HomeMy WebLinkAboutPermit Building 2009-9-1
Status
Iss u ed
CITY OF ~rK.ll"GFIELD
Building/Combination Permit
PERMIT NO: COM2009-01273
ISSUED: 09/01/2009
APPLIED: 08/31/2009
EXPIRES: 03/0412010
VALUE: $ 168,658.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1037 S 40TH PL
. ASSESSOR'S PARCEL NO.: 1802061420100
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single family residence - SAME AS COM 2009-00526 1054 S 40th PI
Residential
Owner:
Address:
BRUCE WIECHERT CUSTOM HOMES INC
3073 SKYVIEW LN
EUGENE OR 97405
, es ~oU tb
.._~ \~\N leqUII _'" \ \\iliN
:rn~"'T\ON' v,-~^" h\l t\"le v'~".^ ",,' IbIU'
{>.\\ovJl,GONTRACTOR,INFORMAffiI0NOlo
100\ilicatlon VVP:001 0 t\"lIOu.\;" -I Ihe IUles~N
Contractor ~n ai'R 952.'..~~;, obtain.~~?~e~h~ \I.;,'j:~nsee
BRUCE WIE<:;tI.~F-T((]l'!S.:r~t~'''!I0l\ffi~ol~,G, 11,0;l;).WtIO\'\
cz, i::.lluiiDDlNG:iNf,ORi"M:l>IO'N I
\1.\ tje\\\.v' .-
# of Stories: 1
Height of Structure 20.00
Type of Heat: Forced Air Gas
Water Type: Gas
Range Type: Electric
Energy Path:
Sprinkled Building:
Expiration Date
09/16/2010
Phone
541-686-9458
Contractor Type
General
3
Lot.Size: 8,983
Sq Ft 1st Floor: 1,570
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport 441
Sq Ft Other:
Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I
R-3
U
VA
nla
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
NhDElV!ELOPMENT INFORMATIO,~ "'ORK
THIS PERMIT SH~~L t)\I"lr\~ERM'\T\S NOT
20.00 AUTHORIQ'y~rlaYiDift: T!1\S NED FOR
. 5.00 COMMEI\#':;~5ett~T.fees'\R~it\DO 2
12.00 Y 180Pr~A~dFD.!ilX98gd: Yes
23.00 AN % of Lot Coverage: 22.20
17.50
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Fullv Improved
No
Storm water to curb via weep hole
Sidewalk Type:
Downspouts/Drains:
Curbside 7'
Curb and Gutter
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of 4
-~!il,~t>!,",!i!~,~'I?,1 ",[ ,"",.:
~iI \' ..'. , .......L.
'['
~L
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Estimate
Estimate
Fee Description
Plan Review Same As
+ 12% State Snrcharge
+ 5% Technology Fee
Ist 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)
Gas Outlets 1-4
Plan Review Major - Planning
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
WilIamalane Single Family
. Total Amount Paid
Plannine: Review
Amount Paid
$250.00
$211.51
$105.98
$79,00
$337.00
$38.00
$9.00
$989.58
$-1,108.15
$88.00
$9.00
$13.00
$100.55
$20.00
$7.00
$211.00
$-30.00
$134.00
$75.00
$551.16
$724.83
$10.00
$1,044.54
$101.97
$158.30
$211.21
$931.65
$75.88
$88;00
$1,108.15
$63.00
$27.00
$2,858.00
$9,493.16
08/31/2009
$1.00
168,658,00
Total Value of Project
Fpp~ P~W
Date Paid
8/31/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
911/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
911/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
9/1/09
I Plan Reviews I
08/31/2009
APP DDK
Pa\?:e 2 of 4
CITY OF ~rKlj~\.d'lI!..LD
Building/Combination Permit
PERMIT NO: COM2009-01273
ISSUED: 09/01/2009
APPLIED: 08/31/2009
EXPIRES: 03/0412010
VALUE: $168,658.00
$168,658.00
$168,658.00
08/3112009
Recei~t Number
1200900000000001010
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
12009000000000010]3
12009000000000010]3
12009000000000010]3
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
1200900000000001013
]2009000000000010]3
1200900000000001013
1200900000000001013
Required street trees as shown on
street tree attached to permit:
species as shown. 2" caliper, leave
name tag on until approved.
CITY OF SPRINGFIELD
Building/Combination Permit
.
Status
Iss u ed
PERMIT NO: COM2009-01273
ISSUED: 09/0112009
APPLIED: 08/31/2009
EXPIRES: 03/04/2010
VALUE: $ 168,658.00
225 Fifth Street, Springfield, OR
541"726-3753 Phone
541-726-3676 Fax
541-726-37691nspection pne
Public Works Review
Structural Review
08/3112009
08/3112009
08/3112009
08/3112009
APP
APP
LKW
CJC
Storm water to cu rb via weep hole
As uoted on plans
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.
L.J?ponirprl Tnr''1Pptiow
Site Inspection: To be made after excavation but prior to setting forms.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction'with footing and/or
foundation inspection.
Footiug: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor iusulation 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.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
r
Final Building: After all required inspections have been requested and approved and the building is complete.
Underground plumbing: Prior to filling the trench and including required testing.
Periineter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to filling trench and including required testiug.
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.
Backflow Device: Prior to covering and provide a,copy of the test report on site at the time of inspection.
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 c~nnected to a minimum of one appliance inclu~ing required
testing. Presure test done at this point.
Paee 3 of4
Status
Iss u ed
CITY OF ~l'KINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01273
ISSUED: 09/01/2009
APPLIED: 08/31/2009
EXPIRES: 03/04/2010
VALUE: $168,658.00
.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726.37691nspection Line
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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.
1 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 front of the property, and the approved set of PIS will remain on the site at all
".-z;g" ------- cf/flJq
Owner or Contractors Signature Date
Paee 4 of4
5A1Y1<-- j\."':, /0') l.f ~ yotL-
Structural Permit Application__ C 7~5Zb
Q \
-
t.~..", ,'-.,'0 II B 0'- e "" '_,.""",'"
225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689
;~i,i5g~~.!'ii~gHiE\9.!~t~E]g;,1.J.1
c.OM~OO ~ -C> / 27~:
PerInIt no.:
Date: 'j(- "Sj- () "}
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days.
Im~'fl1g[A['!G(f)y~:t{NM.i;tiTi{K':e[Q"VA'~'!l'A~I~~\..1
I Thsl'gniSaPturor~e'e.ct has final land-use approval. D'ate.. I ~~tlfKt~.!li'~';';"""~EE~scHEDUitf~"'''''';\'Plf~~'j.~~1
I~,'.f:;;_,_",~.,~, "~~~~~"~'_'~~_"'~':"'>'~"'d'OM,._~!f;!ix,~.li~_~.Jf_',"'~.IO;-f
iE::::D,:::M'DY' DN'"'" i i~~:~:~~1
11';~~:~;~~~~~~;~~~~~~0~~5Nsm~U~;iON7;~;g~"1~\~~,;t~')11 I. Construction type: ' liE I
,,,,,,"~J<I, .."YlL......._..........liL.. ......... .. .. ...._......"....."'.......~~, 1 Square feet: I
,~;rJ~[l!~i]E~N~]M~l~~WNP1r.JQ~~;~c~~~~J*;~i I ~::::f::~::ot: :
1 lob site address: 103/ :5 LJo+~ f I i I Type of Heat: 6-1\> r'/A 1
City: ."-;" 'l~ : d A I State: 0 1t I ZIP: q 7774' II Energy Path: f jJ. I
Subdivision:F; Ih"-i-t r1l<'..\.~V':> I Lot no.: 1 ~ D . I
1 I' , I I OJ new alteratIOn D addition
Reference: /~DZO<::x l{ Taxlot: 2()(OO .'
I"~" '~"'lli.""JI~",~. .'I"'..'.",..,._-,.~~.....'o~'.,.'...,...".'.";w'>':'.~.;'.."".:. I I (b) Foundation-only penmt? D.Yes ~o _
t, .. '"'~';~1!f{",,''' ""1I1R0I1ER:r:v:~OWNER,..,..rt{>',,6,~.".":,.,..,,: eJ."jJ -'1 $ / I.. 176. r Y
,."- ,.,#~....,.\ ,_"",~k:".,.,""'"..._....."...."',..._'._.._L..,4.,_.__.u,.__,..u.i'l"""""'vJ;~.-..."y,"'l;:,;,.d:,.,."-~,,. "",,~t I Total valuation: n 6' ) 0
I Name: (!, (.u< IJ;, d,.,t C \i <,kJ", ~",a..\ :t'1'lc.. 1'::""d"",,';c"'uTi;"'H:"":~","r*.;Y.' "/''''':''':''::]'''':!'';;.~)'>.''''''&.\''_:"'.'I
I..,. -..2..Bml IDgsfees;/~".tJl~lJi..,'A;;~..lnl:.~ "J'",:;,':"~:"t:.k:,-,!'~li t.'" ~"':;<o'J:,(~,.;':5-;~-,':
Address:.>071 St....v'ew /...N . ........;...".:..,,:...,,~..,.. .... .,." ,:'r "~""""''''''':.''
1 . ell '" 7 <<'" 1 (a) Pennit fee (use valuation table): $ I
C,ty: < v're",,,, Statey J'.. ZIP: I 10 J
I ." Lob '7 . ~t't 7'~b' I (b) Investigative fee (equal to (2a]): $ 1
Phone. -0' - '1'1)D Fax. -, - ::>J "'. .
1 I (c) Remspection ($ per hour):' I
E-mail:W;~CJ.'N~ "'o~5 @-CD'"US-I, Ne.t- (number of hours x fee per hour) $
This installation is being made. on residential 0; farm property owned by 1 (d) Enter 12% surchar e (.12 x [2a+2b+2c)): $ I
me or a member of my Immediate family, and IS exempt from IIcensmg g
requirements under ORS 701.0 10. IY~~!'~~~;~~~:::::~:~~=l.~~oc~'~~c~l~~,r~i!3~il!!i1!\<"11
m'31\Il.I.~.n!J:me.)yife..e.~1ilJ?1i.7!it~~l:"~~~(~'lliiII!i0,"'#l!~';ij
1~~"fCONTRACT0RWNSTAii~TiONi~_~1it.q~~'ii1 I (a) Plan review (65% x permit fee [2a]): I*> I $ ~c,) I
I ;~s~n:s: n':;~~;~:'C~;~h:~'C:;~:"~;' ~<., ;;::"11\'1 I (h) Fire and life safety (40% x permit fee [2a]) $ I
1 I (c) Suhtotal of fees above (30 and 3h): 1 $ 1
Address: '3 073 S IL~ ,; (.w !.-.". 1
I City: tl:vij e,r<.- I State:O{1.. I ZIP:G! 7'1c) I f'~4;:.Mi~~,~fm~R~~~~ffe~~~~\Tt'{',~<;{,,?::~t'1,W:.:::~'\t'i~ii~tli~~~1~r~~1k}2!'1
I Phone: '-6J'b <leiS? Fax: 3'i/f..33bZ I !(a)Seismicfee,I%(.Olxpennitfee[2a]): $ I
I E-mail:Wiec..ke.~1r-o....-~S @ CO'\A(t,.54~~",\ I I TOTAL fees and surcharges (2e+3c+4a): $ I
I CCB license no.: 10 I) r 7 1
I Printn~e:'t) e..,...~dc Wt'.:j\u"".......
I Signature: W W._________.,
1~~-i~.Q\l:'G:oc~t~~e~~~~~?~~~M~I;~:~~~;;'~~;;:
IElectricaIP'!:'" /05'17.<:' 5ZIYI'i& I
I Plumhing 5lc.v<; p lu.~h, ') ~.5 0 (, S- ,,~z- 3" &,... I
I Mechanical CFH Yhi) 72.b-O)oO I
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number (OIAAZOO' - 0(Z73 Dale
r--~ ~'~.":;r,::''i''';:'K'>'' '0( ~"lr:-":-...il~"'.~'::'""---:'~,:~",,~-'t- "_ .~:", ;~.\ :"'t.\
1. 'fLOCATION;OEINSTALLATION:"", ~">'f \,
l.:.:.:,""_._RC-_....'~ - .'~-~""-.L..."" .f;:~-.."'r",~"[,;"..-L.,'~'<-,,,: 1:.- ~~ -1.}':"" :~:~."_."
/037 syo+l... pi
LEG; 83zRIPO'br if
ZO(Oc:::>
JOB DESCRIPTION:
H6lA5 e
l.~/.U
f
Permits are nOD-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days,
. ri.n~:.>J!.,;:,~,~';'~~.i!-1~'-r.:~.",;""__,,,,~,~.fl!;;'~+F-;;ft__7_...~.i
"CONTRACrOR'JINS1'AliliATION. ONleY"..
2. ~-':';"";'~':"~"fr"~' ;""';;:;:,'!':.::::.ii:-{, ~~j;,e'P;;'~':-';:Ji:' ':S.....1~~~~4::~,.,s '1
Electrical Contractor L +- c
Address q 2. i S -)
AcyeS
'S o....ef
City S'" ~ \~
Phone 5 lJ> '-/196
Supervisor License Number L{ 17 'i - S-
~ /2/J0/1/
,
Constr. Contr. Number / b S- '-i 7 y~
3)'0
Expiration Date
Expiration Date
Signap;[~D~
Owners Name ~-( IIceLJiec-ked Cu.,,1ol'" llo.....'s
5Il..';n-.\ lyJ
,
Phone by, (,- ') 1( 5'f,
Address ~ I:> 7 3
City t' u s:"<..
OWNER INSTALLATION
The installation is being made on property I own which
.. is not intended for sale, lease orrent.
~s~o
Owners Signature:
Inspection Request: 726-3769
~ :_.;e:'.~~ ~,.":-"',.'::, :' _'<.~; .;t-!::". .. ,~'T.~':-.. :,:-,'~""""',:'r,,"~~-"'.,,_"':" ,..: '"'~,;~ .;....:,':". ~.- '.-,....,.,,~>. ~ ,:: . .~'~~t
3. .. GOMPLETEFEEBCHEDUEE'BELOwilt"\'n";:\~: .';,.:, .,~'c<;A
""* ~',..,L.-:' 1-_.. ,.'," ','''' .'.'. "'} .. ..f.-.k..;.......,;; ";'-.'. .".-:;:..:::..;;~", ,,,.- ...1'.,<,>:.':"-,, _~t:..,i' ....,'., '~,i_., ~'_ ..'::..s'~?_ .
p; '~'!t;:"~';-':f.'::,*.;s-.Yc~:C"~':'~\>~'.;:)"_'?J..'i'o:f~~;cl1,':,,-, '~';';~':if:'':T.-'C' 'fX,;_,:;';;'''':.~.nrz'~-:r;,
A. t ':N.~w.ResidcClti;JI'::::;Sjngl~' f)rM uJti~Fainily -pc'r.:dwelling:u nit.}.~,~~
<...:-_.".......1'.,,:''''_' ":/" 'Mt.;''',;..,,'''' 1,.r_._~~, ,,,, '_._....'..~Tl". ."..~...~"\,." .,_"." ',.J" ,,-~-... J'._.,",.!_:;'-~A..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
Ij'f
~.OO
tf
$J1.00
I
:?
Illl
7\-
$57.00
t'~i~~,:'~~~:~;~~~if""~-i;i~':J:~t.~t{",:;!i~.:1JL\;~ '. ~ "'n.'!#:~-'J'..~~'<.-T-},~_,_~~; --:'..,:!::';r~
B. r~Ser:Vices,o'rFeederS~lnS:t:lllation;+Alte~ralions'or~ Relocation :~.j
~~,;e~':';~~~;;l.~:h-\;.:.-2~:r'~:~ -\>'ol::::....:";,-:;:.''''--~~,.;.'<i:!:J,. ::J~.::''&~ ;:"~:::ri'.&::~':Y"L.:.." ~.;'.;:.:.;U'..::-..:,
200 Amps or less
20] Amps to 400 Amps
40] Amps to 600 Amps
60] Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 73.00
$ 86.00
$]43.00
$186.00
$426.00
$ 57.00
. ...."~'jl~":;'.'Ic-~;,_,,<J.t' ,'~~~{~"'.'s,. "'" '''';''"~'': ..",""',.
C. ,'.T~iJ1P9.~~~fj'.S,ervice~ o).fe~~ers;';IL' /, '"~
" .', ~
"
Installation, Alteration or Relocation
\
$ ~ \.D~ c;Y
$ 79.00
$] 14.00
200 Amps or less
201 Amps to 400 Amps
40] Amps to 600 Amps
Over 600 Amps or 1000 Volts see "W' above.
-'-~~~'::: ;r~,~"~","-,""'!.'~:':, -: ,-', ':-~"~: ._'-;f',_' , -...,,;r;--_7-". .."....~,~ -;- ,-,,-::, '-$-;-' 0;:1 '~L. ';';-'1'
D tfnra'l1ch1Circuits'~,~#I:_"~::'*P.~r,O-"'.-i,~-:~~~\,,,.;.-' :c1.~"L.t:1",:;';,:i:~" ',A.".'t>~\~ -<<,.'f~,' ~
. ~'''~'_ :.,-~_.: ...,..,_~;,,;< -:_">.1~i~ ~;' :,;':__:~- ~~.,~r'..~-'::;r:.,?~ ~:.~_I2",)\:':e' ,; j~ '.,;.r .lI ~-t.:""'~,
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
SelVice or Feeder Permit
$ 50.00
$ 5.00
I:-~,- ..;t,~'.-9;._:;:'"-';J.:{~~'.;- "''t",....,~; , . ".:' ~\l~~:::' -:.i" _'_~ ~-~:_ >~", .' i, ',~';_ " ,;J
E. ~. 'Y'!~~~lt~,~!,~:~,t (~etyi~~{f~~d~r".~'?~)i!~~.~~~~n:~~~ch~J.~~f~.~I.ali~~~:1
Pump or irrigation $ 57.00
Sign/Outline Lighting $ 57.00
Limited EnergylResidential $ 29.00
Limited Energy/Commercial $ 52.00
Mini~~~,)",~I.:,C!:;~..r,~,".,~i~,~~~e~tio~;Fe,~,~s '~.;"2,, 00 ~ Surcharges /
4.SUBT01'Al;OF'ABOVE>--" ;",."., iF 20 l'
]2~St~;~~r~h~ge ' .' ". ~f\~P 7.<:/03
10% AAministrati'''8 F.... \'2...'10 2:12. .\.J:l<\ f
5% Technology Fee \~.ld"" t;6 C( j .
TOTAL ~ z/.rL( S~
Shared D,ive(T:)IIluilding F03\i{!{~'\,pj;CatiJli 7.08.doc
f:c ~ WiUamalane
, t " Park & Recreation District,
Job, No. t!C( - / '273
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
NAME: W /t,-c..tIE:.~ or
ADDRESS:~'7:S %V"Il,i.tJ
,...
, PHONE: fog~- "7'irF
CITY ec..((,FNc STATE: ~IP: 9?40S-
LOCATION OF PROPOSED BUILDING SITE:
,Street Address: Id1t-; ~ C( tJ"'- fL
Plat Name:
Tax Lot Number: !,jdl-I'lt; Ii.( 2tJljp ,.
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitio'ns are ori the
, back.) . .
A. Sinale-Familv Detached
, NO. OF UNITS
J
X $2,858 per unit.:::
$ 2Fs7r
B. Sinale~Familv Attached
NO. OF UNITS
X $3,100 per unit =
$
C. Multi-Familv Aoarlment
NO. OF UNITS
X $2,641 per unit =
$
D. Sinale Raom Occuoancv .
NO. OF UNITS
x' $1,321 per unit =
$
E. Accessorv Dwellina Unit
NO. OF UNITS
X $1,550 per unit =
'$
$
WILLAMALANE SDC
2. . SDC CREDIT (If applicable) SDC payer must furnish proof of
. Willamalane Credit approval.)
$
3. TOTAL WILLAMALANE NET SDC ASSESSED
(If SDC reduced for Credit)
$ '2 F.;$Y
!?4- aA
Development Services Department
City of Springfield
g-t'J/t 61
Date
5
iljl:
City of Springfield Official Receipt
Development Services Department
Public Works Department
"
225 Fifth Street
Springfield, Oregon 97477
54,1-726-3759 Phone
Job/Journal Number
COM2009-01273
COM2009-0 1273
COM2009-01273
COM2009-01273
COM2009-0 1273
COM2009-01273
COM2009-0 1273
COM2009-01273
COM2009-0 1273
COM2009-01273
COM2009-0 1273
COM2009-0 1273
COM2009-01273
COM2009-01273
COM2009-01273
COM2009-0 1273
COM2009-01273
COM2009-0 1273
COM2009-01273
COM2009-0J273
COM2009-01273
COM2009-01273
COM2009-0 1273
COM2009-01273
COM2009-01273
COM2009-01273
COM2009-01273
COM2009,01273
COM2009-01273
COM2009-01273
COM2009-01273
COM2009-01273
Payments:
Type of Payment
CreditCard
cReceil1t1
RECEIPT #:
Date: 09/0112009
8:JO:J6AM
1200900000000001013
Description
Plan Review Major - Planning
Building Permit
Addressing Assignnient
Willamalane Single Family
2 Baths One or Two Family
1st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Fireplace (Listed)
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Fire SF Fee - Residential
Sidewalk Permit
Curbcll! Permit
PW Disc - 2nd Permit
Credit- SDC Storm Improv
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
SDC MWMC Reimbursement
SDC MWMClmprovement
SDC MWMC Administration
SDC Sanitary/Storm Admin
SDC Transportation Admin
Temp Power 200 amps or less
+ 5% Technology Fee
+ 12% State Surcharge
Amount Due
211.00
989.58
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
100.55
88.00
88.00
(30.00)
(1,108.15)
1,108.15
724.83
551.16
211.21
931.65
101.97
1,044.54
10.00
158.30
75.88
63.00
105.98
211.51
$9,243.16
Paid By
BRUCE WIECHERT
Item Total;
Check Number Authorization.
Received By Batch Number Number How Received
Amount Paid
CJC
02594C In Person
Payment Total:
$9,243.16
$9,243.16
Page I of I
9/1/2009