HomeMy WebLinkAboutPermit Building 2010-4-23
CITY OF SPRINGFIELD
Building/Combination Permit
Status ,Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2009-01073
ISSUED:
APPLIED:
EXPIRES:
VALUE:
07/24/2009
06/09/2010
$ 375,630.00
SITE ADDRESS: 2831 20TH ST
ASSESSOR'S PARCEL NO.: 1703240000506
SPRINGFlETYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single Family Residence, Parcell Helfeich Partition
Owner: TONY & LINDA HELFEICH
Address: 1017 HAYDEN BRIDGE ROAD
SPRINGFIELD OR 97477
Contractor License
JEB & JACKIE WIRFS INC 97677
STEVE HAUCK 147618
LOWES WEATHERIZATION 176741
STEVEN R JOHNSON 65065
I BUILDING INFORMATION I
'IoU'"
# of Units: I jil~1iW\lfl\:\)\i\~. 2
Primary Occupancy Group: R4.-.le9ol' \e: \\\ei@lP ~~ . 24.50
Secondary Occupancy Gro~~~O"'tr;;09\eO 'o'l$enl\!l fJ'l; i6'fd Air Electric
Primary Construction Typpi: i:IfI ,\)\e$&~e1' 'tl';'l \1to:!\l\~ " Electric
Secondary Construction T~~\\\\ce'-\ol' t'l},\$'\O ~ ~~O(\ . Gas
# of Bedrooms: Wl O,.p. *'h'.., 0'0"-'(\ ~e; '!tb\\~
~""" 'Co\) f\\ ....~el. n"p.\Ul ~Iding: .', ", No
nu"u' . \WI..... ~e"'e 9.3'
~~, ~~i!, ~
~f\\,Oe1 C~l\~ell LOPMENT INFORMA TlO~
_~\:l'si{i\?~':fr't>-'" ~ .
I PUBLIC IMPROVEMENTS ~ ., ~ \t'\~ \4& ~Q .;
Sidewalk T.i (f..'r\~ t.\l.\fI~ O'^ "
, f"~ e..~.:,,~ I~~ \> ..\t.~ ~ 'Curbside 7'
No O,,\'v' sl! ~r6t ~~t;j\~ To Storm Sewer
Storm water directed to private drain/Ou sep~~'$ ~~~~~ ion fees. '
~\\\t;j ~Ct.fJ ~\Q~'
Added 3 lixtures on Ocotber 29,2009 !': ()~~t: fJ~?t:
\\\'l '\ 'Q\} ,
Contractor Type
General
Electrical
Mechanical
Plumbing
Front yard Sethack:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Availahle:
Speciai Instruction:
Notes:
I CONTRACTOR INFORMATION I
40.00
32.00
10.00
32.00
0.00
Overlay Dist:
# Street Trees Rqd:
'k~~,ed;p~~~~,~ ~qd:
0/0 of Lot Coverage:
Urban Fringe
I
Yes
21.00
;.'
Paee I of 5
Residential
Phone Numher: 541-747-2855
Expiration Date
04/1212012
04/3012011
06/19/201 I
03/12/2012
Phone
541-746-3025
541-221-2665
541-485-2282
541-342-3765'
Lot Size: 17,205
Sq Ftlst Floor: 2,706
Sq Ft 2ndFloor: 818
Sq Ft Basemeut:
Sq Ft Garage/Carport 912
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
2
CITY OF SPRINGFIELD
Building/Combination Permit
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2009-01073
ISSUED:
APPLIED:
EXPIRES:
VALUE:
07/24/2009
06/09/2010
$ 375,630.00
Status
Issued
I Valuation Description I
Cara2e/Misc
SFlDuplex
U VB Utility
R-3 VB 1&2 Familv
$ Per Sq Ft
or multiplier
$37.72
$96.83
Square Footage
or Bid Amount
, 912.00
3,524.00
Value
Date Calculated
Descriotion
Tvpe of Construction
. Total Value of Project
$34,400.64
$341,228.92
$375,629.56
07/24/2009
07124/2009
~
Fee Descrintion Amount Paid Date Paid Receipt Number
+ 12% State Surcharge $37.08 11/9/09 1200900000000001247
+ 5% Technology Fee $15.45 1119/09 1200900000000001247
Residence Wiring 1000 Sq Ft $134.00 1 f 1119/09 1200900000000001247
Residence Wiring Ea Addtl 500 $175.00,.>,,1 '."1 i' 1119/09 1200900000000001247
,;.
+ 12% State Surcharge $7.92 4/23/10 1201000000000000378
+ 12% State Surcharge $288.49 4/23/10 1201000000000000378
+ 5% Technology Fee $3.30;, 4/23/10 1201000000000000378
+ 5% Technology Fee $138.05 4123/10 1201000000000000378
1st Appliauce $79.00 4123/10 1201000000000000378
2 Baths One or Two Family $337.00 4/23/10 1201000000000000378
Addressing Assignment $38.00 4/23/10 1201000000000000378
Building Permit $1,832.07 4/23/10 1201000000000000378
Cnrbcut Permit $88.00 4/23/10 1201000000000000378
Dryer Vent $9.00 '4/23/10 1201000000000000378
Exhaust Hoods $13.00 4/23/10 1201000000000000378
Fire SF Fee - Residential $221.80 4/23/10 1201000000000000378
Fireplace (Listed) $20.00 4/23/10 1201000000000000378
Fixture $57.00 4/23/10 1201000000000000378
Cas Outlets 1-4 $7.00 4/23/10 1201000000000000378
Heat Pump $17.00 4/23/10 1201000000000000378
Plan Review Major - Planning $211.00 4/23/10 1201000000000000378
Plan Review Residential $1,190.85 4/23/10 1201000000000000378
PW Disc - 2nd Permit $-30.00 4/23/1 0 1201000000000000378
SDC Sanitary/Storm Admin $138.55 4/23/10 1201000000000000378
SDC Tran Reimbnrs-Residential $211.21 4/23/1 0 1201000000000000378
SDC Trans Improvement-Resident $931.65., c,) .. 4/23/10 1201000000000000378
".
SDC Transportation Admin $57.14' ' 4123/10 1201000000000000378
Sidewalk Permit " $88.00 4/23/10 1201000000000000378
Storm Drainage Impervious Area $2,770.95:, 4/23/10 1201000000000000378
Temp Power 200 amps or less $63.00 4/23/10 1201000000000000378
Vent Fan $9.00 4/23/10 1201000000000000378
Vent Fan $27.00 4/23/10 1201000000000000378
WilIamalane Single Family $2,858.00 4/23/1 0 1201000000000000378
Total Amonnt Paid $12,044.51
Pa2e 2 of 5
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
workday. ",'''''''' ',/"
.t;
Pa2e 3 of 5
CITY OF SPRINGFIELD
Building/Combination Permit
St. tus
Issued
PERMIT NO: COM2009-01073
ISSUED:
APPLIED:
EXPIRES:
VALUE:
07/24/2009
06/09/2010
$ 375,630.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
l....Reolli..erlJnsnections I
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod aqooting 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 Ooor insulation 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 insp~ctions have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Masonry:
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Bnilding Inspector.
Final Building: After all required inspectious have been requested and approved and the building is complete.
Underground Plumbiug: Prior to filling the trench and including required testiug.
Perimeter Foundation Drains: After gravel and'filter ~loth is installed but prior to backfill.
Undernoor Plumbing: Prior to insulation or decking.
Under-floor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to tilling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbiug:. When all plumbing work is complete.
Underlloor Mechanical. Prior to insulation or decking and including required testing.
Under/loor Gas: After line is installed and .r~quired testi~g and capped if not 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 cnnnected to a minimum of one appliance including required
testing. Presure test done at this point.
Paee 4 of 5
CITY OF SPRINGFIELD
Building/Combination Permit
.;:d.
;.','
PERMIT NO: COM2009-01073
ISSUED:
APPLIED:
EXPIRES: .
VALUE:
07/2412009
06/09/2010
$ 375,630.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Linc
Rough Mechanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Temporary EI~ctric: Approval required prior to Utility Company energizing pole.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
FEMA Certificate Required: FEMA Certificate required to be completed and presented to the City of Springfield
prior to reqnesting any final inspections on this project.
Masonry:
",.;.'t." ',h,+A. ~:'" : \
By signature, I state and agree, that 1 have carefully'e~'amilled 'the completed application and do hereby certify that all
information hereon is trne 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 structu';'e without permission of the Community Scrvices 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 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
times during construction.
~~ ;73
Date
7 ~ /0
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Pa~e 5 of 5
Structural Permit Application
i:ll:pARTMEr.hus~'~N~Y .
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
Permit no.
..\blS
Date:
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.
\ 1J)Sf} ~~
d-'10lP 1...- 1'\1'
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:ii'~; :.;\;,~'c>tfAt;::q9Y'~B~Mg~'fii'l.i~F@:i:V ~~l~'j;tt*!~~~~'!i~
This project has finalland~use approval.
Signature:
This project has DEQ approval.
Signature:
Zoning approval verdied: DYes D No
Property is within flood plain: DYes D No
~~Ald~~~lW9'At~,g9:8yIQ_~~1~.Q,N~~~Q,ctnl.~'~~tgf!t~ii~~,r~~~~~
o Residential D Government 0 Commercial
~.~k~Y,:rw.i;;;:i{'O"'-"'B""~~,S-" ". .
Tl{;:,:SMF i:;.;1~,\"'",'". }L,
Date:
Date:
Job site address:
City:
Subdivision:
Reference:
Name:
Address:
Fax:
E-mail:
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:
Print name:
Signature:
t~~d~~1ItfW~if~..
Name
Electrical
Plumbing
Mechanical
~ .i--
,', ''', -., <To ,''- , '"" .. ....S.C.H."'E-._O...U..'L....E".':7..'...:-.:...
;'~.":'('.:: ;~>~i.1(, ~~\S!:";~.:(~;~-h.F;~-~ _ _ i _ "__
p;~
>::1\~ 'V"""il'I' .<."!i.-~t-':-,"i-iM.i;~'-t--f..."" ;1,'''"'' :-t--".;!::J:i;<;;;/!;f~(c{.@~~ \1H ;,;~" ,;:.."~r''''\[L t.',f:i<,:, W..Ya ~k%:'" l :'; ,
" __ -1\, ,.~.._1!~.).9~)1! Qrm.~".19},~'i'i:;z;;nJ,h1m\:i!~1~y,utirf..J:\f!:'IAl~~'"4.";,~;S~!, -- ,f/'!:,!;:tkA'K:r.:I!
(a) Job description:
Occupancy
Construction type:
Square feet:
Cost per square foot:
Other information:
Type of Heat: b~/f-
Energy Path: 'I ~
o new 0 alteration 0 addition
(b) Foundation-only permit? DYes D No
Total valuation:
(a) Permit fee (use valuation table):
(b) Investigative fee (equal to [2a]): .
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
(e) Subtotal of fees above (2a through 2d):
$
$
$
$
$
(a) Seismic fee, 1% (.01 x permit fee [2a)): $
TOTAL fees and surcharges (2e+3c+4a): $
Electrical Permit Application
D
225 Fifth Street. Springfield, OR 97477.PH(541)726-3753.FAX(541)726-3689
i\!!!0i'2DgPARliM'EFl'mlusElom:"w~'i
i<F""':t-:,:,,'i'-:''''"'''~''<'i';;'"';'*'''''_i':K:~4f>:.tI:.~5'Jt''-'c.-:j~1b;:
rvn_ 1 -2.
Permit no.: \...r\ \ 0
Date: Z' - II - 0 ~
This permit is issued under OAR 918-309-0000. Permits.are uoutransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
,-
&~_~1!0_Q~!!IG0Sl!:BNM.i;NjJ'i&''<<&P.:R:Q;\l'<<~
Zoning approval verified? DYes . D No
~'!;~G:~iJi!:~{0BY.[Q".IJ::ON$JijR(!J.o..il]10ri1.11~i'!I~~~
D Residential D Government 0 Commercial
~JQi3:1!$i)tLEI!(NF2t:5B.Ml\ffiiQ~I'~NJ;l1iJIO'13.~1l10N)~1
Job site address: ft\. ~;-
City:
Address:
City:
Phone:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my inImediate family. This
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
~p.(;)NI!i~QjttO]~lINS.rrIi:\l!lEgJiI~N~~i';)~~~
Business name:
Address:
City:
Phone:
E-mail:
CCB license no.:
ZIP:
Fax:
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
440-2584-J (9/08/COM)
Residential, per unit, service include'd:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft or portion $ 25.00 $
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 $
401 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)
201 to 400 amps (2)
401 to 600 amps (2)
\ $ 63.00 $
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
R. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit
$
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
$ 63.00 $
$ 53.00 $
Signal circuit or a limited-energy panel,
alteration, or extension (2)
Each additional inspection: (I) $58.00
._c__~_:"_~_ '""J<i1-'-~JlI'"
_ 'lK~.R.l!llGJ!;!':lif1lli!.it$.J;1lllIi5"
$ 63.00
$
$'
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A])
(C) Technology Fee (5% of [A])
TOTAL fees and surcharges (A through C):
tt ~ !~!!!!l~l~~e
. Job. No.
~q~\bl3
ADDRESS:
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
PHONE:'1Ltl ~
6>11 ~STATE:1L~IP:ilJtI 1
LOCATION OF PROPOSED BUILDING SITE:
2..[J+t\ ~+
NAME:
Street Address:
Plat Name: ~.
Lot Number:
~(!el
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the
back). .
A. Sinale-Family Detached
NO. OF UNITS l
B. Sinale-Family Attached
NO. OF UNITS
C. Multi-Family Apartment
NO. OF UNITS
D. Sjplale Room Occupancy
NO. OF UNITS
E Accessorv Dwellina Unit
NO. OF UNITS
WILLAMALANE SDC
X $2,858 per unit =
$
'L5$.cxJ
X $3,100 per unit =
$
X $2,641 per unit =
$
X $1,321 per unit =
$
X $1,550 per unit =
$
$ 9PF~~fCJ
~
$ 2ffi5.cxJ
$
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)
'-I 1.Ib t!Of 0
Date
Development'Servic
City of Springfield
5
225 Fift/l ~treet
Spritigfield, Oregon 97477
54]-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECE]PT #:
]20]000000000000378
Date: 04/23/20]0
8:31:27AM
Job/Journal Number
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 1 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 1 073
COM2009-0 1 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
COM2009-0 I 073
Payments:
Type of Payment
Check
cReccintl
Description
Plan Review Residential
Addressing Assignment
Willamalane Single Family
Temp Power 200 amps or less
Curbcut Permit
Sidewalk Permit
PW Disc - 2nd Permit
Fire SF Fee - Residential
Building Permit
I st Appliance
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Fireplace (Listed)
Heat Pump
2 Baths One or Two Family
Storm Drainage Impervious Area
SDC Tran Reimburs-Residential
,
SDC Trans Improvement-Resident.
SDC Sanitary/Storm Admin
SDC Transportation Admin
"'1,
Plan Review Major - Planning
+ 5% Technology Fee
+ 12% State Surcharge
Fixture
Vent Fan
+ 5% Technology Fee
+ 12% State Surcharge
,.
Paid By
PACIFIC HOMES
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
10689
djb
In Person
Payment Total:
<".1
Page I of I
Amount Due
1,190.85
38.00
2,858.00
63.00
88.00
88.00
(30.00)
221.80
1,832.07
79.00
27.00
13.00
9.00
7.00
20.00
17.00
337.00
2,770.95
211.21
931.65
138.55
57.14
211.00
138.05
288.49
. 57.00
9.00
330
7.92
$11,682.98
Amount Paid
$11,682.98
$11,682.98
4/23/20 I 0
22,5 .fi(t~ Street
Spi-iJigfie'ld, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000377 .
8:30:54AM
Date: 04/23/2010
Job/Journal Number
LDP2009-00063
LDP2009-00063
Description
LDAP Short Form
+ 5% Technology Fee
""
.' p.' . ;
Amount Due
450.00
22.50
$472.50
Item Total:
Payments:
Type of Payment
Check
cReceinll
Paid By
PACIFIC HOMES
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
10689
$472.50
$472.50
In Person
Payment Total:
, ",
.. \.' .'
, '/~
Page 1 of 1
4/23/2010
'.
APPLICA nON TO DEFER FEES AND CHARGES
AND CONSENT TO ASSESS LIEN
'~ fY6~,!J
\{ ~ % -V':> ~(f(/
'\~
The owners of the property shown helow hereby apply to the City of Springfield to pay the fees and charges of
$ _12,078.26~, deferred until fmal building occupancy is requested, In the event that the real property on which 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 interest in the property. The owners hereby apply for and
consent to the voluntary imposition of a lien for $_12,109.26 _.upon the following descrihed land in the City of
Springfield, Lane County, Oregon:
SITE ADDRESS 2831 20th St
CITY, STATE, ZIP _Springfield, Oregon
MAP AND TAX LOT
1703240000506
SEE ATTACHED LEGAL PROPERTY DESCRlPTION
BILLING NAME
BILLING ADDRESS
CITY
STATE
+~~f p ~'vdC1 HJ~f4~ ~
'7 . ~'Ir:h,.,,/ /',~ n..rP
.5.()"W~F~'f c./J
0(1 ~ ZIP f7 v7"1
FEES AND CHARGES DEFERRED
RECORDING FEES
TOTAL LlEN
$_12,078.26
$_31.00
$_12,109.26
In 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.
Print Name of Owner
(}Al7~J 1(~ '
~i lure of 0, II /
/77C (17,- / ~?u--,
ignature of Owner
Signature of Owner
r/09,
~e/ 1/ / ()<(
Da& I
747~dfls-~
Phone #
71.(7/ Z6'S~r
Phone #
A h-tho "'1 J \-Ie \ fr ~C}'"'
I Print Name of Owner
(n('),t { wJfru4.
Print Name at Owner '
Date
Phone #
Print Name of Owner
Signature of Owner Date
. OFFICIAL SEAL v
DEYETTE KELL 1
NOTARY PUBLIC. OREGON
, COMMISSION NO. 420351
III CQMMlaS!ON eXPIRES AUG. 15, 2011
Phone #
STATE OF OREGON )
) ss,
County of Lane )
( 1<JI'l day of 01\5 cd f-
7001.
v:\common\accnting\assessmt\Deferred fees contract.doc