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Home My WebLink AboutPermit Building 2010-9-13 . . 'l~ 1 Sf, :,~N..GfFI~ EL~.D.- ~'.'--" l?d.... -1i!J; Jp;P" . 'OREGON www.ci.springfield.or.us '"';-r~t;!"-: ,.-:.~t ,',- CITY o.Fi1)p~RINGFIELD Building n~esidential Permit PERMIT NO: COM2010-01044 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us PROJECT STATUS: Issued IVR Number: ISSUED: 9/13/10 APPLIED: 8/4/10 EXPIRES: 3/11/2011 , ,VALUE: $244,381.00 SITE ADDRESS: 553 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104900 SCOPE: SFD ;~:... WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: OWNER: ADDRESS: New Single Family Dwelling . Phone Number: Contractor Type CONTRACTOR INFORMATION ~ Contractor Name .'_~_' ~. '_"_'~M"_' PACIFIC AIR COMFORT INC. t. '2:.. . TOP NOTCH ELECTRIC lNC J.r~ .t, ~.., K ~ i ,~. .STUTZMAN SERVICES INC . _.,.. _. . /....., HAYDEN ENTERPRISES INC .Lic Type GGB GGB GGB GGB Lie No 39237 172366 31747 92208 Lic Exp Phone 03/25/2012 541-672-9510 09/29/2010 541-317-1998 05/12/2012 541-928-8942 07/29/2011 541-923-6607 # of Units: Construction Type Occupancy Type Occupancy Comments # of Bedrooms: Sprinkled Building: No Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Pe~mit BUILDING INFORMATION ~ o # of Stories: Height of Structure: Lot ,Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: ' Sq Ft Other: Occupancy Load: 24 2 1408 U, Type of Heat: Forced Air Gas Water Type: , ~ Gas. Range Type: ,Gas, H_azm,!~: No . " 980 " 403 5 No Electrical Specialty Code Edition: . . Springfield Fire Code Edition: Path 2A Certified perform~echanical Specialty Code Edition: Municipal I Development Code: Plumbi[l9 Specialty Code Edition: Residential Specialty Code Edition: 2006 Structu~ai Spec'faii}t'Code-Edition: ,~. . j I )ff::. "::"Sit~"(ri'forfnation ~ Yes X':.',' No No No Yes ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the teli'lphone number for the Oregon Utility Notification Center is 1-800-332-2344). NonCE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT .' COMMENCED OR IS ABANDONED FOR ~,;, ANY 180 DAY PERIOD. ' ' . ' . . ~~,._'.'~"" .' ' , '. ' ::, l!llaL . .. -.. 9/13/2010 2:13:58PM Page 10'6 .--' . \ . ;:' J1 ~:.f '.' www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: CpM2010-01044 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm ltcenler@ci.springfield,or.us 1.~' , N~ N\irii_b~r: ;'n...'" "'.;;.~ ...j. ( PROJECT STATUS: Issued ISSUED:;9(~ ~7fpi :: APp[i~b': 8i.i/10 EXPIRES: 3/11/2011 VALUE: $244,381.00 SITE ADDRESS: 553 48TH Pl 5 SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104900 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling DEVELOPMENT INFORMATION I Frontyard Setback: 16 Interior Setback: 5 Sideyard Setback: 5 Rearyard Setback: 31 Solar Setback: 0 Overlay Dist:. # Street Trees Reqd: 2 ., "'T .j' Paved'Drive Reqd: Yes % of LofCoverage: 36.3 Highest point on structu,re to north property line: 18.5 REQUIRED PARKING Total: 2 Handicapped: Compact: PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: - l~;~\i"':;;r ,.~.," i,j..\. l"itLll.h.," , ~W{"ili 'it}.!;,.. ::.d~;':} Sidewalk Type: dElrE, .!.f,tihf .: r:rr;fJ ,:'.~ Downspout/Drains: Valuation Description ~ Descrietion Tvee of Construction Unit' Am'ount Unit Tvoe Unit Cost Value '[ T!. '. r. ." ;;\,,;'::'6\i! 1,.t' &.~~~~' t;;.;t1~~/I. .. . "- . . ~::1r'-'~;' .- ,_....... .:. Ji Jill}', ~.!f~::r' Springfield Building.Permit 9/13/2010 2:13:58PM Page 2 of 6 ", "...., SP~.IH.G.FIE l~ aV' ~,- ~ ,.. m. OREGON CITY OF SPRINGF;IELD Building I Residential Permit PERMIT NO:' COM2010-01044 :L , 225 Fifth St Sprin9field,OR 97477 Phone: 541-726-3753 . Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.cLspringfield.or.us IVR Number: permitcenter@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 9/13/10 APPLIED: 8/4/10 EXPIRES: 3/11/2011 VALUE: $244,381.00 SITE ADDRESS: 553 48TH Pl S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104900 ~J~"~~: '..: '-,;~.."- PROJECT DESCRIPTION: L."".:.'>- ::;"~:. Descriotion Plan Review Residential SDC: Reimbursement Cosl- MWMC Re9ional WastewatE SDC: Total Transportation Administration Fee SDC: Total Sewer Administration Fee SDC: Administrative Fee - MWMC Regional Wastewater ~ SDC: Compliance Cost - MWMC Re9ional Wastewater Sl , sac: Reimbursement Cost - Storm Drainage SDC: Reimbursement Cost ~ Storm Drainage ~DC: Improvement Cost - Storm Drainage SDC: Reimbursement. Transportation SDC SDC: Improvement - Transportation SDC SDC: Reimbursement Cost - Local Wastewater SDC: Improvement Cost - Local Wastewater SDC: Improvement Cost - MWMC Regional Wastewater ~ Residential Fire (.05 Per Sq Foot) Admin fee (10% of applicable fees) Planning - Major Review Structural Building Permit Fee ~ddress Assignment, each new or change Willamalane fees - Single family ,detached One or Two Family Dwelling with Three Bath Range hood/other kitchen equipment Flue vent for water heater or gas fireplace Single-duct exhaust (bathrooms, toilet compartments, utili First Appliance Fee Residence wiring 1,000 sq. ft. or less Each added 500 sq. ft, or portion Temp services 200 amps or less Sidewalk up though 90 Feet Curb CuUDriveway 1 st Cut Multiple Permit Discount (Max 2) Gas Pipin9 up to 4 outlets State of Oregon Surcharge (12% of applicable fees) Technol09Y fee (5% of permit total) Total Amount Paid Springfield BUilding Permit ,J;[J!~~: -rt'~:; SCOPE: SFD WORK INVOLVED: NEW .' ll;YPE OF STRUCTURE: RES :'.i.. ~\. . ". '1..:1 .'. "~ .~ . I "~9~'13/20~ b",,:':2i13:'S8PM' ~" 'r "', -$~lLIY .~ Date Paid 08/05/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 09/13/2010 Receiot # 18590 18590 18590 18590 18590 18590 18590 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 374295 New Single Family DW~~!.!.~f;.' , "1'. ~~.~. _--~:",~""t',;0.:;.)k_;"!<.. ,:;';::~'t--'?lr~F'EE SPA'I'D"" ,:;""",k,,;_,~~.,',,,,,,..',,,_'t+"'~.-';__ ;:_~;.".'.' ,~"."i ''of "'--%-'.:i '-"""::~,._:. ',.'.'-'''',,';,,'!-;:-.-:--. -..=.,,;:,..P' '. - ., ,'_. - Amount Paid $741.11 $101.97 $105.40 $315.76 $10.00 $~2.63, ." $185.3~ '$141:66 i' " , $788.86 ct! I" $3'56.196 \ ~. ',,' $1,383.63 $2,664.42 $1,434.18 $1,333.57 $150.75 $15.08 $211.00 ':j'd ~1'ilt;t94 ,. :~>.\. ~-t_ ~ $38:'60 i J!jjlg-,,::~. $3;468.00 ~7:r:.~; .: ;~$.H~39~00 ~~..l" $13.00 $9.00 $45.00 $79.00 $134.00 $100.00 $63.00 $88.00 $88gg" .$-3P.99 ,.$7.00 " ., $243.71 $110.75 $15,999.73 Page 3 of6 ;.\ -~~. ,-rJ, . , . " :"\1/:1 ";',:,~.' ..::::~~, ':;-' I 5f'.G.~.I.E.L~ ~ltti. ~OREGON www.ci.springfield.or.us f,,~!(r .:' 4;;'~: ,- CITY O!7,SPRINGFIELD Building I Residential Permit PERMIT NO: COM201 0-01 044 IVR Number: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 54f-726-3676 permitcen1er@ci.springfield,or.us PROJECT STATUS: Issued ISSUED: 9/13/10 APPLIED: 8/4/10 ,'J\ EXPIRES: 3/11/2011 VALUE: $244,381.00 SITE ADDRESS: 553 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104900 ' . ;.l," t'e SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES .1 PROJECT DESCRIPTION: New Single Family Dwelling ~':'t,,~}2.s--, .-~~:';"~ ~ . ;:~- fr.~~ ~ ::,:- 't!!~:s~~ _" ~ >~ _':""~:y~ ';-,-'RI'!~t3~I[;,w': '-,.'-: :;:">ty,.[~~f,:0:~<:~i ,..<~;~~D~-~?J:7';C<0.":*~ Deoartment Received Due Date Initial Review 08/16/2010 08/16/2010 Application Acceptance 08/16/2010 08/16/2010 Planning Review 08/16/2010 08/16/2010 Public Works Review 08/19/2010 08/16/2010 Permit Issuance 09/13/2010 08/20/2010 Planning Review 08/18/2010 08/16/2010 Structural Review 08/20/2010 08/16/2010 no F] Comolete 08/16/2010 Reviewer . David Bowlsby David Bowlsby Deyette Kelly Kaye Wilson David Bowlsby Deyette Kelly Chris Carpenter Comments Result Approved Application Accepted 08/16/201~il' J~~~} ~~~a: required 08/16/20.10L .APpr.oved 08/20/2010 Issued 08/16/2010';- tAP.pr6ved ._ I, ' 08/16/2(m) Approved Spoke to Tim D. with Hayden received on 8-18-2010 Starn Front elevation is site specific As noted on plans -,j;~:~, . ", !'. ;' i~. ,I' ,j';~4."; ',i;o:OJ(__ 'i:J10 "1~~J.[]f iQ1: '\l,\;l'__,"., .,J" ., :.~ " , , ..:SW.~:o.'.,,\~f . ~.t c- ':}0t1~t\.i ,1;' I,. - );'.., .. ,". l.::' " ., Springfield Building Permit 9/13/2010 2:13:58PM Page4of6 SPRIH..G .FIE~. It~ :,~dti1 . .,F~OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Res.idential Permit ,l.,> .."If,',,'" \, PERMIT No:C'6Mio1cO~01 044 " ,) , 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield . or. us k." ,", . t:,IV~ Number: PROJECT STATUS: Issued ISSUED: 9/13/10 APPLIED: 8/4/10 EXPIRES: 3/11/2011 VALUE: $244,381.00 SITE ADDRESS: 553 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104900 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling INSPECTIONS REQUIRED I Inspections 1050 Excavation 1090 Street Trees 1110 FoOtin9 1120 Foundation 1150 Slab/Flatwork 1160 UFER Ground ~ '.1' 1190 Retaining Wall . ;~, ;;~- . ~'7' ';-..; I ~ ~. " . :.lb;'7;':. . -,., 1220 Underfloor framing "".". ;"'IYI' .~.:,. . ,""110 1260 Framing 1370 Masonry Veneer 1410 Underiloor insulation 1420 Insulation Vapor Barrier 1430 Insulation Wall 1440 Insulation Ceiling 1520 Interior Shearwall 1530 Exterior Shearwall 1540 Gypsum Board/Lath/Drywall 1999 Final Building 2200 Underfloor Mechanical 1;( ~';j,\".'; ~ ~'~:U !:ht, .1 :';'.':i.~.! . .,:...;:;'J"l .", 2210 Underfloor Gas 2260 Gas Service ~~'..~':~ ~; ',' 2300 Rough Mechanical 2310 Rough Gas 2995 Final Gas .-. .,.... t;;<;,h" ~~;..~::.tf:l.'..i~ ~--, "',~.:t':fl~'" . "~f'~'" M, 2999 Final Mechanical 3130 Footing/Foundation Drains 3170 Underfloor Plumbing Springfield Building Permit 9/13/2010 2:13:58PM, Page5of6 , : ;,~ . ~\~ flf;';. . ' ' S~~I,N. ~.FIEL~ .~~~ J.>*'~v'OREGON CITY OF'SPRIN.<3FIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.cLspringfield.or.us (;:' .. ,- ':,1 :e!;", BuildillgL'Residel'ltial Permit PERMIT NO: COM2010-01044 IVR Number: permitcenter@cLspringfield.or,us PROJECT STATUS: Issued ISSUED: 9/13/10 APPLIED: 8/4/10 EXPIRES: 3/11/2011 VALUE: $244,381.00 ~ . ~ SITE ADDRESS: 553 48TH PL S SPRINGFIELD. "___., ASSESOR'S PARCEL NO: 1802051104900J:;'~;: . " SCOPE: SFD u_:; '~:;;:---.- WORK INVOLVED NEW '3'(; .'5"', '. : "jyPE OF STRUCTURE: RES ~~'~h'fi' ",.,-~.' .. PROJECT DESCRIPTION: New Single Family Dwellirii{' 3200 Sanitary Sewer 3315 Water Line 3400 Storm Sewer 3500 Rough Plumbing 3999 Final Plumbing , ' . \l\,,.' 4000 Temporary Power Service 4225' Service or Feeder 1 '.. I"" ~_.:'::f\ .' :ro:... .,~'f:i ;. 4500 Rough Electrical 4999 Final Electrical (' By signature, I state and agree, that I 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 or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permis~ion of ~he 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 th~-p/6per,ti;';'e:.that ea~h address is readable from the street, that the permit card is located at the front of the property, and the:approve(j~seNjf'Pla'n~ wiil remain on the site at all times during construction. .. , -. . TVi :: . ,..,- .~.., .. Owner or Contractor Signature 1-/~/o Date , 1''-; ~ ("r- - ,.~, _!:,': \, . .-,.... --_. . ,if.; f' ,,'. ''l,.iilct ,.... Springfield Building Permit '1"~1~%~' c1~~'~~~':l~::t i ': ~"l \ 'H 9/13/2010f\2:13:58PM . F;. ~' ,~. .~,~ Page 6 of6 'if" Electrical Permit Application 225 Fifth Streett Springfield, OR 97477. PH(541)726~3753. FAX(541)726w3689 SPRINGFIELD l:o~ ;l! ~t ~,.'~'~~~lll~ii ~lli'\lT.. ,1M. ~~ ~tfiljf....... 'lillJfl J 'tfiW":.t...,.-".~,,-, -.,.;''',",' ,,:~'L'-,,- ;:- ~~ '}':,!::,~~t';U"'tft\ :",a~"~-<='2i;:: J~~~: ~E~A~!~~~.Nl~_!~.~1~1<p.~~l(i~m~~ Date: Permit no.: This permit is issued uuder 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. ~'kYi;,"f2jJ~\fi(BIIb1:~l?IfG:OV.ERNMEt)liTrf~RP.RlD...~~1i~~1! Zoning approval verified? DYes DNa lr:i!;!I~'}j~~[eAiljE({~BY~[QFJcl(;:~N~m8.l!Jpmlbr\l~f!~m~1lj1\fUii!7:~1 o Residential 0 Government 0 Commercial !\f~~:OB\1!$Iif:E~lINJ;,<;)gM~ml0.rIl;wA'Ni:JjjlYC:"!>'A.ljI0ti1ij1m~foii (t... I ZIP: "'l775<;. City: Phone: E-mail: 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: ~j1,~~\C::}lNili~C::iT~0R@ltilSJMl!!I!.MiIQN~f,1~~iffiifB Business name; Address: City: Phone: ZIP: Fax: E-mail:. o CCSiicense no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: . k\~ l\)~ umr ~~~CY.' tc$1a. (',o\Je\{, ex- ~()'\p ~ D~ ~~ . D\\.3\1.\C\a,0 440-2584-J (9/08/COM) ~~~,1JiN'ilf!'W,i~~~EEi~~P8E:D_UL!!I:!mtwk';1l!if~~\iifl; ~.~~~~~~,~t~~~W:;,~~11mt~s.'Wf.~~~!~~;-::~~;,~1$ r<:t'r~ !J,'~~€osf~iit i'f.o1al~t: , urn er,o dnspec IOn~~",,1 em:(\'),j"I1: Q y" '{'i\fe;-""c," '.-"'- f-Ii.\ ~i;:~r.',;l:'I:"'t';;;o:':!lM:t..;l'h~'.~~;~.. .j'Pt';:,:i";~;;;~':;',:'w;..t~_: '~"'i'\"~ I.;.;...:. .~fI'_()I!.i;l ~iI~&O_S, ~'-' Residential, per unit, service included: 1,000 sq. n. or less (4) \ $134.00 $t~, iJ Each additional 500 sq. ft. or'portion Ac. $ 25.00 $\(0 thereof Limited energy (2) $ 32.00 $ Each,manufaclured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: instailation, alteration, relocation 200 amps or less (2) $ 81.00 $ 20 I to 400 amps (2) $ 95.00 $ 40 I 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: instailation, alteration, relocation -,) 200 amps or less (2) t $ 63.00 $0:> V 201 to 400 amps (2) $ 87.00 $ 40 I to 600 amps (2) $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 ofa service 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) $ 55.00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.0'0 $ Signal circuit or a limited-energy panel, $ 63.00 $ ,alteration, or extension (2) Each additional inspection: (1) $58.00 $ ~;if;;~l'~~~~j.~~P.ip.P,t'JIGAlilm~i!JsE:;t,~~lf~~~~~~~ (A) Enter subtotal of above fees $~~.C c) (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ ~ ~ (C) Technology Fee (6% of [A]) $ tl--;q. TOTAL rees and surcharges (A through C): :v.2A-"1 "\\ - . ~ DEPARTMENT USE ONL Y i , StnH Permit Application -- 225 Fifill Street + Springfield, OR 9i477 . PH(S4 1 )726-37S3 . F:\X(541 )726-3689 SP"lNGf',ELD .,' ~, Pemlit no ! CW -- JfJff1 Hr 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, L0CAL G6~ERN. MENTAPPROVAL . ,-" ".,'- ,_. This project has final land-use approval. Signature: This project has DEQ approval.. Signature: Zoning approval verified: I Dale: Dale: FEE SCHEDULE " i ;.ya~ ll.~'dbh;'hif a'nn ~t(o:h'.~, (a) Job description: Occupancy Property is \;,ithin flood plain: DYes DYes DNo ~" UI'lO Construction type: rgJ Residential o Government o Commercial Square feet: Cost per square foot" Other information: /- 0/00 ~- ~, ,'_'0" 'J~!' 'hi 'cA'fEq()R~Y;iOF,i,CONS.TRUCTlbN .",":'--.'.'0', " 'U9B,SITE iN#ORMATIOkANDLOCATIOI'l.. " ff" PL Type of Heat: Energy Path: ~p [XI new 0 alteration 0 addition ,(b) Foundation-only permit? 0 Yes 0 No Total valuation: City: Subdivision: w~5f- w Reference: ' -e-"]... e-5" 1. 1- PR0PERTY OWNER (0 (a) Permit fee (use valuation table): (b) Investigative fee (equal to [2a)): (c) Reinspection ($ per hour): (number of hours x fee per hour) Cd) Enter 12% surcharge (.12 x (2n+2b+2c]): (e) Subtotal of fees above (2. through 2d): Name: Address: City: Phone: ' State: 0 Q $ s E-mail: This installation is being made on residential or farm property owned by me or a member afmy immediate family, and is exempt from licensing requirements under ORS 701.010. $ City: Phone: 5LII - E-mail: CCB license no.: 0 Print name: -/4(( r State: OK $ $ Sign here: CONTRAqrOR'lNST 'LATION fIc" (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): $ Signature: ,'" ': sU,Ei,CONTRAC'rOR INFORMAflO,N" ';:;,".,t.,:c" Name Electrical Plumbing Mechanical CCB License Number Phone Number 17 3/7'17 YI,;L37 / *~iI!~ecT'!l!~e Job. No. c'\D - \\}\ t\ SYSTEM DEVELOPMENT CHARGE WORKSHEET July 1-December 31, 2010 NAME: ~(\L\d.Q)[\ ~ PHONE: ()Jl.f6 Loq~ ADDRES~4b4 !'itA) G.~l ~E:D.R4IP: LOCATION OF PROPOSED BUILDING SITE: Street Address: :SD~ {). L\5~ ~L . rvl Plat Name: \t)\QD\\l)~ Tax Lot Number: \t({i2..OS\\ (~W 1. DEVELOPMENT TYPE (Check appropriate dwelling{s). Dwelling type definitions are on the back.) A. Sinole-Family Detached NO. OF UNITS \ X $3,468 per unit = $ ~4to<(6 ,ex) B. Sinole-Family Attached. NO. OF UNITS X $3,538 per unit = $ C. Multi-Family Apartment NO. OF UNITS X $2,906 per unit = $ D. SinqleRoom Occupancy NO. OF UNITS X $1 ,453 per unit = $ E. Accessory Dwellino Unit NO. OF UNITS Development Services Depa City of Springfield o~ $ $ <~4.to6 ,DO -CY $~lag~ , 0, \0 $ X $1,734 per unit = . 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) Date 5 . ' S~:\~N~_.F~El~. ~._,.~ _:. ":i'i1 ~...0..", OREGON CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 TRANSACTIO~ RECEIPT COM201 0-01 044 553 S 48TH PL www.cLspringfield.or.us pe rmitce nter@ci.springfield.or.us RECEIPT NO: 2010000309 RECORD NO: COM201O-01044 DATE: 09/13/2010 'DESCRIPTION;:;';- ~'''',: ";~')':'i:):/;::1.:0.t':;~;) ):~~i:~)iT~:;';4'3Yk,!';.c_Q_ulil'f.LG:QJi.E--~.'i;'-;': :;'"rAMd@TR.lJE:. . ., SDC. Reimbursement Cost - Storm Drainage 441.00000.448029 SDC. Improvement Cost - Storm Drainage 440.00000.448028 SDC: Reimbursement. Transportation SDC 446-00000-448026 SDC: Improvement. Transportation SDC 447-00000-448027 SDC: Reimbursement Cost - Local Wastewater 442.00000.448024 SDC: Improvement Cost. Local Wastewater 443-00000-448025 .s..~.lrnp,-~ern.ent Cost. MWMC Regional Waste~t.e.!:.2.DC ___...~,:5-00000-448025 ____._~._ .~esidential Fire (.05 Per Sq Foot) 100-00000-424005 Admin fee (10% of applicable fees) 224-00000-426605 Planning - Major Review 100-00000-425002 Structural Building Permit Fee 224-00000-425602 Address Assignment, each new or change 224-00000-425602 Willamalane fees - Single family detached 821-00000-215023 One or Two Family Dwelling with Three Bath ,~\G.-.. ; :).r+~.'22~-OOOOO-425603 Range hood/other kitchen equipment . 224-00000-425604 Flue vent for water heater or gas fireplace .iI7: 224-00000-425604 Single-duct exhaust (bathrooms, toilet compartments, utility rooms) 224-00000-425604 First Appliance Fee 224-00000-425604 Reslgence wiring.1.cl!.29 sq. ft. or less 224-00000-426102 Each added 500 Sq. ft. or portion 224-00000-426102 Temp services 200 amps or less 224-00000-426102 Sidewalk up though 90 Feet 201-00000-~8060 ,,,_,_ Curb CuUDriveway 1 st Cut 2Q1-00000-428060 Multiple Perniit Discount (Max 2) 201-00000.428060 Gas Piping up to 4 outlets 224-00000-425604 ~ of Or<:"90n Surcharge (12% of applicable fees) 821-00000-215004 Technol09Y fe..':..i~% of permit total)_. 100-00000-425605 TOTAL DUE: t: . PAYMENT TYPE ). .;r>AYOR~:;)';;CASHIER DBO\NLSBY. '.",: ~'CO' M"M..E.N....T..S\""~"tiF,,,)'b'f - '.. ~,.^".~.."..._~___.,....____"'"~_.-.~.....,~_~. . _...,.,' . _ .'. .',.._... _ ..._,_.._..... .............~.... ...~~.. <.A _ .. ....._ _~-- .., $141.66 $78886 $356.96 $1,383.63 $2,664.42 $1,434.18 $1,333.57 $150.75 $15.08 $211.00 $1,141.94 $38.00 $3,468.00 $439.00 $13.00 $900 $45.00 $79.00 $134.00 $10000 $63.00 $88.00 $88.00 $-30.00 $7.00 $243.71 $110.75 $14,517.51 . AtilQLJIiIXJ:?A!R~:;tf"",,-i,~.,.'l1 Check 28719 HAYDEN ENTERPRISES INC $14,517.51 \C~.. ; '~)t< :,-,- .::....': i~1 , ':i '." ",. $14,517.51