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Home My WebLink AboutPermit Building 2004-8-18 . Status Issued ~ .- CITY OF SPRIl'''i\.d'lJ'.,LU Building/Combination Permit PERMIT NO: COM2004-00698 ISSUED: 08/18/2004 APPLIED: 06/1412004 EXPIRES: 02/18/2005 VALUE: $ 17,890.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3640 Main St ASSESSOR'S PARCEL NO.: 1702314202501 Springfield TYPE OF WORK: Modular Unit TYPE OF USE: New Commercial PROJECT DESCRIPTION: Velocity Coffee Stand. Using Existing Bldg on property for bathrooms and n sink. Owner: GREEAR JAMES D Address: 1612 COLUMBIA ST VANCOUVER WA 98660 Phone Number: 360-904-2934 Contractor Type Applicant General Electrical Plumbing Contractor DAVID MORGAN OWNER LRBRABHAM PLUMB CRAZY PLUMBING INC I CONTRACTu... mH)RMATION I License Expiration Date Phone 607-9131 8699 136547 12118/2004 541-747-6638 08/31(2005 541-895-4768 BUILDING INFORMA nON I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: I Lot Size: Height of Structure 13.00 Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: ~nge Type: Sq Ft Garage/Carport ~<.:)En~gy Path: Sq Ft Other: '\~~ ,c:l;;~nkled Building: nla Occupant Load: ~ ~'1 - ~%~<;l'~~~OPMENT INFORMATION , :\oo!) ~~~~ \,. ~ ~S "'~,- ~0C, ~-v ~"~'lUlRED PARKING i?-'.; n." "'-~" & ~o c,0 s:s >\ Frontyard Setback:. S~ ~~' ~<O'<' Overlay Dist:, \0 0\0 ,,}0 l?)~'l(~~: Side 1 Setback: ~fV~~$- ~~ R- {:> ~. # Street Trees Rqd: ,# >:$'0 ~0C, ~ <ffa\1Jllt!!jlped: Side 2 Setback'~'\; ~((; ~~<\) <\) <.:5 ~\j Paved Drive Rqd: ~o~ 'Q:\ 'l/' ~ 0 ~>:$'0 ~#t: Rearyard set~l\~? ~<\)~ ~\;;((; ~ ~((; % of Lot Coverage: . 0,0 ~l>,\~o":i ~oo!)($ 'l,c, 0 0....eJ. o~,Q Solar Setbacks: ",-~". ...~((; r-.. <\)'?'- O~. ~:P~~. <:::, 'S' o~~ . 'S' _\~ 6:\' r ^"~, . o..'V 'J-<'~ J' 'li- ",,0 ",,\ r G _....0. .:\.~ l':tX \,)~~. IPUBLICIMPRO~~~*~<:::";V~""'I>'\.~~~"V~,,:>'l;" I \ I .",'Ii ~-4. ~0 0($ ~ Street Improvements: . ,,(f~~v'l>;" l?)<6 ~ ~'Sl!lrwliIk ~)\'Pe: "",dl ~'-I.O ;<:,0 >:$'0.~ Storm Sewer Available: ~ ~ 0 !<). . ~'1~gwna>'iiuts/Drains: S!,ecial Instruction: ~ 1;:pOJ .]f<:'- 'l,' r!J>0" v {:''Q v ~v U-l VN 400 Notes: Pal!elof5 . . CITY OF SPRINGl'lJ<..LD Building/Combination Permit PERMIT NO: COM2004-00698 ISSUED: 08/18/2004 APPLIED: 06/14/2004 EXPIRES: 02/18/2005 VALUE: $ 17,890.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phnne 541-726-3676 Fax 541-726-3769 Inspection Line I Val\J8tion Descrintion I Carport Modular Unit Pavinl! Tvpe of Constructinn Carport Modular Use Bid Amount $ Per Sq Ft or multiplier $16.60 $1.00 $1.00 Square Footage or Bid Amount 400.00 8,800.00 2,450.00 Value Date Calculated Description Total Vnlue of Project $6,640.00 $8,800.00 $2,450.00 $17,890.00 08/11/2004 08/17/2004 08/11/2004 U"". p"ilU Fee Description Amount Paid Date Paid Receipt Number Plan Review CommlIndlPublic $44.46 6/11/04 1200400000000000892 + 10% Administrative Fee $46.74 8/18/04 2200400000000001067 + 70/0 State Surcharge $29.02 8/18/04 2200400000000001067 Add, Alter, Extend Circ Ea Add $36.00 8/18/04 2200400000000001067 Addressing Assignment $31.00 8/18/04 2200400000000001067 BackfIow Device $14.00 8/18/04 2200400000000001067 Encroachment Permit $120.00 8/18/04 2200400000000001067 Garage/Carport $84.00 8/18/04 2200400000000001067 Modular Building $99.60 8/18/04 2200400000000001067 Not Covered Plumbing $14.00 8/18/04 2200400000000001067 Paving $52.80 8/1 8/04 2200400000000001067 Perm Serv/Fdr 200 amps or less $63.00 8/18/04 2200400000000001067 Plan Review Comm/lndfPublic $65.91 8/1 8/04 2200400000000001067 Planning Final Occy Inspection $143.00 8/18/04 2200400000000001067 Sanitary Sewer - 1st 50 Feet $45.00 8/18/04 2200400000000001067 Water Line - 1st 50 Feet $45.00 8/1 8/04 2200400000000001067 Water Line - Each AddtllOO' $14.00 8/18/04 2200400000000001067 Total Amount Pnid $947.53 I Plan Reviews I Pnl!e 2 of5 . . LlJ i: OF ~rKlNGN~LD Building/Combination Permit Status Issued PERMIT NO: COM2004-00698 225 Fifth Street, Springfield, OR ISSUED: 08/18/2004 541-726-3753 Phnne APPLIED: 06/14/2004 541-726-3676 Fax EXPIRES: 02/18/2005 541-726-3769 Inspection Line VALUE: $ 17,890.00 Fire Department Review 06/15/2004 06/18/2004 OK GRG Plan Review: Coffee stand. Job #COM2004-00698. Occupancy Classificatinn: B. Construction type: V-No 140 sq. ft. Please note that Developmental Services has assigned nn address number of 3640 tn this structure, nOI 3650 as shown on the submittal. Provide address numbers in contrnsting color from the background pnsitioned plainly visible and legible from the street or road fronting the prnperty (1998 Oregon Structurnl Specinlty Code 502 and 1997 Springfield Uniform Fire Code 901.4.4). Provide or maintain address numbers in contrasting color from the backgrnund positioned plainly visible and legible from the street or road fronting the property (Oregon Structurnl Specialty Code 502 and Springfield Uniform Fire Code 901.4.4). Initial Review 06/14/2004 06/14/2004 APP LLH Planninl! Review 08/17/2004 08/17/2004 APP EMM Development Agreement has been signed. Planninl! Review 06/15/2004 WE EMM Waiting for submittal ofsigned Development Agreement. To be built per MDS review and signed Development Agreement. Public Works Review 06/15/2004 06/16/2004 APP SB SDC'S ADDED. Applicant says he coordinated with Craig Fitzgerald to connect to existing stub within the P.U.E. ENCROACHMENT PERMIT APPLICATION IS REQUIRED BEFORE CONNECTION OF SEWER IN P.U.E. Structural Review 08/17/2004 08/17/2004 WE JMP David Morgan submitted a revised column and footing detnil. Requested value of modular unit, Structural Review 08/18/2004 08/18/2004 APP JMP Received fax from David Morgan nf the State of Oregon BCD Notice of Plan Review with an $8,800 valuation for the modular unit. Pal!e 3 of5 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2004-00698 225 Fifth Street, Springfield, OR ISSUED: 08/1812004 541-726-3753 Phone APPLIED: 06/14/2004 541-726-3676 Fax EXPIRES: 02/18/2005 541-726-3769 Inspection Line VALUE: $ 17,890,00 Structural Review 06/14/2004 06/15/2004 WE JMP See attached structural review faxed to David Morgan. Multiple calls with David resulted in his saying he will get with an engineer to provide the missing information next week. Structural Review 06/23/2004 06/24/2004 WE JMP Called David Morgan to tell him of the many deficiencies in the responSI to the structural review. He has been working with the state on attaching the canopy to the building with their apprnval of tbe design. He talked about making a number of revisinns and then he will resubmit with more complete information, connections, sections, details, and calculations. Structural Review 08/11/2004 08/1112004 WE JMP David Morgan submitted a revised plan for the canopy. Called him to request base plate detnils nnd heights that correspond to calculations nnd storm water management. He said he would have the engineer make the revisions. Structurnl Review 08/13/2004 08/13/2004 WE JMP Hal Pfeifer faxed structural design revisions for foundations nnd roof framing connections. Still waiting for revised plan. SUB Review 06/25/2004 06/25/2004 APP DH Pre-fab tn be manufactured to state standards-nn energy code inspections. SUB Review 06/15/2004 06/16/2004 WE DH JMP called David Morgan for energy code fnrms. 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. Ueonire'Unsnections I Encroachment: After item(s) have been removed to inspect condition of public right of way. Footing: After trenches nre excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Roofing: Prior to installing any roof covering. Final Fire Department. After all requirements of the Fire Depnrtment have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench nnd including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. Paee40f5 . . \...11 i' OF ~rKll'lul'lELD Status Issued Building/Combination Permit PERMIT NO: COM2004-00698 ISSUED: 08/18/2004 APPLIED: 06/1412004 EXPIRES: 02/18/2005 VALUE: $ 17,890.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line BackOnw Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. . Final Electric: When all electrical work is complete. Foundation: After forms are erected but prior to concrete placement. By signature, I state nnd agree, that I have carefully examined the completed npplication and do hereby certify that nil information hereon is true nnd 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 ofany structure withnut permission of the Community Services Division, Building Safety. I further certify that only contractors nnd employees who nre in compliance with ORS 701.005 will he used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each nddress is readahle from the street, that the permit card is located at the front of the property, and the apprnved set of plans will remain on the site at all times dlJ3CtiOn. e /19 fD t/ Owner or Contractors Signatur Date Pal!e 5 of5 :'t"o," --t...;..... ''t .-'<,.' '\:r~"l~t(. ~.'~,""~ 'r...~, ."-',>t.:. ',. "'"\'~':"....~ ....V"'....\..r \....'5;~"1 " " " ,; . CITY .OR Sf-f@t.1F~LP, -PRl3QQ.N;: ""0 ';.\..-!l ,~"''t:., . ~, '. ., _ . , .. . ,.. ~... '" ~ .>.,' ~ 4 ~>o! _ _ ,.",~ . I ,,'.., ?lJ", . WSPR"NOFlELD ---;~"... "-'0 ~~~J 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726Stl8l "1);""fB'a;"~' _ ~ ELECTRICAL PERMIT AP.R!-IE~TION' 0",& <- O'o~J~&~'" City Job Number lDfrl9jDt\, lJJd:i'6. Date 08 - t 6 '0 4,...~%0. 01),,,,,.. OI,~$"6",. . . . ~ ~~ 1 ![LOCJiTIONOFINSTxri4T;ON"~.'>~~'tl 3. rfc"olrpLEli:FEJfscHED.O:~~i;-: '"c~""O ~'-:G.~&~~~j4'r;\;~ . ;::'-'-~'~iJ.~~_.'.%:;~.,..~...,~'...'~ w._:...:..:.:oi,:U':~;..,~~-;t.~ ~~~~.M"'.;.a...:;:.i.;nl'~'WI.~_ -s-~ -~~~~';;'~~6c.J~ Al tAO ~r\ ~tGaO~ e""''T;~<'\''''~'i"''''''''''G'''''::'''i>t'''''''it~I,'i''''<''\Ii;:~~''''?~ LEGAL DESCRIPTION A. ~~w:g~,,~~'t~~~:tI~!'!jiK~).cJ...~' .''0l1lJ / 11] 2 '3 / 4-2.. Ie> 2- c::; cD I Service Included Installation, Alteration or Relocation 200 Amps or less ~ $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps . .:>,-O'So\ $100.00 ~ ~~ ~:~ O~~~~~.g~;~~~\~~~~~.~~'\~~,~'", . _ .~'_,. t,,,,,"" ":{j D. ~Branch;C.rcUltsie""i.<eloj)"';;''2:2!'i::<I .",",4;".'''1 :" ,'1' .,....,~~" ',r. :<. Ie ~'o,,~w~'=~~W""'q)j!'~0<:r""" . .'. .._0> ". ."" New A1teratilr~&EX~~ICt~l\lIe~wn~,,0 ~ . . .!:S 'O~ <3 <; ~ 'S' ,,~ ~o One Ctr~ ~~ 00; .:><:$ d- ,,,," 1''1> $ 43.00 Ea~?~\1<ll!.~bl @~IHiK>?f~0 '~o""- . '11 _ C() v' S~~~I'>'F~b~i~ e;~ ''So\ I~. $ 3.00 ~ ..<\~~",~~~~~,,:~;/f~o:\~~7-'t"'71"""O.~ -"0"'.-.'"'' ,,-,~ ~,,''''. .. !l~lleou's~seJ;VicOlfeeder:tliotiIlchided)'7Eiich~lnstallitioii1 ,O~~t> -~~~'l>)~it'''''6\=~\S'''''''''-'''--' -~'-.."" e" -.' . " r~ \ _ill>i$ ~ ,.} 0 G 0 ,93 . v'D>qe't-2.'l3'1- ~u~~iRi~fi?~'S' ~~ $50.00 s)~~~~i?t~0 $ 50.00 Limitelt$gyfR<;!sidential $ 25.00 Limited Energy/Commercial $ 45.00 JOB DESCRIPTION con~ ~r 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. f'ffiNr.' RXdiliR.'i'm.'=.' SfALL:4.TI'b~;Om..,:r?1' 2. ;'; ',- ,/~'.n~~''''~''''J:,~.......~.:7.:.~~;:;t..';':'F;.4:w.;...-.;,e.',1'''~~' Electrical Contractor L--/Z- 1312-A-13S1 AM Address b'? ~'\ G. "'-l- City 51' F'I) Phone '7'f1/c;,f.,3f 1/ '1 "14 5 ..o.'t- ~-0' ~ I b / I / () "I < ,\-(o.~ 6 ~C) Sv" ~' C)'<:' Constr. Contr. Number B Go $ffl.~ (l</~",,\.'\J <(. ~'1; ,\'0'- ~'\Jv Expiration Date ,,12_ /'k'11~~!.,.,.<Q"?I- 'IV'" ~" '0'- ,." . Signature of..S~~~,Ei~%~ ~C)'\J ~',~'O Rl'<"v R.,IC ~'<;; 4- '\~~~~\.~ / t;- :7 W~ #' ~ ,,7 Owners Name ,11M. "'/l-'<c'"E~ Address 3S(;'L5' IJ12 WIO~c..~ Q...\.II';)LQ...I.\ Supervisor License Number Expiration Date . ,City w....S"'''''~ .\.l.A Phone \......../ . OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof ._:0 " $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 %~. ~~[ .4.-!'''<;{b';a~.i,(.. ~.m:~'..~(\.t';-~~~ff~';'';.('' '~u:",1':i:r$\,*~~"i1,&~t.;o-".J'ir'_\,~ B. "~$.rXl~~;!g~$J:.~~~~&.t~J~~!}i~~~~~~~~-~~~oi!~~eJp.-~~t~~.~,:~'13 ~ 200 Amps or less I $ 63.00 . ~ 201 Amps to 400 Amps $ 75.00 401 Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 ".. ~j;' ,,~"'~..' .,)" N'_ '-"~,...t ~~':"\''''''''.' ";':;;'i:?"'-,):t,'!'.. ,..;~.:.,..,..~1' rf'-- .r..n.Ft'.,..J!:;..'.........'Io1 C. ~Teiiip' orarv .Ser."iceS!or-;F eeders~,}/;:', :;:~i'-;;.:'~',' ~z~~.- ~~~+,,,, 1:;':' ~bJ.., ... ;;,.=,\.;,.."'~"~" .iI""-:.:.--.......:.u..'.".:ciJ.Ooi;;~~~.".. ",,,i".' . - ~. -,,~.. .~.'....:'~i'.. ...l'.~.".d Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 7% State Surcharge 10% Administrative Fee ./ act .00 \o.c(3 v q,CW" ~ \ ~ S ~€X>~ [;i);~#.Ajl~_ '~\;-_~:::;;,:,..' ";:Qp"";t,.,..;r::~;'~t~,,,>'~''1,;:?<n 1-F~ 4. 1"SUBTOT'AL'DFABOVE'pi." .,,,,!,(,;;.,'''!:,'~, " .~'''',~:.~~.~, ~... '.-..~b.~" ..,'., 'F.;...JM..":: ~....~~"-/.,' ~.t'.>'.\.L~" .~- "":;'.' .: J ' .._.~. '"'"- . " . ,,~. . ~'.' """^;, ' '" . .". .....,0 --, " TOTAL Shared Drive(T:)IBuilding Forms/Electrical Permit Application 1-03.doc _ ATIACHMENTA CITY O~GFIELD SYSTEMS DEVELOPMENT CHARGE ~T JOURNAL OR JOB NUMBER COM20Q4.00698 NAME OR COMPANY: VELOCITY COFFEE LOCATION: 3650 MAIN ST MAP & TAX LOT NUMBER: 17 02 31 42 02501 DEVELOPMENT TYPE: COFFEE KIOSK NEW DEVELOPED AREA (S.F.): EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURFACE (S.F.): 132.00 576.00 ITE: ITE: LOT SIZE (S.F.): 834 834 o . ~ t .'" E~~ oo~ . . i:.i! <l!8 1 "iTORM I)RAINAGE IMPERVIOUS SQ. FT. x S 0.290 PER SF TOTAL STORM DRAINAGE SDq $ 1070 . 2 oS,ANI1ARY ~FWF.R-c.ITI A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) o x S 22.64 PER DFU o x S 17.21 PER DFU TOTAL LOCAL WASTEWATER SOC:' $ :1...IMNSPORT~ , $ , $ I $ 1091 I $ 1092 BLOG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 0.132 x 496.12 x S 17.23 PER TRIP x 0.5 NTF 1$ 564.18 I B. IMPROVEMENT COST: 0.132 x 496.12 x S 76.01 PER TRIP x 0.5 NTF 1$ 2.488.87 I EXISTING A. REIMBURSEMENT COST: .0.576 x 496.12 x S 17.23 PER TRIP x 0.5 NTF 1$ (2.461.87\1 B. IMPROVEMENT COST: .0.576 x 496.12 x S 76.01 PER TRIP x 0.5 NTF 1$ (10,860.50) I TOTAL TRANSPORTATIONREIMBURSEMENTSDC:' $ (1,897.69) 1093 TOTAL TRANSPORTATION IMPROVEMENT SDC:' $ (8,371.63) 1094 Available SIX cn:dit for this tax lot ($10,269.32) TOTAL TRANSPORTATION soq $ I 4 SANITARY SEWER. MWMC NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.132 X S2.417.40 PER FEU. 1$ B. IMPROVEMENT COST: NUMBER OF FEU's 0.132 X S921.71 PER FEU 1$ EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's .0.576 X S2.417.40 PER FEU 1$ B. IMPROVEMENT COST: NUMBER OF FEU's .0.576 X S921.71 PER FEU 1$ MWMC CREDIT IF APPLICABLE (SEE REVERSE) 319.10 I 121.671 (1.392.42) I (530.911 I $ 1054 TOTAL MWMC REIMBURSEMENT FEE: $ (1.073.32) 1054 TOTAL MWMC IMPROVEMENT FEE: $ (409.24) lOSS MWMC ADMINISTRATIVE FEE: $ 1056 TOTALMWMCSOC:I $ ($1,696.26) Available SOC credit for this tax lot SUBTOTAL (ADD ITEMS 1.2.3, & 4) 5 ADMINISTRATIVE FEES' BASE CHARGE (SUBTOTAL ABOVE) S I $ x 5% $ TOTAL TRANSPORTATION ADMINISTRATION FEE:' TOTAL SEWER ADMINISTRATION FEE:' #DIV/O! 1078 #DIV/O! 1079 " ~ steve",- W. Be."t"i:j B.,l'CtS 6/1612004 C(j~OOI>9OI<<JifetOFFEE, 3640 MAIN ST.xls DATE TOTAL SOC CHARGES , NONE JULY 2001 . . DRAINAGE FIXTIJRE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FlXTIJRES x UNIT EQUIVALENT - DRAINAGE FIXTURE UNITS (NOTE; FOR REMODElS. CALCULATE ONI. Y THE NET ADOmONAL FIXTURES) VEWCITY COFFEE FIXTIJRE TYPE BATHTUB DRINKING FOUN!' AlN FLOOR DRAIN INTERCEPTORS FOR GREASEJOIUSOLIDSIETC INTERCEPTORS FOR SAND/AUTO WASH/ETC. 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! DlSHWASHER/ETC SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLELAVATORYIRESIDENTIALBAR URINAL, STALUWALL TOILET. PUBLIC INSTALLATION TOILET, PRIVATE INST ALLA TlON MISCELLANEOUS: FIXTIJRES NEW OLD UNIT EOUlV ALENT 3 I 3 3 6 2 3 6 12 I 3 2 2 3 2 2 1 5 6 3 NUMBER OF EDU'S. TOTAL DRAINAGE FIXTURE UNITS= -EnU (Equivalent DwellinlZ Unit) is a disc~e equivalent to a sinlZle familv dwellinl~ (20 DM set at 167 ~Ions per day DRAINAGE FIXTURE UNITS o o o o o o o o o o o o o 3 .2 o .1 o o o o o o o CREDIT CALCULA TION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE. CALCULATE CREDITS SEPARA TEL Y YEAR RATE PER $1,000 YEAR RATE PER $1,000 ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE 1979 or before $ 5.04 1992 $ 1.52 1980 $ 4.95 1993 $ 1.38 1981 $ 4.88 1994 $ 1.19 1982 $ 4.75 1995 $ 1.03 1983 $ 4.58 1996 $ 0.87 1984 $ 4.41 1997 $ 0.68 1985 $ 4.20 1998 $ 0.46 1986 $ 3.88 1999 $ 0.27 1987 $ 3.50 2000 $ 0.09 1988 $ 3.07 2001 $ 0.04 1989 $ 2.60 2002 $ 1990 $ 2.14 2003 $ 1991 $ 1.71 2004 $ CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE $0.00 x 0.000 $0.00 IMPROVEMENT (IF AFTER ANNEXATION DATE) x $0.00 CREDIT TOTAL $0.00 C0M2004-00698, KING COFFEE, 3640 MAIN ST.x1s JULY 2001 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . s~ Itlir. . Jiiily of Springfield Official Receipt "'elopment Services Department Public Works Department Job/Journal Number COM2004-00698 COM2004.00698 COM2004.00698 COM2004-00698 COM2004-00698 COM20Q4-00698 COM2004-00698 COM2004-00698 COM20Q4-00698 COM2004-00698 COM2004-00698 COM2004-00698 COM2004-00698 COM2004-00698 COM2004.00698 COM2004.00698 RECEIPT #: 2200400000000001067 Date: 08/18/2004 Description Planning Final Occy Inspection Encroachment Permit Addressing Assignment Add, Alter, Extend Circ Ea Add Perm ServIFdr 200 amps or less Sanitary Sewer - 1st 50 Feet Water Line. 1st 50 Feet Water Line. Each AddtllOO' Garage/Carport Paving Backflow Device Not Covered Plumbing Modular Building Plan Review CommfIndfPublic + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Bateb Number Number How Received Check 8/18/2004 KING COFFEE, LLC. 1048 In Person Payment Total: Jmp Page I of I 1:37:27PM Amount Due 143.00 120.00 31.00 36.00 63.00 45.00 45.00 14.00 84.00 52.80 14.00 14.00 99.60 65.91 29.02 46.74 $903.07 Amount Paid $903.07 $903.07