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Home My WebLink AboutPermit Building 2009-11-3 II II CITY OF SPRINGFIELD B 'ld' /e' b.1I t' 'P 't Ul mg om ma IOn erml II , PERMIT NO: COM2009-01587 ISSUED: 11/03/2009 APPLIED: 10/29/2009 EXPIRES: 05/03/2010 VALUE: $ 135,850,00 I! Status ':"., :~,;~;{." Issued::, ;:, , 225 Fifth Street,'Springfield, OR " ' ": :1- I.' 541-726-3753, Phone, ' '0;,' 541-726-3676 Fax 541-726-3769 Inspection Line :;~ , , .~, ,'. " Springfield TYPE OF WORK: Single Family Residence II SITE ADDRESS: 53511 ST ,',,\J:',:, ASSESSOR'S P~RSE~;NO.: '" i70~283402500 t ~ '; ~ROJECTDESf'RIPTI()N: Single Family Residence '; , ,\ 't~;'-", ',.'-. ",' i' '-, . .'.... ~ :' :'~' ':. ~ '. .. TYPE OF USE: New Owner: CUMMINS INVESTMENTS LLC Address: 31221 OSPREY RD .. ' LEBANON OR 97355 -t ~.~' .::~~~,: ... .)i ~~' ,~' .,.~ \ I CONTRACTOR INFORMA TION I Contractor Type" : '. ~ontractor General "![;;H 'i/ DAVIS CONSTRUCTION SERVICES LLC Electrical EASTSID/C ELECTRIC INC Mechanical SUNSET HEATING & AIR INC Plnmbing JOHNS PRECISION PLUMBING LLC !i REQUIRED PARKING I' Ii Overlay Dist: Total: II 2 # Street Trees Rqd: I Handicapped: Paved Drive Rqd: Yes Comp'~ct: ' % of Lot Coverage: 35.65 ''': it ,} .._~~&~~~~~~~~",~~..o; , ",' ~~~"3':~ "~~":!-~,...~, ' ''-l 11 -~t ", :";'f.'~ " I PUBLIC IMPRO~ma8~ ' S\-\~tt ~,~! W'Tll1 :~l , lHI!"r,t:"~\) .' ilkf~ef"El'lJItT.. Fully Improved AU1HOR\2pD tlMf)E~OONEt) roR Curbside 7' Yes COMMENCEPD:J,li\.~ s rai~s: .> 11' Drywell- Provide ANY 180 DAY' PERI . D, Drywell Engineering ,>.. - # of Units: f(... :~'".r', Primary Occupa'ncy pr~up: " Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ( !t,\:: (, " ,1. . 1'" Frontyard Setb~~k: :', ';, Side 1 Setback:"" .."' "',..': .' Side 2 Setback: Rearyard Setback: Solar Setbacks: . - -- . ! li .'~ . Street Improvements:' ' , . , Storm Sewer Available::' Special Instructi~n:;' ' , . License 160347 117770 171706 158279 ,";.;." , I BUILDING INFORMATION I " . \ es yOU \0 1 # of StOl)\'\&iaVl lequ I UtilitY. I R-3p,TTENiIOllite'ilifi'fu&'l ~~Itti!bQreg~o~ l~rwlO , ; lo\loW r\J\e(,T~'e~I-'IIf\@Jte lul~llr Jeut..: . :; i VJ.l,o\\lication W.u!d~'~fll0U.gh Ofthe I. ll~ in OAR 952'~~;\lb<bflil'tOp\es 0 9 ~9"C . :t09_0. Y. ou IFH~4'Iifef.a\~o\e: .\~e ~\\fIQ8.UClft .~~~\~~rl~~~~~~~~). nla I DEV~olfMENT INFORMATION I .'. . 22,00 '5.00 .. ,5.50 10.00 12.50 Notes: Storm water routed to engineered drywell. . -..,' ~ ;:, \ l;,~.. ;[ .. ~'.,- j .1 , " ~t " t. ,', ,- :.~'{Y;' , , Pa2e 1 of4 .. Residential II Expiration Date 06/1412010 , 10/04/2011 08/1812010 01113/2010 Phone 541-868-6294 541-915-9828 541-988-3181 541-736-8690 Lot Size: :, Sq Ft 1st Floor: " Sq Ft 2nd Floor: , JI Sq Ft Basement: Sq Ft Garage/€arport Sq Ft Other: II Occupant Load: il 4,847 1,223 462 .' ._., ~, ;. _i..::,;,_.,,:....:.:... ~,~ i:':l. '.; ,',i.e~({:; , .,~. ifi"<> Status Issued 225 Fifth Street, Springfield, OK",:?;, : 541-726-37S~ .p~-W~~.f.::~~':~f~i~';':~i~,?~dt~~~ff,;~"\~ff,~lf: I" 541-726-3676 Fax Hi :""'''1' ';", ,i ',): 541-726-3769 I~~pecti(lIi Line ,,',.', ,'):1' ", Description Type of Const~!!ction. . Estfmate > \E~:!ima~~.,/'~:jf.~%t~~\>' Garae:efMiscij:iYVB UtilitY' ., ,SF/Duplex :;", :R;3 VB 1&2 Family 'l ' ';=".<,,~. .>. ':',. M I ;:' I' ,;. Fee DescriJitionl.;.tt,1 .' ..,.~~ 'it,'.' j~,~~-;' !' - .' ,::lI-.' + 12% State,S'ircharge'" ,. + 5% Technology Fee 1st Appliance, li.,I,;t .1':. 2 Baths One or Two Fa'mily Addressing Assignment Building Permit Curbcut Permit Dryer Vent Exhaust Hoods, " . Fire SF Fee - Residential, Plan Review Major - Planning Plan Review Re~i4e,ntia,\, PW Disc - 2nd Permit ' Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement -... SDC MWMC Administration ,!'; ,~l; . .:, ~ ,,,;-, .-'>, ;',' SDC MWMC Improvement <, SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Tran Rei';;burs-Residential SDC Trans Improvement-Resident' SDC Transportation Admin Sidewalk Permit Storm Drainage Impervious Area'. Temp Power 20~ am.p"'~r less ,"~ '1;; Vent Fan' j\' 'W ,:t ~ ..I' .', Willamalane Single Family : ':it .\ ~. Jt ". . Total AmoUlit Paid :: I .' ,~ '; :,.i.. ,.:' ~5r:~~>"'.. " " " ',~ "l. " j.r.i .:": ;~.. . " ~,' II CITY OF SPRINGFIELD Building/C~mbihation Permit II I PERMIT NO: COM2009-01587 , ISSUED: 1'1/03/2009 APPLIED: 1012912009 EXPIRES: 05/03/2010 VALUE: $ 135,850.00 II " , I Valuation Descrintion I '" $ Per Sq Ft , or multiplier $LOO $37.72 $96.83 ',; , Amount Paid $188.07 $96.21 $79.00 $337.00 $38.00 $855.27 o $88,00 $9.00 $13.00 $84.25 $21LOO $555.93 $-30.00 $134.00 $50.00 ,$485.02 $637.85 $10,00 $1,044,54 $IOL97 $125.59 $21 L21 $93 L65 $79,57 , ,) $88.00 $68LOO $63.00 $27.00 $2,858.00 $10,053.13 . ,,) ~ Square Footage or Bid Amount 125,000,00 462.00 1,223.00 Valne $125,000.00 $17,426.64 $1l8,423.09 $260,849.73 Total Value of Project "';4P.~P~ Date Paid Receipt N nmber Date Calculated 10/29/2009 10/29/2009 10/29/2009 " 1200900000000001224 , 1200900000000001224 , 1200900000000001224 " 1200900000000001224 " I' 1200900000000001224 " 1200900000000001224 , 1200900000000001224 " 1200900000000001224 , 1200900000000001224 , 1200900000000001224 ), 1200900000000001224 " 1200900000000001224 )' 1200900000000001224 , , 1200900000000001224 , 1200900000000001224 1200900000000001224 " 1200900000000001224 J' 1200900000000001224 , , 1200900000000001224 1200900000000001224 " 1200900000000001224 " 1200900000000001224 1200900000000001224 1200900000000001224 1200900000000001224 " 1200900000000001224 " 1200900000000001224 1200900000000001224 " 1200900000000001224 II " " II II 1l/3/09 1I/3/09 1l/3/09 11/3/09 1113109 1113/09 1I/3/09 1I/3/09 1I/3/09 1I/3/09 1I/3/09 1l/3/09 1113/09 1I/3/09 1I/3/09 1I/3/09 1l/3/09 11/3/09 11/3/09 1l/3/09 1l/3/09 1l/3/09 1I/3/09 1I/3/09 1I/3/09 1l/3/09 1113/09 1I/3/09 1I/3/09 Pae:e 2 of4 .. II II CITY OF SPRINGFIELD' Building/Combihation Permit II .. It PERMIT NO: COM2009-01587 ISSUED: 11103/2009 APPLIED: 10/29/2009 EXPIRES: 05/03/2010 VALUE: $135,850.00 II :; ::-' , " . Status Issued ,', .;' ,':", T',:~,~P..~".."" 225 Fifth Street; Springjield;ORy~:;~i'/ 541-726-3753 Phone1f":":;:}, ' "",';0 ::i 541-726-3676 Fax'; , 541-726-3769 In~pec'tioii'Line ii' ): '~i .;;<~.. . "\ ' .::... Plan Reviews , 10/2912009 APP 10/29/2009 APP DDK Plan nine Review ,'.. ;,10/29/2009 Public Wor~ ~~vie",'.~1;i,\;l,\~tf~/~9/2009 :',r'::f:f;::'~ ,." -J \ Storm water routed to engineered drywell, Dryweii approved by Eric , " Walter. . " , ~ Structural nevi~iv,). '\' . '. >~.:;{,,;;!; '.-::r.~: , 10/29/2009 10/29/2009 APP CJC '~" ;'~. .,:..:~~: :' '\' To Request an inspection call the 24 hour recording at 726-3769. All inspections requestJd before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be matle the following , workday. '_.. ,;~" ' rnl~.t~~;~ ,i I ,Rml\W;s'1Ir'L~.I'&tions I .~t~,', > Site Inspection: ,'. Tobe made after excavation but prior to setting forms. Erosion/Grading Inspection: 'Prior to ground disturbance and after erosion measnres are installed." Ufer,Electrical Ground: Install ground rod at footing and call for inspection in conjunction'with fo~ting and/or o I fonndation inspection, , " ..'". ,.--....,;.. Footing: \~ft~~ t!enches are ~xcavated. Fonndation: 'After forms are erected but prior to concrete placement. , ' Post and'Beam: Prior to floor insulation or decking. ..,~ !' 1 1._ :: Floor Insulation: hior to"aefking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior t? cover a)nd'after all rough in inspections have been approved, .....',.!;. , Wall Ins!llatio\l:.J>rior to cov,'er. , ~ ~ Ceiling Insulation: Prior to cover, Final Building: After all required inspections have been requested and approved and the building is complete. '. .'~ , II Perimeter Foundation Drain~: 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. , . :.'"' ~ <I. ,'. , Rough Plumbing: Prior to cover and including required testing, ;"' I~,. :' . I Shower P~n::Priortocovering and including required testing. 'I' , Water Lt,!ei]ri~r to filling trench and including required testing. , 1." . Sanitary Sewer Line: Prior to f1Iling trench and including required testing. ., ,. 1 Storm Sewer Line: Prior to filling trench. Final Plumbing: When all, plnmbing 'work is complete. . .~~ ::, t ,;: :_i ;- '1 =- ~ ' , :('~ " ~~t;~~l 'i- , I, Paee 3 of 4 " \ ."- .Ii '.-~i ". ,:,... : ~.", , \ L' I' " II CITY OF ~rKl1~t.t<1]<,LD , I Building/Combi'nation Permit II PERMIT NO: COM2009-01587 ISSUED: 11103/2009 APPLIED: 10/2912009 EXPIRES: 05/03/2010 VALUE: $ 135,850.00 II " ,- ,; " ,'~.",;' ',- .- Status Iss'ued'.)'""":' " ,~. ,~:~'; 2.25 Fifth Stree(Springli~ld, OR : 541-726-3753 Plione:"':';:'i, ' " '" 'r.. 541-726-3676 Fax ,c 541-726-3769 Inspection Line 'F 'i-: ,; .' , Underfloor Mechanical. Prio';- to insulation or decking and including required testing. '. ~"0"J::h ',,' Rongh Mechanic'itl: Prior:to',Cover ~ ,- ~ ,', - Final Mechllllic'al: When all mechanical work is complete. ',1. Temponi,ry,~)e~i,r,\c: i,\PP'f.o,::al required prior to Utility Company energizing pole, , ",'.. '..,'...'" Rough Electric: Prior to Gov,er Electric Se.:vic'e: Approval required prior to utility company energizing service. Final Electric: When all electri~al work is cOlI~plete. Curbcut;, Stand~r~:_,After,i~rms are erected but prior to placement of concrete. ~ ~f' . ' ' ~ Sidewalk - Curb"id'e: After forms are erected but prior to placement of concrete, -I' , Erosiim/Gradiug:Inspection: Prior to ground disturbance and after erosion measures are installed; !'-."'" -:" j' .. II ~ I ~ ,,' By signature, I state and agree, that I have carefully examined the completed application and do hereby c~rtify that all information hereon is true and correct, and I further certify that any and all work performed shall be don'~ in accordance with the Ordinances of the City of Springfield and t'lle Laws of the State of Oregon pertaining to the 'work desc'~ibed herein, and that NO OCCUPANCY will bemade of any structure without permission of the Community Servi,ces Divi~ion, Building Safety. I further certify.that,only contractors and employees who are in compliance with ORS 701.005 will be use~ 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 " ", 'II street, that the permit card is located at the front ofthe property, and the approved set of plans will remain on the site at all ~'_ " , ' Ir times during construction. ,. 'I' t ' " r ~~\._ '. I Owner or Contractors ~ignature"" . " , ~ ..:u '"''''' ,~.: " ,;, . ~ . . ~", i . ~ , _ ~. " 1111/04 u Date ,l . Ji}l"';: ,'~ 1 ~. j .~. ~ I , , ' "\ :~} "1+, " f: ii'l , .. , jl ~," . .'" ~,,-; , . .... .~" ,:.;;..;[1.';::"~," ~ ,c: ':..' c, <, ";J ,) "~~I- I,:r .~;' ~ '~: < ~ > .' . , ;1.. !,}i\,:.. ,.~ l () i' ~ .'~ 1 ,'- .. ..'1; ~~~' <, , ~i 1,', , 1 \r. !',~r' ~I;. Paee 4 of 4 1~ .L~ I Residential, per unit, service included: II I 11.000sq,ftorless(4) {II $134.00 $/"3'( I I Each additional 500 sq, fL or portion' I I thereof 2- . $ 25.00 $ ro I Limited energy (2) I II $ 32,00 $ I I Each manufactUred home or modular I II I dwelling. service or feeder (2), $ 63,00 $ 1 Services or feeders: installation, ait~ration, r~locatian I , I 200 amps or less (2) II $ 81.00 $ I _~"'~~I'l.R(!))~,i;Rm,y,[~WJ\lER~\1iii~~~~~~;ril~ I 201 to 400 amps (2) III $ 95,00 $ I Name: &,..._.......s IJJ'" L (...L 1401 to 600 amps (2) IIJ $158,00 $ I I Address: "51:z. 'Z.. I . t:Js PiZ.194 ,rlf) I 601 to 1,000 amps (2)111 $205,00 $ I ICity:Lt~"rv I State: n-,c,lzIP: i1JSI I Over 1,000 amps or volts (2) III $469.00 $ I I Phone: .Q ~l 2~ J'D I Fax: I I Reconnect only (2) ,III $ 63,00 $ I I E-mail: \ Temporary services or feeders: insf.allation, glteration, relocation, I I 200 amps or less (2) /111 $ 63.00 $" ~ I This installation is being made on residential or farm property u. ... owned by me ora member of my immediate family, This I 201 to 400 amps (2) III $ 87.00 $ I property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1), I 401 to 600 amps (2) I III $126.00 $ I Signature; lOver 600 amps or 1,000 volts, see services or {eeders section above I 'I~C:c;jIill!i~~1i~B'l!:IIiIS1l1li~lfJ;\mIQN~i~~\1';]j I Branch circuits: new, alteration, extension pel panel I I Business name: E AS r5/ f)E E<-(c T I( Ie I I a, Feefor branch circuits with pu,chase ofa service or feeder fee: I I Address: 3 'D 1. S' 3 '!3 os C A G. E V ^ Iv E I I Each branch circuit I '&11 $ 6,00 I $ I I City: 5 PI? CD ,I State: of( I ZIP: 97 Y 7<ll I b, Fee for branch circuits without purchase of~ service or feeder fee: I I Phone: - 7 Y (. I V 9 <1 I Fax: - 7 36- V % 0 I I First branch circuit (2) I il $ 55,00 I $ I I E-mail: R/c KG AS T SlOE. '4> '( ~ 1.J () b ,(; () /yJ I Each additiOnal branch circuit II $ 6,00 I $ I I CCBlicenseno,: 1/7770 I BCD license no,:)O'-Y05'c I Miscellaneousfees:serviceorfeedernotincl~ded I I Signing superVisor'S license no,: I.f 7 J. 7 s I Each pump or irrigation circle (2) , I $ 63,00 $ I I Print name of signing supervisor: 1< 0 G € IC. {( J IJ G- I Each sign 0' outline lighting (2) ,I I $ 63.00 $ I I Signature of signin ,. s~r: )/ ~ . - ,j'J . - I Signal, circuit or a li!TIited-energy panel, I $ 63,00 $ g supervl "'^" VI ~ alteratIOn, or extensIOn (2) ,. . j<~,~. ~~~..ft: ~ \Q ~*A 1(,)~."m_."p"[A]).1 '..~ , \\ :"'0. I (C) Technology Fee (5% of [AD II $ lJt-lrl \)- . I TOTAL fees and surcharges (A through (1): $ .zy ~ II [~~';;:."\:o;,:,::,"i:':-",:~'~9J;j;;;::';:'~9~,~;'3;~:~~1 1(~:t;1:~R~Pc~~J,!Yl~t!;,1t~\i.~~il I Pennit no;1f~/)?7 I I Date: ICI/7.,,1~ I , <" " '11.:-: This permit is issued under OAR 918-309-0000, Permits are nontransferable, per~its expire if work, is not started within 18'0 days of issuance or if work is suspended for 180 days. ! 1_~I!'(:j:(i)~1'1G~~E!3.r:-lMg.Nj[f,~J~.I>,R(itVA:~~~1 'Ci;g.f$.pjI~Eil'JrniO I Zoning approval verified? DYes D No I 1il!1j,~J~Ailli;GPJ:~,:tj~liIo-QI\ISltrBI!J~itIO:N~l~li,~ ~l~~~~lm:EJIN~~R~~;r;~Jl)t{FJffI~~~~~@'Ni:~~~l~ . Job site address:,3 $'"1 ~ 5>r I I City: 2f6..p I State:d L I iIP:'~?.f I I Subdivision: 1?62. 2~3 $I I Lot no,: a;z...roO 1~~~pgSGRTR.ml~NllO:~W~B.g~~ JJf;)J SF;) ." Electrical Permit Application ,. . D . e · 225 Fifth Streett Springfield, OR 97477 t PH(541)726-375H FAX(541)726-3689 440-2584-1 (9/08ICOM) 'I.~clural Permit Application 1;'[)~PART~ENi USEONI.:Y I , ( ow( z<?o "t - 01 S?:r1 Permit no,: I Date: 10 -':,21-0 cr This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of is~'~ance or if work is suspended for 180 days. I~ii';', ",.~;';!;'~9CAW:(;Qy'E@Mgt:,(ff('t\~~@yi,(Uj~Mji~!!~w&~~~ll I This project has final land-use approval. I I Signature; Date: I This project has DEQ approvaL I I Signature: Date: I Zoning approval verified: ~Yes ONo I Property is within flood plain: 0 Y es ~ No I ~~i~~~f(tEg,9.~Y>ilQfJlf::9N$;iR!J:CXtlQ:~~'Wi$l;'i/)~~JIiI I 'IT(Residential I 0 Government I 0 Commercial , 1'f.,'J:.>>f;;'.;;-i~Q~X.Slt~!..INIf9~MAt[Q~~ANQtdQGA:ti9~{,1&!~i~;'f):~;j I Job'site add,ess: 5'35"1. ~ 5T, I I City: 5P(Z1I4Flf<0 I State:.olt I ZIP: ?7'f7tJ I I Subdivision: f}fvIZ516,.J Putcl I Lot no,: /7 I I Reference: /70 Z Z "i$1l./1 Taxlo!: 0 Z- .'S'D 0 I I' ' , . :.,,?ROPERTy,QWNER":""'i"',I I Name: ~.h"MI"'~ (f'J,j, Uc I I Address: ~ /Z:z./ ()5Pt2f, t2."L I I City: Lf<8/lMVO>J'-' ' I State:.o.<. I ZIP: '171n-1 I Phone: &;'If I - Z S13 - U. >r> Fax: I I E-mail: I This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010, ",', ,'I ..... I Business name: DA\/l'> (p,.JS't, SUVld.J LJ.-c I I Address: PrO gall 72..,1> I City:, t....t..L I State, c'- I ZIP: '17I(tJ/ I I Phone: ,<i 1- g" R - b Z'J'f Fax I I E-mail: DAv,sCo j.. e MM:.. (eM. I CCB license no,: , bO "l14, I I Print name: <:I'm:r-- DAv, S I II" :l~::t~r::"~_ ,. -jJk-~. ',m ". .. _,' ,",^_"9.~".~'-'! "&"';:~."';!:'::;::K"jSl:J~,-.C<DNJ]MC"'P~.,INI;,()RMAiljLQt<j,,,'i'lJ..:.~w;1i<r.otl I Name I CCB License Number Phone Number 1 , I Eleelrical 1/ 'l0'(D 5'1/. '16. 9B'Z-e I ~1S1 01<' ~ I Plumbing I 1 S-S Z 71 5"f1- fn . 4(,77 1)01-\ rJ.I:' P(lE:C-. ('L I Mechanical I " I""7C(.. ~'1" t;Pf. 'H3/1 ?urv{,~-y Ift.4- ' 225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(54!)726.3689 Sign here: I , CONTRACJ;9R .iNSTAtLA'f1QN:, ,,' II I';::! .., :;<~iii;'7e.'!:,;i'.:7/:~EE!S~HEpi.it~'i,y,.::>'t'~!~":;";i': ','1 y.,.."."''''''':c~',..:..",',,..,';''''';:'4:!'',-::1..:'..'',\',"""''''''''';''''''''''';'''''''''1 ' "~:;~:~U~:;I~:~:i:~~rU]a~:::~;:~~/~:=;~~iei'~i::~1:;~~;"i" Occupancy , ~ "> II I}r$ 11.OOT Construction tYpe: Square feet: I I I I I I I I :;;~:~~~I;i1~i;;~,S)J~?\t!;ti:j~i;~~\1i:i~:",~., :~i:l;,. '':;:~;: ~~,. ~:.:J I I I I (d) Enter 12% surcharge (. 12 x [2a+20+2c]): $ I I '3(~!;I~,b:I,~t,~,I.,~~,~;;,~\:<~~,::i~~'::i~~::~~'~~~~''1!L'I'iiCi''i''"~''''):''';''''l'''; ';1..~'i,r;'__.~_tl_,I:e,:,~~.w}.~~~~t~.~,:;ih~i\~j'S?~'~iN<#~:-':'"~~';:;f.ip.;~"~t~'~lif;:t~i'~$:wM~;;,~lf,~':"" I (a) Plan review (65% x permit fee [2a]): . $ 52 b I (b) Fire and life safety (40% x permit fee [2a]):, $ ,I (e) Subtotal of fees above (3a and 3b): II $ I~A:~'M~~~~Ji.~~,n~&~if~rf.~~e~1iJi:;~~~~~~:f.f~)~1t~!.W~~,~X?(;k:~'i:: ;r.:j< .,'~,Xt/LW'~<:, i"~ . I (a) Seismic fee. 1% (.01 x permit fee [2a]): $ , TOTAL fees and surcharges (2e+3~+4a): S Cost per square foot: Other information: Type of Heat: euc.. FA '2.4 Energy Path: 0' new 0 alteration (b) Foundation-only permit? o addition o Yes )(i No I (a) Permit 'fee (use valuation table): ,[ (b) Investigative fee (equal to [2a]): I' (c) Reinspection ($ per hour): (number ~fhours x fee per ~our) $ $ $ II ~ Willamalane t . Park & Recreation District Job, NO,' tJ9 - 1>.117 SYSTEM DEVELOPMENT CHARGEWORKSHEET FOR 2009 NAME: "~ (l1itJlf;1f> INK LLL-PH~NE: :;j-y 2~>O ADDREss3221 tJ5t'k-y' ~b CITY ~N, STATE:"'c ZIP! 97J'fr LOCATION OF PROPOSED BUILDING SITE: Street Address: )'J' ~ I ..L ~ f Plat Name: l'7tJ '2 zn'l 11.2..5'29c:lrax Lot Number:, / " , , . ~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type definiti~ns are 'ori the back:) A Sinole-Familv Detached, , NO. OF UNITS. / X $2,858 per unit = . $ . 2'f:'SJ' B. Sinole~Familv Attached NO. OF UNITS, X $3,100 per unit = $ C. MulticFamilv Abartment NO. OF UNITS X $2,641 per unit = $ D. Sinale Room Occuoancv NO. OF UNI~S . X $1,321 per unit = $ , E, Accessorv Dwellina Unit NO. OF UNITS ,x $1,550 per unit = '$ '. WILLAMAL,j\NE SI?C $ 2. SDC CREDIT (If-applicable) SDC payer must furnish proof of Willamalane"Credit approval.) $' 3. TOTAL WILLAMALANE NET SDC ASSESSED, (if ,5DC reduced for Credit) ~.~ lie- $; ;2ff6 (d I :2 ~J (151 Date II Development Services Department City of Springfield 5, II , " 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone " . c) 1 :~, ' ._,.~--_!. "RECEIPT'#:- 1200900000000001224 Job/journal Number~~l':;Uescription .. ,;j, '~l ~ , '.....~",,"",'.,~:... ~~',.' '>:,., :..,-,,~. "". ' . ' COM2009,0]587 ",,', ,'Plan Revie",'R,~~idential _.t_ . ....~.,:..,. COM2009-01587 I?uilding Pennjt<', ",c;, COM2009-0 I 587 Addressing Assignry>ent 'COM2009-01587 , Willamalane,~i,!gle Family COM2009-0 1587 " 2 Baths'OneihYirwo Family , ,:~ ',,i,';"f;' ,:.~;",'~":i'J:'~~{:'.,~ COM2009-01587 , ,,", ',)sl'Apphance, i'j' , COM2009-01587 , ':' Nent Fan C0M2009-01587 :,:L "Exhaust Hoods COM2009-0 i 587:':11>;:<Dij~ryen,t {,;" COM2009-01587 ,ResidenceWiring 1000 Sq Ft COM2009-01587 ' Residence Wiring Ea Addtl500 COM2009-01587 Temp Power 200 amps Qr less COM2009-01587 Fire SF Fee -'Residential C0M2009-01587 !,: ,Plan Review Major - Planning COM2009-01587 ;'Curbcut Permit' ; , COM2009-0 1587 ";' , Sidewalk Permit , , COM2009-0 1587 , ' jii, "" PW Disc - 2nd Perinit . , COM2009-01587 Storm Drainage Impervious Area ~~ -t ' COM2009-01587 Sanitary Sewer - Reimbursement COM2009-0 1587 Sanitary Sewer,: Improvement COM2009-01587 SDC Tran Reimburs-Re~ldential COM2009-01587 . SD~ ,Trans Improvement-Resident COM2009-01587 i,SDC MWMC Reimbursement .,' . COM2009-01587 ' 'SDC MWMC Improvement C0M2009-0] 587 '" 'SDC MWMC Administration COM2009-01587'! :. I'SDC Sanitary/Siorm Admin COM2009-01587 SDC Transportation Admin COM2009-01587 + 5% Technology Fee, COM2009-01587 + 12% State Surcharge " . .-, Payments: Type of Payment CreditCard Check ". -1:, <":heck Number Batch Number .,;"..-~." ;Paid'By' ,SCOTTpA VIS DA VIS CONSTRUCTION SRVCS -'.' Received By djb djb 1377 " t ''.'l:~:' ~: ': :., " ,I. ~)n;;i:~t{t~il ':,~ , , ,'i li; !~'. II......' ;.: ,':', } ,- L. 1 '. T( ':J",,'lt-':, t;' ;~: H~ u . ,~ ~~~:'nt:~[1i"~: ;' ,D~rl{~,. , , ,\} ~l ,t . 4~ .! ~ ; ~ ' <,:, cReceiotl - "~.....-:' . . Page] of2 II , City of Springfield Official Receipt , II Development Services Department . , Public W,~rks Department ;1 ~~ Date: 11103/200~ Item Total: . il Authorization lr Number How ReceivedJf 03557d ]n Person I In Person ' I' Payment Total': 'I ] :22:40PM Amount Due 555,93 855.27 38,00 2,858,00 337,00 79,00 21.00 13,00 9,00 \34,00 50,00 63,00 84.25 211.00 88,00 88,00 (30,00) 681.00 637,85 485,02 21L21 931.65 101.97 1,044,54 10.00 12559 7957 96,21 188,07 $]0,053.]3 Amount Paid $9,500,00 $553,13 $1tI,053.]3 11/3/2009