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Home My WebLink AboutPermit Building 2006-10-30 . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line * ; ~ .ITY OF ~rKm\JI'IELD' Building/Combination Permit PERMIT NO: COM2006-01182 ' ISSUED: 10/30/2006 APPLIED: 09/12/2006 EXPIRES: 04/30/2007 VALUE: $ 560,651.00 Status Issued SITE ADDRESS: 4223 Main St ASSESSOR'S PARCEL NO.: 1702323201900 Springfield TYPE OF WORK: Grocery Store TYPE OF USE: Remodel Commercial PROJECT DESCRIPTION: Remodel Save-A-Lot Grocery Store Owner: Address: DONALD V PFEIFER TRUST 2011 NE 164TH PLACE PORTLAND OR 97230 IfUTtCE' TH/S P . AUT: fRM/T S _ HO/J'~~. HAl f r}, vVIf1~A1;-f.' :~lJ YNflr,:, -'ll"ltff /r- >- 11>.,., . ,,~()'1l0R'INFOf-Mr:TION: I' HE WObl( -VUAY ,~)fbAN .I"U/T/ f1 Contractor PER/DO. L.PlUsfD ;!#t"/RJation Date WESTERN CONSTRUCTION SERVICES 63717 01122/2008 WESTERN DESIGN GROUP A C & E ELECTRIC CO., 591 MAINES CUSTOM'GONSTRUCTlON INC 7713 .., It-^'..... R A WARNER P~IP.M~ING'O~:,~_<;:. 151329 /Vor 'l~iBUILbING)INFORM~T10N;'1 onOAt1952_ -~:"er. fh ''''e Ore SYOUto 090, You #lJrStorjes: fLose rUtes gOn Utility Lot Size: C m~. ItJ TJ~.... are M al/ing th!:lelght~L~r~ctur$h OAA Set forti, Sq Ft 1st Floor: nUrnber~ Tfpe;\lh":I~~rOPies Of t 952-001 Sq Ft 2nd Floor: IIIB C orWate.!ilype:Ole: the t he rUles b Sq Ft Basement: en'Ra!!.g~ U~, Utltity N e/~Phone J Sq Ft Garage/r;:arport Energy Pathi132'23 otlflcat/n Sq Ft Other: Sprinkled Building' 44). n/a? Occupant Load: Phone Number: 541-683-9001 Contractor Type General Designer Electrical Mechanical Plumbing 07/2112008 09/23/2008 05/03/2008 Phone 360-699-5317 360-699-5317 503-363-2301 54 t -753-4328 360-896-0370 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION' Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Haudicapped: Compact: I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Fully Improved Yes Sidewalk Type: DownspoutslDrains: Curbside 5' Curb and Gutter Notes: Pa~e I of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descrintion Estimate Pavin~ Type of Construction Estimate Use Bid Amount Fee Description Plan Review Comm/lnd/Public Plan Review Fire & Life Safety -Mechanical Issuance Fee- + 100/0 Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Fixture Furnace - Unit Heater Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Miscellaneous Plumbing Paving Plan Review CommllndlPublic Plan Review Fire & Life Safety Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC SanitarylStorm Admin Vent Fan Total Amount Paid Fire Department Review 09/14/2006 Initial Review Plan Review Comments 09/13/2006 . a:ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01182 ISSUED: 10/30/2006 APPLIED: 09/12/2006 EXPIRES: 04/30/2007 VALVE: $ 560,651.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 553,151.00 7,500.00 Value Date Calculated $553,151.00 $7,500.00 $560,651.00 10/03/2006 10/03/2006 Total Value of Project FpP~, ~ Amount Paid $1,107.05 $681.26 $10.00 $293.20 $146.60 $227.21 $2,041.15 $630.00 $12.00 $96.00 $4.00 $6.00 $45.00 $91.80 $234.49 $144.30 $712.44 $937.08 $82.48 $6.00 $7,508.06 Date Paid Receipt Number 1200600000000001405 1200600000000001405 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 2200600000000001519 9/12/06 9/12/06 10130/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/30/06 10/23/2006 I Plan Reviews I OK GRG See attached comments for Fire Department Plans Review comments. 09/13/2006 10/03/2006 APP LLH 10 JMP WE. Received incomplete responses to structural comments from Gary Young. JMP called Gary to discuss items 6 & 7 (special iuspection signatures and contractor data). Pa~e 2 of 4 .ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01182 ISSUED: 10/3012006 APPLIED: 09/1212006 EXPIRES: 04/30/2007 VALUE: $ 560,651.00 . GP..AIHGf!l1lLD . ~1iIir:-, Status Issued 225 Fifth Slreet, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plan Review Comments 10/26/2006 10 JMP Plannin~ Review Public Works Review 09/14/2006 09/14/2006 09/1712006 10/09/2006 APP APP EMM CJS Structural Review 09/13/2006 09/2212006 WE JMP Structural Review 10/27/2006 10/27/2006 APP JMP SUB Review 09/14/2006 09/22/2006 APP DH WE. Called Gary Young. He said that he will talk to Dean Knutesou who will bring in the missing information. He will also respond to the plumbing comments. No change in use. Discussed permit review timing with Karen from Western Design Group; will try to expedite SDC review CJS 10/06/06 Called Karen (Western Design Group) for information ou demo'd drainage fixture units (sinks, toilets, etc.) for SDC credit CJS 10/06/06 Called K'aren (Western Design Group) to confirm that previous use of property was grocery store 10/09/06 CJS Added SDC's 10/09/06 CJS See attached documents for 9 structural comments faxed to Gary Young. Received the missing special inspection form and contrator data. 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. UeouirerUnsnections I SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval aud prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Footing: After trenches are excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Pa~e 3 of 4 . .ITY VI' ~rKIl~GFIELD Building/Combination Permit PERMIT NO: COM2006-01182 ISSUED: 10/30/2006 APPLIED: 09/1212006 EXPIRES: 04/30/2007 VALUE: $ 560,651.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have beeu requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical 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 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 hcrein, 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 , I street, that the permit ard is located at the front'of the property, and the approved set of plans will remain on the site at all times dU[)lru ion. / ! / ~ d I rJ ~ OwnerUnYra/tors Signature Date Pa~e 4 of 4 SPRilNGFft!!:Lll> ,',;':~ 0:',;' '<",,> ~ . .~J~~~.::~~ ;" ~~ l~~ii~:"".'~;,i City ofSpingfield CoIIDllUDify Serti<:llS Division 2ZS Piflb Street Spribgfillld, 0.ll974 n Te1Qpbone: (541) 726-37S9 Fax: (541)726-3689 CoN\. -z.ocb -Ol\e,~ BuiJdingPennlt/l 5!,\\lE..-~-LO't G.~c:E:.~,( .ProjutTllIe 4"Z..'Z...~ ~p..\t-1. S,~~ Proja:t A.ckhess SpecIal 1m, ' .' ; '" IIIId Te8tiIIg to -"Z."'-o~ Dare S"'{oV-E. ... IS) .... -'" <.n .... '" IS) IS) <TO ... <.n ... '" <.n .. ... .... .. <TO .~ T. applU:anta of pn!iools, .." ,:,:, , s speeiaI :-<..~)Q or 1I!atlDs.. per llia:timJ 1'lO4 of tile Ongcm 8ttuctunI Spociallll Codoo. _ nwioowtho infmnolion bel..... When YDlI bim Ihdlhm. adm~~ on .".." ".,,,..:,.,,,oftha'..t:.., ,,,' lion byslplq bdow,lIIll\ n:tunJ lhIaform 10 tho City, DPOKE A 'PEBMrrCAN BE ............., ThD-..rol .11",.. .. _......._.u.IS,<mdlelldviceof theIC:lpOnBiI@Projoct.r:......___ 0, A1dllteet.aIIAllcomJ;tele.~ BIllI aubmit bh City for rev;."" IIIlII opprooallbis ronn completed em both tho fro~,ond bact. n",OWDOroodG......J ConImctor. _. opplieol>le,obolJ oIao ,,~.... ,,: .':"'.I/la Iblloowinaeondilioa~.:.;_J.1o Special L~,._:..., _ Testing. I. C "'.. ......' iJ ....... :..10 for PIO\lCr nati/ioolti"" fortbe '.......,;"" or 1'l:stilla or ltema IiJled. 2, T..ling ~ry shall lab ""..,., ,:. ....,;~ IIlId llanspoll hm ID1hcir laboratory for prc>por evaIontion or lwsting. . c.,p-ofall h1 ...".., reports ondinspeelionsll1'Oto bollDftllOlbeCityby lire TIIIlIi"ll Agency, J. Spcciol r........::- Aganloy islOsubmit_acd q1lIllifi<:oliom MOlHiIo.Sp<ooial fnspeclgu1olllll>CityCor_vaI, 4. Spooilll IJIllpeCtm sbnlI provide impc>ct;on RlpDds to tho building offioial of all ioopactioo 0Clivities. (ll H 5, Contractor ia "",po1lllibl. to _..w Ute Cuy 4J'Pl'M'd pia... fCD' udditiatIaI iJlIpo<:tloo or l.asting <<quir..",mtI tbo1 may be ooled. BJl:fl)KE A CERTIl'ICA'lE OF OCCUPANcY WD.L BIl lSSU.lD: The Special Cmpeolion ~y BiIIlI.l ,"blllit to !he Building Off'IOialulll_ t1mt 011 item. ..,,:, :" " ~""r--':'..InI"" ~ruJfilted IIIldlejlurlldundwen: ll> the batofth..in......:.... :.". , L~"in __"';.._...- with!heoppm~ Jl!llII8, llpt'Cific:llliomaodoppl!cable , ",~,..._,~.ip provisions. Tlu... items not ee.- llI1dIDl inspcoted slraIl be MIt:d iD n., ":".~-" ThllIllpOJt is II> bo submitted lD the City prior In " n>q11<St for finoI ~::_...L A~.....\.o .ILEDGEMKNTS M~ PU~ F='cp-O OwoerNsme (~ .t:.a1ti 'fq~ _ / Arr/ .1hrtn:' . 1ioTgin'et"'or ArcIIii"CI1i~;;'~'S~..yc "fSI. V. I Testing 1.abora~ NIIIDe (Printed) . I.A~""Y ~~~~ Gcn. ~ DID Nam (pm ~ ' r' ,~a;~~~~~,~w~~ , Siiiianrre ~ OIIieial Name . . ~fI~ o..-alCGn\r' ~ ~~. BuiMiiig officiai Sitlnalllle '0 J> fil IS) ... I R;;inror.::eLl Concrele. Gunili.:. Grunt and ~Ior(:lr: j Conerde I Gunite I Groul I MOItar I I I I I I I ~ m J;\ ii'i o ~ = = m , = <D .!, ~ ~ ~ '" II. V J \/ ,j V \/ " ~. o "" , ~ m ~, m ;;: p,.c[nsll['I~,s(rt:sn:d CCllcrc\c: Pilei Post-'lcrn I Pre-Tcr.s I I I I -, o . "" m ~ ~, m ~ n D ~ ~ g Clmlline SMOKIC CON1'R01.: Le~kabe l-:sting Control Veriricatiul1 5 rUtO'?ING: Insulation imlnllaliurllR- \'n\ue~ n_re~il SbJldsc:HIlS ;!. ;~ SPECIAL INS1'~;C'1'lON ANI! TES'ONG SCUEnULE Ag~fegale 'fest of1vlix De.sig.1 l{einfurcill2 Tes: Mix Oesie.n-Wcil!hm(uli:1 Cerl. + Reinl'i.lI'clnl! J'!iuC:lI1eru ConlilH!OU5 IJDh:h "Iant Irsuc:ct. /losle!.;L PladllJ.!: Cui S,U1UJe~ Samples (l'ickur/Deli'ii:fL't1) Conl1rcs~.i(Jr Te3'" GRADING, EXCAVATION. AND FILL Ac~ep;,":i: testS'''' PSI' ESlablish 11nnl grade l;il.llhccll1elll i:1'ipect~fln.icoDliIlUU\lS 50:1 DemilY STRUC11JRAL STl,ELJW~LlltNG: Sllmplc oodlest (list s?l:dlic nmnbers belm") t/ Sh;)!l :nnlerial idenlit'icatiru) :mi\l ce~l) vi' _ \Veltl jn~DectjtlB -.JLJ. ShOll Fidtl ~/ Ut:rasonic impec\ion vr- SllO~) ~Fickl Hi~h 31renglh Bulling_Sbop _Field AJ2j _N ~X AoIJO _}J ~X Metal de::k welding, il1sr~Clbn v/ Rfinbrcillg SHe! \vdLling iUSJltction V Rdnbrcing sleel mill certili;<ll~ M~I[\l stud welding il1'ltJecliun v' CI1f1crele imtn w(lding insI1cclior Mam:nl resisting itecl flumes ;\ ggregat~ T~Slf Re.ntorcirlg Tes!s Tendnn lest Mix. Designs*' R~jn forcin!.!. {JIi1;emeni (n~rt Pla:r.nclll Cnnc.rele BiI:chtllQ Cancrelc rlrccmt:1H lmlallalion Insreclion Cast Snrnule5 Pick-un Smr.oles I CWllllrcsiioll Tcsls I SlllUCTUIlAI. WOOD, SI-.ear \.vall nailing in~pectinn SIIe"ar wall nnc~nr~ Impec!iDIl ofGlu~ll1m rah. "_. .TiC Jlsi ln5peclioll of IJU>!:> ju:SI fab. Sample and te~1 component; rahr~t1tilm welding of:llet:l accessories ) \L ~mEPRlltWING: . . _F _I' PJ"'::mn~l1t inSp~lti(J1I I)en~il>, h:sls Thilknc:ss le.sts _I ns(~cl hnkhing MASOl\'ttV V/. Speclal.nspedor.sIICS~'itlse;l./SOO l"m_~""g V I'f(~limir..uy uccer.la[);:c :esl'i (m,IYJIHY uuits. \Vall prisrm) Snbs~tll.:enlle~ts lUltJl!:U, g-out, fidd \.\"all prisn1~) Plat:\:.tIlo1t inspec.tiol: OfUlltS, und reinf,)rc~ment :V:ilSUnr:', morlm, grHII, und reinfJfcjn~ SIt.Cl n:rtiliCllel ~: ~ ~ -, ,\IJDlTIONAL tNSRIlCTIONS, O'TIIEtt TEST, & Ii"SPECTIONS: F)on Complekcllw G. ~OI)lI.lfr .1'IHlVlIl~; S'II'ENI;T1I HF.QUIRED IIY ARClIITF.cr OR HNGINEEIt Olt co~nHACT DOCUMENT LOCATION 01' VALUES . D>te ql '2.~lo<o . . CITY OF SPRINGFIELD SYSTEMS DEVEWPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER C0M2006-01 t82 NAME OR COMPANY: Save A Lot Grocery Store LOCATION: 4223 Main St. MAP & TAXWTNUMBER: 17023232 01900 DEVEWPMENT TYPE: Grocerv Store Interior Remodel NEW DEVEWPED AREA (S,F,): 15.117,00 EXISTING DEVEWPED AREA (S,F,): 15.117,00 TOTAL IMPERVIOUS SURFACE (S,F,): ITE: ITE: WT SIZE (S,F,): 850 850 1 STORM DRAINAGE IMPERVIOUS SQ, IT, DO new impervious surface - interior remodel only x $ 0.336 PER SF TOTAL STORM DRAINAGE SDC:I '2 SANI1l\R.Y SEWER-CITY (see reverse side) A. REIMBURSEMENT COST: NUMBER OF DFU's 36 B. IMPROVEMENT COST: NUMBER OF DFU"s 36 >. 88 !l ~ '" ~ ~ E 'll,-M ~ Ul IJ = U 0 O::;:l t.L. W 0:: U $0,00 $0,00 1178 x $ 19,79 PER DFU TOTAL ,LOCAL W ASTEW A TER SDC:' , $937,08 1183 , $712,44 1184 $1.649,521 $1.649,52 -- x $ 26,03 PER DFU ~_ TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW: A. REIMBURSEMENT COST: 15,12 x 102,24 B, IMPROVEMENT COST: 15,12 x 102,24 EXISTING: A. REIMBURSEMENT COST: -15,12 x 102,24 B. IMPROVEMENT COST: ,15,12 x 102,24 x $ t9,8t PER TRIP x 0.48 NTF $14.696,44 ~ x $ 87.39 PER TRIP x 0,48 NTF $64.832,00 ~ x NTFI PER TRIP x 0,48 NTF' ($64.832,OO)! TOTAL TRANSPORTATION REIMBURSEMENT SDq TOTAL TRANSPORTATION IMPROVEMENT SDC:! TOTAL TRANSPORTATION SDC:I $ I 0,48 ($14.696,44)~ $ 19,81 PER TRIP x x $ 87.39 - - 4 SANITARY SEWER ~ MWMc; NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 15,12 x $156.37 PER FEU $2.363,85 I B, IMPROVEMENT COST: NUMBER OF FEU's 15,12 x $1,454,83 PER FEU $21.992,67 ~ EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's -15,t2 x $t56.37 PER FEU ($2.363,85)~ B. IMPROVEMENT COST: NUMBER OF FEU's ,15,12 x $1.454,83 PER FEU ($21.992,67)! MWMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: TOTALMWMCSDC:! $ SUBTOTAL (ADD ITEMS 1.2.3. & 4) I I $1.649,521 ~ ADMINISTRATIVE FEES'. BASE CHARGE (SUBTOTAL ABOVE) $ 1.649.52 x 5% , $82,48 TOTAL TRANSPORTATION ADMINISTRATION FEE: $ TOTAL SEWER ADMINISTRATION FEE: $ Carol Stineman Eng, Tech, III 101912006 DATE TOTAL SDC CHARGES $0,00 1173 $0,00 1094 $0,00 $0,00 1054 $0,00 1186 $0,00 1187 $0,00 1189 $0,00 1175 82,48 1190 $1.732,00 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTURES) Grocery Store Interior Remodel FIXTURE TYPE BATHTUB DRINKING FOUNT AlN FLOOR DRAIN, FLOOR SINK (includes bub drains) INTERCEPTORS FOR GREASFJOIUSOLIDSIETC, INfERCEPTORS FOR SANDIAUTO WASHlETC, LAUNDRY TUB CLOTHES W ASHERlMOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERATORIWATER STATIONIETC, RECEPTOR FOR COMMERCIAL SINK! DISHWASHERlETC, SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIOOUBLE LA V A TORY ('see note betow) SINK: SINGLE LA VA TORY /RESIDENTIAL BAR URINAL. STALuWALL TOILET, PUBLIC INSTALLATION TOILET. PRIVATE' INSTALLATION MISCELLANEOUS' .old sink used as condensate drain for refrigeration units FIXTURES NEW OLD I 25 20 I 2 2 2 2 2 I 2 UNIT EQUIVALENT 3 I 3 3 6 2 3 6 12 t 3 2 2 3 2 2 I 5 6 3 DRAINAGE FIXTURE UNITS o I 15 -3 o o 3 o o o o o o 6 o 2 o o t2 o o TOTAL DRAINAGE FIXTURE UNITS ~ , 36 *EDU (EQuivalent Dwelling Unit) is 8 discharge eauivalent to a single familv dwelling (20 DFU) set at 167 nIlons per day CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE. CALCULATE CREDITS SEP ARA TEL Y II , YEAR ANNEXED 1979 or bCfore 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 t99t RATE PER $ I .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 CREDIT FOR PARCEL OR LANO ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 RATE PER $1.000 ASSESSED VALUE x x $1.45 $1.25 SI.09 $0,92 $0,72 $0.48 $0,28 $0,09 $0,05 $0,00 $0,00 $0,00 CREDIT TOTAL $0,00 $0,00 $0,00 225 Fifth Street . ' Springfi~ld, Oregon 97477 541-726-3759 Phone .~. c.. ' f Springfield Official Receipt D opment Services Department Public Works Department Job/Journal Number COM2006-0 1182 COM2006-01182 COM2006-0 1182 COM2006-0 1182 COM2006-0 1182 COM2006-01182 COM2006-01182 COM2006-0 1182 COM2006-0 1182 COM2006-0 1182 COM2006-0 1182 COM2006-0 1182 COM2006-0 1182 COM2006-0 1182 COM2006-0 1182 COM2006-01182 COM2006-0 1182 COM2006-0 1182 Payments: Type of Payment Check cReceint 1 RECEIPT #: 2200600000000001519 Date: 10/30/2006 Description Paving Building Permit Plan Review Commllnd/Public Plan Review Fire & Life Safety Furnace - up to 100,000 btu Furnace - Unit Heater Vent Fan Gas Outlets 1-4 Gas Outlets 4+ -Mechanical Issuance Fee- Fixture Miscellaneous Plumbing + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC SanitarylStorm Admin Paid By Item Total: <':heck Number Authorization Received By Batch Number Number How Received WEESTERN CONSTR SRVCS INC djb In Person 8476 Payment Total: Pa~e I of I 1:18:20PM Amount Due 91.80 2,041.15 234.49, 144.30 96,00 12,00 6,00 4,00 6,00 10,00 630,00 45,00 146,60 227,21 293,20 937,08 712.44 82.48 $5,719.75 Amount Paid $5,719,75 $=,,/1:1.15 10/30/2006