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Home My WebLink AboutPermit 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