The URL can be used to link to this page

Home My WebLink AboutPermit Building 2010-9-13 " . ' j 5~.RI..NG. FIE.L~.. - . ~.. . '.. OREGON www.ci.springfield.or.us '::d\if ".Vi''';''-'''l CITY OF~iSPRiNGFIELD Building I Residential Permit PERMIT NO: COM2010-01056' .IVR Number: PROJECT STATUS: Issued ISSUED: 9/13/10 APPLIED: 8/5/10 EXPIRES: 3/11/2011 VALUE: $178,000,00 i I I 225 Fifth St : Springfield,OR 97477 Phone: 541.726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe,mltoenterC;,prin'jle'd.oc" I , I SITE ADDRESS: 570 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104600 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: OWNER: ADDRESS: Contractor Type Single family residence - SAME AS COM2010-00203 511 5 48th CONTRACTOR INFORMATION Contractor Name t ..,. ,,," TOPy NEONTCENH ELECTRS'CS'NCC .-/:,j( ~~~.,;M,t,}~, ','. HA 0 TERPRI E IN ." .i', "I.,' ~ "'.. c '._ PACIFIC AIR COMFORT INC .~.~. STUTZMAN SERVICES INC ;, ~':.: I lie Type CCB CCB CCB CCB Phone Nu~ber: , I I Llic Exp 0,9/29/2010 07/29/2011 03/25/2012 0,5/1212012 Phone 541-317-1998 541-923-6607 541-672-9510 541.928-8942 Lie No 172366 92208 39237 31747 # of Units: 0 Construction Type Occupancy Type Occupancy Comments BUILDING INFORMATION 'I u # of Stories: Height of Structure: Type of Heat: Water Ty,pe: Range Type: Forced Air Gas Electric Gas, No' , # 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 Permit 1 16.5 3 Hazmat: No Electrical Specialty Code Edition: . _ _ Springfield Fire Code Edition: P~th 2A Certified performcMechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: "Struciur~1 Sp~cialty"CodeEdition: ". ."~ ,;t, . I !?~. ~ Sit~'lnformation Yes r- ,I"?! No WENTION: Oregon law requires you. to ~ow rules adopted by the O'regon Utility Notification Center. Those rules are set forth In OAR 952-001-001 0 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification' Center is 1-800-332-2344), ' I,'.:. 9/13/2010 2:20:16PM Lot Size: , Sq Ft 1st Floo~: Sq Ft 2nd Floor: I Sq Ft Baseme~t: Sq Ft Garage: I Sq Ft Carport: , Sq Ft Other: ; I Occupancy load: I 4845 1408 403 24 2006 1 . . ;."}. ".'t'.l.-:~.;'H~"" , NOTICE: . E IF THE WORK THIS PERMici ~~~~~ ~~~ PERMIT IS NOT t ~~1H~~~CED OR IS ABANDONEDFOR;;:t . . ANY 180 DAY PERIOD. ','" . Page 1 of 6 CITY OF SPRINGFIELD Building I Residential Permit 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us PERMIT NO:O_0M2010~01056 _.~.:~.~'t" ~..:':t. ':;."l- . .',. ~.i\tR Nun{l>er: ___"".'.' '., ..r.".~... permitcenler@ci.sprlngfield.or.us PROJECT STATUS: Issued ISSUED!' 9/13/10 APPLIED: 8/5/10 EXPIRES: 3/11/2011 VALUE:'$178,OOO.00 SITE ADDRESS: 570 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104600 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: Single family residence. SAME AS COM2010-00203 511 S 48th DEVELOPMENT INFORMATION ~ Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 13.5' 10 10 16 o REQUIRED PARKING Overlay Dist: # Street Trees Reqd: 2 Paved Drive Reqd: Yes % of Lot Coverage: 37.3 Highest point on structure to north property line: 18,5 Total:, 2 Handicapped: Compact: PUB,L1C IMPROVEMENTS I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: 2-t)~ ;'!H~{'I'f'jJ"I~, ..~'~~~~~ ,:.~~it~i;~1 -_...-,--~ ,~ .,,---~ - " . ~ ..1 Sidewalk Type: Downspout/Drains: ':-:\...' ",-I . Valuation, D,es'cription ~ _, <./. ...<,.1.., :" Descriotion Tvpe of Construction Unit Amount Unit Tvoe Unit Cost Valu~ '\' 'd'j~.';: ,'.:.,; t~.t:l~ .1!.J:~~.~i;;:i'!; ',; 'i;-~'~ -""'. . ,'fl~.. '/.:<~:._~. --;"!;:&:"~':.~ . <,:'-~~.. Springfield Building Permit 9/13/2010 2:20:16PM Page 2 of 6 ., .. . -.1:\,~,,: S~~~EL~ ~l!b ~OREGON CITY OF SPRINGFIELD > ..~ I Building I .Residen~ial Permit . ~\., PERMIT NO~' COM2010.01056 IVR Number: www.ci:springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 . Fax: 541-726-3676 permitcenter@ci,springfield.or,us PROJECT STATUS: Issued ISSUED: 9/13/10 APPLIED: 8/5/10 EXPIRES: 3/11/2011 VALUE: $178.000.00 SITE ADDRESS: 570 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104600 " _ SCOPE: SFD ,:',:;'" "I "\ _' ' WORK INVOLVED: NEW " t..,: ':',fYPE OF STRUCTURE: RES ", ,~.' 'I ;. PROJECT DESCRIPTION: Single family residence. SAME AS COM2010-00203 511 S 48th BI .~-~~. cz';'G;p,^/o,,":' 's'''~('';'~1r~:~:..: ",+.",~,,% ;:s:::~ "Cj'"::'~t:~Ie,~IQ!:~~~~f'Y',T;.='~~-~~".:~:~~(:.:y",s:"~.);: DescriDtion Amount Paid Date Paid Plan Review Same As $250.00 08/05/2010 Same as Plan Review submittal Residential $250.00 08/22/2010 !.echnology fee (5% of permit total) $3.68 09/13/2010 Side,,:::alk Repair $-15.50 09/13/2010 Technology fee (5% of permit total) $-0.78 09/13/2010 SDC: Compliance Cost - MWMC Regional Wastewater SI $22.63' 09/13/2010 13.DC: Total Transportation Administration Fee $109:09 . 09/13/2010 SOC: Total Sewer Administration Fee ,. ." ,'$253,9'1!" 09/13/2010 SOC, Administrative Fee - MWMC Region;1 Wastewate".: . $10:00 09/13/2010 SDC: Improvement Cost - MWMC Regional Wastewater ~ . ,,' $1,333.57 09/13/2010 SOC: Reimbursement Cost - MWMC Regional Wastewat. $101.97 09/13/2010 SOC: Improvement Cost - Local Wastewater $1.043.04 09/13/2010 SOC: Reimbursement Cost - Local Wastewater $1,937.76 09/13/2010 SOC: Improvement - Transportation SOC $1.383.63 09/13/2010 SOC: Reimbursement - Transportation SOC $356.96 09/13/2010 ~OC: Improvement Cost - Storm Orainage $756.76' 09/13/2010 !!,OC Reimbursement Cost - Storm Orainage "~,j' ,$313.70,.. 09/13/2010 One or Two Family Dwelling with Two Bath ,'" $,~It.OO 09/13/2010 Range hood/other kitchen equipment .~. $.13.00 09/13/2010 Gas Pipin9 u~ to 4 outlets ' Ci", ','$7.00 09/13/2010 Temp services 200 amps or less $63.00 09/13/2010 Each added 500 sq. ft. or portion $50.00 09/13/2010 Residence wiring 1,000 sq. ft. or iess $134.00 09/13/2010 First Appliance Fee $79.00 09/13/2010 Heat pump $17.00 09/13/2010 Single-du~! exhaust (bathrooms, toilet compartn]ents, utili $36.00 09/13/2010 Flue vent for water heater or gas fireplace $9.00 09/13/2010 Willamalane fees- Single family detached $3.468.00 09/13/2010 ~ddress Assignment, each new or changE! .$~?P? . 09/13/2010 Structural Building Permit Fee - ," $~02.g8.. 09/13/2010 Residential Fire (.05 Per Sq Foot) ---"".l' . $91'75 09/13/2010 Admin fee (10% of applicable fees) $9.18 09/13/2010 Technology fee (5% of permit total) $82.43 09/13/2010 State of Oregon Surcharge (12% of applicable fees) $201.89 09/13/2010 State of Oregon Surcharge (12% of applicable fees) $0.20 09/13/2010 Total Amount Paid $13,685.95 Springfield Building Permit ;: ~:',;ri . -~! ",;.., .' .~..'~, ..,;t ;':'.~1~~ 9113J2010~ '2:20:16PM . ' ~.\ ="),c . ;'1,<:,. :;:>*;j10":,p~'~;-~ Receiot # 4410 4410 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 374298 Page 3 of6 .:. -,~_ of I ',: ..~." ...'~ ~,:~~~;)i;~\1 ~' "~I,: , ",;' www.ci.springfield.OLUS CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010.01056 IVR Number: 225 Fifth St Sprlngfleld,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perrnitcenter@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 9/13/1.0. ~J' APPLIED: 8/5/1 0., ,'~ EXPIRES: 3/11/2011 VALUE: $178,000.00 SITE ADDRESS: 570 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: 1802051104600 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: Single family residence - SAME AS COM2010-00203 511 S 48th ~,,,-~"~~' ~~:: :~1 A -~,,_;Y:,~rzr~~'- c?rl,:% "~~:~:-,w;:s~~a~~"'i[~~:w1:r:}'-/~~-'?~:~~< '"'':;~';::-'";~~~/::::::'';l-'- ~~~s:--T~-i; -s ""\~_ r - 'Cl --<-w~---J Deoartment Received Due Date ComDlete Result Reviewer .Application Acceptance 08/16/2010 08/16/2010 Application Accepted David Bowlsby Initial Revie~ 08/16/2010 08/16/2010 08/16/2010"- ApPT..oved David Bowlsby Permit Issuance 09/13/2010 08/30/2010 08/30/2010" Issued David Bowrsby Public Works Review 08/20/2010 08/16/2010 08/16/20.10" Appr9ved Kaye VVilson Structural Review 08/30/2010 08/16/2010 08/16/2010 Approved Chris Carpenter Planning Review 08/17/2010 08/16/2010 08/16/2010 Approved . Deyette Kelly Structural Review 08/30/2010 08/16/2010 08/16/2010 Review ,Chris Carpenter Comments received on 8-19-2010IStorm As noted on plans- OKI as sc Front elevations are site spec ,. .' . - ",". 1,,:..-':. ,):J.~ ,(I. ,',.,:'IU :~Cljj , "'\1 >'01.':,.. ,E::~J(j ir;'))tl. . :~;'11. C". "UJ1)': Springfield Building Permit 9/13/2010 2:20:16PM Page 4 of 6 . , CITY OF SPRINGFIELD Building t.~esid~ntial Permit ;..;.... ;'.,./ 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us PERMIT NO:"COM2010-01 056 ':f't permilcenter@ci,springfield.or.us IVR Number: PROJECT STATUS: Issued ISSUED: 9/13/10 APPLIED: 8/5/10 EXPIRES: 3/11/2011 VALUE: $178,000.00 SITE ADDRESS: 570 48TH PL S SPRINGFIELD ASSESOR'S PARCEL NO: ,1802051104600 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: Single family residence - SAME AS COM.2010-00203 511 S 48th INSPE'CTlONS REQUIRED ~ Inspections 1090 Street Trees 1110 Footin9 1120 Foundation 1150 Slab/Flatwork 1160 UFER Ground if~: Cd,li:''''!,' 1220 Underfloor framing 1260 Framing 1370 Masonry Veneer 1410 Underfloor insulation '.!i.;. '. '~". ':-';',..>1 v," 1420 Insulation Vapor Barrier 1430 Insulation Wall 1440 Insulation Ceiling 1520 Interior Shearwall 1530 Exterior Shearwall '" '" ,;';.1,;:: 1540 Gypsum Board/lath/Drywall 1999 Final Building 2200 Underfloor Mechanical \...!'r:-C; "'II;' " :-".,~ ..".. 2210 Underfloor Gas 2260 Gas Service 2300 Rough Mechanical 2310 Rough Gas 2995 Final Gas ._.;:~~~'5.: "~~if_\,~~~:p ...:-:::;.I.;~: ;~ 'd'''Fl .~. 2999 Final Mechanical .'. 3130 Footing/Foundation Drains 3170Underfloor Plumbing 3200 Sanitary Sewer 3315 Water Line Springfield Building Permit 9/13/2010 2:20:16PM Page 5 of6 "1'. ':' ...'It: . .;~,': ,-:(;' f . S.P~I..\N..:.... F.I.E~..D. - ~i\ ' " ~ ,; ,~ .... ~i:i'OREGON '..'. 225 Fifth St , Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.cLspringfie!d.OLUS CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-01056 IVR Number: pe rmitcenter@ci.springfield.or.us J PROJECT STATUS: Issued ISSUEQ: .9/13/10 APP'-:I~9: ~/~!2,o; . EXPIRES: 3/11/2011 VALUE: $178,000.00 SITE ADDRESS: 570 48TH PL S SPRINGFIELD"~!.""j, ASSESOR'S PARCEL NO: 1802051104600 - ~) '!.; SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: Single family residence - SAME AS COM2010-00203 511 S 48th 3400 Storm Sewer 3500 Rough Plumbing , 3999 Final Plumbin9 4000 Temporary Power Service 4225 Service or Feeder ,'t'.. ;. -. ~ ;." 4500 Rough Electrical 4999 Final Electrical ,'. .~\;T't:" '> '; ~< 1110 Footing 1118 Footing Drain 1120 Foundation 1160 UFER Ground -- :. iEt;- '3}:'!'hi'- By signature, I state and agree, that I have carefully exa~in~~d~th'~}c6~'~I~ted'apPlic~tion and do hereby certify that all information hereon is true and correct, and I further certlfy;thi3{ any"and-all work performed shall be done in accordance with the .- I...,.,'," I '-, ". c~. . 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 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 times during construction. ~~ "7-'-/':> -/0 Owner or Contractor Signature Date A:j~t;':': ~,...-\'. ,,~ :1 "r: . "'~;}~~~ ;~!G;;~f:r:l:' ::.... 1:{I~t~:~~ :,"j:~!i'I;.~ ;; .,~" Springfield Building Permit , 9/13/2010 2:20:16PM Page 6 of6 225 Fifth Streett Springfield, OR 97477 tPH(S41)726-3753tFAX(541)726-3689 ~P'RINGFIELD ~~;~;!;,:~ ~i~~1;~,,~~i~~ t,~"\;.~~;~;.~;!J-~~.JI IJ . ,: '. , .,~~.",."~.""'i\-'''''::,,~-'~'.:.\H~i,:i:'' DEP ARTMENT;USE':ONL-Y X",,', ,. ,,:,', ;x~,,:~,~t,~:,:?,~":'i.'-O;~.t;..{~~;~,~~~' Permit no. 5'"6 Date: :- 2-- '3 - .Le- This permit is issued under OAR 918-309-0000. Permits arc nontransferable. Permits expire if work is not started within 180 days of issnanee or if work is snspended for 180 days. ~1~~~i~i;ll~ri~O:G-e:lE[G!5)l~t{N.M.-g.Ntt~~:Fjet{Q'.v~ffi%~1~f~~~~~ Zoning approval verified? 0 Yes 0 No \C"',,,,.' l!<l"""~'F '.' ............-..... 'W' ...;ft. ..".... ........". '. ....."-"...1''''.. ,.....,\ \,;~ctJ;f,)f(;1flil~~liEq~By:4~PF,i;jP9NSifiR8,Qml0NtIif,i~tii.'?'"'~~~it(i;, o Residential 0 Government 0 Commercial ~!&tri~;(!J:OB'i!Sljjj't:~11'1\i~(;j.gM~\r"~fN&'AND:*fiQ~~]I(;j.N~I~1';;~:~l)!! Job site address: ~ fi r'" 'L City: 5. Stnte: 0 f<. ZIP: if?Lf Subdivision: tvc::::,h,..l~ Lot no.: t! ~"'J;f,.","""",,,,\,,,," .~.,. .... "w, '-1"'" ....., 'm!,,,,,~,'n',,,,,, "'" ".' t.;rciF1~:i:1i.~rt,~il~tiw.mEs.JI~ ~I f?,mJ~~*~ ~'~VVJ,;) ~JS~lft(,~f!R~:~!.~~:tl~i~~~~~ l-r Rwr(JMf7N~~;W1J.fyt~i~HB~8,~R~KQW){ER~'\ri~~~~~.~*~g~gi~~~:~~!~~ Name: Address: City: Rc 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), Signatme: ~'~~Wi!~i~~QNm~~ill~B~iN$l~~J~llfl'ti1fQ'~[~'f,[~l~~~~fj*ti}t~~,f~~'~ Business name: Address: ZIP: City: Phone: E.mail:. CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing snpervisor: N ,njJ''v'0 Of ~1bBlc\' Co\J~~ ~ . &rd,W- 440.2584-J (9/08/COM) ~\.. ~\1. .lfJ...6CCJ _:~;fJI~Wit:~~'E-E?iS;CHED'Oli!E;'f€~ft~P;.~~9~.~it~%'Y~\%*-r~Uj~ ,..~'k.~...(,t~ .___>___ ... __~.._ ,._ __ _ " _.. _ n' J!K,~. _jtk~."~-",Vf.,i~l,, .1__. ,-". .iifJ", ~~~;;r~~!lg)~ '~:~,"j~~~~~ll~llk~~!t~1'~~li; :~1?] ~~1E~~fJ i~i11:!~~~ Residential, per unit, service included: {JJ t,OOO sq. ft. or tess (4) ( $134.00 d~ Each additional 500 sq. ft. or portion .,..- $ 25.00 $nc d) 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 t to 400 amps (2) $ 95.00 $ 40 t ,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: il1stal/ation. alteration, relocation 200 amps or tess (2) I $ 63.00 $ I 0:' , pD 261 to 400 amps (2) 401 to 600 amps (2) $ 87.00 $ $126.00 $ Over 600 amps ~r 1,000 vallS, 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 fceder fee: First branch circuit (2) Each additional branch circuit $ 55.00 $ $ 6.00 $ Miscellaneous fees: service or feeder not included $ 63.00 $ $ $ 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) $58.00 $ ~~~;!*]J~lyJ{~~t~~~tM~~)~]~~'iG~~'t::lmi~ii($_Et~\~;\~~xW~~rj~~~~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) 63.00 $ 63.00 $ (B) Enter t2% surcharge (.12 x [A]) (C) Technotogy Fee (5% of [AD TOTAL fees and snrcharges (A throngh C): ~ 41.otJ $ 1Cl.lrlf- $ n~'rI llLz.e!"h -otC'tJ ,'\ DEPARTMENT USE ONLY i \CP~ ZO/O .C/O!;"f}. PermIt no.: i , ! : I Da'ef~5'lb This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days ofisSllJnCe or if\l'ork is suspended for 1 SO days. SAf\\t: AS fl( 5" ~4'.#--fL CIO. Z03 Stnll 225 FifLh Streel t Springfield, OR 97477 . PH(541 )726.~753 . r:-\...X(S41)726-36S9 I LOCAL GQVERNMEN'rAPPROVAL. This projecl has fmalland-use approval. i Signalure" Date: This projecl has DEQ approval.. Signature: Date: -. ----~ I , ZOll.ng ul-ll_.IIv,sl \ trifled. 0 Yes 0 No ProperlY is v: i:;-.,;i"', fleed plain: 0 Yes 0 No ....>CAIEGORY:O~i cbNSjRUCTION.... !2J Residential JiJB .SITE. o Govemrnenl D Commercial Job "lie 3ddress 570 ANbLOCATION. f'L City: Subdivision" Reference: ZIP "I7'f7'if. /'0. PROPERTY OWNER Name: Address: City: K~ Phone: ~r" - ~ ~',-;"C; '"'lS- .\....{ . State: 0 Q Fax: E-mail: This installation is being made on residential or farm property owned by me or a member of my immecjiate family, and is exempt from licensing requirements under ORS 701.010. Sign here: LAJ'ION.. I*" Address: '/~rC ( State: oR_ City: Phone:;tf( - E-mail: CCB license no.: Print name: Signature: , ".. _',' ., ." ." ...:.__ '-'-'_ _.:_ : _~ .... .".... u' ,.: .._ ,'''_ ~,.. .,... ", .,. " ''''.'' ,:" ,:-,..,. '__p ':"/': 'SU .BoCGJ N;1)RA'G;rR R I tlFQRMJ';'flRNC: ." .::. Name CCB License Number Phone Number Electrical I 7 T\ &j, Plu mbing 3/ 7'17 Mechanical YIJ- 37 SP;;'''CFoELD "~" I I FEE SCHEDULE i.-ValiJ.~'tioil"iT}formation' .' (8) Job description: Occupancy Constrllclio" rype: Square feet. l:? 'S Cost per square foot: ,t 71170 ("~ -. Other information' Type or Heat: Energy P2th: rl/\ [Y] new 0 alteration (b) Foundation-only permit') Total valuation: o addition Dyes DNa "0. (a) Permit fee (use valuation table): (b) Investigative fee (equal to (2a]): (c) Reinspection ($ per hour): I (number cfhours x fee;: per hour) (d) Enter 12% surcharge (.J2 x [2a+2b+2c1): (e) Subtotal of fees above (23 through 2d): $ $ $ $ (" (a) Plan review (65% x permit fee [2a)): (b) Fire and life safety (40% x permit fee [2a]): (c) Subtotal of fees above (3a ao'd 3b): (a) Seismic fee, 1% (.01 x permit fee f2al): $ TOTAL fees and surcharges (2e+3c+4a): S 2~willamalane t-w Park ancJ Recreation District Job. No. (!ltJ-/OS~6 SYSTEM DEVELOPMENT CHARGE WORKSHEET July 1-December 31, 2010 'NAME: ffA Yi'E,It-- PHONE: 2Z~ Co'? J S- ADDRESs.?'1cW' SiAl f~",-,.e.ctITY 'f)tJfIVP STATE:~IP: 11J7~ LOCATION OF PROPOSED BUILDING SITE: StreetAddress:.J?LJ J. cj,JTA Plat Name:\O.Qr:i\- \,,-)\~ Tax Lot Number: t'ba2.CfQ\\ m@ 1, DEVELOPMENT TYPE (Check appropiiate dwelling(s). Dwelling type definitions are on the : back.). A. Sinqle-Family Detached NO. OF UNITS f X $3,468 per unit = f $ J '( LP~ B. Sinqle-FamilyAtlached NO. OF UNITS X $.3,538 per unit = $ C. Multi-Family Apartment . NO. OF UNITS X $2,906 per unit = $ D. Sinqle Room OccupancY NO. OF UNITS X $1,453 per unit = $ E. . Accessory Dwellinq Unit NO. OF UNITS X $1 ,734 per unit = $ $ WILLAMALANE SDC 2~ SDC CREDIT (If applicable) SDC payer must furnish proof of . . . Willamalane Credit approval.) $ J' 3. . TOTAL WILLAMALANE NET SDe ASSESSED .(if SDC reduced for Credit) ~ (\ $ 7L(C,J? 251 S I /0 Date . Development Services Depa men! City of Springfield . 5 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone a~:;jr1 Wir_- . City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000874 9:33:09AM Date: 08/05/2010 Job/Journal Number COM2010-01056 Payments: Type of Payment CreditCard cReceintJ Description Plan Review Same As Paid By HAYDEN HOMES Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 250,00 $250.00 Amount Paid djb $250.00 $250.00 079479 In Person Payment Total: ,:~ ~w-~ . ;'."~ ',j':' ~,.., l " ) ~. . ',.,' ! .., . -I'" ~ '~,I~.:tlL~" ' ,., ...... ..." . .' ~" >> ._..'.!~:.~';." , t., ,t.,. I -~_ ~,~~( ~;:r:" .~~ .: . .. :t ',,~ " . , ~ "'i .I., . " ,I .7~:~t 'f>i~;~ ~ 'j'}':: . ,.;c .:;,j: ~l..:. Page I of 1 8/5/2010 . . . S~RING...F IfL~ .~ ~::r .tJi ">"".' OREGON CITY OF SPRINGFIELD 225 Fifth 8t Springfield, OR 97477 541-726-3753 TRANSACTION RECEIPT COM201 0-01 056 570 S 48TH PL www.ci.springfield.or.us permitcenter@cLspringfieJd. or. us RECEIPT NO: 20 I 0000311 RECORD NO: COM20 I 0-0 I 056 IDEllC RIP"J'fofli :,,-::.;::,; " ':~ '";t:,0'}"',f Technology fee (5% of permit total) Sidewalk Repair Technolog~ fee (5% of permit total) SDC: Compliance Cost - MWMC Regional Wastewater SDC SDC: Total Transportation Administration Fee SDC: Total Sewer Administration Fee SDC: A~r11ll1istrative_r:ee. MWMC..B"gional Waste~ater SDC SDC:. Improvement Cost - MWMC Regional Wastewater SDC SDC: Reimbursement Cost - MWMC Regional Wastewater SDC SDC: Improvement Cost ~ Local Wastewater SDC: Reimbursement Cost - Local Wastewater SDC: Improvement - Transportation SDC sac: Reimbursement - Transportation SDC SDC: Improvement Cost - Storm Drainage SDC: Reimbursement Cost ~ Storm Drainage One or Two Family Dwelling with Two Bath Range hood/other kitchen equipment Gas Pipin!] up to 4 outlets Temp services 200 amps or less Each added 500 sq. ft. or portion Residence wiring 1,000 sq. ft. or less First Appliance Fee Heat pump Single-duct exhaust (bathrooms, toilet compartments, utilityJooms) Flue vent for water heater or gas fireplace Willamalane fees - Single family detached Address As~~nment, each new or change Structural Buildin~ Permit Fee Residential Fire (.05 Per Sq Foot) Admi!:! fe~J1 O<y~ of applica!?-I~_f.~,~L____",. Technology fee (5% of permit total) State of Ore~on Surcharge (12% of applicable tees) State of Ore90n Surcharge (12% of applicable fees) , '>z>'s,:i:,,,,;;:".~ ~~_C_QU~L~~OJ)J:::"" 1 00-00000-425605 201-00000-428060 1 00-00000-425605 444-00000-426607 719-00000-426604 719-00000-426604 611-00000-426604 .~-_.._. 445-00000-448025 444-00000-448024 443-00000-448025 442-00000-448024 . 447-00000-448027 446-00000-448026 . ,'.L;.:;~:0,00000-448028 441-00000-448029 224-00000-425603 224-00000-425604 224-00000-425604 224-00000-426102 224-00000-426102 224-00000-426102 224-00000-425604 . 224-00000-425604 224-00000-425604 224-00000-425604 821-00000-215023 224-00000-425602 224-00000-425602 --- 100-00000-424005 224-00000-426605 -~.-..._..._.._", - " ---... ......-......-.-- 100-00000-425605 821-00000-215004 821-00000-215004 ,.""_ TOTAL DUE: ';;;;~~PAYOR:~Jt3+;:CASHIER:IP~O~7;[; '. _" "GJ)..M_~,g~is \;",~(f0~'~<%~>f,$':-~~tst:,,:~<._" DATE: 09/13/2010 :i.iVIs:!.i.J]:trQ.[~:: $3.68 $-15.50 $-0.78 $22 63 $109.09 $253.91 $10.00 $1,333.57 $101.97 $1,043.04 $1,937.76 $1,383.63 $356.96 $756.76 $313.70 $374.00 $13.00 $7.00 $63.00 $50 00 $134.00 $79 00 $17.00 $36.00 $900 $3,468.00 $38 00 $902 08 $91.75 $9.18 ----.-..-.-..."...--- $82,43 -- $201.89 $0.20 $13,185.95 AI\IIOlJt{FPAI[)~ . ("Yi~. I P'AX,M'ENTrT'fPE Check HAYDEN ENTERPRISES Cash HAYDEN ENTERPRISES . :,1'h' r"".~) I $13,185.75 $0.20 $13,185.95