HomeMy WebLinkAboutPermit Building 2009-3-17
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CITY OF SPRIN\Jf<lELD
:1
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-00349
ISSUED: 03/17/2009
APPLIED: 03h6/2009
EXPIRES: 09/17/2009
VALUE: . $ 1198,286.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4090 FILBERT MEADOWS Way'
ASSESSOR'S PARCEL NO.: 1802064111800
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New i'
PRO.lECT-DESCRIPTION: Single family residence - Filbert Meadows lot 47
SAME AS COM2008-01818 .1215 S40th PI
Residential
Owner: BRUCE WIECHERT CUSTOM HOMES INC
Address: 3073 SKYVIEW LN
EUGENE OR 97405 .
I CONTRACTOR INFORMATION I
Contractor Type
General
Contractor License
BRUCE WIECHERT CUSTOM HOMES INC 101717
. BUILDING INFORMATION I
Expiration Date
09/16tiO 10
Phone
54 I -686~9458
,--.--..--. ,
"
# of Stories: Lot Size:"
Height ofStrnctnre 17.00 Sq Ft 1st Floor:
Type of Heat: Forced Air Gas Sq Ft 2nd Floor:
Water Type: Gas Sq Ft Basement:
Range Type: ATI!'!!:~~r!c)N: cslf~~:Glir~g€ll1';\;,rP&rY~'~i~ 462
Energy Path: follow rules adSqI1/lt:'On\~P!3 Oregon ttfl Yth
S . kl dB 'Id' 'f' I' Cero" :rho<~\J"ilr.s are se or
pnn e nl mg: Notl ICn a)n ccnpann~ a "AR 952 001
. .......'.nr"l!:t')(H'\1_nn1(]throuahv --
I DEVELOPMENT INFORMKrIDN 'fU may obtain copies ot tne rUles uy ,
. ctlllli I\] the center. (NR~oti)ihtpW~~~NG
. . number for the Oregon tJui'rtr;-..l1Mt c
Front yard Setback: 18.00 Overlay Dist: Center is 1-80cr-litlit.2344). 2
Side I Setback: 14.00 ' # Street Trees Rqd: 4 HandicalJped:
Side 2 Setback: 15.50, Paved Drive Rqd: Yes Compa,ct:
Rearyard Setbac~~OTlCE' '5.00 % of Lot Coverage: 36.30
Solar Setbacks: . FR'MIT sAIAi'l EXPIRE IF THE WORK
THIS p~ _ ___"
AUTHORIZED UNOEK IlltW~qe1Mf~8vTEMENTS 1
r:OMMENCED OR IS AB,.,- "
Street Improvements: 180 DAY prD~i"n d
ANY .ll'.u ,yumprove
Storm Sewer Available: Yes
Special Instrnction:
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Constrnction Type
Secondary Constrnction Type:
# of Bedrooms:
I
R-3
U
VB
5,773
1,634
3
Sidewalk Type:
Curhside 7'
Curb and Gntter
Do.wnspouts/Drain~:
Notes: Driveway approached per variance appeal approval A Storm water to curb via weep hole
I Valuation Descriotion I'
Description
Tvpe of Construction
~4
~~.
$ Per Sq Ft
or mnltiplier
Sqnare Footage
or Bid Amonnt
Value II
Date Calcnlated
Pa2e I of 4
_~!i'_~IN~ElI~~, ~"
t .
,
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Estimate
Garal!e/Misc
SFlDnplex
Estimate
U VB Utilitv
R-3 VB 1&2 Familv
Fee Description
+ 12% State Snrcharge
+ 5% Technology Fee
I st Appliance
2 Baths One or Two Family
Addressing Assignment
Appliance Vent
Bnilding Permit
Cnrbcnt Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Fireplace (Listed)
Gas Ontlets 1-4
Plan Review Maj~r; Planning
Plan Review Same As
PW Disc - 2nd Permit
Refnnd CY - SDC Storm Improv
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500 .
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbnrsement
SDC Sanitary/Storm Admin
SDC Tran Reimbnrs-Residential
SDC Trans Improvement-Resident
SDC Transportation Admin
Sidewalk Permit
Storm Drainage Impervious Area
Temp Power 200 amps or less
Vent Fan
Willamalane Single Family
Total Amonnt Paid
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00349
. ISSUED: 03/1712009
APPLIED: 03(16/2009
EXPIRES: 09iI 7/2009
VALUE: $ 198,286.00
$1.00
$37.72
$96.83
"
$198,286.00
$17,426.64
"
" $158,220:22
$373,932:86
03116/2009
03/16/2009
03/16/2009
198,286.00
462.00
1,634.00
Total Valne of Project
F~I'" Pqir! 1
Amonnt Paid
"
Receipt:Nnmber
Date Paid
$226.16
$112.08
$79.00
$337.00
$38.00
$9.00
$1,11 1.68
$88.00
$9.00
$13.00
$104.80
$20.00
$7.00
$211.00
$250.00
$-30,00
$-1,159.43
$134.00
$75,00
$483,84
$636,30
$10.00
$1,009.17
$97.90
$84.31
$201.54
$888.98
$82.08
$88.00
$1,159.43
$63.00
$27;00
$2,858.00
3/17/09
3/17/09
3117109
3/17/09
3/17/09
3/17/09
3/17109
3/17/09
3117109
3/17109
3/17/09
3117109
3/17/09
3/17/09
3/17/09
3/17/09
3/17109
3/17109
3/17109
3/17/09
3/17/09
3/17109
3/17/09
3/17109
3/17/09
3/17/09
3/17109
3/17/09
3/17/09
3/17/09
3117109
3/17/09
3/17109
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
,1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
1200900000000000194
$9,324.84
I Plan Reviews ~
Pal!e 2 of 4
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00349
ISSUED: 03i17/2009
APPLIED: 03/16/2009
EXPIRES: 09ii 7/2009
VALUE: $ 1'98,286.00
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726"3769 Inspection Line
Phmniu2 Review
03/16/2009
03/16/2009
APP TAJ
Reqnire street trees as shown on the
street tree plan attached to the
permit: species as shown, 2"
caliper, lea've name tag on until
approval. location may be adjnsted
somewhat to account for the locatiol1
of the driveway.
Driveway approached p"er variance
appeal approval A
As noted oil plans and in conditions
of approval letter
Pnblic Works Review'
03/16/2009
03/16/2009
APP LKW
Structural Review
03/1612009
03/1612009
APP CJC
To Request an inspeCtion call the 24 hour recordi,!g 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 b'e made the following
work day.
I Oam.;ra<l Inon t' J
~prrl/lr~
UferElectrical Gronnd: Install gronnd rod at footing and call for inspection in conjnnction with footing andlor
foundation inspection.
Footing: After trenches are excavated.
Fonndation: After forms are erected bnt prior to concrete placement.
Post and Beam: Prior to iloor insnlation or decking.
Floor Insnlation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rongh in inspections. have been approved.
Wall htsulation: Prior to cover.
Ceiling Insulation: Prior to cover:
Drywall: Prior to taping.
Final Bnilding: After all required inspections have been reqnested and approved and the bnilding is complete.
"I
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of ,eon crete.
Rongh Plnmbing: Prior to cover and inclnding reqnired testing.
Water Line: Prior to filling trench and inclnding reqnired testing.
Sanitary Sewer Line: Prior to filling trench and inclnding reqnired testing.
Storm Sewer Line: Prior to filling trench.
Final Plnmbing: When all plumbing work is complete.
Underfloor Mechanical. Prior to insnlation or decki~g and inclnding reqnired testing.
Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance.
Paee 3 of4
_~,,"~'.'I.:!'I..~..!'l.r.I.Iil:...~..._~...;...,........... ...'.......
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CITY VI' ~rKlj~uFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-00349
ISSUED: 03/17/2009
APPLIED: 03/16/2009
EXPIRES: 09/1712009
VALUE: $ 198,286.00
225 Fifth Street, Springticld, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Rongh Gas: After line is installed and reqnired 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 inclnding reqnired
testing. Presure test done at this point.
Rongh 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,
UfoI' Electrical Ground: Install ground rod at footing and call 'for inspection inconjuction with footing andlor
foundation inspection.
Rongh Electric: Prior to Cover
Electric Service: Approval reqnired prior to ntility company energizing service.
Final Electric: When all electrical work is complete.
Erosion/Grading Inspection: Prior to gronnd distnrbance and'after erosion measures are installed,
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbeut - Standard: After forms are erected but prior to placement of concrete.
By signatnre, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all
information hereon is trne 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 describcd herein, and
that NO' OCCUPANCY will be made of any strnctnre withont permission of the Commnnity Services Division, Building Safety.
I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed on this project.
I fnrther agree toensure that all reqnired inspections are requested at the proper time, that each address is readable from the
street, that thc permit card is located at the front of the property, and the approved set of plans will remain on the site at all
"'c7;j'r~
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fr7/0 j
Date
Pa2e 4 of 4
~ .~ Willal11alane
t Park & Recreation District
Job. No. C'9- .J~1
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
ADDRESS:.M.Z? 5tC-v/{ff,w
CITY ~u~
PHONE: ~fjI" 1Y.s- 6
STATE~ZIP: o/Yyq--
. ,NAME: R~tAU tJb~"kJ /:uf~h~}
LOCATION OF PROPOSED BUILDING SITE:
Street Address: ~70 !1t--8eit-1 ;1d4/~~ 1.,)1
Plat Name:
Tax Lot Number: /,[/)2 a f't' /tI~cJ
1. DEVELOPMENT TYPE (Check appropriate' dwelling(s), Dwelling type definitions are on the.
back,) . .
A. Sinale-Familv Detached
. NO. OF UNITS
) X $2,858 per unit =
$ .J-Il5~
B. Sinale-Familv Attached
NO. OF UNITS
X $3,100 per unit =
$ .
C. Multi-Familv Aoartment
NO. OF UNITS
X $2,641 per unit =
$
D._Sir:laleRoom_OcGuoaocll
NO. OF UNITS
X $1,321 per unit =
$
E. Accessorv Dwellino '-'nit
NO. OF UNITS
X$1 ,550 per unit =
$
$
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SDC payer must fumish proof of
Willamalane Credit approyaL)
$
. 3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDt reduced for Credit)
$ :JJ)~ '
aMd~~
Development Services Department
City of Springfield
J I It. I CJ!
Date
5
ZON
INITIALS
DATE
SOURCE
lGJL,
lk\
'b'n .cq
P- ~(l.--'
225 FIFTH STREET. SPRlNGFtELD, OR 97477 . PH,(54t)726-3753 . FAX, (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number (01'1'1700 9 - C>O 5 <.{ ?
JOB DESCRIPTION:
;Io",,~C'
Permits are non-transftrable and expire if work is
not started within 180 days of is~uance or if work is
Suspended for 180 days.
,.' \0
f:-""'7-.Ji....:-~-:&;;::.~:..,'~;,:;r~~~...::~~lb;;:..;~~,,,~....?>";tl 'l':v "t !&..~ 1=. :.k~~~~1:~~f~W-~~"f,7~_ ~.~ f'J'plC:i- .... e..' . > ." -......" >>7>r'L~ J
2 ; ~9R~q!,QR...1N~T~'flq1Y ~Nl~~~\\)\\\'1\'(\B. ~1~eryi~e~~'~~ffedfr~~ !n~sJa,!,!a~i?'n.:t\lte!ation~:oJ~,!l!lo~€ltj9.ri.~r::1
. ,-_..J - -1t:........_Ji<~.,,.,_.~:G.:J..~,_"_~~.....,,!b..\).\~e'?,,'f0v ,at,\. ~t,~a:;~........-~.... ~.a..._\C,.... _""-"'- ~... }-..:t~.( __~ ___,. ..- ~._'ll:i$~,,~
. L +- c- ~'Oo:. 'OQ,O s'o\ RJ\'
Electrica] Contractor \"'-~ e a~ _~\~'\':J'I:(J 'O'\!OO Amps or less $ 73,00
0\' '\.\' ''0'" 0. '" ~'os
...'0($ 0.'0'\ ~0\i?'r" '0\" ,,0201 Amps to 400 Amps $86,00
Address q L -g s 3 ~-2~<3 -<;\\J.t~$ 0\'" ~'O\>'(\O'O-\\"'lJ] Amps to 600 Amps $143.00
~\ "' 'Q.v e\' \\" - ~'(j.f ...e S"v
. :0<() ~~\e'i:> p'o'0'1 ~\'\l <.> cB\> ,,~'o v,o\\ 601 Amps to 1000 Amps $]86,00
City '3 oj) ~ \ 6 ~ 1\0~ ,\o'l',~llP~'~ ,~Q\~\4~1~1>.t>.\. Over 1000 AmpsNo]ts $426,00
. \O":i.\\\c;~"d':J'I: ~~'\ -'0\'o~' ~O\' ~'?l/: Recollllect Only $ 57,00
~O aI>'" -{00 '0 C'o a~'O .'O'\l'\l' ,
''0 RJ. ,,'is'' 119-00 ,(i)' " L'.",.'.,- ,.", '-..-;' :-" ."
Supervisor License N'1l'i'ile~..\\'0":1I\(J.\~"j.,' C. ,: T.C1ilp~r.1'ry Ser\~i,ccsAr I'.criders, ,
C ~'Ov vf'
Expiration Date ~ I 2/ I 0 / II Installation, Alteration or Relocation I
".....""..,,~"I-""....:1~ .'l(;,',' ~"'.'--"":<:""'l'~_.'~-I<-.'\--:"'~'~-_,__ <:'
1. "'LOCAirONOI~llVSTA1iMTjON!;' ';.:
l:..c.'.i R;f'~~.. ,.~,,,.'t-"'iI.Y;{;..0.........,,-"'-";:"''''~';;'~",,1~~iVl'''';;:''''i- .~.. ',.,
4D90 F,\be.vt /lIec...doWS
LEGAL DESCRIPTION:
ISOl 0641
1/800
I
rewt t
I
1
,
Constr, Contr, Number
/ b S- '--17 y-
3)10
Expiration Date
Signature of Snpervising Electrician
fflJ2tM), NJL
Owners Name \S,r vce LJ i ed,ed (,,'>10.....
5Ic....v;~W lrJ
,
Phone b"6b-9ltS"Z
Address :, \;) 7 :5
City t: li JC'"'''--
OWNER INST ALLA nON
The installation is being made on property [ own which
is not intended for sale, lease or rent.
Owners Signatnre:
Inspection Reqnest: 726-3769
f-\cl ~ T eMf
Date
'-'~ ",-:; ~'""1:"I.r."~c "~.:',.'.'l-' ~~.,~"",;<-;:7r:--.~_"',,-~.~~,,,:; .,~";"";',,'.1::""':- .~-"'"".~.. .~._-~, or' -,'. ~'.. .~~.'.,,,
3. ." (XiMPLETE!FEESCHEDUl;EBELOwJt "i."'~ ,? 1,C,~ /., L; 'j
'.\'i<.~~_'_""::" ";c,'...._;i\'--,j;\~" <I:.V: '~"''''''''JVt..-.i- ' ';-.'.~_ -;:;,~:. .-r..~~o.:_J; ';:"';": -::'L'.',. ~ >..)!'~,
A. U~~tf~~_~!_~~~i};f~fif~}1~i{tt~]~fN~~jIjt;;:~J!~_-~~!t'~i~ti
Service Included
~
..m:Q0
rJq
7)
1000 sq, It, or less
Each additional 500 sq, It, or
portion thereof
Each Mannfac!' d Home or
Modular Dwelling Service or
Feeder
$57.00
, .
.,
:."-1
~ :' :. ~
...
$p1JO
$ 79,00
$] 14.00
b3
200 Amps or less
20] Amps to 400 Amps
40] Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" aMlve.
. '.i"':"'~::f:.,.~,~:'~ . "'"\,:,:..;.,;r _>;"-:--:O~' ';,'f"7( '<:..':': . -'! t'\~~~ r~,.' ,;/;.'-". i'L:\;>~} ",y,~r'~ ~ ::',;-:!
D. ~~8ranch'~lrclllts..4t>~. /,;;1"~kf,'" ,.,;""\\J."'t'\.~:;!f :';~[>~~C;t'l"'=''' ~ .....i'i' '.-. '''';
"'-'.'~-'~",.."" ,,",:', ..,'. ""'0<(,""~\J-'-' ,,1,-,; ,-," ,__, ',"
New Alteration or Exten~o.(l ~~'ll1l~ '
One Circuit ~~ ~<(' ~ 'X~ $ 50,00
Each Additional ~r&.il;~~~~~
~""tS servl~~orF~~~~~~<S $5,00
\~~~. ~ .,,~<s c.,~', ... - -.-- -, n.,
.JO.~",' . !l\tX'i)11~'f~i~c(i~/~'~i~l@nil~(i)~F;"~~I~'/t~ii~l[o;t1
~- f:> "~l-'v'"x..'V\)'~~\j", . ...., -. --.... '.. '.~, ,
"\~~ ~i# ~ $ 57,00
. Si-3~'Yghting $ 57,00
Lim~~nergylReSidential $ 29,00
Limited Energy/Commercial $ 52,00
Minimnm Electric Permit Inspection Fee is $52.00 + Snrcharges
..; ~_'''l:,;. ., ~,~_':~"'.~'::'_~'7i~. ~,:j".,;:"': ~_"':,':'::_'.' ;,"Co ~.
4. SUB'rO'I'AHOFABOVE' ,,' ,-' ; ,,'
>~ ":";;" '.~ '.> ;: ;, - - .'
] 2% State Surcharge
-I.G%t'I.J..j:..i;....u.~:..e Fee
5% Technology Fee
z-7Z-
"5 Zh'i
TOTAL
/160
J/8 Z;L
Shared Drive(T:)lBuilding FormslElectrical Permit Application 7-08.doc
225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689
li;{D EkARTM ENiI'USE70'NilW4il
. :/c,~". ''''~'.i'':'-''';h;~.;"..",",,~~.^~...ti<o;:'':t.'''''''~~~~_~1~~!-,
('OM ZOO 7 -
Penn it no.: C> 01 4 '=t
I Date ':1-16-01
This permit is issued nnder OAR 918-460-0030. Permits expire if work is not started within 180 days ofissnance or if work is
suspended for 180 days.
5'-1r5r S S '-lot (I rg.tBiS
Of' \~\ .
5C1..\'l'\c... o....S 123 Z
Structural Permit Appljcatjon~-
Ili~Rl.iI[~!l;l}G.QNjtR~9':t:~R}rNR(jRM~j;iQH~1~~jjr:;;{\)\;)1
[ Name CCB License Number Phone Number I
IElectricall-+-e /05'17.< 5LI'iI'i& I
I Plumbing5IL-voi Plv~~"< b50{'S- ). YZ-31f:,'-- I
I MecbauicalLrH "4brJ 72.6-0100 I
1il':&~j!Ijge:~qQ,~~BNMgNifl4RgRQYJ\i3,~'f~l
I This project has final land-use approvaL I I-l&.. .i,'~~t\i;.1illf;:<;~EE".lfS'CHEDmrE-'~J.l'.i!'~~1\itcWfll!iT,,~~~!,il
SIgnature:. Date:;'~_~""-";"~"'~L-"~M'Af~,,*,,~_..,_",.,,,_...._.,~~, __.,_.__.,_~:Mt~~"t,;~..,~,';B;:"L
11,fd;~;nfi1rtloiiniff6~litilii:i:g~!j\i~~i~~l.{~~~It1!~t':~~'1
I ~;:~;e~ct has DEQ approvaL Date I. I(a;j;~~~~~ri;;i~;;:~'---'- ,%",,,"ffii,w;,,,,,,'1;!:!!>:,_"~\, I
I Zoning approval verified: 0 Yes 0 No I I Occupancy I
II :;~~.";::,~,;,,.it;~~.,~~~,~~~:".,O..'''.\t:::....._9,N._. .~'~"'"'.''''''' '.%.-'i~'_~."'?'<~...":~':i''-:~''",*:-'.'''). I. Construction type: I
~1ilI~1\,;llM:;t<,T~,GQ~YA\(')Ii'j)J.C;OI'j$:1jR_UC}I1QI:-I,,~1if;(';j,\';!;t~'L'in I Square feet: I
l~m;J~~1~ft1~f~~Q~~~@~1~Bm!.JQ~~~~'Fii;i.;~~ I ~::::f:::t:::ot: I
I Job site address: LjfJ9.0 F,/b"''''1- Yhec-..t.O WS (}fIr I I
. Type of Heat:
I City:<;9'-~"'l~:,,--ul State: 0 11. J ZIP: 17177 I Energy Path: I
ISubdivision:F;lh..,-t (l\(&.!-ow~ I Lot no.: 47 I 10 0 ' I
I j B I new alteratIOn 0 addition
1,~:=~~./"~~'?~~.~L,,..!,::,1~:.,._U"!iC'~~:'1I""""1 I (b) Foundation-only permit? O'Yes 0 No cQb
~;",~fjfJ;~"!tj;:RRQBJ:BIX0Q\I\IN.I::R",~);;lf!i':',-,~!:":i:";'Ci".:Jn I Total valuation: I $ I ( t>Z~
I Name:G{~l~ IV;, c~..t ("ski", \I(,,,,..s :tNC- I 1.'2.B' "."ld""';"-O""~"'""'!ii'f;'''''*:,jl'''.'
I?, I .'.'.: Ul lDgJleeS<t~;t~->W?~~Ni't;.'.:."li.~
Address:.:>073 5lC"UI<=W I-N . ' .... _'__'<'~..L,".,'~.. ',,'.
J ' /" I I '" 7 -- I I (al Permit fee (ase valuation table):
CIty: , v'{I~ "-"-' Stateo t\- ZIP:, 10-,
I " , b 'V . q '7 b' I I (b) Investigative fee (equal to [2a]):
Phone: -b~ - 9'-/)0 Fax: -,f,- ::,3 ... ..
I I (c) RemspectJon ($ per hour):'
I E-mail:W;<coh.-.lr ~OI"e-5 Q.LD'-~l'S~. \\Je.t (number of hours x fee per hour)
This installation is being made. on residential or farm property owned by I (d) Enter 12% surchar e (,12 x [2a+2b+2c]):
me or a member of my ImmedIate famIly, and IS exempt from licenSing g
requirements under ORS 7oi,010. I (e) Subtotal offees above (2a througb 2d): I $
~t3~~~;PTa.tIWf!'eifir-W1feiS;;~k'I~~~J~JfW~f~'(ftffgr~~~E:~;J~}!'~t~*~
Sign here: '_.^",...._)._.,_"'~~.'c".."'>~.-A,._"_..~"Affi}t4-j.ji~t.."A~v;-~"':..~~J,l$L"J~J;;:
I"J_~tIt~CO"NTRACTOFr'jNSTALlI2ATI0Ni(1\~W:ll-~i4ii\\';~,fl;jl (a) Plan review (6~0/." ~orl!lit fee [2a)):;;;-" In $ Z ~1>
\1."~,, " !, .,~---,..",.. ....__~,_,...ll,,,.,____.,'~.,.__ -.,-,...." "I\... ,,,,,",m...'. . " I (b) Fire and life safety (40% x permit fee [2a)): $ I
I Business name: \?:nvt.e W;ed"'J' C:u~b...., ~'^"" :five..-- I
I (c) Subtotal of fees above (3a and 3b): $ I
I Address: '3 07 '3 S iL ~ "' ~...J 1-", I
1,~~;l.~)J~~.iI~'~:#:~}I~~~10&;;fl'~~~~{f;~'~i~~~:~t!i\'~:~;~~~~t~lt~~:}I~~~1f5~}i)
I City: Cv~ e,"'" I State:o<L I ZIP..: 0. 7~",1
I -- I I (a) Seismicfee, 1% (.01 x permit fee [2a]): $ I
Phone: -6J'~ clc/5? Fax: ::s'l'l-::; 3 b 'l
I E-mail: W;ed......\"...-..I..-..S@co....(h..4~.....Ie-\" I I TOTAL fees and surcharges (2e+3c+4a): $ I
I CCB license no,: loll (-, I
I Printn~e:~"'v~d" W,.,\oJV f' ~S
I Signature W W _____________- I ~"'" 0...
';,1' 12>\ u
C~,\
$
$
I
I
I
I
$
I $
Wi ~
...;: ...
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: COM2009-00349
NAME OR COMPANY: Bruce Wiechert
LOCATION: 4090 Filbert Mcadows Way
TAX LOT NUMBER: 1802064111800
DEVELOPMENT TYPE: Single Family Residence
NEW DWELLING UNITS I BUILDING SIZE (SF: 2100 LOT SIZE (SF):
L STORM DRAINAGE
5773
II ~
10
I~
IW-l
,I-
m
G
~
DIRECT RUNOFF TO CITY STORM SYSTEM
1 IMPERVIOUS S,F, x I COST PER S,F, CHARGE
I 3250,00 I $0,357 I = I $1.159.43 J
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S,F, 1 x I COST PER S,F, I x 1 DISCOUNT RATE I 1
0,00 I I $0.357 I 1 50% I ~ I
ITEM 1 TOTAL - STORM DRAINAGE SDC $0,00 ,
2, SANITARY SEWER - f:ITY
DISCOUNT
$0,00
$0.00
I 1070
~
-l
^- REIMBURSEMENT COST:
I NUMBER OF DFU's I x
1 23
COST PER DFU
$27,67
$636.30
I
11091
I
1 1092
I'
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x COST PER DFU
1 23 $21.04
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
$483.84
= I
$1,120.14
], TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRlP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI
1 9.57 I I I 1 1 21.06 I 1.00 1 $201.54 I 1093
B. IMPROVEMENT COST:
I ADT TRIP RATE 1 x I NUMBER OF UNITS I x,l COST PER TRIP x I NEW TRIP F ACTORI
1 9.57 , I I 1 I $92,89 1.00 I $888.98 1094
ITEM 3 TOTAL- TRANSPORTATION SDC = , $1,090.52 J
4 SANITARY SEWER - MWMC .....
A, REIMBURSEMENT COST:
INUMBER 7F FEU's 1 x ICOST PER FEU
I $97,90 = $97.90 I 1054
B, IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
1 I I 1 $1,009.17 = $1,009,17 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054
MWMC ADMINISTRATIVE FEE $10.00 I 1056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~ , ,$t,1I7.07 I
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ I $3,327.73 J
:\ AT1MINISTRATIVE FEE: L
1 SUBTOTAL x I ADM, FEE RATE 1= CHARGE
I $3,327,73 5% I $166.39
TOTAL SANITARY ADMINISTRATION FEE: 84.31
TOTAL TRANSPORTATION ADMINISTRATION FEE: $82,08 11078
'-'
Kaye Wilson 3/16/2009 TOTAL SDC CHARGES ~ $3,494.12
PREPARED BY DATE
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
.. ., ..
.EDU (Equivalent Dwel]in~ Unit) is a discharue eQuivalent to a single family dwelling unit (20 DFlJ's) set at 167 gallons per day
MWMC CREDIT CALCULA TION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
CREDIT RATE/$I,OOO II
ASSESSED V Ah!!.L..J
.:~:= $5,29
,C'l' $5,29
~ 5,19
5,12
$4,9~~
$4,80
$4,63
$4,40
$4,07, _'
$3,67 - _"';_
~3.2~,.:.~.~I:,firj[!!,1::":9:\':
$2,73 c',c'c,'
u" $2.25' _-
',$ $1,80 '-
1.59
$1.45
$1,25 -
'---$1'09 '
$0,92
'5.h
___,OA8,
.. _:::- $0,28 .
" ""-"$009,
!,!;!i;;i;!";::!i':1!,~I!iJ.-,.;j,., ,..,'
',;1 '.~ :~~JO})~__
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
IS LAND ELGIBLE FOR ANNEXA nON CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT?
(Enter I for Yes. 2 for No)
BASE YEAR
CREDIT FOR LAND (IF APPLICABLE)
VALUE 11000 CREDIT RATE
$0,00 x $0.00
~ I
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE /1000 CREDIT RATE
$0,00 x $0,00 ~ I
TOTAL MWMC CREDIT
=
2005
$0,00
$0,00
I
I
,
J
2
2
o
- ~-
,,.. ....
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: COM2009-00349
NAME OR COMPANY: Bruce Wiechert .
LOCATION: '4090 Filbert Meadows Wav'
TAX LOT NUMBER: 1802064111800
. DEVELOPMENT TYPE: Single Family Residence '
NEW DWELLING UNITS I BUILDING SIZE (SF: 2100
":,
LOT SIZE (SF>:
1 STORM DRAINAGF,
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S,F, x I COST PER S,F, CHARGE I'
I 3250,00 I $0,357 I = I $1,159.43
, RUNOFF ROUTED TO DR YWELLDESIGNED AND CONSTRUCTED TO CITY STANDARDS,
I IMPERVIOUS S,F, I x I COST PERS:F, I, I DISCOUNT RATE 1 1 DISCOUNT
I 0,00 I $0.357 I I 50% ~. I $0,00
ITEM I TOTAL" STORM DRAINAGE SDC I $1,159.43
2, SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFUs I x
I 23 I
B. IMPROVEMENT COST:
I NUMBER OF DFU's I '
I 23 I
, .
COST PER DFU
, $27,67
COST PER DFU
: $2L04
ITEM 2 TOT AL - CITY SANITARY SEWER SDC ~ I
$1,120.14
~~-~I
,
,
3, TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRJP RATE. I '
I, 9,57 I
I NUMBER OF UNITS I x I
I 1 I
COST PER TRIP
2106
x INEW TRJP FACTORI
I LOO' .' -
B, IMPROVEMENT COST:
I ADT TRJP RATE'I x I NUMBER OF UNITS I x I
I 9.571 I I I
ITEM 3 TOTAL - TRANSPORTATION SDC , = ,
I x
I
I
[NEW TRJP FACTORI
[ LOO',
COST PER TRIP
$92,89
$1,090.52
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
[ I ,[
ICOST PER FEU
1 $97,90
B. IMPROVEMENT COST:
INUMBER OF FEU's I x
I I I
ICOST PER FEU
I $1,009,17
MWMC CREDIT IF APPLICABLE (SEEREVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~,
--
SUBTOTAL (ADD ITEMS I, 2, 3, & 4) ~ ,
) ADMINISTRATIVE FEE:
I SUBTOTAL x [ ADM, FEE RATE [~
I $4,487016 I 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$1,t17.07
$4,487.16
5773
I~
1m
I~
10
I~
[W
~I-
).a
~
$1,159.43 1070
$636.30
1091
. $483.84
11092
I
I
!
,.
,
$201.54
: 1093
II
$888.98 I 1094
j
"I
I
=
$97.90 I 1054
$1,009,17
$0.00
$10.00
1055
1054
1056
CHARGE
$224.36
,
:~
Kaye Wilson
PREPARED BY
3/J 6/2009
TOTAL SDC CHARGES
DATE
. '
151.76 11079
$72.60 11078
= I $4,711.52
fI' ,~, ,.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES)
NO, OF FIXTIJRES DRAINAGE
UNIT FIXTURE
FIXTIJRE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 1 0 3 = 3
[DRINKING FOUNTAIN 0 0 1 - 0
[FLOOR DRAIN 0 0 3 = 0
[INTERCEPTORS FOR GREASE I OIL I SOLIDS / ETe. 0 0 3 0
IINTERCEPTORS FOR SAND / AUTO WASH I ETe. 0 0 6 = 0
ILAUNDRY TUB 0 0 2 = I 0
ICLOTHESWASHER/MOP SINK 1 0 3 = 3,
\CLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0: ,...
I MOBILE HOME PARK TRAP (I PER TRAILER) ,0 0 _12 = 0'"
[RECEPTOR FOR REFRlG / WATER STATION i ETe. 0 0 1 = o "
IRECEPTOR FOR COM, SINK I DISHWASHER I ETe. 1 0 3 = 3';',
ISHOWER SINGLE STALL 1 0 '2. = 2
[SHOWER GANG Jl'<IUMBER OF HEADS) 0 0 2 = ,0 I
[SINK: COMMERClALIRESIDENTIAL KITCHEN 1 0 3 = 3 'I
I SINK: COMMERCIAL BAR 0 0 2 = :,:0 I
I SINK: WASH BASIN/DOUBLE LAVATORY . 1 0 2 = 2 [
SINK: SINGLE LA V ATORYIRESIDENTIAL BAR 1 0 1 = "1 I
I URINAL, STALL I WALL 0 0 5 = .; 0
, I TOILET, PUBLIC INSTALLATION 0 0 6 = 0 [
ITOILET, PRIVATE INST ALLA TION 2 0 3 = 6 I
MlSCELLANEOUS DFU TYPE NUMBER OF EDU'S , ,I
20 = ". '0
,
TOTAL DRAINAGE FIXTURE UNITS 23 I
1<EDU (Equivalent DwellingUnit) is: discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per daL I
--'
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
~ YEAR
I ANNEXED
I BEFORE 1979
[ 1979
I 1980
I 1981
I 1982
I 1983
[ 1984
I 1985
1986 _
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
,
IS LAND ELGlBLE FOR ANNEXA nON CREDIT?
(Enter I for Y cs, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter I for Y cs, 2 for No)
BASE YEAR
II
2
2
2005
CREDIT FOR LAND (IF APPLICABLE) .
VALUE I 1000 CREDIT RATE
$0,00 x $0,00
~ ,
$0,00
. CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA nON)
VALUE I 1000 CREDIT RATE
$0,00 x $0,00 ~ ,
o
TOTAL MWMC CREDIT
=
$0,00
225 Fifth Street
SpringfieId~ Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009.00349
COM2009"00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009"00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349 ,
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
COM2009-00349
Payments:
Type of Payment
Cred itCard
cReceiotl
RECEIPT #:
1200900000000000194
Date: 03/17/2009
Description
Plan Review Same As
Building Pennit _
Addressing Assignment
Willamalane Single Family
2'Baths One or Two Family
I st Appliance
Vent Fan
Exhaust Hoods
Dryer Ven!
Gas Outlets 1-4
Fireplace (Listed)
'Residence Wiring 1000 Sq Ft'
. Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Fire SF Fee - Residential
Plan Review Major - Planning
Cnrbcut Permit
PW Disc - 2nd Penn it
Sidewalk Pennit
Appliance Vent
Storm Drainage Impervious Area
Rcfund CY - SDC Storm lmprov
Sanitary Sewer - Reimbursem~nt
,Sanitary Sewer - Improvement
.SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
SDC MWMC Reimbu'rsement
SDC MWMC Improvement
SDC MWMC Administration
SDC SanitarylStorm Admin
SDC Transportation Admin
+ 5% Technology Fee
+ 12% State Surcharge
,
Paid By
BWCH
Item Total:
Check Number Authorizat.ion
Received By Batch Number Number now Received
kr 02573D In Person
Payment Total:
,
Page I of I
8:33:12AM
Amount Duc
250,00
1,111.68
38.00
2,858.00
337,00
79,00
27.00
13.00
9,00
7.00
20.00.
134.00
75.00
63.00
104,80
211.00
88.00
(30,00)
88,00
9.00
1,159.43
(1,159.43)
636,30
483,84
201.54
888.98
97.90
1,009.17
10,00
84.31
82,08
112,08
226.16
$9,324.84
Amount Paid
$9,324,84
$9,324.84
3/17/2009