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Home My WebLink AboutPermit Building 2001-09-07SPRINGFIELD Job# 01-00641-01 Page 1 of4 Job Number: 01-00641-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 01400 Subdivision : Mirmosa Park %?, RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety 225 North Fifth Street SPringr;4;4, O? ?-477 Location Of Prcncsen 'ite: '1993 00008th St Spr Assesscr': i,l:pi,: 17aJ2613 Lot: 14 Block: Addition:lST dw oF sPR lrGFtELD, oREcoN Owner: Brian Dramen Address: 420 Stonewood SCOpe Cf l.^i'ark: [-rrnrrl Phone Number: City/State/Zip: New 541-747-0811 Eugene, OR 97405 Value: $193,357 -r'o' o+h st. & 8^5 S St. a duplex Contractor Type GeneralContr Plumbino Contr Cor:, ractor Rirl rr.i Hiatt pc i-.:x 173, springfield, OR 97477 Err,rene Exeavation & Plumbing lnc ['. Box 40821, Eugene, OR 97403 Registration # Expiration Date 1 38003 3nD003 Phone 54',t-746-9789 *Qffea-oaoe Quad Area: :l:'^/ #OfUr, : i Constr. Type: (VN)r.^.'1n4 Frame Water lie;r.cr: office use - Land Use: Zoning Code: LDR Bedrooms: Range: # Of Buildings: 1 Occupancy Group: Dwelling Heat Source: Sq. Footage: 2500 To reo'l'"t an ilc6ro^'^" ^rrr tho 24 hour recording at726-3769. Allinspections requested before 7:00 lygpftipa r .,. Verify C:^,':'1 ^r I Footin.r Founci;:: ::-. Post and Seam Floor l:. r':-''^ n Ceiling : Shear',', r Framing Wall lnstri:1'"n Drywall Firev.,:. ! Final tl.' l 'i':'r Building I - ' ''-trll ground rod at footing, and call for inspection in conjuction with footing and/or foundation.nches are excavated. 'rms are erccted but prior to concrete placement. ,loor insulation or decking.,. ,."kiIg. .,,.r. ,r,:ring sheathing with finish materials.- .ver. ,.,]r ,aping. ."t :nd constructed according to plans.- I required inspections have been approved and the building is complete. Temporary Pcwer Underflonr Ptrrmhinq Underflc'r , -i:r Rough Fl:r:,i. :rj Water Line Sanitary i^'rroP f ins Storm : . Final Plt:,,r1 ; Underfloor I l.chanical Rough i' ^' " Final l'l: SW-Ctrrl'- j:': CC-Se:, CC-SI:,' ': Job# 01-00641-01 Required lnspections - Anpr-,,.1 required prior to SUI enfng pole. Plumbing I - nri6r ro insulation or decking. - I r .' ' , ccver or placement of concrete. - i .- acver. -i)i'io:'' i.lling trench. ';ng trench. - rrg trench. -' L i plumbing work is complete. Mechanical I - !:rri1r r1 insLtlation or decking Page2 of 4 ; rchanical work is complete. -'c 1r-€ erected but prior to placement of concrete - r ; re erected but prior to placement of concrete '''- rre erected but prior to placement of concrete Stfeet r.$^r^\,^*1^hf . [:,1il., Cur!: '' : San Sc' :' ' ':t): i Spe:; i : Securi. ':e,': Bond C ' : '-l-inre: t i' '- '^^0 00:00 Att/ Other' Projcci " ': Types Of Warning Devices Reqd. ' " - rnved rt Agr.? Sidewalk Type: AdditionalROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: I To Curb and Gutter 4 00/00/0000 00:00 AM Zonin.Overlay District: # of Street Trees: Land Use: Pave Driveway?Flooil, l^ 1: C::' "' I iz l.4iller ^ 'r'l:rr),?l ^lenwood Area? [ 3: Additional Requirements Required Attachments: Source Locn: Materia!: Pla n r: Urb:.,' Qua:r: Dra,, : Floo.l '- /'l Flood Plain FEMA:nla Electricat I Public Works I l Construetion Tirpes :(Vl'l) tntnt''6 [:rame Occupa;rcy i;': ,-t ; :: i-rr,t' ,1 .' # Of Euii:lings: 1 # Of Berlroc irs: Handicap Lc:css" ] Area 1 'l Main: 25C:; Job# 01-00641-01 # Of Stories: 1 Height (feet): 18 Current Units: ProPosed Units:1 Census Code:New SF - attached Total:3550,1r^. ---",.".:c Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check Residcr:'irl Total , ri lz 06t21t2001 5909 193,357 $418.93 $418.93 Building Buildin^ -'' State S I l BuilrJin-' ' Total i ;l :l 0B/06/2001 0B/06/2001 0B/06/2001 6358 6358 6358 193,357 $644.50 $45.12 $19.34 $708.96 Electrical Tern pc r- r"" Stat-- ^ 'i Admrn : :' Total I . 'r 06t2112001 06t21t2001 0612112001 5909 5909 5909 1 $40.00 $2.80 $1.20 $44.00 Plumbin lVini'r," ' [Vin]r: ' Two i Two L Stal: : Qtr! r ' ACrr "Adm''' : Tot::i . 0B/06/2001 091a712001 0B/06/2001 0910712a01 0B/06/2001 0910712001 0B/06/2001 0910712001 6358 6630 6358 6630 6358 6630 6358 6630 $.00 $.00 $160.00 $160.00 $11.20 $11.20 $4.80 $4.80 $352.00 1 1 l.lechanical Hood ar [Vlinilrrl Admirri:' Less il - Vent t'' Drycr'.r Meclr:' State i:r Total i.: 6358 6358 6358 6358 6358 6358 6358 6358 $9.00 $.00 $.ee $6.00 $12.00 $6.00 $10.00 $2.31 $46.30 0B/06/2001 0B/06/2001 0B/06/200 1 0B/06/2001 0B/06/2001 08/06i2001 0B/06/2001 0B/06/2001 2 1 4 2 Prii;iic Works Nc'.^,'' Ne,." '- 2n:i,' t\lt I Tcl . t- f .-i+ 0B/06/2001 0B/06/200'1 0B/06/200 1 0B/06/2001 6358 6358 6358 6358 30 2 1 1 1 $67.40 $130.00 $30.00 $-60.00 $167.40 Res'/{^^r;-l _ ^r F!y.t:! Devetiinrnt I 08/06/2001 6358 4,765 $1,291.38 .S li ^ l. 1-011-00640ob#J Page 4 of 4 ValuelQuanti$Fee Amount Fee Paid On 0B/06/2001 0B/06/2001 0B/06/2001 0B/06/2001 0B/06/2001 0B/06/2001 0B/06/2001 0B/06/2C0'l ReceiPt# 6358 6358 6358 6358 6358 6358 6358 6358 Sanitar;'3c"lr Resi.le:*r^l -.^r--l ^ r- r;-'. Resirlc'- I ' "^'r'la M\\'i,IC Sanitaf,,rl . _r' .-r,-roflt SDC Arl r 1'' : Residc' ' Tra n'rt r I r '- -"-' ^t Tot:. i : 37 2 2 1 37 2 2 $s97.55 $1,312.04 $48.66 $10.00 $786.25 $246.31 $571.82 $308.54 $5,172.55 temc. t '..',, ';nalane SDC 08/06/2001 6358 1 $1,848.00 $1,848.00 Gr:.. l PIar C' lniti'l i- ' Eng irc PIn''';-'- - ' :dBy ' r:lrhart '1- 'l-.:rplin Date Completed 06t22t2001 07 t09t2001 0710512001 $8,758.14 Comment second driveway approved by Kettwig 7-3-01 Left message with owner onTlsl}l regarding need for LDAP Owner states only filling, grading or excavating 25-27 cu yards. Struct'-r':rl'l -s 0711612001 ''.ve carefully exrrnined the completed application and do, is true and correct, and I further certify that any and all work ,lh the Ordinr,rc:s of the City of Springfield and the Laws ofI vork described hcrein, and that NO OCCUPANCY will be made lhe Community Services Division, Building Safety. lfurther l^),ees who are in compliance with ORS 701.05S will be used on rC inspections are requested at the proper time, that each 1 the permit card is located at the front of the property, and the , site at all times dLrring construction Date By "'-'' heri peri the I of r. cert 'I th i-q ' I fr-l adC: ' ,:,,.a,-t-,-. sis qhlor Plannin^--':, ;-. 'rar apv-::\ -5 LL*{\a l@'fi'*^,-r-- 225 FIFTH STREET 91 177 6tsg RICAL PERN,IIT FEE SCFIEDULE glc or Multi-Family per dl'elling unit. Service Included: e11' LEGAL DESCRIPTION11>>zet >Otrtoo Items Cost6;/ s*6.00 -(Z ,froo -tso/ JOB DESCRIPTION-$ur €cc{t^J t (Lg' 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof E:rch Manufd Horne or Modular Drvelling Service or Feeder Permits are non-transferable and expire if work is not started rvithin 180 days of issuance or if rvork is suspended for 180 days. .. .- $ 50.00 2 Electrical' Contractor Address Ea Supen'isor Expiration Date TALLATION ONLY B. Sen'ices or Feeders rE- Installation, Relocation: 200 amps or less 201 amps to 400 amps i101 amps to 601 amps t0 of Supcrvising Electriciln Over 60 0 amps "B" abo\re or or D. Branch Nerv One E -Each Extensio not Limited Enerp'/Res Linlited Energv/Comm Nlinimum Electric Permit Inspection Fee .I. SUBTOTAL OF ABOVE 7%q Stfie Surcharge frrfrAdministrative F TOTAL $25.00 $4s.00 is 545.00 * Surchargcs { c)c} ,.2z---7(-o d" 1. ae Orvners OWNER INSTALLATION The installation is being tttade on properry" i orvn lvhich is not intended lor srle. lease or rent. Orvners Signature: Sum $50.00 - $69.00 $ 100.00 <t z{qo Expiration Constr Contr. , . C Tcnrt)ot'itrv Sen'ices or Fceders X / Z / Inst,,u,rtiorr, Alteration or Relocation $43.00 Each Additional Circuit or ti'itlt Service or Feeder Pennit $ 3.oo _ lq L, SPFII.., IFTELD The lollowing prolect as submitted has the following zoning, and does not require specific land use approval. Zoning Date {DTL o( 225 FIFTE STREET iinrNcrrut,D, oREGoN 9r47Ped sisnature INSPECTION REQUEST: 726-3769 OFPICE: 726-3759 EIec trical Contractor Address Ci ty Phone ELECTRTCAL PERHIT APPLICATION city Job x,^a"rO/ -OC€r'l/ -a ( 3. COUPI,HTB FEE SCffiDIILE BELOS A. Nev Residential-Single or Hulti-FamilY Per dvelling unit' Service Included:Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home- or Modular Dwelling Service or Feeder $ 8s.00 s 1s.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: tlO --aEffi- t 5. SUBTOTAL OF ABOVE 7% State Surcharge 3Z Administrative Fee TOTAL 200 amps or less 201 amps to 400 amPs - 40L amps to 600 amPs - 501 amps to 1000 amPs- Over 1000 amPs/volts - Reconnect 0n1Y- Temporary Services or Feeders fnsiallaiion, Alteration or Relocation 200 amps"or less I 201 amps to 400 amPs - 0ver 401 to 600 amPs 0ver 600 amps or fOOO-ETts Branch Circuits Nev, Alteration or Extension Per Pane1 one Circuit $ 35.00 i""n eaaitional Circuit or vith Service or Feeder Permit - $ 2'00 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utline Lighting- Limited EnergY/Res - Limited EnergY/Comm 1. LOCATION OFB= I,EGAL DESCRTPTIONao JOB 9 t o/v <-?>,tt4l Permits are non-transferable and expire if vork is not started vithin 180 days oi ii"u"nce or if vork is suspended for 180 days. 2. COI{TRACTOR INSTALI,ATION ONIY s s0.00 $ 50.00 s100.00 s130.00 $300.00 $ 40.00Supervi*sor License Number Expiration Date C. Constr Contr. Number Expirati.on Date Signature of Supervising Electrician D Ovners Name /+-T>r.ur,olx/lt Address L(7-<> { citv f4 /=-, (- 911s11s--7c(7 -c>Et / OVNER INSTALI"ATION The installation is being made on ptop"tty I ovn vhich is not intended for sale, lease or rent. DATE: s 40.00 s 40.00 $ 20.00 $ 36.00 RECEIVED c>6Zr o /?,d /-^* s 40.00 $ ss.00 $ 80.00 see ItBlt CITY OF SPRINGFIELT, SYSTEMS DEVELOPMENT CHA E WORIGHEET JOURNAL OR JOB NUMBER: 0l-00641-01 NAME OR COMPANY: DRAMEN LOCATION 1983 8TH STREET / 805 'S' STREET TAX LOTNUMBER:t7 -03-26-13-07s00 DEVELOPMENTTYPE: DUPLEX NEW DWELLING LTNITS 2 BUILDING SIZE: O SF LOT SIZE: O SF DISCOUNTRATEIMPERVIOUS S.F.COST PER S.F $0.000.00 $0.271 50Y. IMPERVIOUS S.F 4765.25 COST PER S.F. s0.271 I 1.38 RUNOFF ROI.]-[ED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS x x x I. STORMDRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM .38ITEM l TOTAL. STORMDRAINAGE SDC NUMBEROFDFU's COST PER DFU $597.5s37$l6.ls NUMBER OF DFU's 37 COST PER DFU $21.2s $786.2s B. IMPROVEMENT COST: x x ,. SAMTARY SEWER. CITY A. REIMBI.]RSEMENT COST: $ITEM 2 TOTAL. CITY SAIIITARY SEWER SDC COST PER TRIP NEW TRIP FACTORADT TRIP RATE NUMBER OF UNITS 12.05I1.002.559.57 ADTTRIP RATE 9.57 NUMBER OF UMTS 2 COST PER TRIP $16. l2 NEWTRIP FACTOR 1.00 $308.s4 B. IMPROVEMENT COST: x xx xxx 3. TRANSPORTATION A. REIMBURSEMENTCOST: ITEM3 TOTAL - TRANSPORTATION SDC s10.00 NLIMBER OF FEU's 2 COST PER FEU $285.91 NUMBER OF FEU's 2 COST PERFEU s24.33 $48.66 $0.00 SUBTOTAL OF MWMC REIMBURSEMENT,IMPROVEMENT & CREDIT MWMC ADMINISTRATIVE FEE $620.48 $571.82 B. IMPROVEMENT COST: x x MWMC CREDIT IF APPLICABLE (SEE REVERSE) 4. SAMTARY SEWER. MWMC A. REIMBI.]RSEMENT COST: ITEM 4 TOTAL. MWMC SANITARY SEWER SDC 5suBTorAL (ADD ITEMS l, 2, 3, & 4) SUBTOTAL ADM. FEE RATE s246.31.25 5% 5. ADMINISTRATIVE FEF: x $5,172.56 (h rrl cO & rrlFa (,r!& 1070 l09l 1092 1093 1094 1055 1056 1073 6127l0ttlr,,wTu4,l;,r- SDC COORDINATOR TOTAL SDC CHARGES DATE NUMBER OF NEW FIXTURES X UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE FIXTURE UNITS(#NEW - #OLD )x UNIT EQI.IIVALENTFIXTURE TYPE BATHTUB (3-0 (0-0 (0-0 (0-0 (0-0 (0-0 (2-0 (0-0 (0-0 (0-0 (0-0 (0-0 (0-0 (2-0 (0-0 (0-0 (0-0 (4-0 (0-0 (0-0 (4-0 )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x )x J 9 DRINKING FOLINTAIN I 0 FLOORDRAIN J 0 INTERCEPTORS FOR GREASE I OIL /SOLIDS IETC.J 0 INTERCEPTORS FOR SAND / AUTO WASH /ETC.6 0 LAUNDRY TUB 2 0 CLOTHESWASHER / MOP SINK 3 6 CLoTHESWASHER- 3 ORMORE (EA)6 0 MOBILE HOME PARK TRAP (I PER TRAILER)t2 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. RECEPTOR FOR COM. SINK / DISHWASHER / ETC. I 0 J 0 SHOWER, SINGLE STALL 2 0 SHOWER, GANG (NUMBER OF HEADS)2 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 3 6 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 TNSTALLATION 3 t2 MISCELLANEOUS DFU TYPE NUMBER OF EDU's* ( 0 - 0 )x 20 TOTAL DRAINAGE FIXTT]RE TINITS 0 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day DRAINAGE' TURE UNIT CALCULATIb,< TABLE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE, CALCULATE CREDIT SEPARATELY CREDIT FOR LAND OF APPLICABLE) CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) $0.00 $0.00 YEAR ANNEXED CREDIT RATE PER $I,OOO ASSESSED VALUE YEAR ANNEXED CREDIT RATE PER $I,OOO ASSESSED VALUE 1979 OR BEFORE $4.74 1990 $1.96 I 980 $4.65 1991 $1.55 r 98l $4.s9 1992 $1.36 1982 $4.46 I 993 $1.23 I 983 $4.30 1994 $1.0s I 984 $4. l4 I 995 $0.90 I 985 $3.93 t996 $0.75 I 986 $3.63 1997 $0.s7 t987 $3.26 I 998 $0.3s I 988 $2.8s 1999 $0. ls l 989 $2.40 0.000 TOTAL MWMC CREDIT = VALUE / IOOO 0.000 CREDITRATE x $0.00 : x $0.00 r,T U MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE Job# 01-00641-01 SPHINGFIELD RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1983 00008th St Spr AssessorsMap#: 17032613 Lot: 14 Block: Addition:1ST Page 1 of4 Job Number: 01-00641-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 01400 Subdivision: Mirmosa Park n!r icrTY oF SPRiNGFIELD, OREGOTU Owner: Brian Dramen Address: 420 Stonewood Scope Of Work: Duplex Phone Number: City/State/Zip: New 541-747-0811 Eugene, OR 97405 Value: $193,357 1983 8th St. & 805 S St. a duplex Contractor Type GeneralContr Contractor Richard Hiatt po box 173, springfield, OR 97477 Registration # Expiration Date Phone 541-746-9789 Quad Area: # Of Units: Constr. Type: Water Heater: 2RSW 1 (VN)Wood Frame Office Use - Land Use: Zoning Code: LDR Bedrooms: Range: # Of Buildings: 1 OccupancyGroup: Dwelling Heat Source: Sq. Footage: 2500 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 Building I Verify Ground Rod Footing Foundation Post and Beam Floor lnsulation Geiling lnsulation Shear Wall Nailing Framing Walllnsulation Drywall Firewall FinalBuilding - 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. -Located and constructed according to plans. -When all required inspections have been approved and the building is complete. Electrical Temporary Power -Approval required prior to SUB energizing pole. i t\nr tJ UN IL i ! \LrJlJ I Underfloor Plumbing Underfloor Drain Rough Plumbing Water Line Sanitary Sewer Line Storm Sewer Line FinalPlumbing Underfloor Mechanica! Rough Mechanical FinalMechanical SW-Curbside GC-Second GC-Standard Street Improvement: Fully lmproved Curb Cut?f tmprovement Agr.? San Sewer Depth (Ft): 6 - 4 Storm Sewer Available? f SpecialReq.: Security Required: Bond Begin DateTime Special lnstructions: Other Utilities: Project Supervisor: Job# 01-00641-01 Required lnspections Plumbi - 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. -When all mechanicalwork is complete Public Works -After forms are erected but prior to placement of concrete -After forms are erected but prior to placement of concrete -After forms are erected but prior to placement of concrete Page2 of 4 00/00/0000 00:00 AM Sidewalk Type: AdditionalROW? Size Of Line (in): Downspouts/Drains: Enchroachment Permit: San Sewer Tee (in): Bond End DateTime: B To Curb and Gutter 4 00/00/0000 00:00 AM Types Of Warning Devices Reqd. Zoning: FloodPlain?Wetlands? [ Overlay District: # of Street Trees: LDR Land Use: Pave Driveway? Journalnumbers 1: Gomments: 3:2 I Planner: Liz Miller Additional Requirements: Urban Growth Boundary?[ Glenwood Area? [ Required Attachments: Quantity Of Fil!: Source Locn: Supplier: Material: Drainage: Floodway FEMA: n/a Flood Plain FEMA: n/a Construction Types(VN) Wood Frame Occupancy Groups: Dwelling # Of Buildings: 1 # Of Bedrooms: Handicap Access? Area (Sq. Main: 2500 Accessoryl050 Job# 01-00641-01 # Of Stories: 1 Height (feet): 18 Current Units: Proposed Units:1 Census Code: New SF - attached Total:3550 Page 3 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check Residential Plan Check Total Plan Check 193,357 $418.93 $418.93 Building Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building 0B/06/2001 08/06/2001 08/06/2001 6358 6358 6358 193,357 $644.50 $45.12 $19.34 $708.96 Electrical Temporary: 200 Amps or Less State Surcharge - Electrical Administrative Fee - Electrical Total Electrical 0612112001 06t21t2001 06t21t2001 5909 5909 5909 1 $40.00 $2.80 $1.20 $44.00 Plumbing Minimum Plumbing Permit Fee Two Bathrooms State Surcharge - Plumbing Administrative Fee - Plumbing Total Plumbing 08/06/2001 08/06/2001 0B/06/2001 08/06/2001 6358 6358 6358 6358 1 $.00 $160.00 $11.20 $4.80 $176.00 Mechanical Hood and Exhaust Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct Dryer Vent Mechanical lssuance State Surcharge - Mechanical Total Mechanical 0B/06/2001 08/06/2001 0B/06/2001 08/06/2001 08/06/2001 08/06/2001 08/06/2001 08/06/2001 6358 6358 6358 6358 6358 6358 6358 6358 2 $e.00 $.00 $.gg $6.00 $12.00 $6.00 $10.00 $2.31 $46.30 1 4 2 Public Works New Sidewalk New Curbcut 2nd Driveway/Overwidth Appl Fee Multiple Permit Discount - 3rd Permit Total Public Works 0B/06/2001 0B/06/2001 08/06/2001 08t0612001 6358 6358 6358 6358 1 30 2 1 1 $67.40 $130.00 $30.00 $-60.00 $167.40 Devel nt Residential- Single Family - Storm Sanitary Sewer Residential Transportation Residential lmprovement MWMC MWMC Administrative Fee 08/06/2001 0B/06/2001 0B/06/2001 08/06/2001 08/06/2001 6358 6358 6358 6358 6358 4,765 37 2 2 1 $1,291.38 $597.55 $1,312.04 $48.66 $10.00 06t21t2001 5909 Job# 01-00641-01 Page 4 of 4 Fee Paid On Receipt# Value/Quantity Fee Amount Sanitary Sewer SDC Reimbursement SDC Administrative Fee Residential Sanitary MWMC Transportation SDC Reimbursement Total System Development 08/06/2001 08/06/2001 08/06/2001 08/06/2001 6358 6358 6358 6358 37 $786.2s $246.31 $571.82 $308.s4 $5,172.55 2 2 Duplex - Willamalane TotalWillamalane SDC Willamalane SDC 08/06/2001 6358 1 $1,848.00 $1,848.00 Grand Total Plan Check Type lnitial Review-Res Engineering-Res Planning-Res Checked By Bob Barnhart Steve Templin Liz Miller Date Completed 06t22t2001 0710912001 $8,582.14 Comment second driveway approved by Kettwig 7-3-01 Left message with owner onTl1l0l regarding need for LDAP Planning-Res Liz Miller 0710512001 Owner states only fllling, grading or excavating 25-27 cu yards. Structural-Res Tom Max 0711612001 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 street, that the permit card is located at the front of the property, and the apB(oved set of plans will remain on the site at all times during construction(:3rr*vtO.^a,rN"-t Lr*G kcy/ Signature oatiJ