HomeMy WebLinkAboutPermit Building 2010-6-11
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00748
ISSUED: 06/11/2010
APPLIED: 06/10/2010
EXPIRES: 12/1112010
VALUE: $ 171,940.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
54 J -726-3 769 I nspection Line
SITE ADDRESS: 1059 S 41ST ST
ASSESSOR'S PARCEL NO.: 1802061419000
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: New Single Family Dwelling- Same As #COM2010-00639 (1039 S. 41st)
Residential
Owner: BRUCE WIECHERT CUSTOM HOMES INC
Address: 3073 SKYVIEW LN ' "c', '
EUGENE OR 97405
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Mechanical
Plumbing
Contractor
L & E ELECTRIC INC
COMFORT FLOW HEATING
STEVE R JOHNSON
Expiration Date
03/30/2012
06/27/2011
03/12/2012
Phone
541-933-2653
541-342-3765
0"'" I
~'1'te.~\e& llJ 0 'lIOse o~ u\e& 'O'f
# of Units: ~\\o'fff).ll\cell\el. :t\'lIef. I
Primary Occupancy Group: tlo\i\\~~Z.oo\.oO '~~\t~'lIO~ 22.00
Secondary Occupancy Group: \II O~~oU fl\t.'1 o'fJ Y"la~ tlO\\~ Air Gas
Primary Construction Type ~;1' \'lIe 08'" t! 'Za4A). Gas
Secondary Construction Type: Ce.\~~~f'ol \'lIe.. e: Electric
# of Bedrooms: t\\lI., cell\ef nergy Patb:
Sprinkled Building: No
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
1,604
451
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
10.00
20.00
16.00
18.00
0.00
Overlay Dist:
# Street Trees Rqd:
':r.3:ved lid';e Rqd:
i : % of Lot Coverage:
5
Yes
27.30
REQUIRED PARKING
Total: . 2
Handicapped:
Compact:
,....,
.-,-,:,...
~ik; ";..HB~~~~~?j,/~;r'~'" ~ .~:: .~
Street Improvements:
Storm Sewer Available:
Special Instrnction:
I PUBLIC IMPR~VEMENTS t.?~I'-t. W "~~ S ~01_ L
10.\ ",,\C't.. ... ,,~~\.\. L1'~~\\VI~ J",Ill': _":\~
,..v t.I'-Wl,,>J t.?ID\ I\\t.~t'v>' ^",.,
'\\-I\'0? \It.~ \.\~U f>.~f>.1h\lPhsPo.u.ts/Drains:
\.\,\\-101'- ~ GI'- \'0 ,
~GW\W\t.~Ct. ({ ?t.I'-\GU.
r>.~'i ~\l\) ~f:\
:i ..~ ",~ "
Notes:
Paee I of 5
'l,'
CITY OF SPRINGFIELD
Building/Combination Permit
" ~,;:1,
~) \', '; ,l~ n~-,)-
Status
Issued
PERMIT NO: COM2010-00748
ISSUED: 06/11/2010
APPLIED: 06/10/2010
EXPIRES: 12/11/2010
VALUE: $ 171,940.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description ~
Garaee/Misc
SF/Dulllex
U VB Utility.
R-3 VB 1&2 Familv
$ Per Sq Ft
or iritiliiplier
$37.72
$96.83
Square Footage
. or Bid Amount
451.00
1,600.00
Value
Date Calculated
Description
TVlle of Construction
Total Value of Project
$17,011.72
$154,928.00
$171,939.72
06/1012010
06/10/2010
~
Fee Descrilltion Amount Paid) ,,: 'J() D;~,:' Date Paid Receipt Number
+ 12% State Surcharge $215.01 ". .. 6/11/10 2201000000000000682
+ 5% Technology Fee $109.6~ri;; 'I_,-'d.,- f. 6/11/10 2201000000000000682
1st Appliance $79.00' 6/11/10 2201000000000000682
2 Baths One or Two Family $337.00 6/11/10 2201000000000000682
Addressing Assignment $38.00 6/11/10 2201000000000000682
Appliance Vent $9.00 6/11/10 2201000000000000682
Building Permit $1,001.79 6/11/10 2201000000000000682
Credit- SDC Storm Improv $-1,173.95 6/11/10 2201000000000000682
Credit- SDC Storm Reimb $-326.46 6/11/10 2201000000000000682
Curbcut Permit $88.00 .' 6/11/10 2201000000000000682
Dryer Vent $9.00 ~ . ~', .6/11/10 2201000000000000682
Exhaust Hoods $13.00 6/11/10 2201000000000000682
Fire SF Fee - Residential $102.75: i 6/11/10 2201000000000000682
',','" ,
Fireplace (Listed) $20:00 6/11/10 2201000000000000682
Gas Outlets 1-4 $7.00 6/11/10 2201000000000000682
Heat Pump $17.00 6/11/10 2201000000000000682
Overwidth Application Fee $45.00 6/11/10 2201000000000000682
Plan Review Major - Planning $211.00 6/11/10 2201000000000000682
Plan Review Same As $250.00 6/11/10 2201000000000000682
PW Disc - 2nd Permit $-30.00 6/11/10 2201000000000000682
Residence Wiring 1000 Sq Ft $134.00 , 6/11/10 2201000000000000682
Residence Wiring Ea Addtl 500 1 " 6/11/10 2201000000000000682
$75.00,'"" i') ':'J,"
Sanitary Sewer - Improvement $740.60: '.:, 6/11/10 2201000000000000682
Sanitary Sewer - Reimbursement $1,238.~2,...'; ,,,,.. ~, 6/11/10 2201000000000000682
SDC MWMC Administration $10.00,'. 6/11/10 2201000000000000682
SDC MWMC Compliance Charge $22.63 6/11/10 2201000000000000682
SDC MWMC Reimbursement $101.97 6/11/10 2201000000000000682
SDC Sanitary/Storm Admin $141.69 6/11/10 2201000000000000682
SDC Storm - Improvement $1,173.95 6/11/10 2201000000000000682
SDC Storm - Reimbursement $326.46 6/11/10 2201000000000000682
SDC Tran Reimburs-Residential $279.54 6/11/10 2201000000000000682
SDC Trans Improvement-Resident $1,140.17 : 6/11/10 2201000000000000682
SDC Transpo Improvement $1,333.57 , 6/11/10 2201000000000000682.
SDC Transportation Admin $101.65 6/11/10 2201000000000000682
Sidewalk Permit $88.00. , ' 6/11/10 2201000000000000682
;'",
.. Paee 2 of 5
,; .
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,
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
:i'
';'.'("1:.
;),.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20l0-00748
ISSUED: 06/11/2010
APPLIED: 06/10/2010
EXPIRES: 12/11/2010
VALUE: $ 171,940.00
Status
Issued
\;,
,
"
Temp Power 200 amps or less
Vent Fan
Willamalane Single Family
$63.00
$27.00
$2,858.00
6/11/10
6/11/10
6/11110
2201000000000000682
2201000000000000682
2201000000000000682
Total Amount Paid
$10,877.38
I Plan Reviews I
Plan nine: Review
06/10/2010
06/1012010
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.
Overwidth approved for 30"by Jess<
Jones on 6-10-2010 and Storm water
to weep hole to curb
Public Works Review
06/10/20 I 0
06/10/20 I 0
APP LKW
Structural Review
06/11/2010
06/1112010
APP KLK
I;..
To Request an inspection call the 24 hour 't;.e~ording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, ipspections requested after 7:00 a.m. will be made the following
work day. "
~eClllireCUnsnections ~
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection. 'j'
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to e.onerete.
Post and Beam: Prior to floor 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 inspections have been approved.
,,,"_..,.., '-,_.", ...._u " ..
Wall Insulation: Prior to cover. '/~:~~y~ '~;H'n~':l"
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Bolts Installed in Concrete: To be done hy a State Certified Special Inspector. Provide inspection test reports to
City Building Inspector.
;, ,:n~_
Roof Sheathing/Nailing: Before covering sheathing with finish material.
Pa~e 3 of 5
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00748
ISSUED: 06/11/2010
APPLIED: 06/]0/20]0
EXPIRES: ]2/11/2010
VALUE: $ ]71,940.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Hold Downs [nstalled: Special [nspection performed prior to placement of concrete. Provide report to City
Building [nspector.
Final Building: After all required inspections have been, requested and approved and tbe building is complete.
.; " '; I ,~ .. - .' ,
Underground Plumbing: Prior to filling th~Jrench and includin'g required testing.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underfioor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
, ,
Final Plumbing: When all plumbing work is complete.
Underfloor Me'chanical. Prior to insulation or' decking and including required testing.
Underlloor Gas: After line is installed and reqnired testing 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.
Rough Mechanical: Prior to Cover
Gas Service: After line is installed and line has been connected to a minimum of one appliance inclnding required
testing. Presure test done at this point. , " :"', .
. :i:\ ':~~t.'i, \-' , '.,
Final Gas: When all gas work is complete. ", ':'
~ {':I-1.;I,':',11 . ,."~f~
Final Mechanical: When all mechanical work is complete.
.,
Temporary Electric: Approval required prior to Utility Company energizing pole.
Ufor Electrical Ground: [nstall ground rod at footing and call for inspection in conjuction with footing and/or
foundation inspection.
Rough Electric: Prior to Cover
Electric Service: Approval required prior to utility company e!lergizing service.
Final Electric: When all electrical work is complete.
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
.' , ',l.
Sidewalk - Curbside: After forms are ereded but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
.'
,
. '~.
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Paee 4 of 5
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fa%
541-726-3769 Inspection Line
; " ),\~ 'j1-;~4~.""
.:i,;',,~:~ ;',\;:
;,
.,.n.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00748
ISSUED: 06/11/2010
APPLIED: 06/1012010
EXPIRES: 12/11/2010
VALUE: $ 171,940.00
By signature, 1 state and agree, that 1 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 sball 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 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 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.'c'Z1ru";"1N~ . ct. ,,:,~'
Owner or Contractors Signature
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Pa2e 5 of 5
C/JI/JO
, /
Date
5AIYlt A3 la?Jj
Structural Permit Applicati.
S 4/SJ-
<.;iJ,,;. ClTM'GF SPRIN6FIEIoD,GREGON "';"':1,-' :'.:.";: ,: ,,:
T.,r .'~'I"" ,_ . _ ..', ~ .
.. DEPJ\RfMENT.;US'E;ONIi~i.
-' .,. "-'~:>'.""'-"'<'...."~,;,',n\i;".",>~:..,_",, _.,~,'" -"",.":.,~,.:
Pennit no.:Ctff - 74:1?
Date: G - 1..8 - t-Rf
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days oCissuance or iCwork is
suspended Cor 180 days.
~
gf~~m-rrocA"wG'ovERNMEN'ErAPPR6\jA~''"'fi~Z>;\''~I.jlj~7.
. ~" ". ... .,Jilt, ....-..........., '" ...,.. ..... ....!:l1li, ,.~ ,(l,L.""
This project has final land~use approval.
Signature: " , Date:
This project has DEQ approval.
Signature: Date:
Zoning approval verilied: D Yes DNo
Property is within flood plain: D Yes DNo
t~':"~g."h"~""~~"''''..''d';''''''''__~~,:"",,,-<,,,,\,,~,",,,.:-_,,,,,,,,",,_,,...,~,_.,.,.,.,.,,....~., ", '_', ",' , ,'.~ ,',:'_, ." >FJi
Jiti.\I~{;):)ril'i;illl&.!;A:'TE.GQRcY:*.Q!flGQ~~]~lJCIIQtl":::M:'::''';;\';, """'0
[iJ Residential I 0 Government o Commercial
~j~'Wt~Q~1.~IIg~fN.f9BMA'ffQtiVA~pa~QG~f!QN)V.~a;~)Xff)
Job site address: 0 S-q ,),- 4 I ~-r-
City:<:;o r, " ~ f 'dJ State: 0 lL I ZIP: 171 77
Subdivision: F';" h,,-;~ (f\t?.!.uv'). I Lot no.: "I
Reference: I Taxlot:
i!lfi\f~\~,\t0~'\Jt';\Fl};1il[~QP:~Rt'($QWN~iiii{, S;i,) -'\ ~;.:: " ....... ..:,;
Name: I!. {.u< Iv: , Gh. ,t Cv',kll'- \10 "'.'; ::tt\lC-
Address: 30'7'3 sc:".;.:w L-N
City: t vil'n.'" Statepr-- I ZIP:'! 71 0"
Phone: -blb - '1'1,$ Fax: -,17- ~i3b i-
E-mail: W; <vhe. \' 1r-.OVhLS a("'~L"S\ Net'
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:
~~~~~~,~ON:fM9J:O~.~!~~fAP~f!9'@t~j\iik~0.);~;E'i.;;~if::
Business name: 'b"v(e W ,ec.~'.J'~ Lv~b,.... I>o".a.<; I1v'--
Address: '3 07 3 -; lop' CoAl ,-",
City, -f:v'1 e.....<.. State:o..(L I ZIP: 9 7yQ-
Phone: -M~ cI '7 S ? Fax: ::5'1'{ - 33 b Z
E-mail: w; e.(....\..,... ~ \.-..Ql"-~<; @ GO\'\I\ Uo.)'4 ~ V'"L t
CCB license no,: {Ol 7 r I
Printname:'S} .e"\I"~d~ W"o \"''0/
Signature: W W._____-
l;~Ri!:'Wil\\ll!SliB:.cON;[RACtORINFcdRMAtrONi&IIJ~I\1W"'"
,,' ...... .riti.",.. ~..o...._.J~_._.w_.._-.J .~_,.--..._~--,,_t".~..~~... "'.'_"""""~''"'_'" .r..Jt ,~,1,>:<':"F,.'"
Name CCB License Number Phone Number
Electrical t-..e lOS' 7< 5/.-1 'II 'i "
Plumbing 51Lv< i P v.....~.. "l\ .5oll!; " y 2- 3'" b~
Mechanical (PH .~ b V 72.6--0100
'.".' '..'1"'''''''.''.'''._-.",. -~~'.'.'.'."."..'" '..' ''''..'''''i~'.'''.'~ -".&&.'~" 'if"".""".'"
:rt;H~;1.;~1~{€~11'fM~~J>:'o-ift;9$c~fil;'p.U_J;g~:r!:"~~1t-t4..,L:~m0::h~J~
.,~..'o.~..,.too",,,-,:,:o~~'~~\~~i'-;:t.'i;;~J&.}.'~\ .c.- ":,0,. ,.,-~?ti",t,J:"'~,4"T"'~ty;~~~o"'~'\i.~''--
;1;"Y~,I.A~!!9jtji1!!Q.rm.~JiQ,I:I;Ir(~:;'~h;{n-S~~~;1~:~;f;i~~Rij~;}g~~;afl~1tt~~!~~
(a) Job description:
Occupancy
~
Construction type:
Square feet:
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
new 0 alteration D addition
(b) Foundation-only permit? 'D.Yes D No
Total valuation: $
.. 2. Bufld~Qg;f~~~~~~~~~g~~:.lff:~tJ:..... c. . ~~.~!~~E~~~f~r~N~:~~~t:.
(a) Permit Cee (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):'
(number of hours x fee per hour)
s
s
s
(d) Enter 12% surcharge (.12 x [2a+2b+2c]): S
(e) Subtotal offees above (2a through 2d): S
;Y~t~p.U~~1I~YJ~wr~~ira~~r~~~:J~~~8'~~~~~t~ar~~~~~~]}tr~~~~;.
(a) Plan review (65% x pennit Cee [2a]): S
(b) Fire and life safety (40% x permit fee [2a]): S
(c) Subtotal offees above (3a and 3b): S
. 4. l\11"c~[i~'1Ieoiin~e~X{
(a) Seismic fee, 1% (.01 x permit fee [2a]): S
TOTAL Cees and surcharges (2e+3c+4a): S
~^,\J
225 Fifth Street. Springfield, OR 97477+PH(54I)726-3753+FAX(541)726-3689
. ~ bEP.A......RTNiENTUSEONL Y
SPRINGFIELD ~ . ".
Permit no.:C
~ :H-'d
Date:
-~
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.
'.' :l!OCAL>~OVERNMENTAp.F>~()VAt>>:.
Zoning approval verified? 0 Yes 0 No
:.CATEGORY/OF.CONSTRUcTION.....,;...
;:>,;~'~" ~:~'.q'
o Residential 0 Government 0 Commercial
il..jlfftr.)\i.~.OB::SITEi'INFO~NiA:rIONirAIiID;;;t:OCA1;IOl'f,~2i:'.,\1~;;
0) 5 LjISl-
City: :> r- \.l- Stale: ZIP:
&>2. 06/Lf Taxlot.: Of 10
.. .:'.' DESCRIPTION: OF'WORK'. ,.,::','i.. ,':'" . ."
Ol^-Sf" WIll .
Reference:
,,I
PROPERTY..OWNER .
Name: (:,n/u Wi ec-he-.A CJ;,+o""
Address: 307 S s Ie. I/>J
City: (. u v-<-- ZIP: '7 7'10"-
Phone:SV/ -b8b or ~ ~ Fax: GV/-'3Yf ~3b 7..-
E-mail: (;J;.::c.h..~t...<l~58Co".-C-ASf.1V ,,-j-
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:
CONTRACTOR INSTALLATION:
Business name: l- *' e f -ec-+V:G
Address: Z 8 :5 3 -:5'ov-es A c. (e-S
City: S f \~ State: 0 TL ZIP: q 7 'fI'Z
Phone:S~/ -5Z' - 41 'i ~ Fax: '5 -<::-5-
E-mail:
CCB license no.: 0'1> 4'7S- BCD license no.: '0 c..,
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
'-1/7 '/-S-
t;:'O Oe"ov,Je->-
~
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~~.
~. .
'$>~
\ ^~~~\)
~~~~
~
440-2584-J (9/08/COM)
;~~,;r/~.~....~)i~;'(~:~::i1\:;;{~\~~1J~'y~ "U:E'~;~SCH EP.UIJI;:I;}!5gt.::\M~(~;.:J:i~~:~~Vth,/{~!H{
;Number 6(iitspectiori;p~ri;:~~'(j'IQiy.~ost.. Total
. . '.' . .., '. cO..... .'. .,' . ,....r... ". ea;. '. cost'- .
Residential, per unit, service included:
1,000 sq. ft. or less (4) I $134.00 $ J3L(
Each additional 500 sq. ft. or portion ;:s $ 25.00 $7>
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 $
20 I to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158.00 $
60 I 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)
I $ 63.00 $ C. <..
$ 87.00 $
$126.00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a se'rvice or feeder fee:
Each branch circuit
$ 6.00 $
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:':lot included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension (2) .
Each additional inspection: (I)
~;ij2',~\l~~~i&i\':;;!W!;fi,,,~Af!,F>UCANt;:USE};;.t:
(A) Enter subtotal of above fees
(Minimum Permit Fee $58,00)
$
$
$
$
$ 63.00
$ 63.00
$ 63.00
$58.00
!~~f-~.:?-~:{:~?:;0::>:':, ~\>,;., _ .
(B) Enter 12% surcharge (.12 x [AJ)
(e) Technology Fee (5% of [AJ)
TOTAL fees and surcharges (A through C):
$z.7l
$
$
$ -YY z.y
't ~. !!I!!m~l~i~e
. c/o - 00 7l(<6
Job. No.
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
NAME: 7$.tJ crf PHONE: b 0 6- ~ 0 r-D
. 3073. S\L.yv/~'; U ,.-
ADDRESS: CITYEu G-tr<C- STATE~IP: 7"74'0!
LOCATION OF PROPOSED BUILDING SITE:
Street Address:
/D -;- 9
5.
L({~t-
Plat Name: / SDZ ObfL{
Tax Lot Number:
Dr 7'0 0
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the
back.)
A. Sinqle-Family Detached ( --
X $2,858 per unit = $ ?F::; t
NO. OF UNITS
B. Sinqle-Family Attached
NO. OF UNITS X $3,100 per unit = $
C. Multi-Family Apartment
NO. OF UNITS X $2,~41 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 = $
Z g:- S1S ,.-
WILLAMALANE SDC $
2. SDC CREDIT (If applicable) SDC payer must fumish proof of ...--
Willamalane Credit approval.) $
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
$
---
Z3')g
~~
C. I I( I 20rO
Date
Development Services Department
. City of Springfield. .
5
RECEIPT #:
2201000000000000682
Date: 06/11/2010
9:SS:22AM
Job/J()urnarN~mber
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM2010-00748
COM20 I 0-00748
COM20 10-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM2010-00748
COM2010-00748
COM2010-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM2010-00748
COM2010-00748
COM20 I 0-00748
COM20 I 0-00748
COM2010-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM2010-00748
COM20 I 0-00748
COM20 I 0-00748
COM20 I 0-00748
COM2010-00748
COM2010-00748
COM20 I 0-00748
COM20 I 0-00748
COM2010-00748
Payments:
Type of Payment
CreditCard
Check
cReceintl
Description
Plan Review Major - Planning
Plan Review Same As
Fire SF Fee - Residential
Building Permit
Addressing Assignment
Willamalane Single Family
2 Baths One or Two Family
1st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Fireplace (Listed)
Heat Pump
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Sidewalk Permit
Curbcut Permit
PW Disc - 2nd Permit
SDC Storm - Improvement
SDC Storm - Reimbursement
Credit- SDC Storm Improv
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Administration
SDC MWMC Compliance Charge
SDC Sanitary/Storm Admin
SDC Transportation Admin
Credit- SDC Storm Reimb
Overwidth Application Fee
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
BWCH
BWCH
Item Total:
ChecJ< Number Authorization
Received By Batch Number Number How Received
djb
djb
19694
05542d In Person
In Person
Payment Total:
;1 >'::"'.-r;
Page 2 off
Amount Due
211.00
250.00
102.75
1,001.79
38.00
2,858.00
337.00
79.00
27.00
9.00
13.00
9.00
7.00
20.00
17.00
134.00
75.00
63.00
88.00
88.00
(30.00)
1,173.95
326.46
(1,173.95)
1,238.32
. 740.60
279.54
1,140.17
1,333.57
101.97
10.00
22.63
141.69
101.65
(326.46)
45.00
215.01
109.69
$10,877.38
Amount Paid
$9,500.00
$1,377.38
$10,877.38
6/11/2010