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Home My WebLink AboutPermit Building 2008-7-18 -~.~~ ~ 1 . CITY OF SPRINGFIELD' Building/Combination Permit Status Iss u ed PERMIT NO: COM2008-00843 ISSUED. 07/18/2008 APPLIED 06/11/2008 EXPIRES 01/18/2009 VALUE: $ 230,370.00 225 FIfth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LlUe SITE ADDRESS 655 72nd St ASSESSOR'S PARCEL NO 1702352406400 Spnngfield TYPE OF WORK SlUgle FamIly ResIdence TYPE OF USE New ReSIdentIal PROJECT DESCRIPTION SlUgle famIly resIdence Owner BLANKENSHIP MIKE CORP Addl ess 8063 THURSTON RD SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Contractor LIcense ExpiratIOn Date Phone General MIKE BLANKENSHIP CORP 78966 01/09/2010 541-912-4582 Electncal GERARD ELECTRIC Mechamcdl JUNG ENTERPRISES INC 102455 11/17/2008 541-741-0002 PlnmhlUg DOUGS PLUMBING INC 110163 11/24/2009 541-688-3385 # ofUmts Pnmary Occnpancy Gronp Secondary Occupancy Group Pnmdry ConstructIOn Type Secondary ConstructIOn Type # 01 Bedrooms 'n.,,1 BUlLDlNGINFORMATIONI -. -'J ~'YI:lU'I' ".~Ui Il:I4UU6S you1-o 1'1 )W , llelllW\Jr!mirills~he Oregon Utility 2 rrt~~lfl~allon Ceil\! ~TBfJgMIC'AA-elfe set forth; 00 Iff oAR e5~b(lOT~) Brllfa!t9h OAR e52-001-Gas ~~jJ YQ\1 !l1~' 'tWlllJes of the rules b~as 1<ll1l1f1\l the fer. II the telephone G 1\1I4ffibef fOl Ih 'tm'f ~llhtY NotJlicalio"- has I Cante ~"i!R '2-234, ) 'yat Spnnl< e ullalilg4 . No Lot SIze Sq Ft I st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Gardge/Cal port Sq Ft Other Occupant Load 5,891 1,025 1,025 540 I DEVELOPMENTlNFORMATION I REQUIRED PARKING Frantyard Sethack 1800 Overlay DlSt Total 2 S,de 1 Sethack II 00 # Street Trees Rqd 2 HandIcapped S,de 2 Sethack 500 Paved Dnve Rqd Yes Compact Rearyard Sethack 3000 % of Lot Cover dge 3310 Solar Setbacks 1750 Street Improvements Storm Sewer AVdlldhle Special InstrnctIon I PUBLIN uMWlQ.VEMENT.S.. EXPIRE If THE WOR\{ fHI~ ~t;t'tlilll ",,,M ~l'tp~OT FuUy Improved AUTHORIZED UNDER THlal !:nR Yes COMMENCED OR IS ABAtiOOM~g.;\WralUs ANY 180 DAY PERIOD. Setback 5' To Storm Sewer Notes Pdee I of4 -~.;"' Status Issued 225 F,fth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectlOn Lme DescrlvtIon Tvpe of ConstructIOn V Wood Frame Caraee Dwelhnes Caraee Fee DescriptIOn Plan RevIew ReSIdentIal -Mech 1ss 2+ Apphances- + 100/0 Administrative Fee + 12% State Surcharge + 5% Technology Fee 3 Bdths One & Two FamIly BuIldmg PermIt Curbcut PermIt Dryer Vent Exhaust Hoods FIre SF Fee - ReSIdentIal FIreplace (LIsted) Furnace - up to 100,000 btu Cas Outlets 1-4 Plan ReVIew Major - Plannmg ReSIdence WIrIng 1000 Sq Ft ReSIdence WIrIng Ea Addtl 500 Samtary Sewer - 1st 50 Feet Samtary Sewer - Jmprovement Samtary Sewer - ReImbursement SDC MWMC AdmmlstratlOn SDC MWMC Improvement SDC MWMC Relmbursemeut SDC MWMC ReImbursement SDC Samtary/Storm Admm SDC Trdnspo Improvement SDC Trdnspo ReImbursement SDC T. ansportatlOn Admm SIde" alk PermIt Storm Dramage ImpervIOUs Area Storm Sewer - 1 st 50 Feet Storm Sewer Each Addtl1 00' Temp Power 200 amps or less Vent Fan WIllamalane Smgle FamIly I Valuation DescrlOtlOn I II I I I $ Per Sq Ft or multIpher $10500 $28 00 Square Footage or BId Amount 2,050 00 540 00 Total Value of Project FIT' PiWiU Amount PaId $709 68 $40 00 $202 03 $226 90 $113 29 $33700 $1,091 82 $85 00 $700 $1000 $12950 $1700 $1400 $500 $205 00 $11700 $84 00 $50 00 $693 74 $91233 $10 00 $990 39 $-394 79 $95 35 $15748 $862 25 $19548 $62 89 $85 00 $1,042 73 $50 00 $32 00 $55 00 $2100 $2,513 00 Date PaId 6/11/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 7/18/08 Paee 2 of4 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO, COM2008-00843 ISSUED: 07/18/2008 APPLIED' 06/11/2008 EXPIRES: 01118/2009 VALUE: $ 230,370,00 Value Date Calculated $215,250 00 $15,12000 $230,37000 06/11/2008 06/11/2008 ReceIpt Number 1200800000000000636 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 1200800000000000795 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO' COM2008-00843 ISSUED, 07/18/2008 APPLIED. 06/11/2008 EXPIRES, 01/18/2009 VALUE: $ 230,370,00 -iii:."~ Status Issued 225 FIfth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Totdl Amount PaId $10,828 07 Plan RevIews I ImlIal RevIew 06/11/2008 06/11/2008 APP NJM Public Works RevIew 06/11/2008 IO LKW 06/13/2008 Public Works RevIew 06/17/2008 APP LKW 06/17/2008 Structural RevIew 06/11/2008 07/11/2008 WE CJC Structural RevIew 07/14/2008 APP CJC 07/14/2008 Planum!! Review 06/11/2008 07/15/2008 APP TAJ Bob Wilson to look at sIte regardmg dnveway dud SIdewalk on 6- I 6-2008 It was demed Bob will call M,ke aud let hIm kuow of chauges that are needed III dnveway approach Waltmg for new SIte plan WIth changes made III dnveway and SIte plan that shows storm sewer, approach and handIcap ramp WIdth of sIdewalk 7-18-2008 Approved WIth condItIOns (see attached) Waltlllg for applicant to provIde engmeenng solutIOn tor wall bracmg (PrOVIded on 7/9/08) Lateral engmeenng pI oVid ed, sheets 2&3 superceded by engmeenng To Request an mspection call the 24 hour recordmg 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 followmg work day IRp/ll~ EroslOo/GradlOg Inspection Pnor to ground dlstUl bauce and after erosIOn measures are IDS tailed SIdewalk - Setback After forms are erected but pnor to placement 01 concrete Curbcut - Standard After forms are erected but pnor to placement of concrete Ufer Electncal Ground Install ground rod at footmg and call for mspectlOn 10 conjunctIOn WIth footmg and/or foundatIOn IIIspectlOn Footmg After trenches are excavated Foundation After forms are erected but prior to concrete placement Post and Beam Pnor to floor msulatlOn or deckmg Floor InsulatIOn Pnor to deckmg Pd2e3 of4 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2008-00843 ISSUED: 07/18/2008 APPLIED' 06/11/2008 EXPIRES' 0111812009 VALUE' $ 230,370,00 225 Fifth Street, Sprmgfield, OR 54] -726-3 753 Phone 54]-726-3676 Fax 54]-726-3769 InspectIOn Lme Shear Wall Nalhng Before covermg sheath 109 with fimsh mdtenals Frammg InspectIOn Pnor to cover and after all rough 10 mspechons have been approved Wall InsulatIOn Pnor to cover Cellmg Insulahon Pnor to cover Drywall Pnor to tapmg Hold Downs Installed Special InspectIOn performed pnor to placement of concrete Provide report to CIty BUlldmg Iuspector Fmal BUlldmg After all reqUIred mspectlOns have been requested and approved and the bUlldmg IS complete Penmeter FoundatIOn Drams After gravel and filter cloth IS mstalled but pnor to backfill Underlloor Plumbmg Pnor to msulatlOn or deckmg Underlloor Dram Pnor to cover or placement of concrete Rough Plumbmg Pnor to cover and mcludmg I eqUlred testmg Water Lme Pnor to fillmg trench and mcludmg reqUIred testmg Samtdry Sewer Lme PrIOr to fillmg trench and mcludmg reqUIred testmg Storm Sewer Lme Pnor to filhng treuch Fmdl Plumbmg When dll plumbmg work IS complete Gas Service After hne IS mstalled and hne hds been connected to a mmlmum of one apphance mcludmg reqUIred testmg Presure test done at thiS pomt Rough Mechamcal Pnor to Cover Fmal Gas When all gas work IS complete Fmdl Mechdmcdl When all mechamcal work IS complete Temporary Electnc Approval reqUIred pnor to Uhhty Company energlZmg pole Electnc ServIce Approval reqUIred prIOr to utlhty company energIZIng servIce Rough Electnc Pnor to Cover Fmal Electnc When all elech Ical work IS complete By signature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby cerhfy that all mformatlOn hereon IS true and correct, and I further certIfy that any and all work performed shall be done 10 accordance with the Ordmances of the CIty of Sprmgfield and the Laws of the State of Oregon pertammg to the work descnbed herem, and that NO OCCUPANCY Will be made of any structure wlthont permISSIOn of the Commnmty ServIces DIVISIOn, BUlldmg Safety I further cerhfy that only contractors and employees who dre 10 comphance with ORS 70] 005 will be used on thIS project, I further agree to ensure that all reqUIred mspectlOns are requested at the proper tIme, that each address IS reddable from the street, that the permit c rd IS located at the front 01 the property, and the approved set of plans will remam on the sIte at all hmes dU:~g construc n 1// q/ ( V Owner or Contractors Signature Datb Paee 4 of4 ~~ Willamalane t'W Park & RecreatIon Dlstnct Job No ~8'" - ~'{B SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME \Yhl/P g,UJ,n'Uun~'\ P PHONE" <-fCu ~(W~1 Lf ADDREss8;do3,miLV~W CITY 2rf/rvV STATE@IP 97'-f7 < LOCATION OF PROPOSED BUILDING SITE Street Addresi ()c;.c:; ;) (--do- ~ ~ Plat Name Tax Lot Number I/O )...55 9..L} Olo'-\-'.>~ 1. DEVELOPMENT TYPE (Check appropnate dwelling(s) Dwelling type definrtlons are on the back) A Slnale-Famllv Detached NO OF UNITS B Smale-Famllv Attached NO OF UNITS C Multl-Famllv Aoartment NO OF UNITS D Smale Roam Occuoancv NO OF UNITS E Accessorv Dwelhna Umt NO OF UNITS WILLAMALANE SDC X $2,513 per umt = cJD $ d,513 X $2,726 per umt = $ - X $2,323 per umt = $ - ~ X $1 ,162 per umt = $ X $1 ,257 per umt = $ - $ OJ 61:S UU 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane CredIt approval) $ r/ 3 TOTA]CLAMALANE NET SDC ASSESSED . (/C r uced for Credit) ~L/~ hcaJ,od.~ roe iOrPt $ervlces Department C of S Ingffeld I I ) 7 Date $dS15 1/8108' cTJ 5 W/ INITIALS \\I.......... .6!. DATE '\ --;}-.'d--UK I;OIJ' SOURCElY\~.J Date'-1!1 <r126lJK lCOMPiE1:..~i<EE SqiEDULE)lijWl1r,: .' ... . . . . '" ,-. ""'- , - ~ , ,1t;~, 'G'rf~0F;'SpRtNGFiE.eD'~eYREGON'.~ $;':. "', "" t . ." ,..." - "'1.e: ~-" ":' 1:'\, ?""V#.~ t";, ~Jj 3':1' ~ ""'i, ~~ r,~t:;;r ~ ",""-.. X;i~-",,*.f#'.z;&~i/; ~~Vi1 ZON 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-37S3 . FAX (541)726,3689 200 Amps or less $ 70 00 201 Amps to 400 Amps $ 83 00 401 Amps to 600 Amps $13800 60 I Amps to 1000 Amps $180 00 Over 1000 AmpsN olts $413 00 Reconnect Only $ 55 00 A:r,TJZ~J:1:InN<<'regon law requJr~~y~.~r . .......'"'~.,,~w... ...... ~.,.~,~.. SupervIsor LIcense Number faJl:J~ I'ill~ M100ted by the CfeliOJle~ry,Ser:yIces or :Feed~I1t~~"\;:.. Notlflcalion Center Those rules are sel forth Explral10n Date j(J ~/;n lZ~ ~k.001-001 0 through OMalill,Rll,1r, AlteratIon or RelocatIon gUllU. YOU may oLlta," caples of IlMl,rYl!l\PXr less I 0' ,!iaj'iIlS] the cenler. (Nole: the I~pmm'ti .. Consll' Conll' Number <l IH;~,I:;;;t fzr Ih: OregClR Utility NtIlil'I&RwMo 400 Amps Conter Is 1.800-3S2-~J Amps to 600 Amps EXptratlOn Date / / - J {) - 2l>O ?f Over 600 Amps or 1000 Volts see "B" above SIgnature of SupervIsmg Electnc13n D ~~raJlih ClrcihtL '\. New AlteratIon or ExtenSIon Per Panel ~ "^":i ~ '- One CirCUit Q Each Addll10nal CirCUit or With ~/ [ ,I ServIce or Feeder Pernnt Owners Name pJth-.. \4..--. Sl.o.~p Address 6 :r S- 72'" d ~ 1- E 1:~~~~lI'lD;';;~"(Service/fied~r'li~t~~i~d~dj-'EaCh l~~t~ilaho~ J City ~~ PhonNOnw~lt~Plfi~~1( $5500 TI1I:; t't TH1@~ts-fj@;"g $ 55 00 OWNER INSTALLATION ~U~HO:~~~ Ut~~R ABA~1J:~lResldentIaI $ 28 00 The mstallatlOn IS bemg made on )~~~~~ll~\StRIOD. Ll1mted Energy/CommercIal $ 5000 IS not mtended for sale, lease or renf. Mlmmum ElectrIc Permtt Inspechon Fee IS $50 00 + Surcharges 4 r:"silBtfu'AL OEABOVE~'q;..':" ~b Owners SIgnature I,' .' , ."" ,...., ".0,11' 2.5 12% State Surcharge ~O 7L 10% Adrmmstral1ve Fee Z :> b'" 5% Technology Fee It etO 325~ ELECTRICAL PERMIT APPUCATION CIty Job Number , Co W'\ z-o or- - 0 0 g-c.(J L t toz;; OF1N;fl;'::rc()lV~:t 3 LEGAL DESCRIPTION 17D2-.75"2-4 () G l{OO JOB DESCRIPTION /~S e- w / {Lf! ( ~I , Permits are non~transferable and expIre 1f work IS not started wlthm 180 days of Issuance or If work IS Suspended for 180 days (,1' " ~"""'~"" j' ~ ~ '--" 2 I COl"fTMCTOR 1NST~I;ATION 9Nf-Y J Electncal Contractor c::::- e In;\~ ( e...:.,1 \rl.C Address .3qS--/ ~~de-u j3.,. Rd CIty jp t2l J Phone 7 </1-(25 Cf(. InspectIOn Request 726-3769 A ~.~~>i~~i"e~l:lal- ~!~g'I~~~M'~!tt-l1a!!,i1y'per ..dwelii~g UOlt ServIce Included 1000 sq ft or less Each addll10nal 500 sq ft or portIon thereof ( Lj j / /7 8l.! $11700 $2100 Each Manufact'd Home or Modular Dwellmg ServIce or Feeder $55 00 B I s,;ryl~esO! Fe~d~rs, - Insf.lla,tiin,A/.iet~i]~"s,..or R;locahou: . $ 55 00 $ 76 00 $110 00 ss- $ 48 00 $ 400 TOTAL Shared Dnve(T )/Building FormslElectncal Permit ApphcatIon 1-08 doc . , CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBeR COM2008,00843 NAME OR COMPANY M,ke BlakenshiP LOCATION 655 nnd fAX LOT NUMBER 1702352406400 DFVELOPMEN f TYPE Smgle F81mlv ResIdence NeW DWELLING UNITS I BUILDING SIZE (SF 2590 LO f SIZE (SF) I STORM DRAINAGE 5891 1 Ir/J ~ I, Cl 18 10::; I~ ,t- r/J a gj DIRECT RUNOFF TO CITY S roRM SYSTEM , IMPERVIOUS S F x 1 COST PER S F CHARGE 1 3013 50 1 $0346 1 ; 1 $1.04273 , RUNOFF ROUTeD TO DRYWELL DESIGNED AND CONS rRUCTED TO CITY STANDARDS I IMPERVIOUS SF , x I COST PER SF I x I DlSCOUNTRAfE I I 1 000 1 I $0346 I 50% I~I ITEM I TOTAL - STORM DRAINAGE SDC I $1,04273 2 SANITARY SEWER - r:ITY DISCOUNT $000 A REIMBURSEMENT COST I NUMBER OF DFU's I I 34 1 B IMPROVEMeNT COST I NUMBeR OF DFU's I 34 1 x COST peR DfU $26 83 $912 33 I 11070 1 I' 1 1091 1 $1,04273 x COST PER DFU $20 40 $693 74 1 1092 I ITEM 2 TOTAL, CITY SANITARY SEWER SDC ~ , $1,60607 3 I RANSPORTATlON A REIMBURSEMENT COST I ADT I RIP RA Tl-. I x I NUMBER OF UNITS 1 x 1 COST PER TRIP x INEW TRIP FACTORI I 957 1 I I 1 1 2043 I 100 $19548 11093 B IMPROVEMENT COST I 1 ADf rRlP RAIl-. I x I NUMBER OF UNITS I x I COST PER TRIP x 'NEW TRIP FACTORI 1 1 957 , I , $9010 1 100 I $862 25 ' 1094 ITEM 3 TOTAL - TRANSPORT A nON SDC ~ I $1,057 73 4 SANTTARY SEWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's 1 x 1 COST PER FEU I I I 1 $95 35 ; $95 35 11054 B IMPROVEMENT COST I INUMBER OF FEU's , x ICOST PER FEU 1 I 1 1 $99039 ; $990 39 I 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) ($394 79) 11054 MWMC ADMINISTRATIVE FEE $10 00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ; I $700 95 I ._-"-- I SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ I $4,407 48 5 ADMINISTRATIVE FEE 1 SUBTOTAL x I ADM fEe RATE I~ CHARGe I $4,407 48 I 5% I $220 37 TOTAL SANITARY ADMINISTRATION FEE 15748 1079 TOfAL TRANSPORTATION ADMINISTRATION FEE $62 89 1078 , Kaye Wilson 6/13/2008 TOTAL SDC CHARGES ;1 $4,627 85 I PREPARED BY DATE __J DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUJV ALENT = DRAINAGE i'IXTURE UNITS (NOTE FOR REMODELS CALCULATE ONLY TIlE NET ADDITIONAL FIXTIJRES) NO OF FIXTURES FIXTURE TYPE I BATHTUB IDRlNKlNG FOUNTAIN IFLOOR DRAIN IIN1ERCEPTORS FOR GREASE / OIL / SOLIDS / ETC I INTERCEPTORS FOR SAND / AUTO WASH / ETC ILAUNDRY TUB ICLOTHESWASIIER / MOP SINK [CLOTIlESWASHER ,3 OR MORE (EA) IMOBILE HOMF PARK TRAP (1 PER TRAILeR) IRECEPTOR FOR REFRlG / WATER STATION i ETC I RECEPTOR FOR COM SINK / DISHWASHER / ETC [SHOWER, SINGLF STALL [SHOWER, GANG (NUMBER OF HEADSl, [SINK COMMERCIAL/RESIDENTIAL KITCHEN [SINK COMMERCIAL BAR ISINK WASH BASIN/DOUBLE LAVATORY ISINK SINGLE LAVATORY/RESIDENTIAL BAR URlNAL, STALL / WALL ITOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS NEW, 2 o o o o 1 1 o o o 1 2 o 1 o 1 2 o o 3 UNIT OLD EQUIVALENT o 3 o 1 o 3 o 3 o 6 o 2 o 3 o 6 o 12 o 1 o 3 o 2 o 2 o 3 o 2 o 2 o 1 o 5 o 6 o 3 = = = = = = = = = = = = = = = = = = = = 20 = _.EDU (EqUIvalent I?welhng Urut) IS a discharge eqUIvalent to a smgle family dwelhng umt (20 DFU's) set at 167 lmllons neT day DRAINAGE FIXTURE UNITS 6 o o o o 2 3 o o o 3 4 o 3 o 2 2 o o 9 o 34 MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO III ASSESSED V AL~ $t." ~ ,~$5 29.~. { r~' TI~$5 29- 1'" - 1 - n~ -ii"'$"'" r I ',$519'ht ~ ,~$512~~, - ..., _.,. '~L F ".' " $4 98,'~' , . $4 80:" __~ $463', ," L~-~$4 40 =~ " $407' , $367: ~..., J"'- ""l $3 22;e- b"::j-~ a F I I ~ A , .c $273 , r ~~ -:1-,$2-25 ~-.-oE,- ,_,..-; ~-I$1 80 ,"', , i$.1 59" ' . ~>I ~$1-45"1-Lt ~ _ - r.F $1 25t - '/....~J'-:- ~ - r_ --= .>.J-l- _, '$1 09~,-.., ~>-.j, I h,.,c $0 9?~+ --"""!.f~"- ~r$O 72'::-.... -:1-:'-' Jt~ $0-48 ot ~~ I " r'i_-'i!-"" o-'-"l~..?tr-$028,-, ~~ _ 'l ~:$O-'-69-- ~~-c 4-, ~tl".--'-l- -",~ '=;""'-e-' II -~r:-7$O q5 I ~ ~ IS LAND ELGIBLE FOR ANNEXATION CREDIT" (Eoter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX CREDIT" (Eoler I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE/1000 CREDIT RATE $7463 x $529 CREDIT FOR IMPROYEMENT (IF AFTER ANNEXATION) VALUE) 1000 CREDIT RATE $000 x $529 ~ , TOTAL MWMC CREDIT 1979 ~ I $394 79 o = $394 79 [ [ I I I [ [ I [ [ :1 [ [ [ I' J 225 Fifth Street Sprmgfield, Oregon 97477 541-726-3759 Phone ..,*~INo~ne ttiI i/ 1 ~. ~"7 City of Spnngfield Officml Receipt Development Services Department PublIc Works Department Job/Journal Number LDP2008,OOlOl LDP2008,OO 10 I COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008,00843 COM2008-00843 COM2008,00843 COM2008,00843 COM2008-00843 COM2008,00843 COM2008,00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008,00843 COM2008-00843 COM2008.00843 COM2008,00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008-00843 COM2008,00843 COM2008,00843 COM2008,00843 COM2008,00843 COM2008-00843 Payments Type of Payment Check cRecemtl RECEIPT #. 1200800000000000795 Date, 07/18/2008 Description LDAP Short Form + 5% Technology Fee Fire SF Fee - ReSidential WllIamalane Smgle Family Storm Dramage ImpervIOus Area Sanitary Sewer - ReImbursement Samtary Sewer, Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC AdmmlstratlOn SDC Samtary/Stonn Admm SDC TransportatIOn Admm SDC MWMC Reimbursement Sidewalk Permit Curbcut Pennlt BUlldmg Permit 3 Baths One & Two Family Samtary Sewer, 1st 50 Feet Storm Sewer - 1 st 50 Feet Stonn Sewer Each Addtl 100' Furnace - up to 100,000 btu Exhaust Hoods Dryer Vent Gas Outlets 1,4 Fireplace (LIsted) -Mech Iss 2+ Apphances- Vent Fan Plan ReView MaJor. Plannmg Temp Power 200 amps or less ReSidence Wifing 1000 Sq Ft ReSidence Wifing Ea Addtl 500 + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By MIKE BLANKENSHIP CORP Item Total Check Number Authorization Received By Batch Number Number How Received dJb 11801 In Person Payment Total Page 1 of 1 307 17PM Amount Due 450 00 2250 12950 2,51300 1,042 73 91233 693 74 19548 862 25 9535 99039 10 00 15748 6289 (394 79) 8500 8500 1,09182 33700 5000 5000 3200 1400 10 00 700 500 1700 4000 2100 205 00 5500 11700 8400 11329 226 90 202 03 $10,590 89 Amount Paid $10,59089 $10,59089 7/18/2008