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Home My WebLink AboutPermit Building 2010-4-14 CITY OF SPRINGFIELD Building/Combination Permit ~ '. \ :. ~'1. : '~ ~ . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2009-01238 ISSUED: APPLIED: EXPIRES: VALUE: SITE ADDRESS: 5951 ASTER ST 5953 ASSESSOR'S PARCEL NO.: 1702343300607 08/24/2009 10/13/2010 $ 230,000.00 Springfield TYPE OF WORK: Duplex TYPE OF USE: New PROJECT DESCRIPTION: Duplex - 5951/5953 Aster SI. Aster Meadows I PUBLIC IMPROVE~~ \f \\\~ S ,,01 ~O't\~~ ~\1 ~~~~ 1\\\S \'t.~~ Type: ',\\-\\'21 ?0t.~7.t.t) U~tl~: p..~p..~tlO~?wnspouts/Drains: 1\1J1\-1 t.tl O~ ' COWl\lllt.\'\~I\'{ \'c\\\Otl. . p,,\,\'{ ~ \lO Owner: ALBERTS LARRY Address: PO BOX 489 WALTERVILLE OR 97489 I CON:~eTO,RINFORMATlON I Contractor License DUANE A KNIGHTS -' 12112 JEM ELECTRIC INC 161235 MARS HALLS INC 25790 SHAD CHAS~N SURRETT iiiato 158295 ~TfENTlON. oreQOJ[~<1.'!~ T10N ~ , I'Ute9 adoP~ I tot ?'" ~nter. Those lU 952..001- # of Units: Notification 1..oo1othrjDllI1l8tQM, uI s by Primary Occupancy Grouf,a OAR 95 - obtain ~ptfl!lll~bl'li' Secondary Occupancy GroOll9O. 'tou center. (Nayp~~&I!P~tflcation Primary Construction Type calling the Oregoml.lW ~: Secondary Constrnction TypmiRlbercenter is 1-80(kii~~ yp~; # of Bedrooms: 4 Energy Path: Sprinkled Building: Contractor Type General Electrical Mechanical Plumbing 2 26.00 Wall Heat Electric Electric n/a I DEVELOPMENT INFORMATION I Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: . # Strcet Trees Rqd: ';i>li~ed:Diive Rqd: '~ "" ".:; - I;. _t, .;...., _ " . %; of Lot Coverag~: 18.00 5.25 5.25 26.00 30.00 Street Improvements: Storm Sewer Available: Speciallllstruction: Notes: Stormwater to curb and gutter. Page I of 4 Residential Expiration Date 07/10/2011 09/07/2010 12/23/20 I I 01/15/2012 Phone 541- 726-2960 541-729-1074 541-747-7445 541-741-3553 Lot Size: 4,500 Sq Ft 1st Floor: 1,046 Sq Ft 2nd Floor: 984 Sq Ft Basement: Sq Ft Garage/Carport 576 Sq Ft Other: Occupant Load: 2 Yes 36.00 REQUIRED PARKING . ..... Total: 4 Handicapped: Compact: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 'L 'I~: I Valuation DescriDtion ~ Description $ Per Sq Ft or multiplier $1.00 Tvpe of Construction Estimate Estimate Square Footage or Bid Amount 230,000.00 Total Value of Project ~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01238 ISSUED: APPLIED: EXPIRES: VALUE: 08/24/2009 10/13/2010 $ 230,000.00 Value $230,000.00 $230,000.00 Date Calculated 08/24/2009 Fee Description Amount Paid Date Paid Receipt Number . Plan Review Residential $804.60 8/24/09 1200900000000000969 SDC MWMC Administration . $10.00 9/29/09 1200900000000001102 SDC MWMC Improvement $2,089.08 9/29/09 1200900000000001102 SDC MWMC Reimbursement $203.94 9/29/09 1200900000000001102 + 12% State Surcharge $38.16 4/14/10 2201000000000000357 + 12% State Surcharge $254.98 .: <.,!. .fj" 4/14/10 2201000000000000357 + 5% Technology Fee $15.90 .' 4/14/10 2201000000000000357 + 5% Technology Fee $124.09. 4/14/10 2201000000000000357 1st Appliance $79.00 4/14/10 2201000000000000357 2 Baths One or Two Family $674.00 4/14/10 2201000000000000357 Addressing Assignment $76.00 4/14/10 2201000000000000357 Building Permit $1,237.85 4/14/10 2201000000000000357 Curbcut Permit $88.00 4/14/10 2201000000000000357 Dryer Vent $9.00 4/14/10 2201000000000000357 Exhaust Hoods $26.00 4/14/10 2201000000000000357 Fire SF Fee - Residential $130.30 4/14/10 2201000000000000357 Plan Review Major - Planning $211.00 4/14/10 2201000000000000357 PW Disc - 2nd Permit $-30.00 4/14/10 2201000000000000357 Residence Wiring 1000 Sq Ft $268.00 4/14/10 2201000000000000357 Residence Wiring Ea Addtl 500 $50.00 ' 4/14/10 2201000000000000357 Sanitary Sewer - Improvement $881.85 4/14/10 2201000000000000357 Sanitary Sewer - Reimbursement $1,159.72 4/14/10 2201000000000000357 SDC Sanitary/Storm Admin $210.29 4/14/10 2201000000000000357 SDC Transpo Improvement $1,863.30 4/14/10 2201000000000000357 SDC Transpo Reimbursement $422.43 4/14/10 2201000000000000357 SDC Transportation Admin $164.89 4/14/10 2201000000000000357 Sidewalk Permit $88.00 4/14/10 2201000000000000357 Storm Drainage Impervious Area $873.36 . 4/14/10 2201000000000000357 Temp Power 200 amps or less $63.00 I':' .J. \ 4/14/10 2201000000000000357 . Vent Fan $36.00 4/14/10 2201000000000000357 Willamalane Attached (duplex) $6,200.00 . 4/14/10 2201000000000000357 Total Amount Paid $18,322.74 Page 2 of 4 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: COM2009-01238 ISSUED: APPLIED: EXPIRES: VALUE: Status Issued I,'Jan Reyiews .~ Plannine: Review 08/31/2009 Initial Review 08/31/2009 APP LLH 08/3112009 Pnblic Works Review 09/02/2009 APP TSS 08/3112009 Structural Review 09/1012009 . WE CJC 08/31/2009 Initial Review 09/08/2009 . . '09/11/2009 APP LLH Structural Review 09111/2009 WE CJC 09111/2009 Initial Review 09/23/2009 09/23/2009 APP LLH Structu ra) Review 09/2312009 09/23/2009. APP CJC ."'41;,: '~~~';' ;~.:I:' 08/24/2009 10/13/2010 $ 230,000.00 Held per David Bowlsby for Truss Information. Information has not been received as of today, but will process through other department/division. Stormwater to curb and gutter. Need 11001' framing details from manufacturer Revised Plans - Foundation Cantilever Revised Plans - Foundation Cantilever (Still need 11001' framing details from Mfg'r. Cantilever information received requested by Chris Carpenter. As noted on plans To Request an inspection call the 24 hour r.ecording 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. ~eolJire1Jnsnections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to p~acement 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 floor insulation or decking. Floor Insnlation: Prior to decking. Shear Wall Nailing: Before covering sheathi~gwith finish ~aterials. .,..i":." 'i.;"1 t^. Framing Inspection: Prior to cover and afte'r"all rough in inspections have been approved. , 'J-'\" Page 3 of 4 '.l,~~t r-' 1 J~' ,. CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-01238 ISSUED: APPLIED: EXPIRES: VALUE: 08/24/2009 10/13/2010 $ 230,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Firewall: Located and constrncted according to plans. Final Bnilding: After all reqnired inspections have been reqnested and approved and the bnilding is complete. Perimeter Fonndation Drains: After gravel and tilter cloth is installed bnt prior to backfill. :j f,~" .::. 'r '~; . Undertloor Plnmbing: Prior to insnlation 01' de,cking.... Underfloor Drain: Prior to cover or placem~ntof concrete. Rongh Plnmbing: Prior to cover and inclnding reqnired testing. Water Line: Prior to filling trench and inclnding reqnired testing. Sanitary Sewer Line: Prior to tilling trench and inclnding reqnired testing. Storm Sewer Line: Prior to tilling trench. Final Plnmbing: When all plnmbing work is complete. Undertloor Mechanical. Prior to insnlation or decking and inclnding reqnired testing. Rongh Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Temporary Electric: Approvalreqnired prior to Utility Company energizing pole. Rongh Electric: Prior to Cover Electric Service: Approval reqnired prior to utility company energizing service. Final Electric: When all electrical work is complete. By signatnre, I state and agree, that I have carefnllyeXamin~d tbe completed application and do bereby certify that all information hereon is true and correct, and I furthc~fcertf6.:, that any and all work performed shall be done in accordance with the Ordinances of the City of Springtield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made oIany strncln're without permission of the Community Services Division, Bnilding Safety. I fnrther certify that only contractors and employecs who are in compliance with ORS 701.005 will be nsed on this project. I further agree to ensure that all required inspections arc 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. Ow.".'c~d.> D... ~ / 1<(/10 I ~. Paee 4 of 4 1':',_'.. . '<..'/....,....'..."./.,."......,' .~."..""',c.\;;".t,~".{~\,l ;'l.\uc .. c.'~' ,';;' .,;..,~!,,";~, ".n,. D · ""_" ,~<>', " ;;'~!!:J 225 FWrH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726.3753 . FAX: (541)726.3689 ELECI'RICAL PERMIT APPLICATION City Job Number Cc::>t-V1 z.c:,o? - 0 I Z ~ g IJVff~~~~:IATI~:, tj LEGAL DESCRIPTION: 7 170Z-sLf3~ Permits are'non-transferable and expire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder 2. [90Nffii~R'INS!:U-IATIONO~ B.l Services or ~:;;';':;~-;-nst~I;;';i~:, Alte~~~_n~~.~e~o;at;~~: '1 Electrical Contractor -Jl ~ fJo.€ck 200 Amps or less $ 73.00 /) I 201 Amps to 400 Amps $ 86.00 Address 3'6''J~L( S"S~ f:C--~ 401 Amps to 600 Amps $\43.00 DJ . / 601 Amps to 1000 Amps $186.00 City ~n.vc. Phone 7;'1-/077 Over 1000 AmpsNolts $426.00 -'-'t" Reconnect Only $ 57.00 Pump or irrigation $ 57.00 Sign/Outline Lighting $ 57.00 OWNER INSTALLATION Limited EnergylResidential $ 29.00 The installation is being made on property lawn which Limited Energy/Commercial $ 52.00 is not intended for sale, lease or rent. (in~mu_m Electric Permit I~~p~ctio~ F~i: $~~.~~ + ~urcharges Owners Signature: ~ 4.l SUB1VTALOFABO~ .______~~__: 381 ~ ~~~ ~t:~;~~:~~t~~e~ ttS?Z ~~. 5% Technology Fee 1'1 C>S . TOTAL 4CfS. ...,..., Dob07 JOB DESCRIPTION: W, Vl-i:: ~(.A.,(?t..e- )C of- '"T'eHA.1' Expiration Date tj 70C-, OS ID (- fa / b ('). '5 -s,- q -7 - 10 Supervisor License Number Constr. Contr. Number Expiration Date ry?~ ~~ ~~~IALS .6!.. DATE .." SOURCE II ;i.o~ , I / 3. l!::OMPLE'!.?!Plm SCHEDULE BELOW------u-_=: Date A. [N.;;;R:.;~~ni;a~=single o0'ulti.~-",~ly I;er d;-e~in~-u~~-' j Service Included r~1/ ~OO ~ $)(00 zbg 5D zc. " 2- 2- 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $57.00 [ ____._____u_ . _ _____ C. Temporary Services or Feeders .- -----_.- _.- , , Installation, Alteration or Relocation I 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 6.1- $ 5-1.00 $79.00 $114.00 b'S " Over 600_~mps o~lQOO Vo~~e!."~~b.9~":___ D. ! Branch Circui!s___ _ _~___.~__ __~."_~ _ ___ _~_ ~~- J New Alteration or Extension Per Panel One Circuit $ 50.00 Each Additional Circuit or with Service or Feeder Permit $ 5.00 ~-----_.- _. -------.-----::-] E. Miscellaneous (Service/feeder not included) -Each Installation I ---_._-_._---~---- --_.~~ -------, Shared Drivc(T:)IBuilding FonnslElectrical Penn it Application 7-08.doc 2~ willamalane tlJ Park and Recreation District Job. No. ~.q.\~~ SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 NAME: PHONE: \-\1. D'l~ ADDRESS:1l0 ~Df.~CITY~~TEcrlzIP:~ LOCATION OF PROPOSED BUILDING SITE: Street Address: t5qS\ J~~D ASttX ~ ~' Plat Name: f.011aDs Tax Lot Number: \l07~~,,\-~ -nCXJlc()1 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) A. SinQle-Family Detached NO. OF UNITS X $2,858 per unit = $ B. SinQle-Family Attached ?- NO. OF UNITS X $3,100 per unit = $ ~'WJ.~ . C. Multi-Family Apartment NO. OF UNITS X $2,641 per unit = $ D. SinQle Room Occupancy NO. OF UNITS X $1,321 per unit = $ E. Accessory DwellinQ Unit NO. OF UNITS X $1,550 per unit = $ $ ~ta).CO {if 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) $lAOO ,0::/ 4 ,J1; \D Date Development Services City of Springfield 5 . . CIJY OF SPRINGFIELD, OREGON . 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 City Job Number CMe-OO' - 01 z-"S 8: Date i - 2-J.I-o '7 )lZ1 1 & 2 F~mily Dwelling or Accessory IZI New Construction D Demolition D Multi-Family D AdditionlAlterationlReplacement D Other D Commercial/Indu rial D Tenant Improvement Job Address 5151 <: $:$ :$' Lot 00") Block Subdivision Project Name Description of Work/location on premises/special conditions n r{p;;j~1{;.ty~!~thi!it(jf;':';E~:~F~~~~!~\it~{~~J;f~~n~'~ ~ .....",\,...1;' _ ""., .^" .<"._,.~.." ,"'~~." )i;t.L'M ~.J:..~j;""",-~~d_ . '" ._~,::fi?)'~_.r"""'" r: Name {d.rr:/ M.6r' fi s Mailing Addre PlJ BOA l.n'l City W.J.f.uv;/4 State (')r Zip <:J7e.f87 Phone ~I 71f7 c)l::,~ Fax ~~ "t(.S'2- Owner Representative '113 (~,-3 G::.Q. ~ Suite No. J70Z. ~4Jl ~ o6c 7 ~l,&.'~F"mil!i'Dlbelling'~,.,," " SQFt '2.-t)'O ,rJc. " l':';~i!'~;""", x $/SQ Ft Value New Dwelling Area Garage/Carport Area Other Structure Area Phone' Fax TotalValue"",... . ..~.... . .Z-s.O,~O <~".",,;;'i1!:!Jrli ,,;N,~,_' ,r"':>:">~i')'~F1'.i~:,>~sr;M.1!;'t't;;ii:2YVE: ;,~'''.");'''-;..: '0' ~''''',!j;~';'\::f?i''~'''l.- .r;...r~~;.,w;;'.:"'kt:'^'.;; .,-*,.~...-n _":,v,.:t.. 'NCOntntercial'lIiiausmal,/' Mlllti"Famil':;;;;i'jrJ,,~{g'"'Ji1~~ ," ....,'..,_,,_," ...~_,._., ,_ _ .. f:. .._ _ _._".,.. ~__" ._ _ _ '..' ,_, . _ _. ',n_, _..Y;J""~"",,iit~ii,. ,\ _...~::!v..',-",., SQ Ft X $/SQ Ft = Value O ~~;f;'7i;~i'$~i~?k:i.~f{4#Y';~~7f~~~:M~1~~$~~Iif{{,s;;>>iE:~~:&;~~ ::t:Aplnltcant~'F~~t)<j.:)il,;~~~~~1A,':'~iHS:G',~'..o~~fu'~~"t:~~';ifff:;ji' .,._~_ .. r _',"~'. _, ....... .r...,;n~W~~~"";..;7~; ;~";'<:<-"h"""'<i0f''!I",;tr:~~W$''",,,,,-,,,,,,,,'iW;;>,,,, Name L t:.-ni US' Mailing Address 0: O"tJ cliIe/ City eJ. Zip 9?-f7,r Phone 0 Fax 57//5?JS"';;uJ90 Total Value ,0 ifjj:'I1~~t'h'~'Yt"\~\;'t;'ijD'KN,;c<,~"b;;~'E%~","~~"~~~41~~~~~~~~~~~~:':""~~i~~J~~;:~~?',~~'l&\~ ~"~'!;~__!._~.~.,f;;~.~,~~g!l~I.;.~_~gm<~l~~:)~s~Thn~~}]~ It'7'_~,&'.p~_~-4"::"'.;'^,~.iWiJ'$:!i;W1.(eJ'(tJ7\i.' ~~wR~.ff';.t?f~~~1ii~~'L~;1i<4~"~ Name Existing New Existing Building Area New Building Area Address City Contact Person Phone Occupancy Group(s) Const. Type(s) Number of Stories State Zip . Contractor's Name CCB# Expiration Date Phone # General' ~~~ i:/;J:ic,1:zjS- ,1~/I.-2 J-/t7- ~/ 5'1/. ;?:2j->>!LJ Plumbmg _.d t ,fr Mechanical ;::,,~L5- Electrical _77.m ~ II ./ 1::)/'1/1 t-:L/Yo/c1 .5'1/- '1fJ7- ;7/J";7 o ftJtBrilmJir;i[1l1ij~!i;{(Bai~:;;.~~i!f4j 0 ~.j!~!;l!~t!fi!::~J~'~~~~~~~~~ftflf~~Ii~1~~fi4i~~1'~Ji~~~~ Has site review application been submitted? Heat Source: . Primary rL' ( r Sec\lndary . DYes DNo DN/A Water Heater r-I,'rr- Range FL"crEnergyPath Ifso, Name of Planner \ \ ~ I ()4, V}Jo you require any ofthefollowing for this project? . Journal Number ~};(1 ~ Over-width or Second Driveway' . DYes . B No . - Temporary Power '. [2] Yes D No Notice: All contractors & subcontrac 'lI;e :;;\~e licensed with the Construction Contractors Board of the State of Oregon under rovisions ofORS 701 and ma uired to be licensed in the 'urisdiction where work is bein erformed~ iE'oP;O lcelUie.only!~~~'?II!f!'{g! f PLAN CHECK FEE DATE Fax BUILDING PERMIT APPLICATION ~ Shan:d Dri'~)r;d:~~'ding penniIAP~Ii"'U~n 10-02.doe ~~ APPUCATION 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 $ 1>087. S'l, deferred until final 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 . assignillg 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 $ I So 8 7. 5'"'\ .upon the following described land in the City of Springfield, Lane County, Oregon: MAP AND TAX LOT /702 ~1./ 3:S OObo7 SITEADDRESS 5951 As+~"YL s+- CITY, STATE, ZIP sPa./lII'i{.;e-LC, ,012. 97'17'8 BILLING NAME BILLING ADDRESS CITY STATE SEE ATTACHED LEGAL PROPERTY DESCRIPTION L-A ~ Ry ALt3ECrS r~ 'EO,\' L{ 8 <<7 LJ Lre-(LVILLc . D~ ZIP 97481 TOTAL LIEN $ jSOg,. S-9 $ 3./- /5//8.59 FEES AND CHARGES DEFERRED RECORDING FEES $ In addition to the fees and charges indicated above, we agree to pay the fees associated with rec.ording the lien and removal of the lien at Lane County Deeds and Records. ' . We are all of the legal owners of the descnbed land or all of the contract purchasers of record of the descnbed 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 tq 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. ~~ .J -......... ignature of Owner W1~ Prm ame 0 Owner . 9/z'1/ Of 0'11 "2iS-(';2..-'3 Dat6 . Phone # Print Name of Owner Signature of Owner Date Phone # Print Name of Owner Signature of Owner Date Phone # Print Name of Owner Signature of Owner Pbone # OFFICIAL SEAL DEVETTE KELL V STATE OF OREGON ) NOTARY PUBLIC - OREGON ) ss. COMMISSION NO. 420351 County of Lane ) MY COMMISSION EXPIRES AUG. 15, 2011 The foregoing instrumeotwas executed before me this ':lCj +h day ofScp"ic-m ~ _ :;LOO'1 . M commission expires: C;;; / IS II I , ill v:\common\accD.ting\assessmt\Deferred fees contractdoc ~~;~;~i~~~:~;:~::97477 ~----- ii- City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1200900000000000969 Date: 08/24/2009 I :22:20PM Paid By LARRY ALBERTS Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 804.60 $804.60 Job/Journal Number. Description COM2009-01238 Plan Review Residential Payments: Type of Payment CreditCard Amount Paid djb 044993 In Person Payment Total: $804.60 $804.60 -- cReceintl Page 1 of 1 8/24/2009 225 fifth Street Springfield, Oregon 97477 541-726-3759 Phone u::~;. -... .. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000357 Date: 04/14/2010 2:43: I7PM Job/Journal Number COM2009-0 1238 COM2009-0 1238 COM2009-0 123 8 COM2009-01238 COM2009-01238 COM2009-0 I 238 COM2009-01238 COM2009-01238 COM2009-01238 COM2009-0 1238 COM2009-01238 COM2009-0 1238 COM2009-0 1238 COM2009-01238 COM2009-01238 COM2009-01238 COM2009-0 1238 COM2009-01238 COM2009-01238 COM2009-0 123 8 COM2009-0 1238 COM2009-0 123 8 COM2009-01238 COM2009-0 1238 COM2009-0 1238 COM2009-0 1238 COM2009-01238 Payments: Type of Payment Check cReccintl Description Addressing Assignment Willamalane Attached (duplex) Temp Power 200 amps or less Plan Review Major - Planning Curbcut Permit Sidewalk Permit PW Disc - 2nd Permit Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Teanspo Improvement SDC San italy/Storm Admin SDC Transportation Admin Building Pemlit 2 Baths One or Two Family 1st Appliance Vent Fan Exhaust Hoods Dryer Vent . Fire SF Fee - Residential + 5% Technology Fee + 12% State Surcharge Residence Wiring 1000 Sq Ft Residence Wiring Ea AddU 500 + 12% State Surcharge + 5% Technology Fee ; l'},{ l, ~ ,', 'i \'1', Paid By LARRY ALBERTS Check Number Batch Number Received By djb . \.. . ~i') '1' Page I of I Item Total: Authorization Number How Received 135 In Person Payment Total: Amount Due 76.00 6,200.00 63.00 211.00 88.00 88.00 (30.00) 873.36 J,159.72 881.85 422.43 1.863.30 210.29 164.89 1,237.85 674.00 79.00 36.00 26.00 9.00 130.30 124.09 254.98 268.00 50.00 38.16 15.90 $15,215.12 ../' Amount Paid $15,215.12 }}5,215.12 4/14/20 I 0