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Home My WebLink AboutPermit Building 2005-6-8 (2) Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPK11'\jut<lJ!,LU Building/Combination Permit PERMIT NO: COM2004-01594 ISSUED: 06/08/2005 APPLIED: 12/29/2004 EXPIRES: 12/08/2005 VALUE: $ 200,000.00 ~..." . .."' , SITE ADDRESS: 5850 MAIN ST ASSESSOR'S PARCEL NO.: 1702343200300 SPRlNGFIETYPE OF WORK: Commercial MisceUaneous TYPE OF USE: New PROJECT DESCRIPTION: Dutch Bros.# 4~COFFEE STAND - Conventional Const. Commercial Owner: AMIGOS III LLC Address: 8428 THURSTON RD SPRINGFIELD OR 97478 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path' \rsvrmkie'd%~ilding: _. "",'I'.~' . , ~ c"PIP.r. "::,~ "", 1~\S \'t.R\v'I\1 ~ND~ llrDEvE'i;(ipMiNT INFORMATION' fl,\.\1\10RI1r.0 OR IS 1\\:\f\\WV'~' . Frontyard SetbackCO\v'l\v'l't.\'lCr.~ \''t-RIOO. Overlay Dist: Side I Setback: Ml'/ \ BO 0 .' .. _ # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: % of Lot Coverage: Solar Setbacks: " Contractor Type Architect General Electrical Mechanical Plumbing # of Units: ' Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: " # of Bedrooms: Street Improvements: Storm Sewer Available: Special Instruction: " Notes: I CONTRA,CTOR INFORMATION 1 Contractor RON THIENES DELJINC DELJINC LAWRENCE RALPH SABIN III THOMAS E WHITE License Expiration Date Phone 541-726-8795 541-476"1387 541-476-1387 541-582-1224 541-726-9778 40432 40432 163567 86252 09/02/2007 09/02/2007 03/0712007 09/25/2005 BUILDING INFORMATION I B 1 22.50 Heat Pump Electric Lot Size: Sq Ft 1st Floor: 377 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VN Path 1 nla REQUIRED PARKING Total: Handicapped: Compact: ATTENTIOrr'Pi1Bilc;1Mli}tRti'.i'~'~ .v follow roles'i! - c ,I '''';W' 1~li NotiflEli1i9~Wit Those rules are set forth In OAR 952-001 iP"1 0 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telepho~e number for the Oregon!Jtility Notification Center is 1-800-332-2344). Sidewalk Type: DownspoutslDrains': Curbside 5' To Storm Sewer 1>"....' Paee I of6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Estimate 'Pavinl! Estimate Use Bid Amount Fee Description Plan Review CommlIndlPublic -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Addressing Assignment Backflow Device Building Permit Curbcut Permit Curbcut Repair Fixture Heat Pump MinimumlAdjustment Mechanical Paving Sanitary Sewer - 1st 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement Sanitary Sewer Each Addlll 00' SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC SanitarylStorm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Storm Sewer Each Addlll 00' Vent Fan Water Line - 1st 50 Feet Water Line - Each AddIlIOO' Total Amount Paid . . CITY OF ~rK11~hHI!..LD Building/Combination Permit PERMIT NO: COM2004-0I594 ISSUED: 06/08/2005 APPLIED: 12/29/2004 EXPIRES: 12/08/2005 VALUE: $ 200,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 123,000.00 77,000.00 Value Date Calculated $123,000.00 $77,000.00 $200,000.00 04/2112005 04/2112005 Total Value of Project FPPf P'WU Amount Paid $578,92 $10,00 $157,64 $77,03 $31.00 $28.00 $640.40 $35.00 $30.00 $154.00 $12.00 $27.00 $475.95 $45,00 $146.22 $192,35 $42,00 $10,00 $1,954,28 $241.28 $138.79 $502,54 $6,784.56 $1,537.93 $1,960.07 $45.00 $42.00 $6.00, $45.00 $14.00 $15,963.96 Date Paid Receipt Number 2200400000000001547 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 1200500000000000799 12/27/04 6/8105 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 6/8/05 Pal!e 2 of6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review Fire Department Review Initial Review Plannine Review Plannine Review Public Works Review Public Works Review . 03/01/2005 12129/2004 12/29/2004 03/01/2005 12/2912004 1212912004 03/01/2005 I Plan Reviews' I 06/06/2005 ' OK 01/0412005 12129/2004 06/02/2005 01/21/2005 06/06/2005 OK APP APP WE WE WI Paee30f6 . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01594 ISSUED: 06/08/2005 APPLIED: 12/29/2004 EXPIRES: 12/08/2005 VALUE: $ 200,000.00 GRG Comments originally in BIS dated 3122/05: GRG Revised Plan Review: Dutch Brothers coffee kiosk. Job #COM2004-01594. Revisions in civil site work. No changes in plans review comments. Refer to plans review comments dated 1/4/05. Plan Review: Dutch Brothers coffee kiosk. Job #COM2004-01594. Occupancy c1assificatiop: B, Construction Type: V-B. Provide address numbers in contrasting color from the background positioned plainly visible and legible from the street or road fronting the property (2004 Oregon Structural Specialty Code 501.2 and 2004 Springfield Fire Code 505.1). Provide fire extinguishers with a minimum rating of2-A:I0-B:C every 75 feet of travel distance. The top of the extinguisher(s) shall be between 3 and 5 feet above finished floor (2004 Springfield Fire Code 906). SKG EMM Development Agreement signed 6/1/05. No occupancy until ODOT access permit obtained. Needs to submit for Site Plan Review, have approval, submit for Final Site Plan and sign Development Agreement, Waiting for SIte plan review. WIll probably change before final. SDCs included. SDC's added. Curb cuts and encroachment permit fees added. LDAP approved and ready to issue per Billy Curtiss. LDAP fees must be paid. EMM SB EW To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Rpl1l~ Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: After all erosion measures are in place. Backflow Device: Prior to coveri~g and provide a copy of the test report on site at the time of inspection. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Pae:e 4 of6 . . U 1 t' OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01594 ISSUED: 06/08/2005 APPLIED: 12129/2004 EXPIRES: 12/08/2005 VALUE: $ 200,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Electric Service: Approval required prior to utility company energizing service. Final Electric: When aU electrical work is complete. SUB Insulation Vapor Barrier: To be called for at tbe same time as the SUB framing inspection. SUB Final: After aU required energy inspections have been requested and approved, SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Curbcut - Overwidth: After forms are erected but prior to placement of concrete. Curbcut - Close & Repair: After forms are erected but prior to placement of concrete. Encroachment: After item(s) have been removed to inspect condition of public right of way. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete, Shear Wall Nailing: Before covering sheathing 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, Roofing: Prior to installing any roof covering, Drywall: Prior to taping, Bolts Installed in Concrete: To be done by a State Certified Special Inspector, Provide inspection test reports to City Building Inspector. Roof SheathingiNailing: Before covering sheathing with finish material. Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Ceiling Grid: After drywall approval but prior to cover. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector, FInal Fire Department. After all requirements of the Fire Department have been met. Final Building: After aU required inspections have been requested and approved and the building is complete. Underslab Plumbing: Prior to filling the trench and including required testing, Perimeter Foundation Drains: After gravel and filter c10tb is installed but prior to backfill. Pa~e 5 of6 . . CITY OF ~rKlj'lljt<1~LD. Building/Combination Permit PERMIT NO: COM2004-0I594 ISSUED: 06/08/2005 APPLIED: 12/29/2004 EXPIRES: 12/08/2005 VALUE: $ 200,000.00 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 including required testing, Storm Sewer Line: Prior to filling trench. Final Plumbing: When aU plumbing work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I furtber 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 who 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 the proper time, that each address is readable from the street, that the permit c .s located at the front of the property, and the approved set of plans will remain on the site at all times durin ct' / ~~b~ ~.IB;01' Owner or Cv6lractors Signature Date Pa2e 6 of6 225 Fifth Street I. ',1 'S)~ringfield, Oregon 97477 541-726-3759 Phone . .Pirii"""""..... , ~,.....,.~.. '."'- ---'.- .'............. ..:.. .-..,..... :' ?; .<, " },' ;i ...~~ i;.; , ~ __ -""" .! :~:-.,F ;..' lilY of Springfield Official Receipt .velopment Services Department Public Works Department Job/Journal Number COM2004-0 1594 COM2004-0l594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 C.oM2004-0l594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 ,COM2004-0 1594 , . , C,oM2004-0 1594 COM2004-0l594 c;9M2004-0 1594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 COM2004-0 1594 COM2004-01594 COM2004-0 1594 CbM2004-0 1594 COM2004-0 1594 COM2004-01594 COM2004-0 1594 :COM2004-01594 COM2004-0 1594 Payments: Type of Payment Check :, 'i ,\ V'( , ., 6/8/2005 RECEIPT #: 1200500000000000799 Date: 06/08/2005 Description Curbcut Permit Curbcut Repair Sanitary Sewer - Reimbursement Sani\ary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration Addressing Assignment Building Permit Paving Fixlure Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtl 100' Water Line - 1st 50 Feet Water Line - Each AddtllOO' Storm Sewer - 1st 50 Feet Storm Sewer Each Addtl 100' Backflow Device Vent Fan Heat Pump Minimum! Adjustment Mechanical -Mechanical Issuance Fee- + 7% Slale Surcharge + 10% Administrative Fee Storm Drainage Impervious Area SDC Transpo Admin SDC Sani\ary/Storm Admin Paid By AMIGO III LLC Item Total: l.:heck Number Authorization Received By Batch Number Number How Received djb 1130 In Person Payment Total: Page 1 of I 9:13:03AM Amount Due 35.00 30.00 192,35 146,22 1,537.93 6,784':56 241.28 1,954,28 10.00 31.00 640.40 475.95 154.00 45.00 42,00 45,00 14.00 45,00 42,00 28,00 6.00 12.00 27.00 10.00 77.03 157.64 1,960,07 502.54 138.79 $15,385,04 Amount Paid $15,385.04 $15,385.04 elly ofSprmglleld Commu:}~r.r S'r::~':! OJ'Ii:k,jl 12Hifth Stre., . Springf\eld, OR 91471 Telepllonc: (S4I) 126-37S9 Fox: (S41) 126.3689 Special Inspection And Te.rtIng To applicants ofprojecl' requiring speeilil insPecllon or ICSIing as per Section 1101.S of the Oregon Srmetora/ Specialty Code. Please revicw.1h. information below. When JIOII have finished. acknowledge en wer.anding oflhe infonnot[Oll by signing below, BOd rOlllm Ihio form 10 the City. . BEFORE ^ PERMIT CAN BE ISSUED: Th. ~aer oro..-'s rcprcsc.tolive. on 1110 advk:o oflho '..pocalble l'rOjCCl Engineer or Ardoirecr. shall complol., sign. end submit . to IlIe City filr review .nd approval Ibis form .0mplOllld Otl both Ik fiont lad back. Th. Owner ..d G.....I COlllraelor. whe", ......iJ:able, .'baIl also acknowledge !he following .ondltions applicable tAl Speelallmpectian anellor Tuting, _c~ ~A-oI~94- BuildiD& Pennlt II '3>hSIDS " Date eo ~ '- '" J> . .... ..:> eo \SI U1 t7t.rrc:::.t< f;r~ Q;:e.~~~ :Jrojcct T;l~ ~ MAIN ~T ='ff?L~t:{e(.. (7 .'~ Project A~ ~ U1 J> '" ~ '" . en '" .~ I. C.alraclor j, ",p..llb.. for proper Baeiflealion for Ibc lupcctlon or T..aing of Items listed. 2. T..Uag laboralal")' shallLtlkc IlppItlpNle umpl.. and nnsport lhem to their IlIbonlory /Or proper avAllslII!lllI or leltiag. . Cop;:' .rall Jabollllocy nlJIOIU lIlId ilUpecliono are 10 be senl 10 die Cil)' by !he Te.ling AgeJlCy. J. Spedal [.Ipe.lion Afenq is 10 .nbmi. ....... ond quslilicatioos of on.,ice Special I...._h' , 10 !he City for "pproval. o H :< 4. SpccJallospecllr shall provida inspection tqlOIIs to Ihc building official of.1i " ".', ..:.... letiviri... 'il '" S. Conll1lotor '" R:3ponsible to review !he City llppl'l>vedplons for addilional iuspoctloa or lesllog relJuinlDlelll! that may b< nOled, ;S H BEFORE A CERTIFICATE OF OCCUPANCY WILL BE ISSUED: Tho SpeciallDspection Agency m.n submIt to the1luIlding Official II SIaIemenc !bat III Items reqt.iring ~ iospeclion b.... be.. fulmled and reported and wen: 10 rho bestoftbe Impecror'J knowllldge. in conComance witb the approved pIatu, speciflCatillf15 ood applicable worbnamhip. ~ provisions. Those items nolle51ed and/or inspected shaD b< IIlIICd I:, dlc sbCelllellt. The reporl is 10 b< !Ilbmincd to the City prior 10 a request for r",a! inspections. 0 ACKNOWLEDGMENTS I AMI~o6 ~L..~. owner~all1e{Pril1led) Sfgoa~ ~ ~C.() ~(eri~ A~, /"1,~j .~ JAMe:r ~1~~r4 Cw'I. Engineer or Architect Finn (?ri..ed). .algi~~rdutecl Signlllure Speelal JaspCclion. ,~...,; w..... ~lcdJ Special ~. A......v Reo Sign. -- ~~ -., <:"' ~ ---...,,/ <:...1 .. _ ,,\.. l\t. u \ ," ' _ .(, -.: '--""" . 8llild!ng Official NaIr.e (Priot.d) Huilding Officisl SignilCUIc T"'lin; Loboratory Nll"'" (Printed) f04~IlDflUe.,..'8 Ocn. ConlJKUlr Firm Nlm. (Prinled) General CDI\InlOlor Signalure . '0 1> Gl 1'1 c;J ao TCSling LaboraIDl] Rl:p Slgnl"!,e .feE //1)<. Reinforced Conerete, Ganite1 Gro... aDd Marlar: ~I-OwIjt. r;~ Mort.r Precasl/Pr........ed Contre/e: ~ r"".:Il:nL1 Pro-Ten< n-Min2 l I l I I I I SPECIAL INSPECTION AND TESTING SCHEDULE A..~reeate T.e.U" or Mil' DMfvn Rl!IjAftvcino Te~t . MIx D..illJl-Wel"'.....tr r~.., Qeinfnc:iD, ~eI1' Conlinumt< Rafch P1a.t lnlJ' ."meet Plll~ Cast Sanlp'" 'lampl.. f1'tdruplTleliveterl\ Compr~s!ifo" T~. _~ ~""'epafe T~t\!' Re.inforcinr Tes~ ToP-AdM T~ Mix Des'ar.. Reinfon:inor r..... _ ~ Intert PlaumeJlt ConCl1!:~ RII,cllr",1II' Cl\IICrde PJacemer It rn5lallatEon Jn~nec!loo r'.ast .the .,:, """'.'IP ~pIoo< ComIllUlio. T~ SMOKE CONTROL: I..eaka&e resting Conlrol verifica\Rm ROOIllNG .Inslllarion ilUla'lllli<lIl/R~vaI",,'. TuI slrips/serono FIREPROOFING: Plaeemenl inspection Density Tosto Thickne!s _. llUpccl bah:~ing ADDITIONAL INSTRUCflONS, VUU!.A TEST, & INSPECTIONS: "GAADlNG.,EXCAVATION, AND FILL Aeceplln<:e ll:sIs . PSI' I!5IlIbIbb Iillll grade . Fill placemenl ill!peellORleontinttous SoH Density STRUCTURAL Sn:XlJWELOING: SImple llDdleSl Olsr opecifle IIleIIlbm below) SIlop mlllerial identiflCotioo (mill oen) Weld in.pectioo -X Shop _ Field lJIlr."'nie in'peelion Shop Field High J1m.g1h baking Shop _ Field A125 N X F A49D N X F Mc:lDl deck weldi.g inspecIioo Reinforein!: Steel welding inspection Reinforcing oleel mill certifICate Mellll !IUd welding illapcelion Concn:te insen welding Inspeclion MOIIICIlI ~ilIg !tccll'rame.'l ]{ STRUCTURAL WOOD: SbClr wall oaiUa& insPecriD' Shear WlIIIIlChon 1n'Jll!Cllo1l of GIll-lam fol>, . . IlUpeclro.. of 1nlS! jabl tab, Sample and leu compon..... Fabrieot ion welding of steel acccssorin TIC psi MASONRY: _. SpecIal inspc:clian slr.....,. ased' fm _fg Preliminl'Y accepltlnCc 'es15 (m""",'Y lDlirs. wall prism.) Subsequeflllesls (mortar. groul, Iield waU prisms) Pla,e.w,n' inipeelion ofun~.. .nd reiafbn:cmcnl MaonarY. mortm-. groal.1Jld ...infolting lice! tertirll:afe' Farm eomp~I.4A.t.~;, fJsJe~~ · PROVIDE STRENGTH REQUIRED BY ARCHITECf OR ENGINEER OR ~u.. ..,ACf DOCUMENT LOCATION OF VALUES OJ ... , OJ A .... '" (Sl (Sl U1 ... U1 J> uJ .... '" m w .~ (') H :;J 0 "1 Ul ;!l H Z . lf1 H f!! '" " l> Gl '" co .... .....:'~~.~~ --.... _.~.- 11 ., j. .I . .... "l1'li)_. ......~A.-~ ..., ,'....... - --"..........-IlIr_.,., '" "", -......-....WI. " , ,,'....- - ..................._-....~ " ,.....~...- ' \ ~ '.... "', " 1oA4loa.......Aoio.",,- 1........ -4:1611 ,'~... ...... na"""'lIe , " "...._. .-..........-..._.~ '", _,.,.. ., .--" ...--...........,....""'-- .. ~-.._....~...,... ""'_1." ',"._.-......... . ""'''' "", ' ".""-.... -blrIt..TilI!of~ >. 3 "....' ......--..._ :,., '-'-0-.._, '" , 1. .. --, " , '-........-...1. . , '" "." J. ~, '_"'<!I ,,' .....-............, "-GIoIJUJ......o.L .- .o...~_..,-:;:crMtL::-~........bo_":"'_-::::~___iloaoIl. _ " ...,............ ... .' ' , , . " ..., ," ......",.. 'tI ......... I .............~~ ---" ...., "", ,"...-r."__n.._,_ "~"""""'I!"O"_y_. ro <<> -~ ro <<> '" ... 0 '" 0 NI:"..:< '" tfj n.~ ll. ~j Ii .. ~y ... Ie" I . IB I Rl D ;: .. -S Ul ... I- L. I.! .. . '" ~ 0 If '" ~!f , w CD 00: 'I' -' ~~ ~ '" :::J .!.~ ~ 0 . '" ilt '? 1 ... u ri 2 U d ~ "" z: It c.. w " ~ .., ~ W" " ,. ~. u N" ~ I!' ",'" -, ~ ;;; N.., .... ~ ".. l!! w "'- " ....... " ".. :J: ~ f. "'.. ~ .. ~ '" 0: F ~ ~ N '" l~~ UJ ... N riG; :J: ;;; .. l- n ~ ....0 ;'-. .., ~ "'e> <<>0 " <<>.. N... ~ ....... We> .,.... ... ,.. roO <<> .. , -........ I' &1- ~.I., _.a_.I ;;;:";',B~ ~ f-oa... It'flNmKV .~."'~ E_.__~ ~....... .... ............~ ---.. ~~~. .- ~:oDI",," ~ ~ ~':~>~t~ ........ .......1<< ~ , -- ~~-1~ ~ - , - .. . . t .. .1 // /~ ~ J ~ . -.--- . u - :;: iI _.-... i.~llI\.d_ !l :1 .. >> .~ r; . _ ATrACHMENTA . CITY QWlJNGFIELD SYSTEMS DEVELOPMENT CHARGE KSHEET JOURNAL OR JOB NUMBER: C0M2004-0 1594 NAME OR COMPANY: AMIGOS III Coffee Stand LOCATION: 5850 Main SI MAP & TAX LOT NUMBER: 17 02 34 32 00300 & 00400 DEVELOPMENT TYPE: Coffee Stand NEW DEVELOPED AREA (S,F,): 371.4 EXISTING DEVELOPED AREA (S,F,): TOTAL IMPERVIOUS SURFACE (S.F,): , ' , I COFFEE STAND SFR 6,323 ITE: lTE: LO:r SIZE (S.F,): llTORM ORArNACTF IMPERVIOUS SQ, IT, 6323 $ 0.310 PER SF TOTAL STORM D~AGE SIX:' x :1...&\NITARY S'iWER-CITY A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) 8 x $ 24,04 PER DFU . x $ 18,28 PER DFU 8 ~ TOTAL LOCAL WASTEWATER SOC'I $ lJD&ANSPORTA~ BLOG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 0.377 x 496,12 x $ 18.30 PER TRIP , x B, IMPROVEMENT COST: 0,377 x 496.12 x $ 80.72 PER TRIP x EXISTING A. REIMBURSEMENT COST: -1.000 x 9.57 x $ 18,30 PER TRIP x B. IMPROVEMENT COST: -1.000 x 9.57 x $ 80.72 PER TRIP x 0.5 NTF 1$ 0,5 NTF 1$ NTF 1$ NTF'I $ 934 210 14,016 338,57 ~ $ 1,713.041 7,557,08 I (175.11)1 (772.52) I TOTAL TRANSPORTATION REIMBURSEMENT SIX:I $ TOTAL TRANSPORTATION IMPROVEMENT SIX: $ TRANSPORTATION soq $ 8,322.49 ~ $ ,'""1' " ou""'" . . " . ... , B'..,t' .E'iic 0,0 ~ $1,960,07 1070 J ; <~. $192.35 11191 . .; :Zl ,,~ . 0 '"u ~.. '.-' l<: ~-~:.-' $146,22 'lli92,' 338,57 "!", ct. p"' 1,537,93 1093; 6,784,56 "i094 8 ,322.49 ',- (865.31)1 $ TOTAL MWMC REIMBURSEMENT FEE: $ TOTAL MWMC IMPROVEMENT FEE: $ MWMC ADMINISTRATIVE FEE: $ TOTAL MWMC SOC:' $ 2,205.56 , $ SUBTOTAL (ADD ITEMS 1,2,3, & 4) '$ 12,826.69 ~ 4 SANITARY SEWER _ MWMr. NEW: A, REIMBURSEMENT COST: NUMBER OF FEU's 0.377 B. IMPROVEMENT COST: NUMBER OF FEU's 0,377 x $856,69 PER FEU x $7,471.08 PER FEU EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's -1.000 B. IMPROVEMENT COST: NUMBER OF FEU's -1.000 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $82,03 PER FEU x x $865.31 PER FEU 5 ADMINISTRA T'W FEES. BASE CHARGE (SUBTOTAL ABOVE) $ 1$ 323,31 I 1$ 2,819,59 I 1$ (82,03)1 1$ 241.28 1,954.28 10.00 2,205.56 12,826.69 x 5% $ 641.33 TOTAL TRANSPORTATION ADM.INISTRATION FEE:1 $ TOTAL SEWER ADMINISTRATION FEE: $ steveI'\. w, 'E-eau~rrl 'E-arl'l-eS 6/612005 c'ffi\i2hblQl\~1;l;Wl-Bros #3, 5850 Main SUds DATE TOTAL SOC CHARGES ,~; -'-": - , ~054 1054 " ;1055 1056 502,54 1078' 138,791079 f$ 13,468.03 ~ 1 JULY 2004 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXl1JRES x UNIT EQUIVALENT'" DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FDmJRES) AMIGOS III ColTee Stand FIXTURE TYPE BA TIlTUB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASFJOIUSOLIDSIETC, INTERCEPTORS FOR SAND/AUTO WASHlETC LAUNDRY TUB CLOTHES W ASHERlMOP SINK CLOTIlES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRlGERATORlWATER STATIONIETC, RECEPTOR FOR COMMERCIAL SINK! D1SHWASHERlETC, SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIOOUBLE LAVATORY SINK: SINGLE LAVATORYIRESIDENTIAL BAR URINAL, STALUWALL TOILET, PUBLIC INSTALLATION TOILET, PRJV ATE INST ALLA TION MISCELLANEOUS: NUMBER OF EDU'S. . . . \ FIXTURES NEW OLD I UNIT EQUIVALENT 3 I 3 3 6 2 3 6 12 I 3 2 2 3 2 2 I 5 6 3 o 3 o I o o 2 o I TOTAL DRAINAGE FIXTURE UNITS= .EDU (Equivalent Dwelling Unit) is 8 disc~ equivalent to a single family dwelling (20 DFU) set at 167 ~Ions per day DRAINAGE FIXTURE UNITS -3 o 9 o o o 3 o o I -3 o o o o o I o o o 8 o o 8 CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENfS OCCURRED AITER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARA TEL Y YEAR ANNEXED RATE PER $1,000 ASSESSED VALUE $5.29 $5,19 $5,12 $4,98 $4,80 $4,63 $4.40 $4.07 $3.67 $3.22 $2,73 $2.25 $1,80 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AITER ANNEXATION DATE) COM2004.01594, Dutch Bros #3,5850 Main 5t.xls YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998-.. 1999' , 2006 '."" 2001 2002 2003 2004 RATE PER $1,000 ASSESSED V AWE $1,59 $1.45 $1,25 $1,09 $0,92 $0,72 $0.48 $0.28 $0.09 " $0.05 $0,00 $0,00 $0,00 x x CREDIT TOTAL so,oo so.oo so.oo 1 JULY 2004