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Job# 01-00309-01
Page 1 of 2
TRANS#:01-0004862
DATE:APR 06 2001
AMT RECD:2 $ 1516.12
CHANGE:
CASHIER: 004
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00309-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 2207 Henderson Ave Spr
Assessors Map#: 18030313
Lot: Block: Addition:
Tax Lot #: 00400
Subdivision:
Owner:
Address:
Skillern Investments
PO Box 714
Phone Number: 541-746-8601
City/State/Zip: Springfield, OR 97477
New Value: $0
Scope Of Work: Plumbing
Contractor Type
Plumbing Contr
Contractor Registration # Expiration Date
Ready Rooter / chapman plumb
88608 ermi bee rd, springfield, OR 97478
Phone
541-744-7991
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
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
working day.
, Sanitary Sewer Line
Septic Tank Pumped
Required Inspections
I Plumbing
-Prior to filling trench.
-After septic tank has been pumped and filled. Please provide the inspector with receipt and vel
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
-Area (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Job# 01-00309-01 I
Paid On Receipt#
Plumbing
04/06/2001 0004862
04/06/2001 0004862
04/06/2001 0004862
04/06/2001 0004862
Page 2 of 2
Value/Quantity Fee Amount
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
60
$.00
$2.80
$40.00
$1.20
$44.00
Sanitary Sewer
Residential Sanitary MWMC
Residential Improvement MWMC
MWMC Administrative Fee
Sanitary Sewer SDC Reimbursement
SDC Administrative Fee
Property Annexed 1997
Total System Development
Grand Total
System Development
04/06/2001 0004862
04/06/2001 0004862
04/06/2001 0004862
04/06/2001 0004862
04/06/2001 0004862
04/06/2001 0004862
04/06/2001 0004862
23
4
4
1
23
$371.45
$490.12
$41.70
$10.00
$488.75
$70.10
$.00
$1,472.12
$1,516.12
Plan Check Type
Checked By
Date Completed
Comment
Engineering-Res Steve Templin 04/02/2001
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
::ae P~~ct address is readable from the street. Y/at ~ I
,~, . ~
Signature . Date
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET'
JOURNAL OR JOB NUMBER: 01-00309-01
,NAME OR COMPANY: SKILLERN INVESTMENTS
LOCATION: 2207 HENDERSON
TAX LOT NUMBER: 18-03-03-13-00400
ANNEXATION YEAR 2001 LANE COUNTY ASSESSED VALUE (LAND)
DEVELOPMENT TYPE: DUPLEX SEWER HOOKUP
DWELLING UNITS: 2 BUILDING SIZE: SF LOT SIZE:
J - STORM DRAINAGE
IMPERVIOUS S.F. COST PER S.F.
x
0.00 $0.271
I ITEM 1 TOTAL - STORM DRAINAGE SDC
2. SANITARY SFWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I COST PER DFU
x
I 23 I $21.25
B. IMPROVEMENT COST:
NUMBER OF DFU's COST PER DFU I
^
23 $16.15
I ITEM 2 TOTAL - CITY SANITARY SEWER SDC
3. TRANSPORTATIO'ti
A. REIMBURSEMENT COST:
ADT TRIP RATE NUMBER OF UNITS
x
9.57 0
B. IMPROVEMENT COST:
ADT TRIP RATE NUMBER OF UNITS
x
9.57 0
I ITEM 3 TOTAL-TRANSPORTATIONSDC
4. SANITARY SFWER - MWMC
x
x
,
A. REIMBURSEMENT COST:
I NUMBER OF FEU's . COST PER FEU
x
I 2 $245.06
B. IMPROVEMENT COST:
NUMBER OF FEU's COST PER FEU
x
2 $20.85
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
I SUBTOTAL (ADD ITEMS 1,2,3, & 4)
UDMTNTSTRA TIVE FEF:
SUBTOTAL ADM. FEE RATE
x
$1,402.02 5%
~T~
4/4/01
SDC COORDINATOR
DATE
COST PER TRIP I x NEW TRIP FACTOR
$16.12' 1.00 ,=' '
SF
=1
=1
$0.00
$0.00
=1 $488.75
=1 $371.45 II
=1 $860.20 "
$0.00
COST PER TRIP
$68.55
I x NEW TRIP FACTOR
, 1.00 =1 $0.00
=1 $0.00
,
~'I
=, $490.12
=1 $41.70 l
=1 $0.00 I
=1 $10.00 ,
=r $541.82 II
- ,.I
=1 $1,402.02
=1
$70.10
TOTAL SDc CHARGES = $1,472.12
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXA nON DATE, CALCULATE CREDIT SEP ARA TEL Y
YEAR CREDIT RATE PER $1,000 YEAR CREDIT RATE PER $1,000
ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE
1979 OR BEFORE $4.74 1990 $1.96
1980 $4.65 1991 $1.55
1981 $4.59 1992 $1.36
1982 $4.46 1993 $1.23
1983 $4.30 1994 $1.05
1984 $4.14 1995 $0.90
1985 $3.93 1996 $0.75
1986 $3.63 1997 $0.57
1987 $3.26 1998 $0.35
1988 $2.85 1999 $0.15
1989 $2.40
CREDIT FOR LAND (IF APPLICABLE)
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA nON)
VALUE / 1000 CREDiT RATE
0.000 x $0.00 =1
0.000 x $0.00 =1
TOTAL MWMC CREDIT =1
$0.00
$0.00
$0.00