HomeMy WebLinkAboutPermit Building 2010-12-27
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CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00841
IVR Number: 811190293911
www.cLspringfield.or.us
225 Fifth SI
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenler@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
Issued
12/27/2010
12/27/2010
12107/2010
EXPIRES:
VALUE:
06/05/2011
$151,538.00
SITE ADDRESS: 4867 GLACIER DR, SPRINGFIELD, OR 97477
ASSESOR'S PARCEL NO: 1802051109900
PROJECT DESCRIPTION:
New SFD. Same As 4851 Glacier - 510-659
Phone Number:
OWNER:
ADDRESS:
JHD3 LLC
2464 SW GLACIER PL
REDMOND OR 97756
SCOPE: Single Family Residence
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
CONTRACTOR INFORMATION
~
Lie No Lie Exp Phone
31747 05/12/2012 541-928-8942
39237 03/25/2012 541-672-9510
92208 07/29/2011 541-923-6607
C220 07/01/2011 541-317-1998
Lie Type
CCB
CCB
CCB
ELECTRICAL
BUILDING INFORMATION ~
Electrical Specialty Code Edition:
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
Municipal I Development Code:
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Cod~ Edition:
Contractor Type
Plumbing Contractor
Mechanical Contractor
Contractor Name
STUTZMAN SERVICES INC
PACIFIC AIR COMFORT INC
HAYDEN ENTERPRISES INC
TOP NOTCH ELECTRIC INC
Electrical
# of Units:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Hazmat:
Occupancy Type
Construction Type
Occupancy Typ.e
Construction Type
R-3
Type VB
U
Type VB
# of Bedrooms:
Sprinkled Building:
Fire Alarms:
Energy Path:
3
No
Path 2A Certified
performance-tested
duct system
1
16.58
Forced Air Gas
Gas
Electric
lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
4574
1408
Sq Ft Basement:
ATTENTSq!Ft Gil,agO'1law rC4b:iires youto
foil ow nfsq'FtiCarport:by the Oreg,on Utility
Notificatic~ Gc~toL Those rul8s are set forth
, Sq Ft Other: 24'AR 952001
in OAR 9SOJ-iJ01-UU1D through u --
0090. YouOR?l1f'tl'8~'\~?tdjpies of the rules by
cailing the center. (Note: the telephone
number for the Oregon Utility NotificatIOn
Center is 1-800-332-2344).
2008 '
Site Information
Engineered Fill:
Fill Volume:
Flood Hazard Area:
land Hazard Area:
Retaining Wall:
Soils Repor:': Required:
Springfield Building Permit
12/27/201 9:18:06AM
M'hICE"
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
,NY 180 DAY PERIOD.
Page 1 of 6
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
Phone 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.ci.springfield.or.us
Building I Residential Permit
PERMIT NO: 811-SPR2010-00841
IVR Number: 811190293911
permitcenter@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
12/27/2010
ISSUED:
APPLIED:
12/27/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$151,538.00
SITE ADDRESS: 4867 GLACIER DR, SPRINGFIELD. OR 97477
ASSESOR'S PARCEL NO: 1802051109900
SCOPE: Single Family Residence
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
14
5
5.18
25.62
o
New SFD - Same As 4851 Glacier - S10-659
DEVELOPMENT INFORMATION I
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
2
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
PROJECT DESCRIPTION:
Yes
% of Lot Coverage:
Highest point on structure
to north property line:
39.5
18.5
PUBLIC IMPROVEMENTS
I
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
~
Descriotion
R-3 1 & 2 family
U Utility, misc.
Tvpe of Construction
VB
VB
Unit Amount Unit Tvoe
1,408.00 Sq Ft
403.00 Sq Ft
'Unit Cost
96.83
37.72
Value
136,336.64
15,201.16
151,537.80
Springfield Building Permit
12)27)201 9:18:06AM
Page 2 of6
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00841
IVR Number: 811190293911
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
pe rmitcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
12/27/2010
ISSUED:
APPLIED:
12/27/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$151,538.00
SITE ADDRESS: 4867 GLACIER DR, SPRINGFIELD, OR 97477
ASSESOR'S PARCEL NO: 1802051109900
SCOPE: Single Family Residence
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
New SFD: Same As 4851 Glacier - 510-659
FEES PAID
~
Description Amount Paid Date Paid Recipt #
~Ianni"-g - Major Review - City $211.00 12/27/2010 ___~_ 2010001148
Admin fee (10% of applicable fees) $9.18 12/27/2010 2010001148
Gas Piping up to 4 outlets $7.00 12/27/2010 2010001148
Flue vent for water heater or gas fireplace $9.00 12/27/2010 2010001148
Residential Fire (.05 Per Sq Foot) $91.75 12/27/2010 2010001148
Structural Building Permit Fee $920.39 12/27/2010 2010001148
One or Two Family Dwelling with Two Bath $374.00. 12/27/2010 2010001148
Fur~yp to 100,000 BTU $17.00 12/27/2010 2010001148
Vent for appliance other than furnace $9.00 12/27/2010 2010001148
R~~g~'h~~di~~r kitZher;-equ;p';;~';;--~------' -------------$1300--------- --- 12/2712016---- -- . -2010001148-
s;;;gT.;~;~b;;;hrooms:toilet-c;;,;;pa;;;;:;;;;;-s, utili -------$3600-----~--12/27/2010-- -. -- ---"201-0601-1-48
Heat pump --------------------------$1Too.-------12/2712010--- -- . 201000i1'48
First Appliance Fee .$79-00---.-------,2727/2010----- -- ---201 000i-148
Residence wiring 1,00o;q~ft(;;:T;,-S;- $134.00 12/27/2010 ---2016001148
Each added 500 sq. ft. or portion $50.00 12/27/2010 2010001148
Temp services 200 amps or less $63.00 12/27/2010 2010001148
Sidewalk up though gO Feet $88.00 12/27/2010 2010001148
Curb CuVDriveway 1st Cut $88.00 12/27/2010 2010001148
Multiple.!'.ermit Discount (M~~~) $-30.00 12/27/2010 2010001148
~eimbursement Cost - Storm Drainage. $415.55 12/27/2010 2010001148
.sDC;:~rTlprov_'''11..nt..c::.?~!___~!''_'rn_l?raina.g..____.______$!545~ __...1~/_2~/_201 0.____ ______201 ~?O~ 2.':.8_
SDC: Reimbursement Cost - Local Wastewater $2,761.72 12/27/2010 2010001148
SDC Improve,;;e;:;t-C~;;- ~L~~-;'IW~;;'r-------- - $1,39282 121'27t2010-----'- ---.----------zD10001148
si5C:'ReT;;~;~~~nt - Tra~;p~atjon SDC ._-- $426.92 -'12/2712010-----'--2010001148-
SDC: Improvement _ T~rtatjon SDC ,~--- --$1~,597"62 12/2m610 _________u -Z61OCio114S-
SDC: Reimburse;;:nent Cost - MWMC Regional WastewalE $101.97 -----12i27i:2.oio------.-.2010001148
SDC: Improvement Cost - MWMC Regional Wastewater ~ $1,333.57 12/27/2010 2010001148
SDC: Compliance Cost - MWMC Regional Wastewater 51 $22.63 12/27/2010 2010001148
SDC: Administrative Fee - MWMC Regional Wastewater: $10.00 12/27/2010 2010001148
SDC: Total Sewer Administration Fee $319.42 12/27/2010 2010001148
SDC: Total Transportation Administration Fee $121.45 12/27/2010 2010001148
Technology fee (5% of permit total) $93.72 12/27/2010 2010001148
~!e. of Oregon Surch~rge (12% of __applicable fees) $207.41 12/27/2010 2010001148
Address Assignment, each new or change $38.00 12/27/2010 2010001148
WTil"malane fees - Single family d;;j,;ci;d'----- -- -'$1,216:3-"-- ---12T27i2Oi'O~---------201 0001148
Willamalane fees - Single family detached $2,251:66---------;zlvi2D1o---.-----.---2010001148-
._~~__~__.__.~._~,______~"" ,_____'._+.w_._____.~__~_~.____ .-+___ .___..... ___+_ . ._
Same as Plan Review Submittal $250.00 12/07/2010 2010000988
Springfield Building Permit
12/27/201 9:18:06AM
Page 30f6
..
- ,.
SPR...INGFIE.L~
.i?
:? ,~
. ..<": . OREGON
WWW.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00841
IVR Number: 811190293911
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769'
Fax: 541-726-3676
permilcenter@ci,springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
12/27/2010
ISSUED:
APPLIED:
12/27/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$151,538.00
SITE ADDRESS: 4867 GLACIER DR, SPRINGFIELD, OR 97477
ASSESOR'S PARCEL NO: 1802051109900
SCOPE: Single Family Res.idence
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
New SFD. Same As 4851 Glacier - S10-659
Total Amount Paid
$15,501.66
Plan Review
~
Deoartment
Initial Review
Received Due Date
12/10/2010 12/10/2010
Comoleted
12/10/2010
Result
Approved
Reviewe r
David Bowlsby
i;~~~~__-=""" ;,-');',-",,;, . !.-.,;"~~2^';"",,,_.:.........-.. ' . . .:' . ';" ""n""--_\4~;.k---.-;.,-~.__~,__...' '-_~,_, .~___-"".__._J
Planning Review 12/10/2010 12/10/2010 12/15/2010 Approved Deyette Kelly
Comments: Front elevations are site specific and contain REQUIRED design elements. Inspectors will field check that actual
elevations match submitted designs as shown on the approved set of plans. Meets minimum setbacks. Inspector to
verify placement at time of footing inspection. '.
eyblic",W9rl{s;R'~vieVJ77~';1t~,.,.~, 12/1 DI2Ofb,i::l,~rfD7~19:12~OJ D,:~, \j:/' Approved,~~" :}"d~~:li:~1>:[,": "K~Y~XVils6hK~'
.J ~'",,,,' ,~. '~~', ","~,,:"'.,," "".::.'~," ",-,,,, K"'i;""'~,':' .,',',' F.>.", ',",~ ~"0-r'e'/f,'..d"'-"",' "",~, '/~., '. "";,,,-,,'" ",'1, ,;;", ,'7" ',;f. ':..". ''',,<''''.,
~";,,'
;"Comments: St6rinwaterto'"tap,,- tP",' ',"~ .,.:=-., ~.,,~ ,<.r, "'; ;..~,'", "~"", ,'- ::~'''-0't.' /.
'''',_~,' "",""f.F',~~",,,'1"""'-' ,~,),"-l,""" '," "",,~. ' ""'.ff' ~'::",~l-m_5:"""''''''* ~ ~
Structural Review 12/10/2010 12/10/2010 12/17/2010 Waiting Internal Kip Kaufman
Comments: Public Works
-'7t._,,:-->~
'-"~-.~ '1
. ' , , .
.., ~
. }; -' ),
: " ,: .~,., ,~
Springfield Building Permit
12/27/201 9:18:06AM
Page 4 016
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00841
IVR Number: 811190293911
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:
STATUS DATE:
Issued
12/27/2010
ISSUED:
APPLIED:
12/27/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$151,538.00
SITE ADDRESS: 4867 GLACIER DR, SPRINGFIELD, OR 97477
AssEsOR's PARCEL NO: 1802051109900
SCOPE: Single Family Residence
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
New sFD - Same As 4851 Glacier - 510-659
INSPECTIONS REQUIRED ~
Inspections
1020 Zoning/setbacks
1090 Street Trees
1110 Footing
1118 Footing Drain
1120 Foundation
1160 UFER Ground
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in
conjunction with footing and/or foundation inspection.
1220 Underlloor framing
1260 Framing
Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
1370 Masonry Veneer
1410 Underfloor insulation
1420 Insulation Vapor Barrier
1430 Insulation Wall
1440 Insulation Ceiling
1520 Interior Shearwall
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Shear Wall Nailing: Before covering sheathing with finish materials.
1530 Exterior Shearwal1
1540 Gypsum Board/Lath/Drywall
Drywall: Prior to taping. lath/Plaster: To be made after all lathing and gypsum
board, interior and exterior are in place', but prior to plastering.
Final Building: After all required inspections have been requested and approved and
the building is complete.
Underfloor Mechanical. Prior to insulation or decking and including required testing.
Underfloor Gas: After line is installed and required testing and capped if not attached
to an appliance.
Gas Service: After line is installed and line has been connected to a minimum of one
appliance including required testing. Presure test done at this point.
Rough Mechanical: Prior to Cover
Final 'Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
1999 Final Building
2200 Underfloor Mechanical
2210 Underlloor Gas
2260 Gas Service
2300 Rough Mechanical
2995 Final Gas
2999 Final Mechanical
3130 Footing/Foundation Drains
Springfield Building Permit
12/27/201 9:18:06AM
Page 5 of 6
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00841
IVR Number: 811190293911
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:
STATUS DATE:
Issued
ISSUED:
APPLIED:
12/27/2010
12/07/2010
EXPIRES:
VALUE:
06/05/2011
$151,538.00
12/27/2010
SITE ADDRESS: 4867 GLACIER DR, SPRINGFIELD, OR 97477
ASSESOR'S PARCEL NO: 1802051109900
SCOPE: Single Family Residence
WORK INVOLVED: New
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
New SFD - Same As 4851 Glacier - S1 0-659
3170 Underlloor Plumbing
3200 Sanitary Sewer
3315 Water Line
Underfloor Plumbing: Prior to insulation or decking.
Sanitary Sewer Line: Prior to filling trench and including required testing.
3400 Storm Sewer
Storm Sewer Line: Prior to filling trench.
3411 Perimeter Rain Drains
3500 Rough Plumbing
3999 Final Plumbing
4000 Temporary Power Service
4225 Service or Feeder
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
4500 Rough Electrical
4999 Final Electrical
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
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 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~
/( -7.?- -IQ
Owner or Contractor Signature
Date
Springfield Building Permit
12/27/201 9:18:06AM
Page 6 of6
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This permit is issued under OAP. 91S-:!60-li030. Fermils expire ifworh:is not 5(~Ulecl \\"iihin
suspelloeli fOI 1:30 dt:lvs
LOCAL GOVERNMENT
APPROVAL
I
I
I03le:
I
IOa\e:
01\]0
i This proieci h3.s fln3i 13nG-liSe approval
1 Sign31ur"e-
\ This projecl h3S OEQ ;:;ppro\'al.
; Signa!\..Ire:
\ ZOlling 3ppie,val verified'
I
\ Proptrry !~, '.\ :;;-;;;, need plain"
Dyes
DYes
", ,
U :'~Q
I,CA TEr:;O.RY OFCONS.TRpCTIQN.
i [ZJ Residential 0 Government 0 (O",iTiCLC;;o!
JOB. SITE INFORM;,TIONAND LOCATiON..
Job "i,e addresc:
PR..
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I ZlP: 97y'7'?:
City: ~~(.,,~(("Icf
OR
Su bd i v IS ion.JWc::">l-o.Jl~ '.> i LOl no.: ~O :
Relerenc~ /862.051) I T3.xIOI 0 9900
PROPERTY OWNER
Name: /./"'>p= fk,WlP ,
Address: rY';(OL( <.lJ r:,!Q(,'r-( ,
City:
() .
\'(c>c.{.;,;oncA
Slate: 0 Q
fin;:
I ZIP1; 7<;(" I
I
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I
Phone:)L! I - ~ - r:,c: "'l.S-
I.-mail:
This jnsll'i1lation is being made on residentiai or farm property owned by
me or 3. member of my immediate family, cmd is exempt from licensine.
requiremenls under ORS 0\.010_ ~
Sign here: - '{;
CONTRAqOR
Business name: // ",f 1'1'-
Address. )1 ,q 5~
City Rc yY!onv{-
Phone 5'11
.INSTA'LATION
.' " -' -, . ."
;Ju. '"V ~
I j ""-
larc f
Slate uK.
Fax.:J-1I-1-J/
E-maiL
CCB license no..
o
~ d G~Il@)k;y~
Print name:
~
Signalurc
S U BcoNTRACi.6R; I NFOR i;1AII'cM
I I I
,r\,lDrne I CCB Lic~~1St N\.~rnbo:r. Phone Number -I
Elect; icnl 17]\(/0 I \
1
Plumbing 317'17 I
Meth:lnicnl 30;;2 31 1
FEE SCHEDULE
1. VJlu.o'tion inform3tion. .
(3) Job descriplion:
Occupancy
Squ3ri: feel
Con~Ir1lc{iOi: c:.'pc.
=B~
COSt per square rOOl.
Gihe, ir,ioLmation:
Type ofHt::Jl:
="'>
Eoergy P:;(\1: .:JA
CZI new 0 alteration
o addition
o Yes ~o
(b) Foundation-only permil')
Tot~d v[]lu::ltiow
(b) Investigative fee (equal to pa)):
(c) Reinspection ($ per hour):
(number cfhours x fee:- per ho,-"r)
>
(d) Enter 12% surcharge (. \ 2 x [2?--72b+2c]):
le) Subtotal of fees 3bove (2a through ld):'
$
uc)
(8) Plan review (55% x permit fee (~~,AJ'
(b) Fire and life safety (40% x permit fee [2a]):
(c) Sublot>!1 offe:e:s 3bove (3~ ;;nd 3b):
$
c
(a) Seismic fee, \ oJ" (.01 x permit fee [2a1):
$
TOT~\L fees :lnd surcharges (2e+3c+'13): .$
.,.,
Electrical Permit Application
225 Fifth StrecttSprillgfield, OR 97477 tl}H(541)726-3753t FAX(541)726-368?
\ <'bf:fl).:ft>'(\ 0 ~C\ cD
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DEP ARTM ~NT US'E.ONLY;',,',
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Permit no.:S', 0 -'3''-; I
Date:. J).. 7 I D
This permit is issued under OAR 918-309-0000. Permits arc nontransferable. Permits expire if wal'l< is not started within 180
days of issuance or if worl< is suspended for 180 days. .
~~~1.f:''<<1?~~}:~~O.Q'A:I1%~~0\ZEJ{~(M-~_Nr~1~~J~1~~ov~(hl~~11tt~tift,~~",%,[~;
Zoning approval verified? 0 Yes 0 No
.t~~~l11~~f~tG~:m_~-~~QR~~~Q~~~[g;:Q"N.$mRlJ CmICrN.wt.?&~t~'1~~;t\!fi:g:%2
o Residential 0 Government 0 Commercial
~Ni&Yt'Jif()B't!S:I;rE~INF,.ijSriilAmIQN;P~ND;\i!00Atl(;iNJ((N~ibr~:\
Job site address: 'Ii 'C.e't- C-tL.AGt~ D~
City: <)~~P\ U'LO' o<L ZIP:
Subdivision: Wdll.llf-Sb~ Lot no.: 80
r~~1%~~n~~~~e~~~~v-PE:~~C,Ri~ml'O.N-~J:r~~t.v~(0J~lS0i:~l~~~~~~~~~~~~:,\~~~
l~~1;~~~~~J~~i~]P,_ROJ:~~F{11ii't~~Q,W,N-~Rt{i~rdl~1~~1g;iNi!~}i~r~t~i
Name: O{:/1'J ~
Address: V{~t{ $' t.J C.
City: MP~D
Phone~f&"SlP - 5T1"t,
E-mail: ~ c..~c>~
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:
~~1~~~~~c):fNm~Gm.ot~~fN~)1#~l!J,i.mIQ-~~,1l~J~~g~~:~:'M~6iW
Business name:
Address:
City:
Phone:
E-mail:,
CCB license no.:
ZIP:
Signing supervisor's license no.:
Print name of signing supervisOl:;
Sjgnature of signing supervisa'r:
'G\e& ~~:
,,,,'J./ \\J~ ~~U~~
~~OV~ ~61q ~'J%Ct
~. ~~O~ .'
~ . ~\ ~\\ V\C\6
440-2584-1 (9/08/COM)
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~~riu,W.p.,~r4g,f'..IT~.~pecho}l~R.eIlL~tE..rir(!j'L5~\~~ ,Q!y~ ~\~l~r^"'.j;!}~t?t. f#!",p'__a _.:,",1
l..,..,<'",.\"l "",l.,...,..b.r-.,,_,;(<r::'!4;j~,P;.,,_ i,,-,~,g,l;"A<~i~'io'...1;"Il!Z' '.,"'"',,.!:j.; '!:~....-J.,...!-:_f!..:,:;tl,~ ;\~co_s t)f1
Residential, per unit, service included:
1,000 sq. ft. or less (4) I $134.00 $~d' ..
Each additional 500 sq. ft. or portion ~ $ 25.00 $'::J) Dl
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 $
201 to 400 amps (2) $ 95.00 $
401 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: installation, alteration, relocation
200 amps or less (2) \ $ 63.00 $Jo'~ .
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Over 600 amps or 1,000 volts, see services or fceders section above
Branch circuits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a 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) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
.alteration, or extension (2)
Each additional inspection: (1) $58.00 $
~~~~~ii!nF~~~~~~~RRTIj~~'~jf~j!ts~~~~l;~m~1M~~~tliflW~~
(A) Enter subtotal of above fees $~41~ ~
(Minimum Permit Fee $58.00) ~
(B) Enter 12% surcharge (.12 x lAD $ .({.J
(C) Technology Fee (5% of [AD $ ,f)~.1.). B
TOTAL fees and surcharges (A through C): ~ 11'1t?1 ,
, .",-.,/
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0.'7'
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~
2~ willamalane
. . t\i Park and Recreation District
Job. No.
~\\)-PA\
SYSTEM DEVELOPMENT CHARGE WORKSHEET
July.1-December 31, 2010
t'!,A,ME: ~\\~~ \1..0.... . . PHONE:5L\ \ ~~~ (oC\~
.. ADD~ESS: ?~l\\cA S~ .. tITY~STATE~IP: Q\l5.P' .
L~CATIONOF PROPOSE~~~E: . o. .. . ..
..SlreefAdd~~~tl( ....
. Plat~ame\}. .. . ..' 0... o. T~LotNu~ber: \'b0'2.Cfj. \ ~~[)CJ
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the
back.) .
. A. SinQIe-Family Detached 0
NO.OFUNITS \
X $3,468 per unit =
.. $ ~\o~,cP
B~ SinQle-Family Attached
o NO. OF UNITS
X $3,538 per unit =
$
C. Multi-Family Apartment
. NO. OF UNIl:S
D. . SinQle Room Occ~pancv
X $2,906 per unit = .
.. . -. .
$
. .
NO. OF UNITS
X $1 ,453 per unit = .$
E. AccessorvDwellinq Unit
. ..
NO.OFUNITS
. WIl:'LAMALANE SDC
X $1,734 per unit';'
$
$ '::A\t:f?;; C?
$.0
$~~.
~jJj~()\D
Date
2. SDC CREDIT (lfapplicable)SDC payer must furnish proof of
. WillarnalaneCredtt approval.) .
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credtt)
5
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00841
4867 GLACIER DR
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenter@ci.springfield.or.us
RECEII'T NO: 2010001148 RECORD NO: 81 I-SPR20 I 0-0084 I DATE: 12/27/2010
tbES.s;.RJR:tIQNJ,~t'1t'';:'lbjit&~,!i,F:'\',j."". :,*~f'.;:".~'"J.';;,;.tgi;~c_Qu}4:t'::C:OQ~.~J~",,, t~ArIIO_UN,LDJ,IE;J..;:..;;;:<::"::: 'J
Planning - Major Review - City_ 100-00000-425002 $211.00
Admin fee (10% of applicable fees) 224-00000-426605 $9.18
Gas Piping up to 4 outlets 224-00000-425604 $7.00
Flue vent for water heater or gas fireplace 224-00000-425604 $9.00
Resldentia) Fire C05 Per Sq Foot) 1 00-00000-424005 ,.____.~~~~
Strue;.!ural Buildin9. Pern:>i.!.~ee 224.00000-425602 $920.39
.~~w.2. C~ily Dw"l~ng_ wit!:'.!.~ Bath. __ ___.__.._____ _ __._ 224:~0_000-425~~~______....__,.___ __.._. _$~ -:?O_
Furnace - up to 100,000 BTU 224-00000-425604 $17.00
---'-....--.---"-----.--.- --'-~ ----------,---.-----_._,-_._.._~--
~~~.fo!~ppliance other tha~-'nace 224-00000-425604 __.____.__. ___29:0.9_
~-"g_"-l:ood/other ki!chen equipment 224-00000-425604 .___~.OO
Si~g!,,--duct exh~ust (bathrooms, toilet compartments, utili!~.n:!.~) 224-00000-425604 $3~
Heat pump 224-00000:425604 $17.00
First Appliance Fee 224-00000-425604 $79.00
Residence wiring 1,000 sq. ft. or less 224-00000-426102 $134.00'
Each added 500 sq. ft. or.!?_,,-,!!on 224-00000-426102 $50.00
Temf'..Services 20.0 amps or less ..._____... 224-00000--:26102 $63.00
Sidewalk up though 90 Feet 201-00000-428060 $88.00
..- -----_.- ._-_._-._----------- ..._-~--,---_._-
~':'~_ Cut!Dr~e,^,ay_ ~s!.C!!!. _._.______._____ __._______=O~~~~~~~__. _._.__ ____:.. $8890
~':'Itipl"_.P.ermit D!~"~unt (~~x2L___ ._____.____.____ __~c:.1-09.'l.C10-4~Cl.~?. .,.. __ ____. ____. $::J.00c:.
~_DC Re~':'cs"_ment Cost :~t~r':".2_'_a_"'~_g!. ___ ____ _..,__.___.~41-O0~00-~::.80~9 _.. _ __... $415.55
SDC: Improvement Cost - Storm ~-,_aina~e __ ___._.____<< ~4~-00Cl.~.:~S.~28__.__.. _____ ... _. . .._$.75~~4
SDC: Reimbursement Cost - local Wastewater 442-00000.448024 $2,761.72
'~____M~._.___ ~____,_.._~._
,?DC: Improvement Cost - Local Wastewater 443-00000-448025 $1,392.82
SDC: Reimbursement.. Transportation SDC 446-00000-448026 $426.92
SDC:..!..n:provement - Transportation SDC 447-00000-448027 $1,597.62..
SDC: Reimbursement Cost - MWMC Regional Wastewater SDC 444-00000-448024 . $101.97
.---.. --." - --~._._---_.-
~9,~"2Pro-:.e.':'2.ent Cost: MWMC Re~!onal Wastewater SDC_ 445-00000-446025 $1,33357
~~_q~~plia!!.ce C~M..C. Reg.!:>~I.Was~e"::~':!:.~.__.__444-09.?00-426_60!_____ _.___~22.6_::"
sD~~~9r:ninjst!ati~~~~~~- MWMCE*:~!9~~~ste:~a~r SDC ____.~6~-~O~OO-426604 _._m___~'_. ___'_m_'__. !1_~.?_O_
SDC: Total Sewer Administration Fee 719-00000-426604 $319.42
-- --~ _.-~----_..----- -----,~----"--"-------~,- --<-.. ----- - --_. --- . -...-.-. -~. -'''-'
SDC:..:r?~a1.!,:~POrt~.!'.~~.A.dmi'2!stratio-"-.Fee ..__........2:'.9:~0_c:.DO~26~9':...._. ___ _______ _ ". $121.45
!!s!ln~lo_gx_~-"-J5% of e"-cn:!.~t totaL______...____ .__.___...!.90-09.Cl.0.9:~256~_______~.72__
State of Oreg~n Surcharge (12% of applicable fees) 821-00000~2..5Cl.9.-:..... !.207 ~~.:..
Address As~gnment, each new or change 224-00000-425602 $3800
.._._-- ~.'-...."-
yvillamalane fees - Single family detached 821-00000-215023 $1,216.34
Willamalane fees - Single family detached 821-00000-215023 $2,251.66
TOTAL DUE: $15,251.66
I~ip A YME..NTTy!'>g-:; 7 'pAVORr.a,t CASHIER.KKAU'MAN"~c6MMENTStJ-t\_'-' 1:; ",-.:~ ;t~ '.,";TijYAiVlou NT.,P A'ID,~;,;;;'~r-:<Ji -:',~'ft
"... ." _ ~____ ~.--","-~'''''*",-'..,_....",.-6.,:tt.:........_______ _.._..........___..~#.........""'. .J..tr........~=::"~il_;r~..-.0-___~.___~,.,_.-.-.,..J...=_.._.......,..;;..,,,.....~.""'"':u
.:~.J
. Check Hayden $13,000.00
32313
Credit Card Hayden $2,849.91
082244
$15,849.91
5[:~~N~:L~.
~...
~OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00841
4867 GLACIER DR
CITY OF SPRINGFIELD
225 Fifth 81
Springfield,OR 97477
541-726-3753
permitcenter@cj,springfield.or.us
RECEII'T NO: 2010000988 RECORD NO: 811,SPR2010.00841 DATE: 12/07/2010
[D. E...S.. GRII'.TI,O,N, ,"':.; "..1~.i0 ~".' ,.,,;.. ",1 Z"." '" ::" '. . f.ii"~~<".'i ",iA' "C'O'... '\:)"N' 'T" ,C" ODE ;;;'>..~.:' ~,,'AMO\:)Nt DU E ",. ',;;, .' .1,
_. ....__.,..,,_..,,_~ __ ...... , _.__. ,.." "-'~"'~;.. ~~..._"._ ....' ". _.. ,'''. ".. ~-"~ .. .. ._.... "_,, ...,._,.~....."..,....,.,.k"_~;;,,,,-,-,-______-~
Same as Plan Review Submittal 224-00000-425602 $250.00
-.------
. TOTAL DUE: $250,00
!;:t'PA)"MENT;r:;),,~E,;;;tz.BA)"bR- <dC;C6S~IER;DBOYVLSB?:':_'Cj:lM.M:~:t:lli;~'.:z' - ~::d ~ ',-,,;', .AMOUNT PAID. .;'." . ----.J
Credit Card
074773
hayden homes
lot 80
$250.00
$250.00