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Home My WebLink AboutPermit Building 2002-08-01Status: Issued 225 Fifth Street Springfield, OR 541:726-3753 Phone 541-726-3676 Fax 541:1 26-37 69 Inspection Line Buildin g/C ombin ation Permit PERMIT NO: 98-00367-01ISSUED: 0810112002APPLEDz 0212512000 E)(PIRESz 0811212003 VALI]E: SITE ADDRESS: 1343 00011th St ASSESSOR'S PARCEL NO. : 1703264405200 PROJECTDESCRIPTION: Renewed permits 080102.D8 Owner: Nick Roehl Address: 3205 Western Drive Eugene OR Contractor Tlpe General Electrical Owner Plumbing # of Buildings: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: SETBACKS Frurtyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Contractor Oregon Lumber Packaging Inc BURRELL BROS ENTERPRJSES INC Nick Roehl Contractors Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Paved lkive Rqd: oh License Expiration Date Duplex Alteration Residential Phone Number: (541) 344-0183 Phone Number: 541-579-3364 Phone (s41) s43-s333 s4t-747-2724 (s41) 344-0183 (s41) 607-8879 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARIilNG TYPE OF TYPE OF USE: Inc &A\ \ffi."nr.0, \.r$ompact: tun Sidewalk Type: DownspoutVDrains CONTRACT OR INF ORMATI ON Notes: 1of 3 Spr \(\ -.,r&; Status: Issued 225 Fifth Street, SpringfieH, OR 541:726-3753 Phone 541-726-3676 Fax 541:7 26-37 69 Inspection Line Buildin g/C ombinatio n Permit PERMIT NO: 98-00367-01ISSUED: 0810112002APPLIEDz 02125/2000E)PIRESz 0811212003 VALTJE: Description Type of Construction $ Per Sq Ft Square Footage Total Value of Project Fee Description Plan Check Fee Building Permit Mechanical Issuance Mechanical Permit Plumbing Permit SDC-Administrative Fee SDC-Sanitary Sewer SDC-Transportation SDC-Willamalane Administrative Fee - Mechanica Administrative Fee - Plumbing Mechanical Issuance Minimum Mechanical Permit Minimum Plumbing Permit Fee Renew Permit - Building Renew Permit - Mechanical Renew Permit - Plumbing State Surcharge - Mechanical State Surcharge - Plumbing Renew Permit - Building Renew Permit - Mechanical Renew Permit - Plumbing + l0o/o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Total Amount $2,666.83 Value Date Calculated $83.53 $134.93 $10.00 $15.75 $9s.76 $49.63 $51s.46 $477.21 $924.00 $0.45 $0.4s $10.00 $15.00 $15.00 $64.25 $7.50 $4s.60 $r.05 $1.05 $64.2s $22.50 $45.60 $s.80 $4.06 $43.00 $1s.00 3127198 4lt9t98 4fig198 4n9t98 4n9t98 4figt98 4lt9t98 4n9t98 4lt9t98 2125100 2t25100 2t2st00 2t2st00 2t2sl00 2t2st00 2t2st00 2t25t00 2t25t00 2t25t00 81u02 8nt02 8nt02 2lt3t03 2lt3t03 2n3t03 2n3t03 Receipt Number 29244 33532 33532 33s32 33s32 33s32 33532 33532 33532 724 722 724 724 722 724 724 722 724 722 10131 10131 10131 r200200000000000690 1200200000000000690 1200200000000000690 1200200000000000690 Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. 2of3 Valuation Description F ees rat(l I Status: Issued 225 Fifth Sfeef Springfield, OR 541:726-3753 Phone 541-726-3676 Frx 541:7 26-37 69 Inspection Line Buildin g/C ombin ation Permit PER,MIT NO: 98-00367-01ISSUED: 0810112002APPLIEDz 0212512000E)CIRESz 0811212003 VALI]E: Reouired fnsnections By signature, I state and agree, that I have carefully exarnined the completed application and do hereby certi$ 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 hereiq and that NO OCCUPANCY will be made of any structure without permissftrn of the C-ommunity Services Division, Building Safety. I further certiff that only contractors and emphyees who are in compliance with ORS 701.06 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 3 of 3 211312003 l0:20:37AM City of Springfield Development Services Department Public Works Department Official Receipt 225 Fifth Street Springfieldo Oregon 97 477 541-72G3759 Phone Receipt #z 1200200000000000690 Date: 0211312003 Line Items: Job/Journal Number Description Amount Paid 98-00367-01 98-00367-01 98-00367-01 98-00367-01 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7Yo State Surcharge + l0%o Administrative Fee Payments: 43.00 15.00 4.06 5.80 Line ltem Total:$67.86 Tlpe of Payment Paid By Received By Check Number Confirm No How Received Amount Paid Check NICHOLAS ROEHL djb In Person 67.86 Total:$67.86 Page I of I cReceipt.rpt @L) of3 SPRINGFIELD Job# 98-00367-01 RESIDENTIAL PERMIT Gity Of Springfield Community Services Division Building Safety Page 1 Job Number: 98-00367-01 Office:726-3759 Inspection Line: 726-3769 Tax Lot#: 05200 Subdivision: 225 Fifth Street Springfield, OR97477 Location Of Proposed Site: 1343 00011th St Spr Assessorsil"p*, 17032644 Lot: Block: Addition: clTY oF SPRINGFIELD, OREGON Owner: Nick Roehl Address: 3205 Western Drive Scope Of Work: Duplex $17,500 Phone Number: City/State/Zip: Alteration 541 -344-01 83 Eugene, OR Value: $0 Contractor Type GeneralContr GeneralContr Plumbing Contr Contractor Oregon Lumber Packaging lnc PO Box 22201, Eugene, OR 97402 Dave Hahm xx, xx, XX Contractors Plumbing Service lnc Po Box 7636, Eugene, OR 97401 Registration # 66307 Expiration Date 5t1t2004 Phone 541-543-5333 541-683-6507 541-607-8879101624 \t Quad Area: # Of Units: Gonstr. Type: Water Heater:Ra \s0 t0s # Of Buildings: Occupancy Group Heat Source: Sq. Footage: hR La To request an inspection call the 24 hour recording at 726-3769. All a.m. will be made the same working day, inspections requested after 7 Required lnspecti - Prior to cover. - Prior to cover. -Prior to cover. -Located and constructed according to -See Plan Review and/or lnspectors Notes, or prior to cover if applicable. Building b'j Rough Mechanical Rough Plumbing Framing Firewall Special Progressive Framing Progressive Transfered -Prior to cover, working day. \he \s1 Job# 98-00367-01 Page 2 of 3 Required Inspections Plumbing Underfloor Plumbing Rough Plumbing -Prior to insulation or decking. -Prior to cover. Rough Mechanical -Prior to cover. Gonstruction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main:Accessory Mechanical # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total Fee Paid On Receipt# Value/Quantity Fee Amount Transfered Records Plan Check Fee Building Permit Plumbing Permit Mechanical Permit SDC-Sanitary Sewer SDC-Transportation SDC-Administrative Fee SDC-Willamalane Mechanical lssuance Total Transfered Records 03t27t1998 04t19t1998 04/1 9/1 998 04/1 9/1 998 04t19t1998 04/1 9/1 998 04119t1998 04/1 9/1 998 04t19t1998 29244 33532 33532 33532 33532 33532 33532 33532 33532 84 135 96 16 515 477 50 924 10 $83.53 $134.93 $95.76 $15.75 $515.46 $477.21 $49.63 $924.00 $10.00 $2,306.27 State Surcharge For Building Permit Building Administrative Fee Total Building Buildins 02t25t2000 02t25t2000 724 724 $.oo $.00 $.00 Minimum Plumbing Permit Fee State Surcharge - Plumbing Administrative Fee - Plumbing Total Plumbing Plumbing 02t25t2000 02t25t2000 02t25t2000 722 722 722 $15.00 $1.05 $.45 $16.50 Minimum Mechanical Permit Administrative Fee - Mechanical Mechanical lssuance State Surcharge - Mechanical Total Mechanical Mechanical 02t25t2000 02t25t2000 02t25t2000 02t25t2000 724 724 724 724 $15.00 $.45 $10.00 $1.05 $26.50 Permits w/o Srchg Renew Permit - Building Renew Permit - Building Renew Permit - Plumbing Renew Permit - Plumbing Renew Permit - Mechanical 02t25t2000 08t0112002 02t25t2000 08t01t2002 02t2512000 724 10131 722 10131 724 64 64 46 46 8 $64.25 $64.25 $45.60 $45.60 $7.50 Job# 98-00367-01 Page 3 of 3 Fee Paid On Receipt# Value/Quantity Fee Amount Permits w/o Renew Permit - Mechanical Total Permits w/o Srchg 08t01t2002 10131 23 $22.50 $249.70 Grand Tota!$2,598.97 Date 225 FIFTH STREET SPzuNGFIELD. OREGON 97177 INSPECTION REQUEST: 726-3769 OFFICE: 726-3'759 EL 'zuCAL PERIVIIT APPLICATION Citi'Job Numrrer ? K-oo 36 7-O I 3. COIvIPLETE FEE SCI{EDLJLE BELOW A. Neu' Rcsidcntirrl-Singlc or Multi-Frmily pcr drvelling unit. Scrvicc Includetl. Iterns Cost LOCATIO t3.1 3 NOFIN STALLATIONrL- >t LEGAL DESCRT?TION(?o zGqq otzso Sunr JOB DES6 +-\ The following proiecl as submitted has the lollowing .on'n! ano-d'oei not requlrcruQp3qlte m$$$eCRTPTION (-r G-L^,rt i Each adclitiortal 500 Manufd Home or --. $ 106.00 $ r 9.00 $5000 _ $ 63.00 _ $7i 00_ 00_ .00 _ .00 12,; $5o.oo __ $69.00 $loo.oo _ approval Pernrits arc non-lrAnsfcrable arrd expirgut" il'rvork is rlot startcd u'itltin Iti0 days of issuancc or if rt'ork is strspended for I iiO days Sen,ice or Feeder B. Se rlicc.s or Fecders Instullation, Altcrtttions or Rclocation: 200 arnps or less 201 anrps to -100 arnps -l()l anrps to 600 amps 601 anrps to 1000 amps One Circr.rit Each Aclclitional or Feecler \S ne Lighting Euergl'/l{es inritccl Energv/Comnt Zoning L-(-o Authorized Signature 2 CONTRACTOR INSI'ALLATION ONLY Burrell Bros. Electric 40159 Booth Kelly Road Springfield, Oregon 97 4tB\l\-ts{*\ Srrpcrvi-sor Licertsc i,-unrbcr 4E())S - Expiration Dzrte Con st r Contr. Nu nrb.rf6\A$\.e- Erpiration Date Signirturc o1'Srrltcn isirtg Ele ctriciltn Nlme C 2 citr > rtb P hone O\\/NER INSTALLATION The instrtllation is being tttade on propertl I o*'n *'ltich is not intended lor sale. Iease or rent. Over 1000 Reconnect arnps/r,o C. Tentp o\ 'C "8" a D- Brirnch Circuits Nuv Alterntiort or Extension Per Panel C, Ob not inclutletl) I $43.00 E Service{ s3oo /) _ $50.00 _ _ $50.00 _ _ $25.00 _-- $li 00 i\linirnunr Elcctric Pernrit Inspcction Iec is S]5'00 * Strrclrlt'gcs 1. SUBTOTAL OF ABOVE 7%, Statc Surchurge 8ol, Administratile Fce t5 - "7 rL On rre r:- Signltturc 1'oT.\I- ,\(o L I Atttr'css l3\9 ll*L s,l--- [. RESIDENTIAL PERMIT "",,f,:fl ,?":Hll ggBfl,,", o nBuilding Safety Page 1 Job Numbe r: 98-0O367-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 05100 Subdivision: of2 IE'ANS# : rl1- AAAAT2? 0f;IE:FEB 15 1000 ATiI RECD;? $ 6T.10 IHANEE; IHSHIEft:O5T 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1343 OOOI lth St Spr AssessolsMap#: 17032644 Lot: Block: Addition CITY OF OREG,ON Owner: Nick Roehl Address: 3205 Western Drive Scope Of Work: Duplex Phone Number: City/State/Zip: Alteration 541-344-0183 Eugene, OR Value: $0 Gontractor Type Plumbing Contr Gontractor Contractors Plumbing Service lnc Po Box 7636, Eugene, OR 97401 Registration # 101624 Expiration Date 8/15/99 Phone 541-343-0975 Quad Area: # Of Units: Constr. Type: Water Heater: Office [Jss - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at726-3769. All inspections r.equested before 7:00 a.m. r,riitt be made'the same working day, inspectiohs requested after 7:00 a.m. will be made the following working day. Required lnspections ng Rough Plumbing FinalPlumbing Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Main: - Prior to cover. -When allplumbing work is complete. Accessory: # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total: Fee Paid On Receipt# Value/Quantity Fee Amount 02t2512000 722Minimum Plumbing Permit Fee $15.00 (sq. Job# 98-00367-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount State Surcharge For Plumbing Permit Renew Permit - Plumbing Plumbing Administrative Fee Total Plumbing 02t25t2000 02t2512000 02t25t2000 722 722 722 46 $1.05 $45.60 $.45 $62.10 Grand Total Signature $62.10 a rL'.Zu -c;7Date SPRINGiFIELD Job# 98-00367-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety rrF'f8 t8[fri:,Ee FHi$ 10.co A[[T* : 100-00000-425602 RCPTS :01-0000?24INI[K R0EHL J0Bt:98-00167-01 Job Number: 98-00367-01 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1343 00011th St Spr AssessorsMap#: 17032644 Lot: Block: Addition Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 05100 Subdivision: ctTY oF SPRINGF|ELD, OREGON Owner: Nick Roehl Address: 3205 Western Drive Scope Of Work: Duplex Phone Number: City/State/Zip: Alteration 541-344-0183 Eugene, OR Value: $64 Gontractor Type Plumbing Contr Contractor Contractors Plumbing Service lnc Po Box 7636, Eugene, OR 97401 Registration # 101624 Expiration Date 8/15/99 Phone 541 -343-0975 Quad Area: # Of Units: Constr. Type: Water Heater: Office [Jsg - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording a1726-3769. 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 Ceiling !nsulation Framing Drywall Final Building Rough Plumbing FinalPlumbing Rough Mechanica! FinalMechanical -Prior to cover. -Prior to cover. -Prior to taping. -When all required inspections have been approved and the building is complete. Plumbing -Prior to cover. -When all plumbing work is complete. Mechanical -Prior to cover. -\A/hen all mechanicalwork is complete. Job# 98-00367-01 # Of Stories: Height (feet): Current Units: Proposed Units: Census Gode: Does not apply Total: Page 2 ot 2 Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main:Accessory Fee Paid On Receipt# Value/Quantity Fee Amount State Surcharge For Building Permit Renew Permit - Building Building Administrative Fee Total Building Building 02t25t2000 02t25t2000 02t25t2000 723 723 723 64 $.00 $64.25 $.00 $64.2s Plumbinr Minimum Plumbing Permit Fee State Surcharge For Plumbing Permit Renew Permit - Plumbing Plumbing Administrative Fee Total Plumbing 02t25t2000 02t25t2000 02t25t2000 02t25t2000 722 722 722 722 46 $15.00 $1.05 $45.60 $.45 $62.10 Minimum Mechanical Permit Mechanical Administrative Fee Renew Permit - Mechanical Mechanical lssuance State Surcharge For Mechanical Permit Total Mechanical 02t25t2000 02t25t2000 02t25t2000 02t25t2000 02t25t2000 8 723 723 723 723 723 $15.00 $.45 $7.50 $10.00 $1.05 $34.00 Grand Total $160.35 Signature Date OF SPFI]l.GFIELD RESIDENTIAL PERMIT APPLICATION CITY OF SPRINGFIELD COMMUNITY SERVICES DIVISION BUILDING SAFETY Page 1 ilob Number: 980357 225 North Fifth Street Springfield, OR 97477 LocaEion of Proposed Work: 1343 l1TH ST Assessors l,tap #: a7032544 Lot: Block: office Inspection Line 7 26 -37 59 7 26 -37 59 Tax Lot #: 05200 Subdivision: Owner: NICHOLAS F ROEHL Address: 3205 WESTERN DRIVE Describe Work: COIWERT S.F. TO DUPLEX Phone #: 344-0183 city/state/zip: EUGENE, oREGON 9740]. REMODEL General Contractor DAVE HAHM 01,24395 28a04 CROW RD EUGENE OR 974029158 ConsC. Cont,ractor #Expires o7/31-/e8 Phone 583-5507 QUAD AREA: 2RNW # OF UNITS: 2 CONSTR. TYPE: VN RANGE: E -- oFFrcE usE -- LAND USE: 1120 ZONING CODE: LDR # OF BDRMS: 1 # OF BLDGS: 1 OCCY GROUP: R3 WATER HEATER: E To request an inspection, call the 24 hour recording at A11 inspections requested before 7:00 a.m. wil-l- be made inspections requested after 7:00 a.m. will be made the f REQUTRED INSPECTIONS I,NDERFI,OOR PI,IIMBING - Prior TO insul ROUGH PLTIMBING - Prior To cover. ROUGH MECIIAIiIICAL - Prior to cover. ROUGH ELECTRICAL - Prior To Cover. FRA.MING - Prior to cover. INSULATION - Floor,' prior to decking DRYWALL - Prior to taping. ation or decking wal1/Ceiling; Prior to cover FINAL PIJITMBING - When all plumbing work is complete. FINAL MECHA}IICAL - When a]-1 mechanical work is complete. FINAL ELECTRICAL - When al-l- el-ectrical work is complete. FINAL BUITDING - When all required inspections have been approved and the building is complete. Lot Type: CORNER Item Main Garage REMODEL Total Value Building Permit Fee surcharge/admin --- BUILDING PERMIT --- Square Feet x $/Square Feet VaLue 0.00 0.00 17, 500 . 00 t_7, 500 . 00 128.50 ]-0.29 TOTAL FEE (A)r.38.79 bY 9 SPRINGF!ELE, ilob Number: 9803 57 SPTNGFIELq Page 2 PLIIMBING PERMIT Item Residentlal Bat.h (s) Plumbing Permit Surcharge/admin TOTAL CHARGE 1 Fee 9L.20 9L .20 7 .30 98.50(c) VenL Fan Dryer Vent Mechanical Permit Issuance Surcharge/admin TOTAL PERMIT - - - MECIIAI'IICAL PERMIT 1 (D) 3.00 3.00 26.20 15.00 10.00 L.20 MISCELLAIiIEOUS PERMITS Surcharge/admin CITY SDC WILLA]V1'\LA}IE TOTAL MISCELTANEOUS PERMITS 0.00 1, , 042 .30 #sLe€- (E)ffi+*$= ?2y'.* (Excluding Electrical) unless otherwise noted TOTAL AMOT'NT DUE - - - (A, B, C, D, and E combined).2.foh+e- zzz?,7? BUILDING VAIJUE, PI'AN CHECK AI{D BUILDING PERMIT This permit is granted on the express condition that the said construction sha1I, in al-l respects, conform to the ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any Eime upon violation of any provisions of said ordinances. Plan Check Fee: 83.53 Date Received By: Plans Reviewed By: AL WARD Building Site Reviewed By: LISA HOPPER Paid: 03/27 /98 Date: 04/14/99 Receipt Number z 29244 --- ADDITIONAL COMMENTS --- CONVERT SINGLE FAMILY RESID TO DUPLEX ADDITIONAL ? PAVED OFF STREET PARKING SPACES RQDJ DR]VEWAY REQUIRED TO BE PAVED ?>V 1 allhl ry By signature, I Etatse and agree, that I have carefully examined the completed application and do hereby certify that all- information hereon is true and correcL, and I further certify that any and all work performed shaIl 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 strucEure without permission of the Communi-ty Services Division, Building Safety. f further certify that only conLracLors and employees who are in compliance with oRS 701.055 will be used on this project. CITY OF ONEGON SPRINGFIELD Job Number: 980367 Page 3 I further agree to ensure that al-I required inspections are requesLed at the proper tj-me, 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 afl times during construction. + ln /"2 Signature Date Receipt Number Date Paid Amount Received Received By: --- VALIDATION --- f L 4/ze,/t t,24,n -: JoB NO. .q8fi 367ATTACHMENTA '::,. ) C ITY 0F SPk^ r"lGFI ELD SYSTEMS DEVELOT iNT CHARGE WORKSHEET LOCATION 1343 Nap // rrt DEVEI-OPMENT TYPt PenorlGL .< l=/L foD Dt €*.) BUILDING SIZE 1. ST0RM DRAINAGI N/o Neat R,f IMPERVIOUS SO FT 2. SAN ITARY SEi\rER -C ITY NO. OF PFU'S OT SIZ X $0.225 PEP. SQ. FI $ X $.16. 86 PER PFIJ Ft. tl (See Revers: Side) 3. TRANSPORTATiON NO OF UNITS X iRIP RATE X COST PER TRIP a s st{A6 $ 4 77,LtX t,ol x $472.49 x _ x $472.49 x $472.49 $ X 4 . SAru itARv SrWtq -N';vc * PER FEU + $10 Ml^Jl'lC/ADM FEE sa $ NO. OF FEU'S X MIdMC CREDIT IF APPLICABLE (SEE REVERST) 5. ADMiNISTRATIVE FEES BASE CHARGE (SUBIOTAL ABOVE) X .05 TOTAL-MI^]MC SDC $ SUBTOTAL (ADD ITEMS 1,2.3 & 4) $ qqz ' L7 s 44,a3 SDC Coordinator Date:4-e-16 ToTAL SpC $ L r4z, y) NAME OR COMPANY. |.lr\ I t-rt1c, lJl\ll t r-ALtrlJLA I ltJa\l I AoLE. NumDer oI New Ftxtures X Unlt Eeuivalent-=, (NOTE: For remodels, calculate only the NET additional fixturesl " ' FIXTURE TYPE Bathrub...... Drinking Fountain.... Floor Drain.................. lnterceptors For GreaserOil/So1ids1Etc................ lnterceprors For Sand/Auto Washi Etc................ Laundry Tuo/Clotheswasher...... Clotheswasher - 3 Or More..... Mobile Home Park Trap (1 Per Trailer)..............., Receptor For RefrigeratoriWater StationiErc....... Receptor For Commercial Sink,/Dishwasher/Etc.. Shower, Single Stall..... Shower. Gan9......... Sink: Bar. Commercial, Residential Kitchen......,.. Urinal, Stall/Wall... Wash Basin lLavatory, Single....... Toiiet, Pubiic lnstallation. Toilet, Privare..... Misceilaneous: NUMBER OF UNIT . FIXTURE NEW FIXTURES-,- EOUIVALENT UNITS -) L- 2 1 2 3 6 2 6 b 1I 3 2 i iHead 2 2 1 6 4 L z- TOTAL FIXTURE UNITS CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in rable, calculate credits separates. Year Annexed Rate per $1,000 Assessed Value Rate per S1,COO Assessed Value 1979 or before 1 980 1 981 1 982 1 983 1 984 1 985 1 986 $ 3.97 3.89 3.83 3.70 3.55 3.39 3.20 2.91 1 987 1 988 1 989 1 990 1 991 1 992 1 993 1 994 1 995 1 996 ) z.co 2.17 1.73 1.31 0.92 o.74 o.61 0.45 o.31 o.1 7 Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) XS (Rate X Assessed Value) (Rate X Assessed Value) CREDIT TOTAL RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) fiesioenciai...;............ Commerical lndustrial.... Governmental..........., 0.4 o.9 o5 0.5 IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT I I l II tt =$ Year Annexed €e Willamalane Park & Recreation District SYSTEM DEVELOPMENT CHARGE WORKSHEET NAME: ADDRESS: LOCATION OF PROPOSED BUILDING SITE: Job. No. PHONE:l8 srnre:QF zrp I {,q 1 Street Address: Plat Name:Tax Lot Number: DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculalions 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 = $ B. Single-Family Attached NO. OF UNITS X $924 per unit = $I C. Multi-Family Apartment NO. OF UNITS X $692 per unit = $ D. Manufactured Home Park NO. OF UNITS X $699 Per unit = WILLAMALANE SDC 2. SDC CREDIT (it applicable) SDO-payer must fumish proof of Willamalane Credit approval. See SOC Credit Worksheet. 3. TOTAL WILLAMALANE NET SDC ASSESSED oo \ (if SDC for Credit) qA+6) $ $ $ / ,/1-r 2, Develo City of nt Date eld UUnrfwt S F Ud&J\aL q\NUl & +c \,,r