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Home My WebLink AboutPermit Building 2007-2-8 Status Issued '\ jCITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00053 ISSUED: 02/08/2007 APPLIED: 01/11/2007 EXPIRES: 08/08/2007 VALUE: $ 81,466.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6244 Fernhill Lp ASSESSOR'S PARCEL NO.: 1702343405300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Remodel Residential PROJECT DESCRIPTION: Complete remaining unfinished basement area Owner: NICK GRAND & SUSAN GONDA Address: 6244 FERNHILL LOOP SPRINGFIELD OR 97478 Phone Number: 546-7889 I CONTRACTOR INFORMATION I Contractor Type General Contractor License DAVID ZARZYCKI GENERAL CONTRACTlU05626 BUILDING INFORMATION I Expiration Date 04/26/2009 Phone 541-688-0243 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R3 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,057 VB n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING oMDit;}6fit: Tptal: #j5~~~\lfq~HALL EXPIRE IF THE WORAandicapped: P:Aut~~~~UNDER THIS PERMIT IS NQ(fompact: %COMMENGf~g5:R IS ABANDONED FOR l\tly 1 g~ l'^V D!:Qlnn I PUBLIC IMPROVEMENTS I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Sidewalk Type: Fully Improved Storm Sewer Available: Yes Downspouts/Drains: Special Instruction: , . NTION'Uregon IdW f~4Ujjd~ yvu. i.V A' II:. " rl h\l tho lIreaon l!tlllty Notes: Don M, Requested early review of this file, No need to PUI~B\f6'WroWe-~teMemetl't'telliodet ~~Yf8~~w SDC fees for additional DFU's,JLP N ffication Center. Those rules are 2 001 , 0 I U31-ee~ 0 ~rQ,,~h ()A~ 9,5 - ,.-, 0.'\ ~o~- btain copies of the rules b' Valuation Descri 6. OU may 0 (N t . the telephone - ca Ingthecenter. 0 e,.. $ Per Sq Ft Sq'iffi~8~the Oregon Utility NotltlCatlOn or multiplier or Bid Amoemnter is 1_8(y0'-l.!JS2-2344).Pate Calculated To Storm Sewer Description Type of Construction Pa2:e 1 of 3 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00053 ISSUED: 02/0812007 APPLIED: 01/11/2007 EXPIRES: 08/0812007 VALUE: $ 81,466.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Bid Amount Estimate $1.00 $1.00 6,466,00 75,000,00 Use Bid Amount Estimate Total Value of Project ~ $6,466,00 $75,000,00 $81,466,00 01/29/2007 01/11/2007 Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $304,30 1/11/07 1200700000000000028 -Mechanical Issuance Fee- $10.00 2/8/07 1200700000000000132 + 10% Administrative Fee $61.05 2/8/07 1200700000000000132 + 5% Technology Fee $30.52 2/8/07 1200700000000000132 + 8% State Surcharge $48.84 2/8/07 1200700000000000132 Building Permit $495.45 2/8/07 1200700000000000132 Fixture $70.00 2/8/07 1200700000000000132 Miscellaneous Mechanical $39.00 2/8/07 1200700000000000132 Plan Review Residential $17,74 2/8/07 1200700000000000132 Sanitary Sewer - Improvement $197,91 2/8/07 1200700000000000132 Sanitary Sewer - Reimbursement $260,27 2/8/07 1200700000000000132 SDC Sanitary/Storm Admin $22,91 2/8/07 1200700000000000132 Vent Fan $6,00 2/8/07 1200700000000000132 Total Amount Paid $1,563,99 I Plan Reviews I Initial Review 01/12/2007 01/16/2007 APP LLH Public Works Review 01/16/2007 01/19/2007 WI JLP Public Works Review 02/01/2007 02/01/2007 10 JLP Public Works Review 02/06/2007 02/05/2007 APP JLP Public Works Review 02/07/2007 02/07/2007 10 JLP Structural Review 01/16/2007 01/29/2007 APP DLM Waiting in order PW rcvd for rvw,JLP Rcvd phone call from David V, Tld him PW rcvd file 1/19/07 & they #26 of 41.JLP Don M, Requested early review of this file, No need to pull plat or sewer maps-basement remodel. Added new SDC fees for additional DFU's.JLP Rvsd SDC worksheet & SDC fee's per plans which Don brought to me tOday,JLP See documents for Plan review comments, No need for Planning review since work is entirely withing exist'g bldg, dim 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 work day. Pa!!e 2 of 3 CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2007-00053 ISSUED: 02/08/2007 APPLIED: 01/11/2007 EXPIRES: 08/08/2007 VALUE: $ 81,466.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ReQuired Insoections I Floor Insulation: Prior to decking, Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover, Ceiling Insulation: Prior to cover, Final Building: After all required inspections have been requested and approved and the building is complete, Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing, Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete, Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Shower Pan, Prior to covering and including required testing, 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 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 times during construction, Owner o~~~!..:" ' ~ 06/ V~+ ., Date Pa2e 3 of 3 JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS 1. STORM DRAINAGE; DIRECT RUNOFF TO CITY STORM SYSTEM I .IMPERVIOUS S.F. x 'I COST PER S.F. CHARGE I 0.00 1 $0.336 = I $0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. x I COST PER S.F. I x I DISCOUNT RATE I 0,00 I $0.336 I I 50% ITEM 1 TOTAL - STORM DRAINAGE SDC '$0.00 2. SANITARY SEWER - CITY 1-- , A. REIMBURSEMENT COST: NUMBER OF DFU's x 10 B. IMPROVEMENT COST: NUMBER OF DFU's I x 10 I CITY OF S"'I'NGFIELD SYSTEMS DEVELOPMEN'~:Yl'~RKSHEET C0M2007-00053 Nick & Susan Gonda 6244 Fernhill Lp o SINGLE F AMIL YRESIDENCE o BUILDING SIZE (SF: o [f) ~ Cl o U tx: ~ E-< '[f) ...... Ci ~ o LOT SIZE (SF): DISCOUNT $0,00 1 $0.00 1070 COST PER DFU $26.03 $260.27 1091 $19.79 $197.91 1092 =1 r 3. TRANSPORTATION ITEM 2 TOTAL - CITY SANITARY SEWER SDC $458.17 A. REIMBURSEMENT COST: ADT TRIP RATE x I NUMBER OF UNITS x I COST PER TRIP x INEW TRIP FACTOR 9.57 I 0 I $19.81 I 1.00 = $0.00 1093 B. IMPROVEMENT COST: I ADT TRIP RATE x I NUMBER OF UNITS x I COST PER TRIP x INEW TRIP FACTOR I 9.57 I 0 I $87.39 I 1.00 = , $0.00 1094 ITEM 3 TOTAL - TRANSPORTATION SDC = , $0.00 I I 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's x ICOST PER FEU I 0 I $91.61 = ,I $0.00 1054 B. IMPROVEMENT COST: NUMBER OF FEU's x ICOST PER FEU 0 $961.52 = 1 $0.00 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) =1 $0.00 l1054 MWMC ADMINISTRATIVE FEE = 1 $0.00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =1 $0.00 "'" " SUBTOTAL (ADD ITEMS 1,2, 3, & 4) = , $458,17 5. ADMINISTRATIVE FEE; SUBTOTAL x I ADM. FEE RATE CHARGE $458.17 I 5% $22.91 TOTAL SANITARY ADMINISTRATION FEE: 22.91 1079 , TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00 11078 - / Jeff Prociw 2/7i2007 TOTAL SDC CHARGES =1 $481.08 I PREPARED BY DATE -,,--,;-.--:-,.::,.:-;.-./ , DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 1 0 3 = 3 I DRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 0 0 3 = 0 I CLOTHES WASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBlLE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER, SINGLE STALL 1 0 2 = 2 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 I SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LA V ATORY/RESIDENTIAL BAR 2 0 1 = 2 URlNAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 10 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE] 979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$l,OOO ASSESSED V ALOE $5.29 $5.29 $5.19 $5.12 $4,98 $4.80 $4.63 $4 .40 $4,07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR 2 2 1979' CREDIT FOR LAND (IF APPLICABLE) V ALOE / 1000 CREDIT RATE $0.00 x $5.29 = I $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) V ALOE / 1000 CREDIT RATE $0.00 x $5.29 o = $0.00 TOTAL MWMC CREDIT 225 Fifth Street Sprihgfield, Oregon 97477 541-726-3759 Phone Cj.... of Springfield Official Receipt L iopment Services Department Public Works Department Job/Journal Number COM2007 -00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 Payments: Type of Payment CreditCard cReceinl1 RECEIPT #: 1200700000000000132 Date: 02/08/2007 Description Vent Fan Miscellaneous Mechanical ~Mechanical Issuance Fee- Fixture Plan Review Residential Building Permit + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Paid By DAVID M ZARZYCKI Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 007112 007112 In Person Payment Total: Page I of 1 9:51:07AM Amount Due 6.00 39.00 10.00 70.00 17.74 495.45 30.52 48.84 61.05 260.27 197.91 22.91 $1,259.69 Amount Paid $1,259.69 $1,259,69 2/8/2007 ~%\o1 t?~~) CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00053 ISSUED: 02/08/2007 APPLIED: 01/11/2007 .EXPIRES: 08/16/2007 VALUE: $ 81,466.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6244 Fernhill Lp ASSESSOR'S PARCEL NO.: 1702343405300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Remodel Residential PROJECT DESCRIPTION: Complete remaining unfinished basement area Owner: NICK GRAND & SUSAN GONDA Address: 6244 FERNHILL LOOP SPRINGFIELD OR 97478 Phone Number: 546-7889 Contractor Type General Electrical I CONTRACTOR INFORMATION I Contractor License DAVID ZARZYCKI GENERAL CONTRACTIll05626 REYNOLDS ELECTRIC 17252 BUILDING INFORMATION I Expiration Date 04/26/2009 02108/2009 Phone 541-688-0243 541-343-7297 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R3 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,057 VB n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Fully Improved Yes Sidewalk Type: Downspoutsillrains: To Storm Sewer Notes: Don M, Requested early review of this file, No need to pull plat or sewer maps-basement remodel, Added new SDC fees for additional DFU's,JLP Paee 1 of 3 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-00053 ISSUED: 02/08/2007 APPLIED: 01/11/2007 EXPIRES: 08/16/2007 VALUE: $ 81,466.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Bid Amount Estimate Use Bid Amount Estimate $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 6,466.00 75,000.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $6,466.00 $75,000.00 $81,466.00 01/2912007 01/11/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $304.30 1/11/07 1200700000000000028 -Mechanical Issuance Fee- $10,00 2/8/07 1200700000000000132 + 10% Administrative Fee $61.05 2/8/07 1200700000000000132 + 5% Technology Fee $30.52 2/8/07 1200700000000000132 + 8% State Surcharge $48.84 2/8/07 1200700000000000132 Building Permit $495.45 2/8/07 1200700000000000132 Fixture $70.00 2/8/07 1200700000000000132 Miscellaneous Mechanical $39.00 2/8/07 1200700000000000132 Plan Review Residential $17,74 2/8/07 1200700000000000132 Sanitary Sewer - Improvement $197.91 2/8/07 1200700000000000132 Sanitary Sewer - Reimbursement $260.27 2/8/07 1200700000000000132 SDC Sanitary/Storm Admin $22.91 2/8/07 1200700000000000132 Vent Fan $6.00 2/8/07 1200700000000000132 + 10% Administrative Fee $6.40 2/28/07 1200700000000000218 + 5% Technology Fee $3.20 2/28/07 1200700000000000218 + 8% State Surcharge $5.12 2/28/07 1200700000000000218 Add, Alter, Extend Circ $43.00 2/28/07 1200700000000000218 Add, Alter, Extend Circ Ea Add $21.00 2/28/07 1200700000000000218 Total Amount Paid $1,642,71 Initial Review Public Works Review I Plan Reviews I 01/12/2007 01/1612007 APP LLH 01/16/2007 01/19/2007 WI JLP Waiting in order PW rcvd for rvw.JLP 02/01/2007 02/01/2007 10 JLP Rcvd phone call from David V. Tld him PW rcvd file 1/19/07 & they #26 of 41.JLP 02/06/2007 02/05/2007 APP JLP Don M. Requested early review of this file, No need to pull plat or sewer maps-basement remodel. Added new SDC fees for additional DFU's,JLP Public Works Review Public Works Review Pa2e 2 of3 CITY OF SPRINGFIELD' Status Iss u ed Building/Combination Permit PERMIT NO: COM2007-00053 ISSUED: 02/08/2007 APPLIED: 01/11/2007 EXPIRES: 08/16/2007 VALUE: $ 81,466.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 02/07/2007 02/0712007 10 JLP Rvsd SDC worksheet & SDC fee's per plans which Don brought to me today.JLP See documents for Plan review comments, No need for Planning review since work is entirely withing exist'g bldg, dim Structural Review 01/16/2007 01/29/2007 APP DLM 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 work day. Reouired Insnections , Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved, Wall Insulation: Prior to cover, Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking, Rough Plumbing: Prior to cover and including required testing, Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete, Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Shower Pan. Prior to covering and including required testing. 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 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 times during construction. Owner or Contractors Signature Date Paee 3 of 3 City of Springfield 1J:lectrical Authorization To Begin Wo' E-mailedTo:dan@reynoldselectric.com Receipt # EC508998 2/28/20072:09:37 PM Check on status of permit By Phone: (541)726-3753 or Email: permitcenter@ci.springfield.or.us D New construction [i) Addition/alteration/replacement Description [i) I or 2 family dwelling D Multi-family D Commercial/ Industrial I.Job no.: 17914 IJob address: 6244 FERNHILLLP I City/StatelZW: SPRINGFIELD. OR 97478-7732 I Suitelbldg.lapt.no.: Project name: Zarzycki / Grano Cross street/directions to job site: Off Main Street I Su bdivision: I Tax map/parcel no.: 1702343405300 I Lot no.: finish bonus area in day light basement I Name: dan IPhone: (541) 343-7297 I Email: dan@reynoldselectric.com I Fax: lEi. lie. no.: 20-155C ICCBlic.no.: 17252 I Business Name: REYNOLDS ELECTRIC INC Contact: dan Address: 2175 W 2ND AVE City/StateIZW: EUGENE OR 97402 Phone: 5413437297 I Fax: 5413454508 Em ail: dan@reynoldselectric.com I Metro lie no.: I City lie no.: I Supervising electrician's lie, no.: 2520S I Supervising electrician's name: JOHN A REYNOLDS, JR Upon review and approval by your local jurisdiction, your permit will be e-mailed or faxed within one business day, with instructions on how to schedule your inspection. NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained. The local building department may determine that an Authorization To Begin Work is null and void if it does not meet applicable land use laws and local ordinances. 11,000 sq, ft, or less I Ea. addl 500 sq. ft. or portion I-Limited energy, residential (with above sq, ft) I-Limited energy, multifamily residential (with above sq, ft) rSc,"~~?~f~~~'i~~t#'~~i~~,~.Iij,tllt.i~n,A.@/(j~reloelltion 1200 amps or less ' 120 I amps to 400 amps 1401 amps to 599 amps 200 amps or less I 20 I amps to 400 amps I 40 1 amps to 599 amps I Branch circuits -.NEW, alteration, OR extension, per panel A Fee for branch circuits with above service or feeder fee, each branch circuit B. Fee for branch circuits without service or feeder fee, first branch circuit; each addl branch circuit $43.00 $43.00 71 $21.00 I I I $3.00 I I I I - I I j I Service reconnect only I Each manufactured or modular dwelling, service and/or feeder I Pump or uTigation circle Sign or outline lighting Signal circuit(s) or limited- energy panel, alteration, or extension. not offered online at this jurisdiction J Subtotal $64,00 I Minimum Fee $45.00 I State Surcharge (8% of permit fee) $5.12 I City Of Serin~e1d fees * $9,60 I TOTAL PERMIT FEE $78.72 I 10% Local Admin Fee; 5% Local Technology Fee I I I I I ;, City Of Springfield This Authorization To Begin Work must be posted at the job site until replaced by a Permit. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007 -00053 COM2007-00053 COM2007-00053 COM2007-00053 COM2007-00053 Payments: Type of Payment ONLINE CHGS cReceintl RECEIPT #: 1200700000000000218 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Cj....' of Springfield Official Receipt L lopment Services Department Public Works Department Date: 02/28/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received Paid By ONLINE PERMIT CHGS ddk Page 1 of 1 ONLINE Reynolds Online Electric Payment Total: 3:02:35PM Amount Due 43.00 21.00 3.20 5.12 6.40 $78.72 Amount Paid $78.72 $78,72 2/28/2007