HomeMy WebLinkAboutPermit Building 2009-7-30
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-0I095
ISSUED: 07/3012009
APPLIED: 07/29/2009
EXPIRES: 01/30/2010
VALUE: $ 179,755.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Li~e
SITE ADDRESS: 1216S 41ST ST
ASSESSOR'S PARCEL NO.: ]802064112400
Springtield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: New Single Family Dwelling SAME AS 1215 S 40TH PL
, I
Residential
Owner: BRUCE WIECHERT CUSTOM HOMES INC
Address: 3073 SKYVIEW LN
EUGENE OR,'97405
J CONTRACTORINFO~ATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor License
BRUCE WIECHERT CUSTOM HOMES INC 101717
L & E ELECTRIC INC 105475
COMFORT FLOW HEATING CO. 460 '
STEVE!'it~:J~mN~,o~reqon law requires YOU.~~065
foi:ow rule!. biiiiLDiNG'IN'FORMA:T'j0Nll
Notification ,--, " .,
, OAR 852-001-0010through OAR 952-001:
In 1 b# of Stoc1ies:of the rules by ,I
0090 You may 0 lall.l "-'VI-' ;,"" ,.
caTh-3 the centefIe\g~Jtl!1 i;l,ttUM'JJi~ho~e .17.00
nuruJer for the o1fygSI~tl(l~earNotIM,orcell AIr Gas
, VB Center is "'1Jte.r-J:y,pll:344). Gas
Range Type: Gas
Energy Path:
Sprinkled Building:
Expiration Date
09/16/20 I 0
03/30/2010
06/27/2011
03/12/2010
Phone
541-686.9458
541-933-2653
541-726-0100
541-342-3765
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type '
Secondary Construction Type:
# of Bedrooms:
3
Lot Size:
Sq Ft 1st Floor: 1,685
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport 440
Sq Ft Other:
Occupant Load:
No
J DEVELOPMENT INFORMATION'
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
18.00
5.00
10.00
19.79
0.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
REQUIRED PARKING
2
Street Improvements:
Storm Sewer Available:
Special Instruction:
3
Yes
37.20
_ ,,. "T~I=' \NO?'\<.
I PUBL~ l.IlWifR~f.Mt;~~'1 ty,.I'\l\~E~WlI\ \S NV 1
. 1\.('\;:' r '-' I' \lNUd, 1\-IIS ~nMO~
Fullv Improved h\l1\-\ORIltO OR IS h'O~ p .
No }!A\IJ\tNCtO 100. Downspouts/Drains:
Driveway approach approv~~ '\~ Wjl.)li:P.k~A conditions
Total:
Handicapped:
Compact:
Curbside 7'
Curb and Gutter
Notes: Storm water to curb via weep hole.
Page I of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Constroction
Caraee/Misc
SFlDuplex
U VB Utilitv
R-3 VB 1&2 Familv
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
2 Baths One or Two Family
Addressing Assignment
Appliance Vent
Building Permit
Credit- SDC Storm Improv
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Fireplace (Listed)
Cas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As
PW Disc - 2nd Permit
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
SDC Tran Reimburs-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 Amount Paid
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$37.72
$96.83
Square Footage
or Bid Amount
440.00
1,685.00
Total Value of Project
FpP~, ~
Amount Paid
$216.88
$108.22
$79.00
$337.00
$38.00
$9.00
$1,034.35
$-1,215.08
$88.00
$9.00
$13.00
$106.25
$20.00
$7.00
$211.00
$250.00
$-30.00
$134.00
$75.00
$507.07
$666.84
$10.00
$1,146.50
$101.97
$90.58
$211.21
$931.65
$88.18
$88.00
$1,215.08
$63.00
$27.00
$2,858.00
$9,495.70
Date Paid
7/30/09
7/30/09
7/30109
7/30/09
7/30109
7/30/09
7/30109
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
7/30/09
Paee 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01095
ISSUED: 07/30/2009
APPLIED: 07/29/2009 '
EXPIRES: 01/30/2010
VALUE: $ 179,755.00
Value
Date Calculated
$16,596.80
$163,158.55
$179,755.35
07/29/2009
07/29/2009
Receipt Number
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
1200900000000000855
Status
Issued
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
Plaonine: Review
I Plan Reviews, I
07/29/2009 APP
07/29/2009
Pnblic Works Review
07/29/2009
07/29/2009 APP
Structural Review
07/29/2009
07/2912009 APP
CITY OF SPRINGl']~LD
Building/Combination Permit
PERMIT NO: COM2009-01095
ISSUED: 07/30/2009
APPLIED: 07/29/2009
EXPIRES: 01130/2010
VALUE: $ ]79,755.00
DDK
Required street trees as shown on
street tree plan attached to permit:
Species as shown. 2" caliper, leave
name tag on until approved.
Structure meets minimum setbacks.
l\1inimum setback letter attached.
Storm water to cnrb via weep hole/
Driveway approach approved
thronght Variance A conditions.
As noted on plans / reveiw letter
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.
~irprlln~,np('tiwi.l
Erosion/Grading Inspection: Prior to gronnd distnrbance and after erosion measnres are installed.
Vfer Electrical Gronnd:, 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 floor insnlation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Walllnsulation: 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 Fonndation Drains: After gravel and filter cloth is installed but prior to backfill.
Vnderfloor Plnmbing: Prior to insulation or decking.
Vnderfloor Drain: Prior to cover or place~ent of concrete.
Rongh Plnmbing: prior to cover and including required testing.
Paee 3 of 4
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~ '''WP'J''''''''''''\0!'''i0''''~'''i''*it"'>!<,;iT':l",:;,',
1\,:. "', .'
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-01095
ISSUED: 07/30/2009
APPLIED: 07/29/2009
EXPIRES: 01/30/2010
VALUE: $ 179,755.00
225 Fifth Street, Springfield, OR
541- 726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Water Line: Prior t~ 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.
Undertloor Mechanical. Prior to insulation or decking and including required testing.
Underslab Mechanical. Prior to insulation or decking and including required testing.
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 minimom of one appliance including reqnired
testing. Presnre test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When allgas work is complete.
Final 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 ntility company energizing service.
Final Electric: When all electrical work is complete.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Cnrbcut - Standard: After forms are erected hut prior to placement of concrete.
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 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 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 card is located at the fr~ property, and the approved set of plans will remain on the site at all
timeSduringconC:030~ . - '~()/()l
, I
Owner or Contractors Signature Date
Paee 4 of4
_,RINOP'....D ~," Z ON \ ~
; A. ____ . INITIALS ~~ _
~... 'DATE . ~. ~\.. D"'\
~ ~ SOURCE ~~
225 FIITH STREET. SPRINGFIELD. OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPUCA TION
City Job Number !!9- Ie) 95
. -- - . - . ; - . -. '. "1f',"- _. '", -, .- --....... '.: - ~..- -. "
I. ;LQCA1JONOFlN!~TAI,!4nmv::,:' 3.
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LEGAL DESCRIPTION:
/ffDZ 0 bY ( olZl.{o'O
JOB DESCRIPTION:
J!Ou-"::>(c {v,/Lv I (~~
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
~"'''''''-- ,>:' _ .,'r--:;J'.J:;.:"~"'-""""'''''-';;''.''"';;:<-'''.~ ':V".',\>:'";-'..'
2 "Co~cti:JR,[N.:rr-:1i,LA.1joiy~gN!:i'f;
. _.~~_ -. - _.>..J< ..'.r-, ".., ..:;........ "_'_ol-~:" ___-'ri .__ . '.
Electrical Contractor L +- c
Address q Z. -g s '3
Acy-~s
--S ,....--e r
City S.o (C \ ~
Phone5lJ> '1196
Supervisor License Number
'-f17'i-S-
/2/;0/11
Expiration Date
::+ro
Conslr. Conlr, Number
I b S- '--/7 5-
3)10
Expiration Date
Signature of Supervising Electrician
Fcl)~.OwL
Owners Name ~y lice WI "c.ked
Address ~IO 73 Sic,", .:(1,-'>
,
Cusic!'" Ilo >'" s
Phone
lyJ
1:,"3(,-94)3
City f. liS:''''''
OWNER INSTALLATION
The installation is being made on property I own which
. is not intended for sale, lease or rent.
Owners Signature:
. ;(
InspeetlOn Request: 726-3769 ~ 'b ~ '-.;
...
7/;'0//67
Date
i:X!~~LlfIj>flil!,~~!!.~P.ULE~Eip,lf'-
'...... ......
<'., "'>:',,'"
~;:;,'~'.--, ~".-:-;;:-.,,,:.- J, --7. ~ -;".... '-;'-.-'- =;-'~':,-\C;<--.~
A. .!'If,...Res!d~n,liar-:;'~ili.gleor; [\'lti,lli-Familr p~r,dwe~I,in~ "n!~'" '.:1
Service Included
1000 sq. ft, or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
( j!XOo 13 cf
3 $)'00 7::)'
$57.00
l::-='~';;--""'-'~~:-:~~._"'1.-~:--""\'::-'-'-~'-::.?'''''_-_~'"'<,:, ,_ :-:"'"..-- '':;,',''1
B. .~~~<2~ ~:~,F~~e~~__~;I,~~a!~~a~~~~_~~ AIt.er:at_isrs'or Relo~~l.ti~![:...;.~~
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 73.00
$ 86.00
$143.00
$186.00
$426.00
$ 57.00
. c. ; '~fe:I~'p~r~~ry:~~r~fc~~sri{Fe~d~}~. "\~:
. ", ~",. ," -,
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
100
$ 79,00
$114.00
1,3
Over 600 Amps or 1000 Volts see "B;' above,
D. t'-, 8'r~~~:~ '.~i~~l~!is<~~~lf'" !".~ ": ',- ,,;?-.,~~,~ ~ ~-':,:~ ,~,;::~;; . . '~:":"
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
~.,~. <~.) - :i
. .
$ 50.00
$ 5.00
E.
t "":::".,.,-'; ':_"'-~' :,'''""".,' ~ ,~,... ~";,- .., ,", " :.,:. ';. '. :~-:.,' I
MisS.,ell~.ne~njs (~en'_icel(eed~r,not iriclud.e'dh..:E~~h Ins!all~~to~ .
. '. . ,. ..'
Pump or irrigation $ 57.00
Sign/Outline Lighting $ 57.00
Limited Energy/Residential $ 29.00
Limited Energy/Commercial <C~ 52.00
Minimum Electric Permit ~nspection Fee is ~oo + Surcharges
4. ' SUB1"oi"A-";oh~oVE ::' -,-' 'i Z 7 2-
'? 2-b'{
12% State Surcharge
] 0% Administrative Fee
5% Technology Fee
/ ) to-.
-:?I% ~-
TOTAL
Shared Drive(T:)lBuilding Forms/Electrical Permit Application 7-08.doc
Willamalane
Park & Recreation District
Job. No. t:!9-/~1)
, SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
NAME: BWC-H.
pHONE: G't!k; -n.5-o
STATE~ZIP:"? 7as-
ADDRESS::JdI3 S~ IIIIf!!:...J CITY &::uG.
LOCATION OF PROPOSED BUILDING SITE:
Street Address: I :J. I , S. 4.f IJ r
PlatName: Tax Lot Number:
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 =
$ ;2..8S' 0-
B. Sinale-Familv Attached
NO. OF UNITS
X $3,100 per unit = .
I
$
C. Multi-Familv Aoartment
NO. OF UNITS
X $2,641 per unit =
$
D. Sin ale Raom Occuoancv
NO. OF UNITS
X $1,321 per unit =
$
, E. p..ccessorv Dwellina Unit
NO. OF UNITS
,X $1,550 per unit =
"$
$ '2. 6 S8?O
J!f
$
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SDC payer must furnish proof of
Willainalane Credit approval.)
3. TOTAL WILLAMALANE, NET SDC ASSESSED
(if SDC reduced for Credit)
$ _.:2FS;-~
? I 2'7 I oS
Date
~'/~
Development SerVices Department
CitY of Springfield
5
225 Fifth Street. Springfield. OR 97477. PH(54 1)726-3753 . FAX(54 1)726-3689
. 2..J) S YOt-t..(J1 ,
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I~ . .oEP,l\Bl~~!;tI",\,t~~!.9~.SX~~:
8PQINC"'8LD ':::J
~~ Pennit no:cY'1-1 07s
IP "A I" . So...~ Co\.)
Structura ermlt pp lcatIoD-_
Date: 71..27/0,/
This permit is issued under OAR 918-460~0030. Permits expire if work is not started within 180 days at issu~nce or if work is
suspended for 180 days.
Ii!WA"";::~""~EoCA['4G0i1ERNMENT,""AeF1ROvAi'cl~~~!.tiir;1
~.~~___,-_t(.;_.._._^~..,,__._~~.'ii!...___.,.-....,_ ~ _,-,-'\. _ .,.."<.~I>._"r.
I This project has final land-use approval. I
Signature: ' Date:
I This project has DEQ approval, I
SIgnature: - Date: (a) Job description:
I Zoning approval verified: D Yes D No I I Occupancy
I Property is within flood plain: DYes D No I I, Construction type:
",f"';\\j;"'i:li:f.,~;r~rCA'~T"-E~G~O-'R''''~'OF.:'?'C~O-N''S'''-R''UC:\"iONi,'!lJbt\i',; .",:':ct,'1 I
!;~<!':::'i~....".~ .~"'?.'..~},._.,_.~___..__<, ~.!tl",""_,l,\h".,,,,.._~..ir,...._,--. ..."'-_ .:-~~:;'~o,_-,'i"",_,;, ,', ':'c_::;, Square feet:
l&ii~~~~~t~TJ~~0~~it@]~;O:N[Jt~~4TI;~i~~%~~~ i ~::~:f:::t~::ot:
I Job site address:, I 'z.) b ,5 L{ (~+- I I Type oCHeat:
I City:<;o'~;"'lL<--I'\ 1 State:OiL I ZIP: 9717l' I I Energy Path:
I Subdivision:F; ,hd't, I""",,l-U\J'~ I Lot no.: "J=)' 3 I I D D .
I I I new alteratIOn
I;;;:;~;~~~~~~"__f~';;'~*~:';;":&""'~""""'c""'"",,.~"'c"'"~~~"1.~.~:..""""."p'<:'. :;(,,-\'!,;,":"'-;fr:'.'~ ',~!,.. . I (b) Foundation-only pennit? D No
~,4,4$"~l';11!.?.if~~T.:~~t:P.B9_e~BtE{(~9.WNg~~";':-~:2,r,::,,~".:~):~i:y,,~I'l;:-.,. I Total valuation: I s
tl Name: fl>'2i" l/ C (" tv '-'" C.hii ~.t C v SKlW'- ~ (\o\.a~ :tN c.. 1:',2: BIlndirrg~:~'re-est;;<~i;t~~?q~i~t-.,:'~;';;;' .:: < ; 'f_: !:-';,~{r,~,;;\l,?;",:,~tr,-~,~,>",;_.:_t,~:;,:._,'~,~~,.,'\
~'''',,-,:t,'~;,:'!:1
Address,~071 s~".\<::w L-N ,,,. ,...-..-,.-." '" -." ,
lei I '" 7 - I (a) Permit fee (use valuation table), $
City: < "'1e,,-,,- StateO I- ZIP:, Y 0'5 . ,
" v , b v ,tY 7'7b' I (b) InveStlgatlve fee (equal to [2a]): $
Phone: -.1-1'1So Fax: -J -:;/0<-' I"
(c) RemspectlOn ($ per hour):'
I E-mail:W;(c,\-,."r \-..O~S QCD;OL"~\" Ne.'" (number of hours x fee per hour)
This installatlb' on isfbeing mad de, on ~esidlentialdo: farm proPfrerty'lowned by I (d) Enter 12% surcharge (,12 x [2a+ 2b+ 2c]):
me or a mem er 0 my ImIDe I~te LamI y, an IS exempt om lcensmg
requirements under ORS 701.0 I O. l:r3(~1'p'~I.~<~~~~=~:~~~fi~~:,~~:r:~~;t~,~;~~;;~:!~;~,:,.j~~~Jl;'7~~;~;@~'~^~;~"\~E~~';:
~)'f\;_ ,~ag:Jr~~!~lY?~ ~.~~~~f~,!l'1f,\;~i!.,t;:t';il~,;~71,;tff..;~f};,f~J~A:W~,:~?;~[i~.;,.,~t
Sign here:
~~~-f~~9.Q~IM9IQ1iiiNsJAi:~ffQNl;!~~~1!iW,{J:;,~3{ii~lil I (a) Plan review (65% x permit fee [2a]):
I I (b) Fire and life safety (40% x permit fee [2a]):
Business name: '\b'(vtC. lJ;e(.,~t'..J''( Cu....bt- ~y\..Q.\ J"owG I
I I I (c) Subtotal of f.e, above (3a and 3b): , $
Address,'3073 <;iL1V;e..v 1-",-
I':'~. '_Mi~~~.fi:$!r~.~~#,sJ~'~~~~~~t\,t.::;;, ';';,'.:-: ~~{ ~;~': ,:,;_'_;A~'~l~_~~~,~F~J~~~~\~~~_::~),
I City: {:"~ e,~ I'State:o'.1: I Z'::'17)"'1
I Phone: -M & cl ~I s y I Fax: :s'tlf" ::, 3 b l (a) Seismicfee, 1% (.01 x permit fee [2a]): $
I E-mail: W; <::61...... \ Jr..o I'>-L S @ (.0'''' u..s4 ~ 1N6' I TOTAL fee, and ."rcharge, (2e+3c+4a): S
ICCBlicenseno,: /011(7 I
I Printn~e:~eoJ...~,;Ac Wt'.~'ro'J"v" I
I Signature: W W __________.' I
{~d%S~~~\4_i1!~fr~,[@f~qH~p;lt~~:~:~~~*~~t;r~~~~\1
.{i~;,~~t~;;r@1t)J!f!Q!m~ljQp.l};~]]~~;~;G~~~%~~1~m~_J~)~4
D addition
DYes
$
$
$
$
1'~"1\;;"-""'>'J'-~lUB'" 0NTR"A' --:-'TN---RMAti0N""'""""~"""" I
~~.^"..Y.Ji~11f..;?,~~;~~_"._,. _,,7,9..~_-, ..,_,..,....'-gJ":,QR.t<__Jf5~L_____\;~L,:__ .~a~~w~.'t~~,',\~\ I,}
I Name CCB License Number Phone Number I
IEleclricall-+-C /05'17.< 5/-1'11-;& I
I Plombing51L;,<i Plc~l,'.,< b5065" :; ~l-3'(" I
I Mechanical(fH "~br) 72.(,--0}0" J
~<y ~l\
225 Fifth Stroeet
Springfi'eld, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0] 095
COM2009-0 I 095
COM2009-01095
COM2009-0] 095
COM2009-01095
COM2009-0 I 095
COM2009-0 1 095
COM2009-0 I 095
COM2009-0] 095
COM2009-0 I 095
COM2009-0 1095
COM2009-0 I 095
COM2009-0 1 095
COM2009-01095
COM2009-0] 095
COM2009-0 I 095
COM2009-0] 095
COM2009-0 I 095
COM2009-0 I 095
COM2009-0 I 095
COM2009-0 1 095
COM2009-0 I 095
COM2009-0] 095
COM2009-0 I 095
COM2009-0 I 095
COM2009-0 I 095
COM2009-0 1 095
COM2009-0 I 095
COM2009-0 I 095
COM2009-0] 095
COM2009-0 I 095
COM2009-0] 095
COM2009-0]095
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
ii~'
" ,~
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000855
Date: 07/30/2009
Description
Building Pennit
Addressing Assignment
Willamalane Single Family
2 Baths One or Two Family
1 st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets]-4
Fireplace (Listed)
Residence Wiring] 000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Fire SF Fee 0 Residential
Plan Review Major - Planning
PW Disc - 2nd Pennit
Curbcut Pemlit
Sidewalk Pennit
Stonn Drainage Imperv~ous Area
Credit- SDC Storm Improv
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Trim Reimburs-Residential
SDC Tr~ns Improvement-Resident
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sariitary/Stonn Admin
SDC Transportation Admin
+ 5% Technology Fee
+ 12% State Surcharge
Plan Review Same As
Paid By
BWCH
Item Total: '
Check Number Authorization
Received By Batch Number Number How Received
djb 00590c In Person
Payment Total:
Page I of I
2:10:39PM
Amount Due
1,034,35
38.00
2,858,00
337,00
79,00
27,00
9,00
13,00
9,00
7.00
20,00
134,00
75,00
63,00
106,25
211.00
(30,00)
88,00
88.00
] ,2]5,08
(1,215,08)
666,84
507,07
211.21
931.65
101.97
1,146.50
10,00
90.58
88,]8
108.22
2]6.88
250.00
$9,495.70
Amount Paid
$9,495,70,
$9,495.70
7/30/2009