HomeMy WebLinkAboutPermit Building 2008-11-24
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2008-0I698
ISSUED: 11/24/2008
APPLIED: 11/21/2008
EXPIRES: OS/24/2009
VALUE: . $ 95,200.00
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS, 1843 S 57TH ST
ASSESSOR'S PARCEL NO., 1802033210300
Springfield TYPE OF WORK, Single Family Residence
TYPE OF USE, New
PROJECT DESCRIPTION, Single family residence SAME AS COM2008-01484
REQUIRED PARKING
Overlay Dist, Total: 2
# Street Trees Rqd, 4 Handicap1"?'
Paved Drive Rqd, ATTENTION: OrYesln law rrE6\\'ip~~i\'Utl
% of Lot Coverag~tllloW rules ad18:00d by tha Oreuol: Utlmy
Notification Center. Those rules are ~8tI(jrt~
. ~. n nC'lM1.nn1 n throuah OAR 952-001-
. I PUBLIC IMPROVEMEOODs.. ,You may obtain copies 01 me rUles IJY
. ",w!ng the center. (Note: the tel~phono
Street Improvements, Fully Im~roved number fd\i~~1Yal~el)pe:J!i1i~3~~ilflcatIQncurbside 7'
Storm Sewer Available, . Yes CrD'.l~JnkpJu~P!6~~~s,. . Curh and Gutter
Specialdnstruction, Storm water to curh via weephole
I~ Ilvl::.
NoteJ:HIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Owner, HAYDEN HOMES LLC
Address, 2464 SW GLACIER PL
REDMOND OR 97756
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
HAYDEN ENTERPRISES
TOP NOTCH ELECTRIC INC
PACIFIC AIR COMFORT INC
PLUMBING PLUS INC
License
92208
172366
39237
90482
BUILDING INFORMATION I
# of Units,
Primary Occupancy Group'
Secondary Occupancy Group,
Primnry Construction Type
Secondnry Construction Type,
# of Bedrooms,
# of Stories, 1
Height of Structure 14.50
Type of Heat' Forced Air Gas
Water Type, Gas
Range Type, Gns
Energy Path,
Sprinkled Building: n/n
I
R-3
U
VB
2
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side I Setbnck:
Side 2 Setbnck,
Rearyard Setback,
Solnr Setbncks,
13.00
51.00
9.00
15.00
12.50
Paee t of 4
Residential
Expiration Date
07/29/2009
09129/2010
03/25/2010
05/10/2009
Phone
541-228-1081
541-317-1998
541-672-9510
541-926-3190
Lot Size,.
Sq Ft 1st Floor,
Sq Ft 2nd Floor,
Sq Ft Bnsement'
Sq Ft Garage/Cnrport
Sq Ft Other,
Occupnnt Lond,
6,187
. 832
280
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Dwellines
Garat!:c
V Wood Frame
, Garaee
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
Curhcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Furnace - up to 100,000 btu
Gas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Sanitary Sewer -Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDCTranspo Improvement
SDC Transpo Reimbursement
SDC Transportation Admin
Sidewalk Permit
Storm Drainage Impervious Area
Temp Power 200 amps or less
Vent Fan
Willamalane Siugle Family
Total Amount Paid
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01698
ISSUED: 11/24/2008.
APPLIED: 11/21/2008
EXPIRES: OS/24/2009
VALUE: $ 95,200.00
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$105.00
$28.00
Square Footage
or Bid Amount
832.00
280.00
Value
Date Calculated
$87,360.00
$7,840.00
$95,200.00
11I21!2008
1l/2112008
Total Vaiue of Project
JiPp<, Pl!J,dJ
Amount Paid
$42.00
$11 1.04
$126.58
$72.09
$165.00
$37.00
$8.00
$625.81
$88.00
$8.00
$11.00
$55.60
$15.00
$6.00
$211.00
$227.00
$121.00
$22.00
$378.66
$497.97
$10.00
$1,009.17
$97.90
$104.58
$888.98
$201.54
$78.4 7
$88~00
$576.86
$57.00
$16.00
$2,513.00
$8,470.25
Date Paid
Receipt Number
11/24/08
.11/24/08
1l/24/08
11/24/08
11/24108
1l/24/08
11124/08
11/24/08
1l/24/08
] 1124/08
11/24/08
11124/08
11/24/08
11/24/08
1l!24/08
] 1124/08
t t /24/08
11124/08
1l/24/08
11124/08
t 1/24/08
11/24108
11124/08
1l!24/08
] 1124/08
1l/24/08
11/24/08
1l/24/08
11124108
11/24/08
] 1124/08
11/24/08
]20080000000000]]70
120080000000000]]70
1200800000000001170
1200800000000001170
1200800000000001170
1200800000000001170
1200800000000001]70
t20080000000000]]70
1200800000000001170
1200800000000001170
1200800000000001170
1200800000000001170
1200800000000001170
1200800000000001170
1200800000000001170
1200800000000001170
]200800000000001170
. 1200800000000001170
t20080000000000]170
1200800000000001170
1200800000000001170
]200800000000001]70
1200800000000001170
1200800000000001170
120080000000000]]70
1200800000000001]70
]200800000000001170
]200800000000001170
1200800000000001170
120080000000000]]70
1200800000000001170
1200800000000001]70
Paee 2 of 4
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CITY OF ~t'Kll"ltdflJ!.,LD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2008-01698
ISSUED: 11/24/2008
APPLIED: 11/21/2008
EXPIRES: OS/2412009
VALUE: $ 95,200.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannint! Review
11/21/2008
Plan Reviews ,
11/21/2008 APP
DDK
Access restricted to one
driveway/lot. Follow Street Tree
plan.
Storm water to curb via weephole
Approved as noted on plans
Public Works Review
Structural Review
11/21/2008
11/21/2008
I t/21/2008 APP
11/21/2008 APP
LKW
CJC
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.
I Rpn~~,nprtinw
Vfer Electrical Ground, Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation, After forms are erected but prior to concrete placement.
Post and Beam, Prior to lloor insulation or decking.
Floor Insulation, Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection, Prinr 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.
Hold Downs Installed, Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Final Building, After all required inspections have been requested and approved and the building is complete.
Perimeter Foundation Drains, After gravel and filter cloth is installed but prior to backfill.
Vnderlloor Plumbing, Prior to insulatioil or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
WaterLine, Prior to filling trench and including required testing.
Sanitary Sewer Line, Prior to filling trench and including required testing.
Storm Sewer Line, Prior to filling trench.
Final Plumbing, When all plumbing work is complete.
Vnderlloor Mechanical. Prior to insulation or decking and including required testing.
Pa2e 3 of4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2008-01698
ISSUED: 11/24/2008
APPLIED: 11/21/2008
EXPIRES: OS/24/2009
VALUE: $ 95,200.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Undertloor 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 minimum of one appliance including required
testing. Presnre test done at this point.
Rough Mechanical, Prior to Cover
Final Gas, When all gas work is complete.
Final Mechanical, When all mechanical work is complete.
Temporary Electric, Approval reqnired prior to Utility Company energizing pole.
Underground Electric, Prior to cover
Rough Electric, Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric, When all electrical work is complete.
Curbcnt - Standard, After forms are erected but prior to placement of concrete.
Sidewalk - Curbside, After forms are erected hut prior to placement of concrete.
Erosion/Grading Inspection, Prior to ground disturbance and after erosio.n measures are installed.
By signature, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 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 d'uring construction.
..~ if )-u.~
Owner or Contractors Sig~~t~re cJ
/h9c.;~('
Date
Paee 4 of4
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CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
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JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
L STORM DRAINAGE
COM2008-01698
Hayden Homes
1843 S. 57th Place
1802033210300
.Single Family Residence.
1 BUILDING SIZE (SF:
1112
LOT SIZE (SF):
6098
DIRECT RUNOFF TO CITY STORM SYSTEM
1 IMPERVIOUS S.F. x I COST PER S.F. CHARGE I
1 1617.00 I. . $0.357 I = I $576.86
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TOClTY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I
I 0.00 r I $0.357 I I 50% ~ 1
ITEM I TOTAL - STORM DRAINAGE SDC , . $576.86 ~.
2 SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
1 18 I
B. IMPROVEMENT COST:
I NUMBER OF DFUs 1 x
I 18 I
. DISCOUNT
. $0.00
$576.86
COST PER DFU
$27.67
$497.97
COST PER DFU I
$21.04 I
$378.66
ITEM 2 TOTAL- CITY SANITARY SEWER SDC
= I
$876.63
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRJP RATE 1 x
I 9.57 . I
B. IMPROVEMENT COST:
1 ADT TRIP RATE I
1 9.57 I
,
$888.98 11094
I
---l
$97.90 1 1054
I
$t,009.17 I 1055
. $0.00 1 1054
I NUMBEROF UNITS 1 x 1
I I 1 I
x INEW TRJP FACTORI
1 1.00 1
COST PER TRIP
21.06
$201.54
x
I NUMBER OF UNITS I x I
I I I I
= ,
COSTPER TRJP
$92.89
$t,090.52
x INEW TRJP FACTORI .
1.00 I ~
4. SANITARY SEWER - MWMC
ITEM 3 TOTAL - TRANSPORTA nON SDC
B. IMPROVEMENT COST:
INUMBER OF FEU's 1 x leaST PER FEU.
I I. I $1,009.'17
MWMCCREDlT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL c MWMC SANlT ARY SEWER SDC ~,
A. REIMBURSEMENT COST:
[NUMBER OF FEU's I. x
I I
ICOST PER FEU
I $97.90
,',
=
=
$10.00
$t,1l7.07
~
,
SUBTOTAL (ADD ITEMS t, 2, 3, & 4) ~ I
, $3,661.08
1070
...J
11091
I
11092
I
I
1093
11056
I
I
I
11079
_1'1078
5. ADMINISTRATIVE FEF:
I SUBTOTAL x. I ADM. FEE RATE I~
I $3.661.08 I 5% I
TOTAL SANITARY ADMINISTRATION FEE:
IOTAL TRANSPORTATION ADM!!'IISTRATION FEE:
Kaye Wilson
PREPARED BY
" CHARGE
$183.05
104.58
$78.47
11/21/2008
TOTAL SDC CHARGES
~, $3,844.13
DATE
DRA1NAGEF~TURE UNIT(DFU) CALCULATION TABLE
NUMBER OF NEW FixTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTIJRES)
NO. OF FIXTURES .
FIXTURE TYPE
J BATHTUB
IDRINKlNG FOUNTAIN
J FLOOR DRAIN
I INTERCEPTORS FOR GREASE 1 OIL 1 SOLIDS 1 ETe.
I INTERCEPTORS FOR SAND 1 AUTO WASH 1 ETC.
ILAUNDRY TUB
ICLOTHESW ASHER 1 MOP SINK
ICLOTHESWASHER - 3 OR MORE (EA)
IMOBILE HOME PARK TRAP (I PER TRAILER)
I RECEPTOR FOR REFRIG 1 WATER STATION iETe.
I RECEPTOR FOR COM. SINK 1 DISHWASHER 1 ETe.
ISHOWER. SINGLE STALL
I SHOWER, GANG (NUMBER OF HEADSt
I SINK: COMMERCIALIRESIDENTIAL KITCHEN
I SINK, COMMERCIAL BAR
ISINK: WASHBASIN/DOUBLE LAVATORY
ISINK, SINGLE LAVATORY/RESIDENTIAL BAR
IURlNAL, STALL! WALL.
ITOILET, PUBLIC INSTALLATION
ITOILET, PRIVATE INSTALLATION
NEW
1
o
o
o
o
1
1
o
o
o
1
o
o
1
o
o
1
o
o
1
OLD
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
. UNIT
EQUIVALENT
3
1
3
3
6
2
3
6
12.
1
3
2
.2
3
2
2
1
5
6
3
I
I
I
I
I
I
I
I
~
I
I
I
. . I,
, ..
TOTAL DRAINAGE FIXTURE UNITS . I .
*EDU (Equivalent Dwellin):: Unit) is a discharge equivalent to a sinl1:1e family dwelling unit (20 DFU's) set at 167 gallons per day
MISCELLANEOUS DFU TYPE
NUMBER OF EDU'S
YEAR
ANNEXED
I
Ii
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
BEFORE 1979
1979
1980
1981 .
1982
1983
1984
1985
1986
_ 1987
1988'
1989
1990
1991 "
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
...
..
CREDIT RA TE/$ I ,000
ASSESSED VALUE
29
, 20
DRAINAGE
FIXTURE
UNITS
; 3
; 0
; 0
; 0
; 0
; 2
; 3
; 0
; 0
; 0 I
; 3
; 0 I
; 0 II
; 3 I
; 0 I
; 0 '.. I
; 1 "', ,. J
; 0 I'.
.' i
; 0 l
; 3
; 0
18 I
I
.
2
2
2005
~ ,
$0.00
, . I
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
I
. I .
. IS LAND ELGIBLE EOR ANNEXATION CREDIT?
.1'
(Enter I for Yes, 2 for No)
IS IMPROVEMEl'h ELGIBLE FOR ANNEX. CREDIT?
I
(Enter I for Yes, 2 for No)
IBASE YEAR, ..
CREDIT FOR LAND (IF APPLICABLE)
VALUE 11000 CREDIT RATE
$0.00 x $0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE 11000 CREDIT RATE
$0.00.' x $0.00
.TOTAL MWMC CREDIT
r
"
\
I
1
~ ,
o
;
$0.00
II
SPRINGFIELD ~.~=n. ZON LJ.,( .
f,\.$\--<;t}j:'i~~-!~l~~ INITIALS IV M , I
c.'iMt DATE 1f/2.t./"OD
--, ~ ~ SOURCE f)'\~
Date \ ~ .....1..- 'i I' '0 is
225 FIFTH STREET. SPRlNGFlELD, OR 97477 . PH,(541)726-3753 . FAX, (541)726-3689
ELECTRICAL PERMITAPPLICATJON
City Job Number CCIM. z.ooE'- Of 6 'j %
Electrical Contractor. -r;,,j?)J~fcj, r:/ec 200 Amps or less $ 70.00
,
. 201 Amps to 400 Amps $ 83.00
Address ;;20879 .... .~1'~~--.:.'-reQUire:~0~~: ::~~~o,,:s s .... .::~~:~~_ _ .. ._..' _...
() I " ",n(\ \a~. _ ",~Qo'rI UW"in . p ~
,n~1 f.[1?'t~;..z:!t! :~'tJ- -. wgelrtJlr~'}\JDPSlvUjIS ~"u.uu
:;\\(11<1-'\1\1';(; a~~~(. iMse ru~e~~~\l~gruy $ 55.00
'O\Ir.r.~\ISnce _0010\\lroU9 olll),E1tules J ~ .,. .
N Ii;("""-O{)\ .ncoples € ..i:1!Ws"!lfv:,~"''''',",CVj~-\\i;~li'''JU~'~''~
Supervisor License Number \\1 01'\' 1;/:./ ..."1~\90bt~\ l\~ote'. \f\ .~~~ ., ~nx€\.~~tJS2WJif~-1~t~~\~!f~f~~f~il*-~?I~,~_~"~~rf~~r.I~~~
009ll;. ';'t\1e cenler. on Ulili\'! 0 .
Exprration Date (2&tF1l~o' lor I\le Or,e2!)0_332.2~1)bll"tion, Alteration or Relocation
Hull.... let ,., . - ..
Cen 200 Amps or less
Constr. Contr. Number /7;2 -:'.cR {" 201 Amps t,::~o..A.ri1ps
401 Amps.io 600 Amps
~'i
Over 600 Amps or 1000 Volts see "B" above. .
D. ~~B'l!i\'tiJr""'."@"~.iil!1lii1!~.~~ifJj',.lll,~i!!"J!I?t~.;t-.., ""''''':ll\r.';j~i",<\!'J..
Signal ~re ofS~pervAsingFlectrician f~"'-.;l~_.,..m\~~f~~~~~',,",'-~i!~ti~~~.k~,;~~*6i~~~
(L( h i C\-r. ~. A-\.. I New Alteration or ExtensiouPer Panel S.?
C~~ or; One Crrcmt ~()~'f- $)81>0 Sl
---.s Eacb AcJ.~~~~~~~~Witb .
- HAy~(;;}./ f:::7'Ir: ~~~w~~~1~t $ 4.00
Owners N:e u Tl{ - 'CSt..) G./'~~~ S~~_~~Vt~'~""''ll'01f~~~'~~~'''~~~~
Address ~ ~ 0 U ~~~~ U\~~~'<1'Jl~~l,~l'<'l!~~$!Jl,'t-lt..g~~~.l!l.~,~RlmJH,iJi1&
City ~ ~ON~ Phone e.z:fr..'C~~?fJ>t.'V ~~br irrigation $ 55.00 . _
CG~\ "\ 'O\) 'V~ SignJOutJ,ine Lighting $ 55.00
OWNER INST ALM-TION . i'~'{. Limited EnergylResidential- - - ---- --. . $-28:00-
. The installation is being made on propertY Town .which. --- Lumted Energy/Co=eTClal $ 50.00
is not intended for sale) lease or rent. MiD~mum Electric Permit Insp~ction Fe~ is $50.00 + Surcharges
4. :il'i~n;~~~~~~:~~~~1I:_~"~~?J;~i .~~~~';~~~.~.j)l ~C7C>
Owners.Signature: _ -'. ':.,.'!"',lOI"OI<l1"~~~W'~' '. ""i;i1.:.,~';~~,.", ~ w
- 12% State Surcharge . Z--'1
10% Admin.istrative Fee z: 0
5% Technology Fee 10
~$I.{~ -
Shared Drive(f:)IBuilding FormsfElectricaJ Permit Applicat)on 1-08.(
, .
.. .. .,. .. _... ','" _" ... ~....""","",""~'" _...."'~~T'!':'.T1
>s;.=;'~""""'''''~'''\'J-'"''''.''~''''-''''''''"''t!Wi~~''-''''''~~&~"<jj'''''.-'''''''''<'.dn'XT'~' ::".7i~'U~;o.!J_"
. 1. ~~;~~~\WJt~~l\i~~~tWfr~~f,iI~~
/B43 50 57 Sf
LEGAL DESCRIPTION:
J BoZO g~Z
(CsoD.
JOB DESCRIPTION:
d~~ tJ I fl.c I.Jewtf
Permits 3re Don-transferable and expire if work is
Dot started within 180 days of issuance or if work is
.____ _ _Suspende(l.Jou&O.days____-:-_
.. .. .n[j.i<;'iI.("'t'~Ulr<;~'~'li~:!~'.!~;i;iO-iiWJj'lt~.:'H 1'~~.'~~~,~~"~I~{1.-~fi..1K~~;&~1~~.~.~~'.. 1:..
~'m(!)Wfli')M,I!@E1!l . ,. $"," '. '~"fJlf,l?"M(i)1YiWJ\ ,,~
2. ~'M,~,:;:"i~"Io1!'~~~$. .j, '. ~j~iC.s: 1~':l,.._~'t, .li!,,~.,;~ - -.. ,!~
uty
Expiration Date
Inspection Request' 726-3769
3. !~~l:yr~~t.,!~=I~JI~~!ti~~lllllfi'
A. ~mlf~~~lzr'ifi;rrffitsr~f~~6'~it{tflt1~EW~i~'}~'~t~~lftt~*''i~~~J~~1~1~
;~ffi.f~d~~""'jf~(';~:';:!;fw:1-wn~<1l;!'j,;:(;,;:t~'(~~~~ili::~;2:.~~!~lB-~~~~~~gl~~
Service 1ncluded
. 1000 sq. ft. or less
Each adilitional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
-'- _.E""der
It I
~.OO
tt
$ }100
IZ(
z.Z
$55.00
. . -B~ ~.'.~J'fN11~~i~t:q~~"1a.,~.>~Ji~Ijl1~~~.'4~rr~...,,:~'18i\~Wrm.'\;~'~~:r:f~i'f.~~~.....~.: "~'t;'.Iml1'~~"'~f~'~'.;m~~.iil
. tp?el1i,lC_es~QE~l_li.:Ce e:r;s~~ nsffi a fion~~lteJ:atrollS'()r . . 'elbcatIQgi~i
. ~..if&~,;(:",,""t>:"',ffr,-:;'~:;:!';~ii!.t.~,;.'JL~""'i'D'~;'~~.~r:~tF~""....,'i,,\:";:.:...eB~'!\r';,.'... .', ;l!-'iI:i:i'~"c~
$ 55.00
$ 76.00
$110.00
TOTAL
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fjfth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-01698
COM2008-0 1698
COM2008-01698
COM2008-0 1698
COM2008-0 1698
COM2008-01698
COM2008-01698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-01698
COM2008-01698 .
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008cO 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-0 1698
COM2008-01698
COM2008-0 1698
Payments,
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Date: 11/24/2008
9,32,30AM
1200800000000001170
Description
Plan Review Same As
Plan Review Major - Planning
Building Pennit
Addressing Assignment
1 Bath One & Two Family
Furnace - up to 100,000 btu
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
-Mech Iss 2+ Appliances-
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl SOD
Temp Power 200 amps or less
Fire SF Fee - Residential
Willamalane Single Family
Stonn Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sanitary/Storm Admin
SDC Transportation Admin
Curb cut Pemiit
Sidewalk Pennit
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Amount Due
227.00
211.00
625.81
37.00
165.00
15.00
16.00
8.00
11.00
8.00
6.00
42.00
121.00
22.00
57.00
55.60
2,513.00
576.86
497.97
378,66
201.54
888.98
97.90
1,009.17
10.00
104.58
78.47
88.00
88.00
72.09
126.58
111.04
$8,47U.25
Paid By
HAYDEN HOMES LLC
Item Total:
<':heck Number Authorization
Received By Batch Number Number How Received
njm 042030 In Person
Payment Total,
$8,470.25
$8,47U.25
Amount Paid
Page] of I
11/24/2008
~~ Willamalane
t'\ij Park & Recreation District
Job. No. &- / tJ '1 tf
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008
NAME: 1M'I/J9I
PHONE: )-").f ~ '?:lS-
ADDRESS: 2L(~'I $JJ4tft.102-CITY R..f:F:DPft:JIVD STATE:~ZIP: t:t'J?J&
LOCATION OF PROPOSED BUILDING SITE:
Street Address: Ifi{ 3 . S ~1'A
Plat Name: Tax LotNumber: /$(J:z o'J';2.. lo3~D
1. DEVELOPMENT TYPE .(Check appropriate dwelling(s). Dwelling type definitions are on the
back.)
A. Sinole-Familv Detached
NO. OF UNITS
I
X $2,513 per unit =
$ /)13
B. Sinole-Familv Attached
NO. OF UNITS
X $2,726 per uriit =
$
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. TOTALWILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit) .
a-a~
$ ;1.$'13
Development Services Department
CitY of Springfield
II t ;;ZIt ~dr
Date
5