 $6.00 $1,266.71 Square Footage or Bid Amount 252.00 318.00 Value $24,948.00 $23,214.00 $48,162.00 Date Calculated 12t0U2006 12t0u2006 t2nt06 Ut8t07 ut8t07 ut8t07 ut8l07 ut8t07 ut8t07 ln&t07 ut8t07 ut8t07 ut8t07 u18t07 t/r8t07 ut8t07 ut8t07 Fees Paid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 12t05t2006 12t05t2006 12t05t2006 12105/2006 t2tzu2006 12n8t2006 12t05t2006 0U1u2007 IO LLH 0u17t2007 APP LLH No Planning issues. Sanitary line location ok'd by building division & storm H2O tied to exisiting approved sytem per owners wife by telephone @ 726-5368 in the am l2ll9l2006.JLP Plans sent to Building Department for review under contract with the City of Springfield. Plan review completed by The Building Department, Shawn Eaton, under contract with the City of Springfield APP APP APP SKG TAJ JLP Structural Review 0u1u2007 Page 2 of3 Valuation Descriotion I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2006-01538ISSUED: 0111812007APPLIED: 1210112006 EXPIREST 0711812007VALUE: S 48,162.00 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. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during l-18'C1\. Owner Pase 3 of3 Date U Keourreo tnsDecnons I Construction Contractors Board Permit ot53 Address:,4 f Date: /-l{- 07 Statement: lnformation Notice to Property Owners About Construction Responsibilities 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion' 3A. My ge,neral contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR A 3B. I will be my own general contractor. If I hire subcontractors,I will hire only subcontractors licensed with the Constnrction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice io Property Owners about Construction Responsibilities on the reverse side of this form. 700 Summer St I\E Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us R n tr ct- lg-cn7 applicant) (White copy to issuing agenq) perunitfile, pink copy to applicant.) @ate) Property_owner.doc 06-0 I -04 Issued Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Constructton Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Ltcensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will befi.led with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38: Actimg e$ Yaur *wm #exrorat Cdntractor? X${r&rer$Arf0}q} NOTIGE T* PffiSPffi&TY SWhIER$ AmsuT fisN$?ffi u*?$&hr Kxsp*hi$r&x LNTtrs t{07k This lnfarr*a#on f#oiice to Prap*rty Owners a*ouf So*structian &espcnsJbilffles }y€s dere}cped by the ea*sfrucfion Confraefors $*ar$ in arcord*nce w;'ffl $&,5 fSr"S$$f$J, passed by tha 1989 Oregon L*gislatur*. trl'1'ole arc actrng as yrlur $wyi conffactor to coilstrllcl a ne\t.horne or make a substantial improvernent t+ *n existlng st*.leture, y*lr oa,? pre\"rnt many pioblems by being arvare cf ttrr* follorving respcnsibilities and o$noern$. KNmpX*yex- &s$p*xas{b*&i**es You rvili, in mosl insf*ncrs, b* rul*d t* i:a an "eff1pls3"€r" and th* cq:nk"a*t*rs ;r*u ***tract with will be "employees" if y{}ri u$e ecntract*rs :tclt licerxseel rvith th* C*nskx*ti*n C*nka*t*rs $*ard t* d* iab*r in cl:nskt.l*ting *r tr assist ix the c*&$kr:*lisln *r i:xpr*v*m*nt *f a r*si<trenlicii stru*tr"r*. "&s ttae ealpfi*yer, y*{! must cornpty wltk tke f*X}owing: *reg*x's Withk*Ist*m6 T'xx Law: As an emplcy*ro y*u mrlst rvithhold in*cxr* taxes {1"<lrn en:ptr*ye* }yeg*$ at th* fime *rnpl*ye*x *r* paid. Y*ri :aiill bs tria?:le fi:r the tex pay":??trirts *v*n if y*x dnr:'t ;:etually withSleild the tax fr*m yoxr en:p}*y***" Fcr rnor* tnf*n*xti**, eatrtr th* $*par{xrei:t *f R-*v**lr* *lt 5$3-37S-4S88" Un*mphyment Insur*nee Taxl As an err:ployero you are required to pay a tax for unemploymer*Einsuranse purposes on the vreges *lall employees. Fsr cl*re infor:nation, call the Sregon Empl*ym*nt $epartmmrt at 5CI3-94?-148$. The Oregon Business ldenfification Hurnber (S;l'{} is a cambined number for both Orrgon Withholding andUner,nploymentInsrxanceTax.Ttlfi1e{braBIN,*ail503-945-8091orforthe appropriate forms. lVorkers' Compcnsation Insuraxce: As an employer, yclu are subject to the Oregon'W'orkers' Cornpensation Law, and m:":st cbtain wcrk€rs' compe*sation insurance fbr your empioyees" If ycu fail to obtain workers' compensation i*surance, you could be subject to peaalties and be liable for all claim costs if one of your employees is injured on the job. S*r more information, call the W'orkers' C*n'rpensation Division at the Department of Cii*sumer 'and Business Senrices at 503-947-78 15. U"$. [mt*rmal X.ev*mxe $ervie*: As ax e:xp]oyer, y$:"l m$st withh*ld f,ederal ineome tax fr*m ernployees' wages. Y*x will be liabtrri {*r the 1ax payme*t *ven if y*u didn'{ *et*a}ly wiNhh*Xe3 t}re lax. For a F*der*i EIN numb*r- c*ll th* S{$ al t-8S0-829-4933 r:r visit their weh site a.t 3yx3-v-rrj*ggy" $ther Kesponsibffliticx nmcl Aree$ sf C*mcerns C*ds Cqrxxrplixx*e; As ihe peixrit J:*l*er f*r this g:r*j*e{, y*u ar* r"*sp*nxttr:}c l.r;r res*lving any f*i1ure to r:teet **de reqxir*rnrmts th;lt rnay l:e br*cght 1{3 }'$L}r att*::ti*n ilx*rag}r in*p*eti*n*. Liahilitv and Froperty Damagc f nsurance: Contact 1'nrrr insurance agent to qee if you have adequate insurance cov*ras* .ftir a*eid*nls and *r:rissj*ns ***h xs {*llil:g t**ls, pa.in{ r"}v*r spr.ry} rvaier <Sarrage fr*m pipe puncrures, firc *r *'*rk thal rur*st be redon*:" Time: &{akr sxr* you have suffl*ieylt time 1o sup*rv{se y*xr emp}*yees. Xxper*ise; Make xure y*u have i1:* skills t* **t as y*Llr sl:r/r, g**rral conk;ref*r" 1* coordinatr the rn.ork *f r*ugh-in and fi:rish lraeles, axd tt:r n*ti$: buitding *flicjals as th* appr*priate ii*:ies s*: thr:y ca* p*rfr:rrrx the req*ir**l inspectrons" If y*r: h*v* ad*litional qu*sti*ns ea[] the C*nstrxeti*n Co*tract*rs Bnard {5t}3-3?S-{"S21) or wrjt* the *gency al F* B*x }41;li), Sairm, fiK 973$$-5fi52. Prop*rty_*w::er"do* (}$-* 1 -{i4 CITY OF SPEINGFIELD SYSTEMS D EVELOPM HEET IOT RNAL ORJOBNLMBER: COM20.r 538 NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DE\ELOPMENTT\?E Neil Gosswiller I 135 6th St SINGLE FAMILY RESIDENCE NEW DWELLING LNITS 0 1. STORM DRAINAGE DIRECT RL]NOFF TO CITY STORM SYSTEM COST PER S.F $0.336 BUTLDTNG SIZE (SFl 252 LOT SIZE (SF) CITARGE $84.58 DISCOLTNT $0.00 5 0 IMPERVIOUS S.F 252.00 RUNOFF ROUTED TO DRY'*ELL DESIGNED AND CONSTRUCTED TO STANDARDS TTEM 1 TOTAI - STORM DRAINAGE SDC 2. SANITARY SE\\ER - CITY A REIMBI.IRSEMENT COST: IMPERVIOUS S.F 0.00 NT'MBER OF DFU'S 6 B. IMPROVEMENT COST: NTA4BER OF DFU'S 6 B. IMPRO\EMENT COST: ADT TRIP RATE 9.57 SUBTOTAL s359.48 COST PER S.F $0.336 COST PER DFU s26.03 $ 19.79 NIA{BER OF LNITS 0 NUI,IBER OF TNITS 0 ADM. FEE RATE 5o/o FEE: $84.58 x x x x x ITEM 2 TOTAL - CIry SANTTARY SEWER SDC s274-90 3. TRANSPORTATION COST:A xx xx COST PER TRIP $ 19.8 r COST PER TRIP $87.39 $0.00 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR 1.00 ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER.MWMC A. REIMBTJRSEME}JT COST: NUMBER OF FEU's 0 B. IMPROVEMENT COST: NUMBEROFFEU's 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATN'E FEE rTEM 4 TOTAL - MWMC SANTTARY SEWER SDC SUBToTAL (ADD ITEMS 1,2,3, & 4) 5. ADMIMSTRATTVE FEE: s3s9.48 CTIARGE s17.97 TOTAL SANITARY ADMIMSTRATION FEE: Jeff Prociw r2n9t2006 DISCOTINT RATE 50v, ADT TRIP RATE 9.57 $84.58 $1 I 8.74 s0.00 s0.00 $0.00 $0.00 $0.00 I s377.45 )070 I091 1092 I 093 t094 1056 079 078 0 E]oct) Fa rrl& COST PER FEU $91.61 COST PER FEU $961.52 PREPARED BY DATE TOTAL SDC CHARGES x x DRATNAGT rixrunn uNIT CALCULATION TABLE NUMBER OF NEW EXTURES X UNIT EQI.]IVAI.ENT = DRAINAGE FDffURE T,NTTS FOR CALCUIATE ONLY TTIENET ADDMONAI NO. OF FXTURES LT].IIT TYPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NUMBER OF EDUS TOTAL DRAINAGE FD(TT]RE UMTS lsa to unit set al I 67 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VAIUE BEFORE 1979 IS LAND ELGIBLE FORA]'INEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (tr APPLICABLE) VALI.'El IOOO CREDITRATE $0.00 x $5.29 $3.67 CREDIT FOR IMPRO\EMENT (IF'AFTER ANNEXANON) VALUE/ IOOO CREDITRATE $0.00 x $5.29 $2.2s $1.80 TOTAL MWMC CREDIT 20 DRAINAGE FD(TIJRE UNITS 0 2 2 1979 $3.22 1987 1988 1979 1980 I 981 1982 1983 1984 1985 1986 $2.731989 1990 l99t 1992 1993 1994 1995 1997 1998 1999 200t $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 3 000BATHTUB 0010DRINKING FOUNTA]N 3 000FLOOR DRAIN 3 000INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 6 000INTERCEPTORSFOR SAND / AUTO WASH / ETC. 0020LAI.]NDRY TT.-TB 3 000CLOTI{ESWAST{ER / MOP SINK 6 U00CLOTHESWASHER - 3 OR MORE @A) 00120MOBILE HOME PARK TRAP (I PER TRAILER) 1 000RECEPTOR FOR REFR]G / WATER STATION / ETC. 3 000RECEPTORFOR COM. SINK / DISFIWASHER / ETC. 202ISHOWER- SINGLE STALI- 0020SHOWER GANG INTLIMBER OF HEADS) 3 000SINK: COMMERCTAL/RESIDENTI.AL KITCHEN 2 000SINK: COMMERCIALBAR 0020SINK:WASH BASIN/DOI'BLE LAVATORY 1 101SINK: SINGLE LAVATORY,RESIDENTIAL BAR 5 000URINAL. STALL/WALL 00b0TOILET, PUBLIC IN STALLATI ON 3031TOILET, PRTVATE INSTALLATION 6 CREDIT RATE/$I,OOO ASSESSED VALI]E YEAR ANNEXED s0.00 $0.00 2000 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Citu of Springfield Official Receipt L ;lopment Services DePartment Public Works Department RECEIPT #: 1200700000000000041 Date: 0111812007 ll:14:03AM Job/Journal Number coM2006-01538 coM2006-01538 coM2006-01538 coM2006-01538 coM2006-01538 coM2006-01s38 coM2006-0r538 coM2006-01538 coM2006-01s38 coM2006-01538 coM2006-01538 coM2006-01538 coM2006-01538 coM2006-01538 Description Fire SF Fee - Residential Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Storm Sewer - lst 50 Feet Vent Fan M inimum/Adj ustment Mechanical -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + llYo Administrative Fee Amount Due 12.60 84.58 1 56.1 6 t18.74 17.97 364.80 56.00 45.00 6.00 39.00 10.00 25.54 40.86 s2.34 Item Total:$1,029.59 Payments: Type of Payment Paid By eheck Numbei Received By Batch Number Authorization Number How Received Amount Paid Check NEIL GOSSWILLER njm 183 In Person Payment Total: $ I,029.59 -51,o-rt39,- cReceint I Page I of I I11812007 *$n*r'a$F.l*["s