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Home My WebLink AboutPermit Building 2008-10-1 , ',_I,Nolmil.;D, ,_...,""".......,..."."'"",.. ""'-,0',,' j: . ! CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2008-01484 ISSUED: 10/0112008 APPLIED: 09/3012008 EXPIRES: 04/0112009 VALUE: $ 95,200,00 225 Fifth Street, Springfield, OR 541- 726-3 753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1910 S 57TH PL ASSESSOR'S PARCEL NO.: 1802033300400 Springfield TYPE OF WORK: Single Family Residence, TYPE OF USE: New , Residential PROJECT DESCRIPTION: SFD same as 5773 Pumice Owner: HA YDEN HOMES LLC 'Address: 2464 SW GLACIER PL REDMOND OR 97756 I CONTRACTOR INFORMATION i Contractor Type General Electrical Contractor HA YDEN ENTERPRISES TOP NOTCH EL'ECTRIC INC License 92208 172366 Expiration Date 07/2912009 0912912010 Phone 541-228-1081 541-317-1998 BUILDING INFORMATION,. 2 # of Stories: I Height of Structure 17.00 Type of Heat: Forced Air Gas' Water Type: Gas Range Type: Electric Energy Path: Sprinkled Bnilding: No Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: , Occupant Load: 5,388 832 # of Units: Primary Occupancy Group: Secondary Occnpancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I , R-3 U VB 280 I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: , Solar Setbacks: 12.00 26.00 20.00 12,00 0,00 Overlay Dist: # StreetTrees Rqd: Paved Drive Rqd: 0,10 of Lot Coverage: 3 Yes 20,63 Total: Handicapped: Compact: 2 I PUBLK IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Fully Improved Yes Sidewalk Type: DownspoutsIDrains: Curbside 7' Curb and Gutter Storm to curb NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR , ANY 180 DAY PERIOD. ATTENTION: Oregon law requIres you to follow rules adopted by the Oregon Utility Notification Center, Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090, You may obtain copies of the rules by calling the center, (Note: the telephone number for the Oregon Utility Notification' Center is 1-800-332-2344). Notes: Pa2e I of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descriotion TVDe of Construction V Wood Frame Garaee Dwellines Ganu!e Fee Description -Mech Iss 2+ Appliances- + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee I Bath One & Two,Family Addressing Assignment Appliance Vent Building Permit Curbcut Permit Dryer Vent Exbaust Hoods Fire SF Fee - Residential Furnace - up to 100,000btu Gas Outlets 1-4 Plan Review Major C Planning Plan Review Residential Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDCMWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Improvement - SDC Transpo Reimbursement SDC Transportation Admin Sidewalk Permit Storm Sewer Each AddtllOO' Temp Power 200 amps or less Vent Fan Willamalane Single Family Total Amount Paid I V al~ation Descriotion I $ PerSq Ft or multiplier $105.00 $28.00 Square Footage or Bid Amount 832.00 280.00 Total Valne of Project ~m PlW AmounfPaid $42,00 $112.74 $128.62 $72.94 $165.00 $37.00 $8.00 $625,81 $88,00 $8,00 $11.00 $55,60 $15,00 $6.00 $211.00 $406,78 $121.00 $22,00 $378,66 $497,97 $10.00 $1,009.17 $97.90 $68.72 $888,98 $201.54 $85.49 $88,00 $17,00 $57,00 $16,00 $2,513.00 $8,065,92 Date Paid 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/li08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 10/1/08 Paee 2 of 4 CITY OF ~rK1J'It:.l'lJ!,LU Building/Combination Permit, PERMIT NO: COM2008-01484 ISSUED: 10/01/2008 APPLIED: 09/30/2008 EXPIRES: 04/0112009 VALUE: $ 95,200,00 Value Date Calculated , $87,360.00 $7,840,00 $95,200,00 09/30/2008 09/30/2008 Receipt Number 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 1200800000000001023 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-0I484 ISSUED: 10/0112008 APPLIED: 09/30/2008 EXPIRES: 04/0112009 VALUE: $ 95,200,00 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . Plan Reviews, I Plaonine: Review 09/30/2008 09/30/2008 APP DDK Access restricted to I drivewayllot. Follow street tree plan. Pnblic Works Review 09/3012008 09/30/2008 APP LKW Storm water to curb , Sfructunll Review 09/3012008 09/30/2009 APP CJC Approved as noted on plans 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, Rpf\llirprlln~,npl"tiow Erosion/Grading Inspection: Prior,to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected bnt prior to placement of concrete, Curbcut - Standard: After forms are erected but prior to placement of concrete, Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. Footing: After trenches are excavated, Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to 11001' insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sbeathing 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 reqnested and approved and tbe building is complete. Underl100r Plumbing: Prior to insulation or decking, Undernoor Drain:. Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing, Water Line: Prior to filling trench and including required testing, Sanitary Sewer Line: Prior to filling trench and inclnding reqnired testing. Storm Sewer Line: Prior to filling trencb, Final Plumbing: Wben all plumbing work is complete, Pal!e 3 of 4 CITY OF SPRINGFIELD. Building/Combination Permit Status Iss u ed PERMIT NO: COM2008-01484 ISSUED: ' 10/0112008 APPLIED: 09/30/2008 EXPIRES: 04/0112009 VALUE: $ 95,200,00 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Underlloor Mechanical. Prior to insulation or decking and including required testing. Underlloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimnm of one appliance including required testing. Presure test done at this point. Rough Meehanical: Prior to Cover FinalGas: When all gas work is complete. Fina' Mechanical: When all mechanical work is complete, Temporary Electric: Approval required prior to Utility Company energizing pole, Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing serviee, Final Electric: Wben all electrical work is complete, By signature, I state and agree, that I have carefull)' examined tbe completed application and do bereby 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 wbo 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 tbe proper time, tbat each address is readable from the street, that the permit card is located at the front of the property, and tbe approved sei of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pa2e 4 of4 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET --_._--"--, -- JOURNAL OR JOB NUMBER: COM2008-01484 NAME OR COMPANY: Hayden LOCATION: 1910 S, 57th TAX LOT NUMBER: 1802033300400 DEVELOPMENT TYPE: Single Family Residence NEW DWELLING UNITS I BUILDING SIZE (SF: 1112 LOT SIZE (SF): 5338 I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F, x I COST PER SF CHARGE I 1411.75 I $0.357 1 = 1 $503,64 RUNOFF ROUTED TO DRY WELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S,F, I x I COST PER S,F, I x I DISCOUNT RATE I I DISCOUNT I 0,00 I 1 $0,357 I I 50% 1 ~ I $0,00 ITEM I TOTAL - STORM DRAINAGE SDC '$0.00 $0.00 2, SANITARY SEWER - CITY A. REIMBURSEMENT COST: 1 NUMBER OF DFU's I x 1 18 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 18 ,I COST PER DFU $27,67 $497.97 COST PER DFU $21.04 $378.66 ITEM 2 TOTAL - CITY SANITARY SEWER SDC '" I 3, TRANSPORTATION $876.63 A. REIMBURSEMENT COST: I ADTTRIP RATE I x 9.57 I B, IMPROVEMENT COST: I ADTTRlP RATE I x '9,57 1 I NUMBER OF UNITS I x I I I I x INEWTRIPFACTORI I 1.00 I COST PER TRIP 21.06 $201.54 I NUMBER OF UNITS 1 x I 1 I I I = , x ,INEW TRIP FACTOR I I 1.00 I ITEM 3 TOTAL- TRANSPORTATION SDC COST PER TRIP , $92,89 $1,090.52 $888.98 4, SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x I I I ICOST PER FEU I $97,90 = $97.90 lj I~ '" (3 gj 1070 1'1091 I I 1092 I I. I 11093 I 11094 I ~ I I 1054 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU 1 I I $1,009,17 = $1,009.17 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~ $0.00 1054 MWMC ADMINISTRATIVE FEE $10.00 I 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $1,117.07 J SUBTOTAL (ADD ITEMS,I, 2, 3, & 4) , = I $3,084.22 I 5, ADMINISTRATIVE FEE: ...- 1 SUBTOTAL x I ADM, FEE RATE I~ CHARGE I $3.084,22 I 5% 1 $154,21 TOTAL SANITARY ADMINISTRATION FEE: 68,72 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $85.49 11078 Kaye Wilson 9/30/2008 TOTAL SDC CHARGES =1 $3,238,43 PREPARED BY \ DATE DRAINAGE FIXTURE UNIT (DFUl CALCULATION TABLE II NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS' (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTIJRES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EOUIV ALENT UNITS I BATHTUB 1 0 3 = 3 DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC, 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 ICLOTHESW ASHER / MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EAl 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 [RECEPTOR FOR REFRlG / WATER STATION / ETC, 0 0 '1 = 0 [RECEPTOR FOR COM, SINK / DISHWASHER / ETC. 1 0 3 = 3 ISHOWER. SINGLE STALL 0 0 2 = 0 WHOWER. GANG (NUMBER OF HEADS) , 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0, 3 = ,3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2 ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 1 0 1 = 1 IURlNAL. STALL / WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 18 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a sin,gle family dwellinA unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULA TION TABLE: BASED ON COUNTY ASSESSED VALUE " I I I YEAR ANNEXED [ BEFORE 1979 Ii 1979 1980 , 1981 I 1982 1983 I 1984 I 1985 [ 1986 [ 1987 I 1988 I 1989 [ 1990 I 1991 I 1992 I 1993 'I 1994 I 1995 [ 1996 [ 1997 [ 1998 [ 1999 [ 2000 I 2001 CREDIT RATE/$I,OOO III ASSESSED VALUE--'J i <~i~;:;~ ,- $5,19 ,;'~1~i~:~ri ~::_~~~ jL)~:.~~:,~::;~~~ ~'~::1-1 ,~:i:~~f;:: ~iI~:;_~:b~'iji~,i .,,;~ ": $3.67 .+,", ,. - 3.22 :'~~~~:!:i:i::;~':':;;~!m 0',,"' . --"""",._- - $2,73 _ ~~ , ~~:~~: '!il""':~ ' IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 2 2 2005 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0,00 x $0,00 ~ , $0,00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0,00 x $0,00 ~ , o TOTAL MWMC CREDIT $0,00 = CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: COM2008-01484 NAME OR COMPANY: l'layden LOCATION: 1910 S, 57th TAX LOT NUMBER: 1802033300400 DEVELOPMENT TYPE: Single Familv Residence NEW DWELLING UNITS I BUILDING SIZE (SF: 1112 LOT SIZE (SF): L STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F, x I COST PER S,F, CHARGE I I 1411.75 I $0.357 1 = I $503,64 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S,F, I x I COST PER S,F, I x I DISCOUNT RATE I 1 . 1 0,00 I 1 $0.357 I 50% 1 = I ITEM I TOTAL - STORM DRAINAGE SDC ' '$503,64 2, SANITARY SEWER - CITY A REIMBURSEMENT COST: I NUMBER OF DFU's I x I 18 I B, IMPROVEMENT COST: I NUMBER OF DFU's I x I 18 I COST PER DFU $27,67 COST PER OFU $21.04 3, TRANSPORTATION ITEM 2 TOTAL - CITY SANITARY SEWER SDC A. REIMBURSEMENT COST: I ADTTRIP RATE I x, I 9,57 I B, IMPROVEMENT COST: I ADTTRIPRATE' I I 9,57 I I NUMBER OF UNITS I x I I I I I x I NUMBER OF UNITS I x I I I 1 I = I 4, SANITARY SEWER - MWMC ITEM 3 TOTAL - TRANSPORT A nON SDC ri 10 u p:: I ~ w..:l 'E- en a ~ 5338 DISCOUNT $0,00 $503.64 1 1070 -, = , I 11091 $497.97 $378.66 1092 =, $876.63 COST PER TRJP x INEW TRIP FACTORI 21.06 I 1.00 I = I $201.54 'i 1093 COST PER TRJP I x INEW TRIP FACTORI $92,89 I I 1.00 '" I $888.98 1094 $1,090.52 I A REIMBURSEMENT COST: INUMBER OF FEU's I x I I B. IMPROVEMENT COST: INUMBER OF FEU's I x I I I' ICOST PER FEU I $97,90 ICOST PER FEU 1 $1,009,17 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =1 = $97.90 1054 = $1,009.17 $0.00 $10,00 I 11055 I 1054 1056 $1,117.07 I il -----~ $3,587.86 SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5 ADMINISTRATIVE FEE: = , I SUBTOTAL x I ADM, FEE RATE 1= I $3,587,86 ! 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Kaye Wilson PREPARED BY CHARGE $179.39 9/30/2008 TOTAL SDC CHARGES 100,21 11079 I $79,18 11078 :'~ DATE '- DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE I)NITS (NOTE: FOR REMODELS. CALCULATE ONL Y,THE NET ADDITIONAL FIXTURES) NO, OF FIXTURES . DRAINAGE UNIT, FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS [BATHTUB 1 0 3 = 3 IDRINKING FOUNTAJN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE lOlL 1 SOLIDS 1 ETe. 0 0 3 = 0 IINTERCEPTORS FOR SAND 1 AUTO WASH 1 ETe. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 ICLOTHESW ASHER 1 MOP SINK 1 0 3 = 3 !CLOTI-lESW ASHER - 3 OR MORE (EAl 0 0 6 = 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG 1 WATER STATION 1 ETC, 0 0 1 = 0 !RECEPTOR FOR COM, SINK 1 DISHWASHER 1 ETe. 1 0 3 = 3 SHOWER. SINGLE STALL 0 0 2 = 0 SHOWER. GANG (NUMBER OF HEADSl 0 0, 2 = 0 SINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2 I SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 IURINAL. STALL 1 WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 18 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a sinlPe family dwellinj~ unit (20 DFU's) set at 167 gallons per day I. MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE I YEAR L...f.NNEXED ~EDIT RATE/$I-:oooIi I ASSESSED V AWE I] f::;,-j!~~~.H': :6~'~ :>i~~~~;:'i-;r'li.!: -- $519 ~ ~-l!'il'~~~~~-! '$'5~{2..- :~~Th~~L'i"i~~i:1' .. .-.... ... --... 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 " --$498-- ( : Jr' ~;~~~.~;c;;~ ~:" ;;;t~;?i~- ~:~b~ ~i:~j;]~.i!!:t'~~ , . ::~:~" ~;:~~c :,1:, , ~' ~;;~ ,$f..;~3 "__",_._~,:~,:11', ,r:I,)j ; "'1 $2:g5 . $1:80 . $1:59 $1:45 $1'f5 $1~09 - $0,92 - $0,72 $O~8 $0,28 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 2 2 2005 CREDIT FOR LAND (IF APPLICABLE) VALUE 11000 CREDIT RATE $0,00 x $0,00 $0,00 ~ , 1 ' , CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE 11000 CREDIT RATE $0,00 x $0,00 ~ , o TOTAL MWMC CREDIT $0,00 = 2~ Willamalane t.... Park & Recreation District, Job. NoCf\rvI) 1"\DZ' ... 01 '-f-0<f SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAMEC\-l t>fU2.'Y\ ~ffi~ 1\; ll,G. PHONE: WI - ~4,g -1 0'61 ADDRES~L} SL2I (-:5 t ~ ~cl01.cY\cl. STATEOVZIP: C[77=:.f - v' YL '~ LOCATION OF PROPOSED BUILDING SITE: StreetAddr~ss:\C\ \0 5. 5~~, Plat Name: Tax Lot Number: i (50)..033'3 oaQ.i:su 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.)' ' A. Sinole-Familv Detached NO. OF UNITS X $2,513 per unit = B, Sinole-Familv Attached NO. OF UNITS X $2,726 per unit = C. Multi-Familv Aoartment NO. OF UNITS X $2,323 per unit = D. Sinole Room Occuoancv NO. OF UNITS X $1,162 per unit = E. Accessorv Dwellino Unit NO. OF UNITS X $1,257 per unit = WILLAMALANE SDC 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval.) 3. TOTA\- WILLAMALANE NET SDC ASSESSED ~:ti1;;:;;) ~. evelop'm~nt S.'PIVices Department ! City ofttgfiFld , ' /0 Date, $~5L~. on $ - $ $ .-- $ .sV $~~I.~. : $9 , oU $ :J, 6/3 . I d( I 0 J- 5 S~~B.-itJ., .... ' -r.j' _.=",..~,--',r . City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-01484 COM2008-01484 COM2008-01484 COM2008-0 I 484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-01484 COM2008-01484 COM2008-01484 COM2008-0 1484 COM2008-0 1484 COM2008-01484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-01484 COM2008-01484 COM2008-0 1484 COM2008-01484 COM2008-01484 COM2008-0 1484 ' COM2008-01484 C0M2008-01484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 C0M2008-0 1484 COM2008-0 1484 COM2008-0 1484 Payments: Type of Payme~t CreditCard cReceintl RECEIPT #: 1200800000000001023 Date: 10/0112008 10:39:31AM Description Plan Review Major - Planning Sidewalk Permit Curbcut Permit Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo ReimbUlsement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC SanitarylStorm Admin SDC Transportation Admin Plan Review Residential Building Permit Addtessing Assignment Willamalane Single Family I Bath One & Two Family Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 -Mech Iss 2+ App1iances- Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee - Residential + 5% Technology Fee + 12% State Surchatge + 10% Administrative Fee Amount Due 211.00 88,00 88,00 497,97 378,66 201.54 888,98 97,90 1,009,17 10,00 68,72 85.49 406,78 625,81 37,00 2,513,00 165,00 17,00 15,00 16,00 8,00 11.00 8,00 6,00 42.00 121.00 22,00 57,00 55,60 72.94 128,62 112,74 $8,065,92 Paid By HA YDEN HOMES Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid dim 017932 In Person Payment Total: $8,065,92 $8,065,92 "' Page I of I 101112008 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Gii:~""';'il.";~. ...'. ~ . ~..:_.::,1^..:. City of Springfield Official Receipt Development Services Department Public Works Department Job/Journnl Number COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-01484 COM2008-01484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 COM2008-0 1484 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Date: 10/0l/2008 1200800000000001023 Description Plan Review Major - Planning Sidewalk Permit Curbcut Permit Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement 'SDC MWMC Administration SDC SanitarylStorm Admin SDC Transportation Admin Plan Review Residential Building Pernlit Addressing Assignment Willamalane Single Family 1 Bath One & Two Family Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Drycr Vent Gas Outlets 1-4 -Mech Iss 2+ Appliances- Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee - Residential + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By HA YDEN HOMES Item Total: Check Number Authorization Received By Blitch Number Number How Received dim 017932 In Person Payment Total: Page 1 of I 10:39:3IAM Amount Due 211.00 88,00 88,00 497,97 378,66 ,201.54 888,98 97,90 1,009,17 10,00 68,72 85.49 406,78 625,81 37,00 2,513,00 165,00 17,00 15,00 16,00 8,00 11.00 8,00 ,6,00 42,00 121.00 22,00 57,00 55,60 72.94 128,62 112,74 $8,065.92 Amount Paid $8,065,92 $8,065,92 1011/2008 wi ZON ^ I lN1TIALS (\ r i)Y-. DATE IO/U\' SOURCE '(Y\~S~ ns FIFTH STREET. SPRJNGFIELD, OR 9747.7 . PH:(541)726-3753 . FAX: (S41)726-3689 , ' ELECTRICAL PERiVIIT APPLICATION f'-~ It( ~U City Job Number ~;>;;:~~.",,""'-"""al;:f",!;".;r'~"~..fu"""''':''i'~''''''''~;~~7}~t~~$'''''1:~,:o:-.-@r.'",;'-;','.$,;( 1, ;:1iJlf!)'(iEilfl1l!(i)1-y.:,@1fflIiY$iIi' " ,^ w, : . ,0N:iiif:~::,~~i~ iU:WJ"'j'i.'i:F,,g.~';;;'~i'1f-!.j;F;;-,~{<:;'~"""''''''''^Ni,~(r..1!'''''''''''~;!i,~.'~JA,,,c~i'-&:t.~'J\J.'2t~ /C,/f) ~. ~'71{ LEGAL DESCRIPTlON: I<;O~ '()~.3 C!OU{)D JOB DESCRIPTION: NeW SFD Permits are Don-transferable and expire'ifwork is not started within 180 days of issuance or if work is __.._ _ _Suspende(LJOl:..l80_da)'s~----~-- 2.' Electrical Contractor, T;,fJ/DIcJ-r .r-/ec Address ;;Lo8t9 ~~ cf ",--.. ,.._,.(....,- -'_..: ---",..'--"...,,- PEone -5"11-3'; I f 7715 CIty () I ,r)Wc.P1 Expiration Date Lfo:/I( S :;2n q n 2 ")w(; ~'i Supervisor License Number Constr, Contr, Number Expiration Date Sigoal 're ofSgpervjsinf\,Electrician (0'JJ\N~'~~~ . ~ Owners NM,~ ktr 'f bE AI #-6/1'LCJ . ,) ~ . Address _ 2-.!::J~'f 5 w , L~/fLI cL- City I1./:C:7J..K\ tJ1J I) Pbone .'71{/ :/'l..? 2- ~/3c)/o f. , f ~n""~"'''f'!m':~~''';?''''<'::;I''',"~~l'''''''''''~'"'"'''''''''''.''"r""",'n?-r'n'~''''''n''''''' . """""""'~",,",- ~'1!;oiVfi;,. ^' ..' J3'"~jjjE""'ffffAW'-""'"'''''''''''''''"''"'"'''~'''~:I!'~''' 3. tfiJ~71~{'~,;dt~gr~ij~ll~~,l}J:~~T~~~~~~~~~irf~il~~lf~l Date A . i'il~~~~~r~m\~~~1$r@5"1l\!i~Wl~~~F~~~1~c~t~mw0~~~~J&~!-1~~ . ;k'i'g:ill:~b~~~~..l&R.~,,~~,~~i!J};1~,ti~~rp)J}1~B~J1~~,,;'~~~um~gl~~H Service Included 1000 sq, ft, or less Each additional 500 sq, ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or __Leed.eI.- I / $ 21.00 '].1 $117,00 /1'7 $55,00 - - - -B~ ~1'~\~~~~_~.~~~~Z:!};l.~~'('''J..1ji!~li;J~'fr~t,:@1~'Ct;'~:r.iJ1~'~~~'''t:1;,\;IN$tfr-';:~.>:~1I'~~..'tr17!gt.~}~;fm8~3."l . : ~., e:!.},'I::'lG.~':O:Q.II~j;~~l:;i.ta,.Q,S '4,11-3 lOTI 'tA.'Jer;a'tlons.lOI;:r.Kcloeatfbn'~~ , .' ':.f-~.~~.?;!:<oi,.r-..,lij'i". ~~. gw~~'l;"-:,",,,,~~~:,,'.~'l-i.o>~;;<':H~w~r'-l.-'~~1~"1Vi.:m:~.a:~~ 200 Amps or less, $ 70,00 201SW!l6bJ~on law requires yoq:m,oo 40N;1C1l\I!I~Ba.P.QPJed by the vregDn LJ~~~,OO ' l v 0 lilit'er, Those rulc~ "'" ~"l TqJjb 60~:OO;;!~~'Othrough..Ol\i:la~?~~mL:00' -, ~:OOifl;unp",)vuj1.8"ill ~ujJles Dtme rUI~uu ReccililJg~ center. (Note: the teleph-05Ei>5,OO number for the Oregon Utility Notification C. _~lfti1.i1!;~"'.IIl\:~~~ll~~"fl\~,rlllti,~~foimlllil'~t'."~.:~'I~~.'ll f1ht"~lC!'2ft.";J;;.~.(W"":1;jlj';._"-~...~",,.,;.q'!o;~~1.~~<<~~\Ite.\f~~~Jf~,,~;;(li,g:.W;!jt~ O staUation, Alteration or Relocation N TI . THIS P~B Wf~SIPIRE IF THE W~mv.l $ 55,00 S'S""" AUTHOlM1S{l,J ~~ 'pERMIT IE ~Jg: $ 76,00 COMMENCED R I ~ ONED FOr. $110,00 ANY 18~W^\)O~"","l'lH::>r1000 Volts see "B" above, D 'r~w.ill~\~-J:j.' I j'1{m~lIlJl1ft:;jr~l'W~~S'"U~~;!:liDI~~,gj'~'."i" ~11~~}~$' . \.~mt.Q~ .1~l~.wgJ!-1.....,~ ' "ilr,it;f1 ;'"' .iilit-~,J!F-%-",i'j:Jt~~~~.., ,,,J.. '" ~'t} ~~;c , ~""~~I "'" ""'"'ID '>0:.. '''U:m New Alteration or Extension Per Panel One Circuit Each Additional Circuit or witb SeIVice or Feeder Permit $ 4&,00 $ 4,00 E. ~\'1~~lfl'll~1r!l'~'t~l;"f~'t1i1\!1r'1!\~r~ttli\l~ ;S~11lf1l:~lll't ~,- ' . ~...~Lw:l~"~".'!-; "",,",,,~j;~~. ~-ll'~ ".W~~,,~o;;r,;~l('!I"'~ ' . g'14< .,... li~ > ~.t~ Pump or irrigation $ 55,00 Sign/Outline Lighting $ 55,00 OWNER-INS-T-ALLA-TlON Limited'EnergylResidential--' ",--, "$-2&,00-' "...-..-. , The installation is being made On propertY lawn .which - -- .. LlIDJted cnergy/Co=ercwl :> )0,00 is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fe~ is $50.00 + Surcharges 4 .m(i}m1l!~1~!i\1'lJ!mm1W\.;1~tlt'~~.,j1'If'l'i,'!l"l"'1 I 3 Owners'Signature: . ~1;.:Wi~~1'llh'j;;t,~j~r;;"~~~'1F.;,r."..~t~1;,~~~;~~~j~~,1~)~c~!~~~$~~ 1_0 - 12% State. S~charge ' ":1 ?'....J...k, 10% Administral1ve Fee i q , ') 5% Tecbnology Fee ' ?J , t, S Inspection Request: 726-3769 TOTAL ~/).~ Shared Drive(T:)lBuilding FcnnslElectrical Permit ApplicaJ,ion ]-08.(