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Home My WebLink AboutPermit Building 2009-9-21 , , . CITY OF SPRINGFIELD Building/Combination Permit Stat~s D~[~~~f:~!,r:a.\~~~~~greement 225 FIfth Street;:Sp~IDgtield,'OR"', . 541-726-3753 Phone1, ' ' ~ 541-726-3676 Fax~,,\, ;':.. : :,' --. . . - ""-'~ ,,;: ;:~.... ,..::;;... ~., .;' ... " 541-726-3769 In'sp'ectioii:Line;':\'1:: ,:~, , . '. :."".:, '.(" PERMIT NO: COM2009-01395 ISSUED: APPLIED: EXPIRES: VALUE: 09/21/2009 . 04/02/2010 $ 393,255.00 SITE ADDRESS: 2589 17TH ST, Springfield TYPE OF WORK: Single Family Residence ASSESSOR'S PARCEL NO:: 1703243102700 , , ': i:",'t':i!L,;;;';f~:;~;;~~~;~,i TYPE OF USE: New Residential , PROJECT DESCRlP;fION," Single' family residence. Legacy Estates lot 2 - DPA - DO NOT FINAL Until Fees . )i:"" (: '. Have Been Paid , i;"i":' ,'" . . Owner: Address: . ,; ......-:};;T. ',..::l'''~~'i'h:' ..t. .,'_ ., '. MATT'& MARlASA YRE 350 66TH STREET i';:'. '/' SPRINGFIELD OR 97478 .'_ ': [" I CONTAACTOR INFORMATION I ,_ _' I _, ~, ..;""1",, ~- ~,"'1~L..Fi"~' .. ,j "'" . 'lOv Contractor T~Jje~"::t Contracthr \a'l'l ~e<1J:~e;O(lIj\~~~\'lI License general.,., ,"'0,: j. .,.. HOMESTX\-,ES,u'!e: G~ \De 0 S a~e se~_ClCl\- 89219 "'Electrical .,..': "lfT\;,'; 1';EAS'I;SIDE~ELE€:r-RICINC)~O,X'-9'6 \e~ wi 117770 . . ~,'~ "f\\:.-\~ '(j.V-' \\\V- l\' r- ~u ~ Mechanical " . MARSWELS.I,NC',,, \D~01l9 ~ 0\ \De '^o(le 25790 ,;"\U'I" 'c'" \...1(..0 ~f'\ \v \""IV.::.... \e~\\. n Plnmbing . D9Jl(~~D ~,!::!j)WI~,,,$I co:_. Il\e\e -",\ci,lo 167921 \~ O~" i~1.I \\\a2e~eBuiLiHNG;INF0RMA nON I : .. ClCl9~ii~9 \~e \'(Ie.v;-_~ClQ'~~- ' # of Units:, ~,; ;~i.'i\W" :::" C~'Peq~(lw~ IS \ # of Stories: 2 Primary Occup~ncy;,Gronp: (I R-Y Height of Structure 29.00 Secondary Occupancy Gronp: U Type of Heat: Forced Air Gas , Primary Constr*cti()n l)pe , VB Water Type: Gas Secondary Construction Type: Range Type: Electric # of Bedrooms: 'c .5 Energy Path: Sprinkled Building: n/a Phone Number: 503-701-7792 Expiration Date 02/19/2010 10/04/2009 12/2312009 01/16/2010 Phone 541-345.8000 541-915-9828 541-747-7445, 541-688-1931 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1l,290 2,735 . 1,014 776 , DEVELOPMENT INFORMATION , , . . ,:, , REQUIRED PARKING " ..,." . >' "",9.v" Overlay Dlst: I ", " ux. $\1.ntaJi 2 # Street Trees Rqd: 9.x.3\r I" \'ffii,';dicapped: Paved Drive R!1<l: 1>:\.\. ff,?\Ye"c.?-~\1 r&,-mpact: % of LoH::!i[erage:\1 S1\ c?- 11-31~on(\~t.() , ~v ?t.v,WI \l~()\:. ~1>:~\Jv '\\-\\S ~nI1t.() ~n IS r>: . I PUBLIC ~MPR~;viMENT>'s:,: ?~?-$)$. \JV' Q\J v' , 1>:\\'{ '\ u Sidewalk Type: .J~i~"{<t~ ~~~:~ ;;.f.; :1 ~~y 1 Frontyard Setb~c~:" <" 2(UO ' " Side 1 Setback:';:' \, 10.00 , " Side 2 Setback:;! ',I '0.' ~ 20.40 Rearyard Setback: : 24.60 Solar Setbacks: 0,00 " Subdivision Not Accepted ,,; ~1, Street ImproveI!lents:_ ',$:' 'd!~l'~'.?ii K1 , :1 '. . " , ' ' Storm Sewer Available: DownspoutslDrains: , Special Instruction:" .. For this parcel in Legacy Estates, it is the recommendation to the Building Division, by' the City , ,I 'j' '\. Engineer: "that no connections shall be made to sanitary or storm H20 systems, until the Notes: Stormwater to c.idbdild,~".:" accepted by City Council". ",".f " f !,,--,~' " "'~. l\" ~~~~- " .v.,.t:, ': ~ 1 'J" Paee 1 of 4 ~, " . 1: '"ll' . -.'NQI!!I~ll -":::ftVZ::;:~;;;':J~f'P'!"n";:'lil'" ;l' ,,',' ,,' ~.~ " CITY OF SPRINGFIELD Building/Combination Permit ~. ;:: ',_..r,-. Status ' i>~feiiedPayment Agreement :" - .' ",' ~, ~. ~ ; ,i 225 Fifth sireet!i,SPQngfield,,()R;.,. :i . 541-726-3753 Phone, . ,"' . -:t;:",," - I. c,. r;<~. 541-726-3676 Fax. ' . .,i, 541-726-3769 Inspection Line PERMIT NO: COM2009-01395 ISSUED: APPLIED: EXPIRES: VALUE: ':'f;\t.N:1~~1 ~ ':. .. ~;,H,;~' "" LDescription:f~ni~'fype,,,f Cons!ruction . ' - ';'" :":: _' ;k:~; , -:;~~~: ,. :;~::._,.{. Gara!!e/Misc U VB UtiliWi",r . SFillnplex R-3 VB 1&2 Familv I V aluati~n Descrintion I $ Per Sq Ft or multiplier $37,72 $96,83 Square Footage or Bid Amount 776.00 3,759.00 D Total Value of Project :,1 :: ::~:' - :t' ';'~ ~J: '~"':: " i '~1. r .r t f'- 'I ~~e DescriJtj~~';~}~~11~~~~ ~, SDC MWMC Administration '. SDC MWMC Improvement SDC MWMC Reimhursement J;'pr<' pqWJ Amount Paid Date Paid $10.00 $1,044.54 $101.97 10/6/09 10/6/09 10/6/09 u Total Amount Paid --: ,)~ $1,156.51 '; . ; ~~ r. I.. .- , ,1" I ., : "initial Revl~~raT ~;Q,. 09/22/2009 I Plan Reviews I 09/23/2009 APP LLH Plannin!! Review, 09/23/2009 WE DDK 09/24/2009' /, j A' f' i, ,; ;~r --oj: ,ji"~~:I: ,;+:,q;:' ; f :-. ' , ., " '~ ) ~ ,~~ ::~,_1. , ...",. "!''';'''' Plannin!! Review. 09/25/2009 09/25/2009 APP DDK u " Structural Review il'I;;!"" "e!' 09/23/2009 ':. . ,ti"?,r;:_ '.' 'I, h.,~,J l"" \ .' ,\ : \ '.r~' \ ~l' I 't."I' ," "',H',,' .'\.' " :.', ";..il 09/28/2009 WE CJC ~.i ;. '., .!: T ~; 't'., ;f .1' J' J~~)li - ; ~ :;. . :. ;~ ~i. . ~~. ~!" 1- ~: .' Lo\. , Pa!!e 2 of 4 09/21/2009 04/02/2010 $ 393,255.00 Value Date Calculated $29,270.72 $363,983.97 $393,254.69 09/23/2009 09/23/2009 Receipt Number 2200900000000001137 2200900000000001137 2200900000000001137 Plans do not appear to meet solar sethack, Spoke to contractor, They will provide documentation. regarding how solar will he met. On hold until solar issue resolved. [received letter from contractor regarding solar protection 9/24/09 see attached document), Solar Exempttion -Insignificant Benefit. See letter from contractor attached. Need additional engineeriug for sencond 1100r and chimney. Contacted Engieer Adam Clough 9/28/09, .. ..o.:....r:\. ".( ~..J ~~:. t "',~ CITY OF SPRINGFIELD Building/Combination Permit 'Status' Deier~,~d:P~ym~~~Agreement . .....-., <Of, ,'" 225 Fifth Street, Springfield, OR;,,:.'t ' 541-726-3753 Phone' 541-726-3676 Fax 541-726-3769 Inspection Line, :-:..;:- PERMIT NO: COM2009-01395 ISSUED: APPLIED: EXPIRES: VALUE: 09/21/2009 04/02/20 I 0 $ 393,255.00 Public Works~~;ie~;t?i ,. 09/23/2009 :";';';' l" . I:~;:',<" ~'. . " . . ' " :..':~~~;i:k,~t:,t-"~j} .' 10/02/2009 APP TSS For this parcel in Legacy Estates, it is the recommendation to the Building Division, by the City Engineer: "that no connections shall be made to sanitary or storm H20 systems, until the subdivision is accepted by City Council", () .:~. Stormwater to curb and gutter, .i . ~ .",To Request an' inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 "~~m. will be ni'ad~ tlle'same working day, inspections requested after 7:00 a.m. will be made the following work day. '- " ,,,I R/,n~ , . ",: L' ..:I ':-'1-~ . ~,; , . Ufer Ele~tric~l G~ou~~: ~1;f~1I ground rod at footing and call for inspection in co~junction with footing and/or foundation inspection. . ~ . Fooiing:~~f~~rJ~e,nc~es are t:xcavated.. Final Gas: When all gas wor!' is complete, Final Mecbanical: Wben all mechanical work is complete. Temporary Electric: Approval required prior to Utility Company energizing pole, " ' Rough Electric: .]'rior to Cover ~ :1" . , Electric Service: Approval required prior to utility company energizing service, Final Electric: When all electrical work is complete, t'~ '~, (' Erosion/Grading Inspection:. Prior to ground disturbance and after erosion measures are installed, , Curbcut - Overwidth: After forms are erected but prior to placement of concrete, Sidewalk - Setback: After forms are erected but prior to placement of concrete. . .' ~ . .' "I~ I,lj " . FoundathlD: ;Aft~r forms are erected but prior to concrete placement. ~ :! -; , , Post and.Beain: Prior to floor insulation or decking. Floor Insulation:,' Prior to decking. :1 :. ~ " Shear Wan Nailing: Before c,overing sheathing with finish materials, Framing Inspection: Prior to cover and after all rough in inspectious have been approved. Wan Iusulation: Prior to ~~yer. '" Ceiling ~~SUl~!~~R:, Prior..~~.iov~r. ! '," ". t I Drywall:, Prior to taping. ' Masonry~:; ~'; ;~.;!~" ~: ". Final Building: After all req~ired inspections have been requested and approved and the building is complete. Paee 3 of 4 " ..I. " CITY OF SPRINGFIELD Building/Combination Permit Status Deferred Payment ;,\greement 225 Fifth Street, Springfield, OR ..,: 541-726-3753 Phone . '''- 541-726-3676 Fax ";, : :.~-c.~,,' .,.., 541 726 3769 I' . '.' ':L" ..:.::." ",v"',:fl1i;"" ,', . , - - "n~spec,t!9!1,:, l!1,e;j,:';i~t;;'i;';,,( -,.- ":t~"V~\1;"~ "'~ . ""':::"1 ,,' PERMIT NO: COM2009-01395 ISSUED: APPLIED: EXPIRES: VALUE: 09/21/2009 04/02/2010 $ 393,255.00 <E ;~ ,~,; '-. Peri~e,tet.F:o,~nd~!ion Drains: After gravel and filter cloth is installed but prior to backfill. . ~'" , "';O::,\'~T -..' " .,' ':;< ,'" ,"."" . Uudertloor'Pi,,'riibiugCPrior'.to iusulation or deckiug, Undertloor.Drain: Prior i~j~ver or placement of concrete, Rough Plumbing: Prior t9 c.oyer an~Iucludiug required testing. ,~ '"." , . Shower Pau., Prior to ,covering aud including required testing. . ;.;;;:~:!f''':~;~-'::;:~~;' ~;l};."';;<~'U.-'..:~.:' ~: . Water, Line:>Prio'j. to filling 'trench and including required testing. 'M: t ~- ... Sanitary Sewer Line: Prior to filling trench and including req uired testing, . ~:.;/."!~ Storm Se\ver'Line: ,Prior to filling trench. ' Final Plumbing: When all plumbing work is complete. Undertloor Mechanical. Prior to insulation or decking and including required testing, u Undertloor Gas: After Iin~ is,.installed and required testing and capped if not attached to an appliance. 'ii::: ~1'r.j...:.J" 'j~'\' 1 ;..~ ~:~.; Rough Gas: After Iiue is installed and required testing and capped if not attached to an appliance. "..^!' . Gas Se"':ice: After line is installed and line has been counected to a minimum of one appliance including required testing. ~res~re iest done at this point. ' ".. ., . Rough Mechanical: Prior to .cover By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information her~on is tr!'e and c~r~eft, a~d 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 he 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 i~ 'e~~ure that all required inspections are requested at the proper time, that each address is readahle from the street, thatthe permit c~rd is located at the front of the property, and the approved set of plans will remain on the site at all times during constructiOl". . I 11/(A; ~ -lo.~,., 0../' V'- Owner or Conll:actors Signature A:,;' ,I "';1 .. "\ T .,; 1'). . " 101(/1 /D4 Date I I \'l I . I ~. :1. ~ . .'l~' J '~l ~, ~'" .!..; .n .'t " .', ,") " I. ,1 ~Pf/l. ,"~ t-;"J. ~.{:;~C'~ 1 ; ri . ~r ~ l' ,-. :,",:!' :F'l:;,);;~i;i~ , <, " i; .~,., , :'j.:l'i'. I, .~:. 'n, Ltl -,.f' "e'! l' ~: ':':: ~"! .'" f ',) Paee 4 of4 ll~ i; ~i. \,',,:; t. .,).;...:;;~::.~~ This permit is issued uuder OAR 918-309-0000, Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days, 17I!G~~i.,i\!rG-:c:tilEB.NMJ;Nmr~ee:Ii(:j?Y.i([!:41!ll!~ft'~1 ~~~~~~~~~tK~fTiC:~~~tRW.Qii]IQg;~f>llR~1 ~esidential J 0 Government I 0 Commercial 1:::~~;~I~E~~~~:~ifJl(:j-Ni'j~1~0~:~f~~r~~;~i! I City: S \>~'b I State: uL I ZIP: 9o? C( 7 7 I Subdivision: 1703. Zl.j '3 l I Loi no.: C 27 <'c. ~~~=jj'E$:0'RltiJiiI0J':lJQFJ{WQRK~~_ I .IIv IA.S t-r vII tL,. r I 200 amps or less (2) $ 81.00 $ ~~~~BJ::{9P.cEB~i[€l)!\lr\JER~i\iA:'i~~~78i~'i.1;"lKI 201 to 400 amps (2) $ 95.00 $ Name: /11Arr rf mAl./A- SAVIle" I 401 to 600 amps (2) $158,00 $ I Address: ~ S- O. I b 6 rC. sf 60 I to 1,000 amps (2) $205,00 $ I City: SPI':"~ I State: o!l- I ZIP: ~747g I Over 1,000 amps or volts (2) $469.00 $ I Phone:'503 701- 77 i Z I Fax: I Reconnect only (2) $ 63.00 $ I E-mail: I Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property I 200 amps or less (2) I. $ 63.00 $ h"3 owned by me or a member of my immediate family. This I 201 to 400 amps (2) $ 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 $126.00 $ I Signature: lOver 600 amps or 1,000 volts, see services or feeders section above 1 I~G~Qr\JmR18cJil0Rli1JNS!t~I:1G'Ami€lN.~]]'(;~.f~i I Branch circuits: new, alteration, extension per panel I Business name: E A S rs/ [) EEL (c. T I( , c.. ' I I a. Fedor hranch circuits with purchase of a service or feeder fee: I Address: 3 ~2S'3 If:,05CAG-E. vA"'E I I Eachhranchcircuit I I $ 6.00 I $ I City: 5 (J'(" CD I State: CJ p<.. I, ZIP: '77 y 7~.1 I b. Fedor hranch circuits without purchase of a service or feededee: I Phone: -7Y,./V9<fIFax: .736-Y%011 First branch circuit (2) I 1$55.001 $ I E-mail: R Ie K (3 ^ S T S 10 E, ~ 'y ~ H <:> () ,C 0 Jv1 I I Each additional branch circuit $ 6.00 $ I CCB license no.: 1/7770 I BCDlicenseno,:~O-Y05'c I I Miscellaneousfees:serviceorfeed~rnotincluded Signing supervisor's license no,: ~ 7 2 7 5 I I Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: 1< 0 (;. € ((, I( J IJ G- I I Each sign or outline lighting (2) $ 63,00 $ I Signature of signing supervisor: 1 I.... , . I~ I 1 Signal circuit or a lim, ited-energy panel, $ 63.00 $ 1 "-"'i Vl 1 alteratlOo, or extensIOn (2) ~~~=;;;~~~$~~ffin&~~ I (A) Enter suhtotal of above fees I' ~ ~ (Minimum Permit Fee $58.00) $ .3: -/ /1 I (B) Enter 12% surcharge (.12 x [A]) $ L(7b~ I (C) Technology Fee (5% of[A]) $ n an, I TOTAL fees and surcharges (A through C): $ U hll t(7 1 Electrical Permit Application "'..... '" B 225 Fifth Streett Springfield, OR 97477 <PH(541)726-3753 < FAX(541)726-3689 \S)~&": .~~~ '~ ''0 ~ (J' \ 440.2584-J (9/08/COM) ~~Jifr;PE~A~TMENfu1usg~Wbi:~~,. 1~,Jj''''!l''''''',.-;':_'''.:i;_~~::~'^'rf~~~~~~f:' Il~~~p~o,- Of:3 c; S- I Date: 0:~ i I ~~~~I$JPB~[jJ!Jrn~ ~~~~~t'I~~~'q~l; ~l'i$,.;fj~~'kWA'1&.;~,;:Z.;iffir'E',~ii<'l~'"1'Jm'~~'c'i';;""C$;l:; Residential, per unit, service included: 11,000 sq. ft. or less (4) , lEach additional 500 sq. ft, or portion thereof ' I Limited energy (2) I Each manufactured home or modular dwelling service or feeder (2) . . Services or 'feeders: installation, alteration, relocation $134,00 $ /34 $ZOcf I /1 il I 1 $ 25,00 $ 32.00 $ $ 63.00 $ 1;"~~~R:::'i.~E~N/~~:t' .s- Permit no.: I Date '7-zr-oCj I 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, Structural Permit Application '""DpA - --- 225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689 1~~;i~~:i:<';,~)k:~:,;~}S$\;~Q,~A~,;"~QYE.t~frM~:~ft~:;~'[Ff~CQy~U.~~~l~i~~~B I This project has final land-use approval. Signature: Date: I This project has DEQ approval. Signature:. Date: I Zoning approval verified: 0 Yes 0 No I Property is within flood plain: 0 Yes .wo I 1Iif.l'''I''i:%<'$'I'l!r'''''{;A:tE'G0RY~0fi:C0NSfR8c;fr0N''';O-;'<'1i:;:~;:Sii!""""'1 ~J~~?~y'">'}J;~,~".,, ';._.__.__~,.,~:..rftf,,:"_;BL:, :__ _.=--._;.,~..,:.L_ .'__,,~;:;g,t~;"~..~?G:~ ~",,;,;~,e,f,:,ii?,.,e,:~,,:,'oia,,~"'''_S'I;;:E''''''I!N"'-~,'O"~RoM,;eA,:~m,'I-O':Nn_~"'A"N,"',"D",",J,'o<>i:JC'~"A'C;I~O"~N;,:~;~,I",,''''f,r,,1 ~~~~01~:,.:-::'r;:~~;",.' ~.\t . il ~), E' .'1 . " 3L..~.' ~~.,_' _..:I"d:..J~j1~'1i~:i'.~~t~;\ I Job site address: 2,'5""89 ~I. ni~ J.;!:.. I I City: 5p":,^" C:dll State: oR I ZIP: 1''171 I I Subdivision: J.i,.,.n" b;.b.-tes I Lotno,: :!l. 2- I I Referencelrav3. 2:.4 ~ ( I Taxlot: 0 2-7~ I h:;", '"., ,:.', ", P'RQ~EBTY"Q1i\.rN~~;?,rr~,"i:!f:\, \. 'I I Name: ~..l+-.. M... __',~ ,<;..,... rL 1 I Address: ").So 'u"" '" / I I CitY, '--'__';'j C:.-d) I State: Oft I ZIP: "'11m I I Phone: ....,- 1112 Fax: I .. J"'~ E-mall: ~ e. ~j. <"'1.'" 'A_ 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. Sign here: " ,.'",' ~ONTRAC[i:()~:ti~S~AtLA'J'lQN!"'<''.)i'_ ,"}, .::',,'1 I BUSi", ess name: J.ldkoJ S~ :t.., r Address: '-1'16 L H, r_ '" _' S". I City: ~^( I State: 0(( I ZIP: <i 1 <1. "'/ I Phone:'5"'if -~(-Y;l\n~ Fax:5'1/-Co1. '15'51 I E.mail: .)...1 ~ e LI"_.',I.Yli'A I CCB license no.: <6'1'Z-I'l I Print name: J<kl v.rl-r"'C:;:, /1 I I Signature ('u~ I f:;tj[;i~1\~::&~EhGQ:{~~~;:~~~~~~~MAi'~~:~:=;,~~i I Electrical 11,.110 ""S- '1\'lA I Plumbing b4", L/!iI'I,'5, ("tc(' I ~ J, . I Mechanical "l 5'1 ~" 1'11 ' 111L15 ~9 1~~:~!:;~:~:,.?}>~~/3~:\~?~~~~~I~_~~'~'$.~~~f1fQP'~~!~?~Rr~~"?T~}rl1Xr:~}t~'~'::;;'~':1 .1:fjj:~y_~f:~~iI9:rr(f~f9I~If~:(i9~n.~1iffJGl~,~~~l{~:;r:f~1@~~{~fk~,~,R~~~~~'f;~:1 I (a) Job description: Si..../r f-Io,,,,,,.(.. ~,~cI:~ I Occupancy ~ '3 . + ~ l I Construction type: V i1 I I Square feet: 1 f Cost per square foot: ) , I Other information: I I Type of Heat: G-KS r= A I I Energy Path: i A I I .EJOew 0 alteration 0 addition I I (b) Foundation-on]y permit? 0 Yes -ErNo 1 Total valuation: I $ S/j'i..<JI)<J I 1~2~%I!~tt4~lYg:~te~.sJ~~1~n~&r~~jt~1{~~~~~t~ir;~!0t;;;~~0~~~::~12;~\~:\~~j,~~:~1 I' (~) Permit fee (use valuation table): I $$ I (b) Investigative fee (equal to [2a]): I (c) Reinspection ($ per hour): I $ (number of hours x fee per hour) I (d) Enter 12% surcharge (,12 x [2a+2b+2c]): I $ I (e) Subtotal of fees above (2a through 2d): $ I 1~~Jf:iJJ~1r~~J~wI!~:~~~~1~~~,~]1>~'~~~;ffi\Qif~~t~~~~1 1 (a) Plan review (65% x permit fee [2a]): $ I (b) Fire and life safety (40% x permit fee [2a]): $ 1 (c) Subtotal of fees above (3a and 3b): $ (al Seismic fee, ] % (.0] x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): $ ~ ~~?0 ~ ~Cf , : ':';:"~ 225 Fifth Str:eefl~;t:"iiti;f.;:j':<\{:( .' Springfield,breg~Ii97477'c" ,; 541"726-3759 Phone ':. . .:l :'';: .~. ,- ';'~';"::;~;X;-f~~'~~.;;~{i.'~~ . ' City of Springfield Official Receipt Development Services Department Public Works Department . .,..,.-',..,.....,. ".'. · .' RECEIPT#:;' "2200900000000001137 .:., , Job!Journal Number" . Description . ',',_ ." . COM2009-01395 . SDC MWMCR~inibursement :,' . -;'; _: -' '. ._'.:.':.'l.~_.J: . COM2009'0 1395:'c:,.)yjSDC,MWMC,Improvement . , . -.--;:_J;~'''_:: 'll-./"~:'':::: ,-, ,'" .:., ""'~, ' .. COM2009-0 1395. ~.;;:V);SbtMWMC Administration . '. :-:'~~f>':~,' .:;-~~" . ~;~;no~n~:~'~ent .,.it ~ff~ii-~1r~y.~~~' ':;:~:;b::'M~f0~~:;'~"",,-, . CreditCard :'MISS,MARlA TSA;YRE' ,,'.. '.~ ", : .'~:; l! " , ~l . -'.' 1; l. . 'I~ ;' ...... . . -,~;,;.-~,;,'~,:.:'._' ~t ", .'! ~\..~~. .~ - . "i ,.....<1. r"', " ;, "; ~I -. .,.::." ~ t ,~ . ,; , :"::VI , , ;~ .; ~i;i".. ,; :;'1. 'I "'~(- ,1 . ,\, "t' .t 't~.' ", {t !}\ . ,- , ' - ",~~,'l f"~?'f:.: -J .. J. f' I ' '~{ '. > - \ 'U' f~: . ~~' ...., .1}~ ~-:.f"!\~ ~:':, " ; ~"jJ.. . ',' 1~;' .. !, {'I ':;f f' ; f r' , ~, , -:f !-i' , ., , , Date: 10/06/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received DJB 00575C In Person Payment Total: I: " :}1,1 r ~l: ': " 1 ;1. \ " "? 1 : \ ,; . Ii , ". ,. ~- ,t , . ,> " Page 1 of 1 ;Z" _~l " e . \; , , cReceintl 9:50:45AM Amount Due 101.97 1,044.54 10.00 $1,156.51 Amount Paid $1,156.51 $1,156,51 101612009 ~~ APPLICATION TO DEFER FEES AND CHARGES AND CONSENT TO ASSESS LIEN The owners of the property shown below hereby apply to the City of Springfield to pay the fees and charges of $ Ill.!. cr 8.2. L/, deferred until final building occupancy is requested. In the event that the real property on whicb the fees have been deferred pursuant to Ordinances 6233 and 6234 is sold or conveyed, the fees or charges deferred shall become immediately due and payable to the City of Springfield, Sale or conveyance includes either actually. selling, conveying or assigning any or all of the property or any or all of the owner's i1i~rest in the property. The owners hereby apply for and consent to the voluntary imposition ofa lien for $J..lL3...1P,. L.upon,the following described land in the City of Springfield, Lane County, Oregon: MAP AND TAX LOT j'ilJ S' 2<17/ (J 2. 7 tJO SITE ADDRESS 2~"ff7 17"~ SI CITY, STATE, ZIP 5f'I2I1V(,~Je:-C/~ t)/Z 97L/?? SEE ATTACHED LEGAL PROPERTY DESCRIPTION JWA I' i MA-itA- 3S0 bQ+t-.. S.f/l....... ~ .gdd ~e.f::7::,.-6, V $ IL/7.?S!!i- $ ? /.!!!=' s.fA Yc'<L BILLING NAME BILLING ADDRESS CITY STATE ZIP 97C{7'i5 FEES AND CHARGES DEFERRED RECORDING FEES TOTAL LIEN $ /l./l/Z 9. z4 [n addition to the fees and charges indicated above, we agree to pay the fees associated with recording the lien and removal of the lien at Lane County Deeds and Records: We are all of the legal owners of the described land or all of the contract purchasers of record of the described land to which these fees and charges are applicable. We waive any and all irregularities or defects,jurisdictional, or otherwise, in any proceedings to impose, calculate and collect these fees and charges; and in the imposition and collection of the lien consented to in this application. We promise to pay these fees and charges when final building occupancy is requested or at such time the real property is sold or conveyed. The charges may be paid in full at any time without penalty. We understand that if there is a subsequent failure to pay the fees and charges the City shall have the right to enforce payment of the amount due in any manner provided by the general law of the State of Oregon, or by the Springfield Municipal Code, including but not limited to foreclosure of the land. In the event of any proceeding to enforce collection or to foreclose, the entire unpaid balance and any fees shall be considered delinquent and due. We also agree to pay the city's cost of collection or foreclosure and any attorney fees necessary for such collection or foreclosure, rv\(Ur'I(~ So.t'\rb , Print Name of Owner ~.J >171 f1~ ~/j(Mt Signature ofOwneY' m/0 (0 ~ Data <-,riJ,-Yin3-72fo'ir Phone # Print Name of Owner Signature of Owner Date Phone # Print Name of Owner Signature of Owner Date Phone # PrintName of Owner Signature of Owner Date Phone # (Q~ day of ~ . OFFICIAl SEAL BRENDA JONES , NOTARY PUBLIC . OREGON . COMMISSION NO, 429141 MY COMMISSION EXPIRES MAY 2'7. 2012 . Jp(j1 . . STATE OF OREGON 5S. County of Lane v:\common\accnting\assessmt\Deferred fees contract.doc Glh:~~,i ~",.,.',..'<,)J ~,... 12/3/2009 8:36:39AM City of Springfield Development Services Department Public Works Department Transaction Log For Date: 11/17/2009 Line Items: Job/Journal NumlJ Tran Cod np:~,..riutiD.J1 Revenue Account No Amount Paid COM2009-0 1395 1061 Plim Review Residential 224-00000-425602 $1,238.46 COM2009-01395 1020 Addressing Assignment 224-00000-425602 $38,00 COM2009-01395 1074 WilIamalane Single Family 82 I -00000-215023 $2,858,00 COM2009-0 1395 9111 Fire SF Fee- Residential 100-00000-424005 $226.25 COM2009-0 1395 1040 Copy 6th @ 75 cents 224-00000-425602 $0,75 COM2009-0 1395 1041 Copies - Ea AddtI @ 50 Cnts Ea 224-00000-425602 $23,50 COM2009-01395. 1231 . Plan Review Major - Planning 100-00000-425002 $21 LOO COM2009-01395 1002 Building Permit 224-00000-425602 $1,905.33 COM2009-0 1395 1005 3 Baths One & Two Family 224-00000-425603 $402,00 COM2009-0 1395 1006 1st Appliance 224-00000-425604 $79,00 COM2009-0 1395 1006 Vent Fan 224-00000-425604 $45.00 COM2009-0 1395 1006 Appliance Vent 224-00000-425604 $9.00 . COM2009-0 1395 1006 Exhaust Hoods 224-00000-425604 $13,00 COM2009-0 1395 1006 Dryer Vent 224-00000-425604 $9,00 COM2009-0 1395 1006 Gas Outlets 1-4 224-00000-425604 $7.00 COM2009-0 1395 1006 Fireplace (Listed) 224-00000-425604 $20,00 COM2009-01395 1006 Heat Pump 224-00000-425604 $17,00 COM2009-0 1395' 1004 Residence Wiring 1000 Sq Ft 224-00000-426102 $134,00 COM2009-01395 1004 Residence Wiring Ea AddtI 500 224-00000-426102 $200,00 COM2009-0 1395 1003 Temp Power 200 amps or less 224-00000-426102 $63.00 . Page 7 of II cTransactionLog.rpt G[p~~,','...l,i 1tfiI~.'i:'''. '''',. i: . ..,,_~- "".J """-''''-''-~'''~.~''"_.' I -, COM2009-01395 COM2009-01395 COM2009-0 1395 COM2009-01395 COM2009-01395 COM2009-0 1395 COM2009-01395 COM2009-01395 COM2009-0 1395 COM2009-0 1395 COM2009-0 1395 COM2009-01395 COM2009-01395 COM2009-01395 Payments: Method Check Transaction Log For Date: 11/17/2009 1005 1141 1142 1148 1141 1178 1183 1184 1173 1174 1190 1175 2099 1099 Miscellaneous Plumbing Curbcut Permit Sidewalk Permit PW Disc - 2nd Permit Overwidth Application Fee Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC Sanitary/Storm Admin SDC Transportation Admin + 5% Technology Fee + 12% State Surcharge Paid By Received Check "Ir 551568 D., WESTERN TITLE ESCROW dib Page 8 of II 12/3/2009 8:36:39AM City of Springfield Development Services Department Public Works Department 224-00000-425603 201-00000-428060 201-00000-428060 201-00000-428060 201-00000-428060 440-00000-448028 442-00000-448024 443-00000-448025 446-00000-448026 447-00000-448027 719-00000-426604 719-00000-426604 100-00000-425605 821-00000-215004 $95.00 $88,00 $88,00 ($30,00) $45.00 $2,154,99 $1,130,73 $859.81 $211.21 $931.65 $252,60 $69,64 $ 170.02 $359,80 Line Item Total: $13,925.74 A"1W!l:l! I # How ~ In Person $13,925.74 Amount Paid Payment Total: $13,925.74 ~ cTransactionLog.rpt