HomeMy WebLinkAboutPermit Building 2010-3-3
"
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00256
ISSUED: 03/03/2010
APPLIED: 03/01/2010
EXPIRES: 09/03/2010
VALUE: $ 163,024.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: ]033 S 4]ST St
ASSESSOR'S PARCEL NO.: 1802061418600
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single family residence - SAME AS COM2010-00241 1086 s 41st
Residential
Owner: BRUCE WIECHERT CUSTOM HOMES INC
Address: 3073 SKYYIEW LN
EUGENE OR 97405
I CONTRACTOR INFORMA nON ~
Contractor Type
General
Contractor License
BRUCE WIECHERT CUSTOM HOMES INC 101717
ATTENTION: ~rmwL~~;=~ON I
follow rules adul""u U I '
# of Units: Nolificatiqn Center. T~\lP~!MI ,are seUorth ]
Primary Occupancy Group: 1~^Q~Ra~'ll01-00101' II ~1. 1700
. 0090; 'fa may obtai ' .
Secondary Occupancy Group. =;,'1- _ ~ _ . _ . I ph Atlled AIr Gas
P. C . T "",nn eeemer, . e ONI G
nmary onstructlO~ ype tijjffitiGt 6f tllii Ore' n i otIfIllIdIcm as
Sec?ndary ConstrnctlOn Type: tliifitii; ~ 1 ~.QP( . : ). .
# of Bedrooms: j ~ergy at :
Sprinkled Building: '
Expiration Date
09/16/2010
Phone
541-606-5050
Lot Size: 8,809
Sq Ft 1st Floor: 1,519
Sq Ft 2nd Floor:
Sq Ft Basement:
,
Sq Ft GaragelCarport 336
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENTlNFORMATION ~
REQUIRED PARKING
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
17.00
12.00
5.00
13.00
5.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I
Yes
22.70
Total:
Handicapped:
Compact:
2
Street Improvements:
Storm Sewer Available:
Special Instruction:
, I PUBLIC IMPROVEMENTS ~
FNQT.ml;v;d,;r-~::-Btf.r.i::';~:~~jt~iYJ:~:;f~};;t~:;;~~;':Sidewalk Type:
THIS PERMli SHALL EXPIRE IF THE WcmKnspoutslDrains:
Storm wat~l!l'ff\O'R\'l!I!I)'UNl!lm THIS PERMIT IS NOf( ,
COMMENCEQ .9R IS ,ABANDONED FOR.,;;M:.,: '
ANY 180 DAY;p<ERIOD. " "', ,
Curbside 7'
Curb and Gutter
Notes:
I Valuation Description I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Estimate
Estimate
Fee Description
Plan Review Same As
+ 12% State Surcharge
+ 5% Technology Fee
1st 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
Plan Review/Residential Hourly
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 Compliance Charge
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
Willamalane Single Family
Total Amount Paid
Initial Review
03/01/2010
$1.00
Total Value of Project
163,024.00
"
~
Amount Paid
$250.00
$206.07
$103.71
$79.00
$337.00
$38.00
$9.00
$969.23
$-1,063.85
$88.00
$9.00
$13.00
$92.75
$20.00
$7.00
$211.00
$58.00
$-30.00 ,
$134.00' r
$50.00 "i"
$507.07"
$666.84 .
$10.00
$22.63
$1,333.57
$101.97
$160.48
$211.21
$931.65
$81.96
$88.00
$1,063.85
$63.00
$27.00
$2,858.00
$9,708.14
',',
"
'"
Date Paid
3/1/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/1 0
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
'3/3/10
3/3/10
313/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/1 0
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
3/3/10
I Plan Reviews ~
03/01120 0
t'." '
if, '.
OK
Pace 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00256
ISSUED: 03/03/2010
APPLIED: 03/01/2010
EXPIRES: 09/03/2010
VALUE: $ 163,024.00
$163,024.00
$163,024.00
03/01/2010
Receipt Number
1201000000000000183
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
1201000000000000195
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00256
ISSUED: 03/03/2010
APPLIED: 03/01/2010
EXPIRES: 09/03/2010
VALUE: $ 163,024.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Planninl!: Review
0310112010
03/01/2010
APP
DDK
Required street trees as shown on
street tree plan attached to permit:
species as shown. 2" caliper, leave
name tag on until approved.
Garage sethack average ~ 18'+
Public Works Review
Structural Review
03/01/2010
03/01/2010
03/02/2010
03/02/2010
APP
APP
LKW
CJC
Storm water to curb via weep hole
As noted 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...Jl.eollirerUnsnections ~
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to 11001' insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with Iinish materials.
Framing Inspection: Prior to cover and after all ro~~h in inspections have been approved.
Wall Insulation: Prior to cover.
";r: l'
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Masonry:
Final Building: After all required inspections have been requested and approved and the building is complete.
.'
Perimeter Foundation Drains: After gravel and Iilter cloth is installed but prior to backlill.
Underlloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rnugh Plumbing: Prior to cover and including required testing.
Water Line: Prior to Iilling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to Iilling trench.
Paee 3 of 4
CITY OF SPRINGFIELD
',. . i .
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00256
ISSUED: 03/03/2010
APPLIED: 03/0112010
EXPIRES: 09/03/2010
VALUE: $ 163,024.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Final Plnmhing: When all plumbing work is complete.
Underlloor Mechanical. Prior to insulation or decking and including required testiug.
Underlloor Gas: After line is installed and required testing and capped ifnot attached to an appliance.
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 connected to a minimum of one appliance including required
testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Rough Electric: Prior to Cover
'C',
'~''"'. . I.
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
\
By signature, [ state and agree, that [ have carefully examined the completed application and do hereby certify that all
information hereon is true and 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 of any strnctnre withont permission of the Commnnity Services Division, Bnilding Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed 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 plans will remain on the site at all
,;m"""';Tliur 'S100
Owner or Contractors Signature Date
,.....t ;,
, ,."
Paee 4 of4
Electrical Permit Application
.
225 Fifth Street. Springfield, OR 97477tPH(541)726-375HFAX(541)726-3689
" ,".,.I.."i'p.:;.{~',.'" ...,". .'- . .. ,
DI:~~RTMENT.USE ONLY",..
C/O ~OO Z S-
Permit no.:
Date:
3-( - (Q
This permit is issued under 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.
~
~ c.&.r
~ ';
".' "'<"\1EOCAL:;cG0VERNMENT:~AP.f'ROVA(jj,,,,'.f;('~1':"~0:
Zoning approval verified? 0 Yes 0 No
g ::.!~;H,:.i/\~CATEGoRY(1i0F,~\Cc5NSl'IUjc;noN~,'1i. ii",'
o Residential 0 Government 0 Commercial
~~J,j-'iJoBi$IT:E\~.INI;QRNiA'J10NI'j/'i.NjjElL()C'AliloN;~Rt:~.lj
Job site address: .{ 033 Lf ,st
City:
ZIP:
Reference:
. 'DESCRIPTION
tlvuS<= W lie
:0F-",W()R.(.:~~j"':<1;::ri'-~.t*~~~;V:~:Y:;:.",,~,y'
Tewt f
'PROPERTY OWNER .
Name: (2,'{'\JU W, eJ-.e..A CJ;-f-o""
Address: 307 S sit ) i-J
City: .( u V-<-- 0 It- ZIP: 1 71 0 'j
Phond'll-bzb Of ~ '8' Fax: G'IJ-'5Yf ~3b -z,
E-mail: l.-J;a.....e~l-k()~.5eCD\hC....St.IV..-t
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
; 3CONTRACTOR INST ALLATI0N:
Business name: k +- e f ec..+V: G
Address: 'Z 3 :3:5 -:50v--eS Ac<(e.-5
City: S f \~ State: 0 )'L ZIP: q 7 'f '7-g
. Phone:$'1/ -5Z' - 41 'Ill Fax: '5
E-mail:
CCB license no.: I O~ 4 75"
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
L\h~
Wr):f~
BCD license no.: '') c....
'-1/7'1-S-
/;;'\J OeMvJy
I
440-2584-) (9/08/COM)
ti;;:/j:;;\~7~y1~~~$i~~~,~Z~~~i~':;,F,:E,I;'~S'CH_f:[j.O'tje2,~i~~~~;~\~~$~~}~1t<~;
, ,,- .. ........- - - ';'-'. -, ',_<,h'.,_, ',- ~ ';.(o~t Total'
)~urribe~';~f~inspecti~'lisper,it~rn'(il ;,:'. 'Qty.; .j.,
,.~.,.: ,. _' "-,,,",;',, "'..!".... -, -,' ,,:: 'Vii;.;',,,,!I.;(,",;i ....\":, t~~'~. '.- _'~_' A..:~!l~\ ,"c"st. '.
Residential, per unit, service included:
1,000 sq. ft. or less (4) I $134.00 $ /5lf
Each additional 500 sq. ft. or portion L $ 25.00 $')0
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
40 \ to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) I $ 63.00 $ 1:3
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alferation. extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit $ 6.00 $
b, Fee for branch circuits without purchase ofa service or feeder fee;
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder ':lot included
Each pump or iiTigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
;~~f!~~~~~i&~~~~~A:F~'euTcANttXOS'EWi~t~~~Jj~~1~1;t'a~;f~~~ ::~:~
(A) Enter subtotal of above fees $
(Minimum Permit Fee $58.00) Z'i,
(8) Enter 12% surcharge (.12 x [A]) $ '7 '1blf
(C) Technology Fee (5% of [A]) $ J Z. 7/-
TOTAL fees and surcharges (A through C): $ --H;;P'
~
5o...vY\f:- c.. S lo"ii b S Lf IS +
Structural Permit Application~_ ("'0 - Z ~ I
~){~~;kn ~(j;~'OF $'pRINGFIELD; 9RpGQN .~:'. ':,.. '.; ,:\~;;.:. .;--
~PA1"Q,",II1.D~
~.,.~~..
;.;~~,
lIi)l<. .'<:!'
DEPARfMENl'.'USEONii~
.. ..' )"'~"""~'.' ;"-.~.,;-,,;,,..l\":r>'.,:.~"'l<.';'-;""_':"'-'f; ,ct,;
COWl zo, 0)- 0 0 Z S- f:,
Pennit no.:
Date: :5 - f - 10
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.
"''"''''\':''!!i11>lP'ilOCA'~-:-GOVERNMeif'''AePRO\jAilif''~f'''~~~'.j/jl;l:""'1
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This project has final land-use approval.
Signature: Date:
This project has DEQ approval.
Signature: Date:
Zoning approval verified: 0 Yes 0 No
Property is within flood plain: 0 Yes 0 No
~~~iZt}1;ji~~4g~Tg(:rQ[Y&9R;i:GQij~tR(JC]ipN1:\~i~!.i;;",,';:i
Residential 0 Government 0 Commercial
m~~~9:E~~~ii~ZfN(QJ:!r.lATjQ!{?ISNPll[IQ~ATIQNHs;i,:"i).~j
It) SL/lS
City: State: 0 (L 177
225 Fifth Street. Springfield, OR 97477. PH(541)726~3753. FAX(541)726.)689
Subdivision: ; ~ yo\-
Reference:f Be> LO ( Taxlot:
~~~;;~a~A;illt:~~'~1;~*1;~~J{Q[gRTI(~~.QWN~~Ef:'
Name:13{ <<.(,J:<d,,,tCv',Kll"Il.:l,,,O.!. :t1\lL-
Address:3073 51:. .\C:.W L-N
City: t Vi c"-<- StateC./-o ZIP:'] 710<)
Phone: -b,b< 9'i)g Fax: -,n- ~'-3b?
E-maiI:W;~6h.,,\" ~O""'-S c CO"'<~~1. vvc.t'
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:
~~!l:1~i\C'4Ir;;CO'NfRACTORi"iiNS"TA~lAfibNi;i'~!''''S1!;{1ii',;;;, "'''it;
"~...!f'...,o;.8lWI'~U~,,,::~.,_,._". _.',......;_.. ._,:......_,..~~K"..._...._'",..._,.._ _~. ,'. A., _ ~~(;~.,.,.ir;!l..;;;);;;"ti. "".". '/1"";".:
Business name: ~,u", lJ;ec-l,,", Cu,\:>" 1-'."",,-, ]:)J<...
Address: '3 0'7 3 S I:: "' ~.,) LA
City: {.' 1J - C. r<-
Phone: -M& cl'75?
E~mail: w; ~<-k>, I \,-.0 I"" S
CCB license no.: (O I J r'7
Print name:
Stare:O<L ZIP: Cj 7)" l
Fax: .3'1 - 33 b z.
@ co,''' u..~4 ~ "h-I
Signature:
~~'T!ii.'!i.M$.!i!l}PQN:tBAg,fQa:IN[d.RMA."i:(d.N~\r4.t~:t>iL.{;;"
Name CCB License Number Phone Number
Electrical/.+-e '>LI 'II i (,
Plumbing 5!c.vd , Y l- 3 '1 b,
Mechanical CI"H 7 2.6'-0) DO
(a) Job description:
Occupancy
".~1... --'.'>."\~W.'.";(\'.M1-'~. '~.-"f"'.".'.'. ,.I'.....,~'
~,ii,,;i\~l\'$j;"^'!,a!I"'" ."EE;~!l!;.ttEDUI;E:\1~.
,~i~,V;tju3ilonn.iiigrtnatiijri,~~~;1~)~~~~,',':,!~'i~Jf~
" _,).'. .... '_~"__""<"."~"_"'_"'_"___ "1<,,,,.) "" _,J, "." '.; ,..JS ._,
Construction type:
Square feet:
Cost per square foot:
Other infonnation:
Type of Heat:
Energy Path:
new 0 alteration
(b) Foundation-only permit?
Total valuation:
:- 2. Buihi.~~-g"f~~~1:~~~~~;if~/lt~~%t<'1}' /..
(a) Permit fee (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):.
(number of hours x fee per hour)
o addition
D.Yes
$
$
$
(d) Enter 12% surcharge (.12 x [2a+2b+2c]): $
(e) Subtotal offees above (2a through 2d): $
~li:rpia'D~~~~Yi~iY~~~~~' ~~,:~~~(~~~;1f;W~~'IDrt~~J~r6.f~'M~~!Nj;1~~-:
Z 6
(a) Plan review (65% x permit fee [2a]):
(b) Fire and life safety (40% x permit fee [2a]):
(c) Sobtota. of fees above (3a and 3b):
4. Misce.[Iii'ileauS'f~~s'}\'.,. ,. '
(a) Seismic fee, 1% (.01 x permit fee [2a]):
TOTAL fees and surcharges (2e+3c+40): $
$
~
e~willam.al~"e
.' t~ Park and Recreation Dlstnct .
Job. No. (lIt) -2 :>h
. .
-_._-------~ -- ._~--,---
.' ... ".. -.."...
----_..~,----- ..+...
_, - 'm_...____ u..__. . . ."_ _.... _...._.__.. _.. . . ."
----. - -~ - - ------- --------------.--
, .
, SYSTEM DEVELOPMENT CHARGE WORKSHEET
January 1-June 30, 2010
"'NAME,J3,cJ;fLl:},dIEC ttE1t.i ~~~"'-S-'PHONE:P.II b8u. t:t'fr%, - . .
ADDRESS:'30'71 Sl4'vl/;W LN CITY cll.t,E"NI:, STATELl/C- ZIP: C!?lfOS"
LOCATION OF PROPOSED BUILDING SITE:
. Street Address: ) J ~:! .r' q-( s r
Plat Name:
Tax Lot Number: '
1'.' DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type definitions are on the
back.)
At SinQle~Familv Detached
NO. OF UNITS
I
X $2,858 per unit =
B. SinQle~Familv Attached
NO. OF UNITS
X $3,100 per unit =
C" Multi-Familv Apartment
NO.OF UNITS. .
X $2,641 per unit =
, .
D. Sinqle Room Occupancy
.'
--'__c=I\IQ._QLUNIIS'
~L$.t;3~Lper unit =
E' Accessorv Dwellina Unit
. NO. OF UNITS
X $1,550 per unit =
WILLAMALANE.SDC
, .
. .
2. SDC CREDIT (If applicable) SDCpayer must fumish proof of. .
, " ,vyill<lrTl<lI<3l1e C.rEl~it approyal.), .",
_ . _ .~ '.__ _ .......n _. .._..____...___._..__....._..__.__..n__...__.....,. ___" .'_n....'..__._.._...__.._.._._....___......__u__. __. ____
,c'-==,=c==~=a:-TOTALWILLAMALANE NET'SDCASSESSED -=-;;co~'~. . ..
(if SDC reduced for Credit)
~.
$ ..::l-d s:S"'
$
$
$-
$
$2~~
$
o
. -".-.-, ...-., .
-, -+~---~-'---'-' - - -- ..-
- ~ -~-- -~.__.
$ . ?-Tst
Development Services Department
City of Springfield
:1/~
o
Date
Ii)
5
225 Fifth Stn'et
Springfield, Oregon 97477
541-726-3759 Phone
.r~~Q~~...- . .., . .
IIIL . .
~,,_... -" " -
''''''C h,,~, ""...,' ",,~~
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
Date: 03/03/2010
8:41:40AM
1201000000000000195
Job/Journal Number
COM20 I 0-00256
COM20 I 0-00256
COM20 I 0-00256
COM20 1 0-00256
COM2010-00256
COM2010-00256
COM20 I 0-00256
COM20 1 0-00256
COM20 1 0-00256
COM20 1 0-00256
COM20 I 0-00256
COM20 1 0-00256
COM20 1 0-00256
COM20 1 0-00256
COM20 1 0-00256
COM20 1 0-00256
COM2010-00256
COM20 1 0-00256
COM20 1 0-00256
COM20 1 0-00256
COM20 I 0-00256
COM20 I 0-00256
COM20 1 0-00256
COM20 I 0-00256
COM20 1 0-00256
COM20 I 0-00256
COM20 I 0-00256
COM2010-00256
COM20 I 0-00256
COM20 1 0-00256
COM20 I 0-00256
COM20 I 0-00256
COM20 I 0-00256
COM20 I 0-00256
Payments:
Type of Payment
Cred itCard
cRcceiotl
Item Total:
Check Number- Authorization
Received By Batch Number Number How Received
Description
Plan Review Major - Planning
Sidewalk Permit
Curbcut Permit"
PW Disc - 2nd Permit
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC MWMC Compliance Charge
SDC Sanitary/Stonn Admin
SDC Transportation Admin
Credit- SDC Storm Improv
Plan Review/Residential Hourly
Building Permit
Addressing Assignment
Willamalane Single Family
2 Baths One or Two Family
1 st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Fireplace (Listed)
Residence Wiring 1000Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Fire SF Fee - Residential
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
BWCH
djb
Page 1 ?fJ
'. .
Amount Due
211.00
88.00
88.00
(30.00)
1,063.85
666.84
507.07
211.21
931.65
101.97
1,333.57
10.00
22.63
160.48
81.96
(1,063.85)
58.00
969.23
38.00
2,858.00
337.00
79.00
27.00
9.00
13.00
9.00
7.00
20.00
134.00
50.00
63.00
92.75
206.07
103.71
$9,458.14
Amount Pllid
04503d In Person
Payment Total:
$9,458.14
$9,458.14
3/3/20 I 0
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
: :
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wrr ..
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000183
Date: 03/01/2010
8:35:05AM
Job/Journal Number
COM20 1 0-00256
Payments:
Type of Payment
CreditCard
cRcccintJ
Description
Plan Review Same As
Paid By
BWCH
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
250.00
$250.00
Amount Paid
djb
03545d In Person
Payment Total:
$250.00
$250.00
Page I of I
311/20 I 0