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Home My WebLink AboutPermit Building 2006-10-17 (2) 'CITY OF SPRINGFIELD 4 Status Issued Building/Combination Permit PERMIT NO: COM2006-01133 ISSUED: 10/17/2006 , APPLIED: 08/31/2006 EXPIRES: 04/17/2007 VALUE: $ 296,497.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6434 FOREST RIDGE DR ASSESSOR'S PARCEL NO.: 1702344302700 SPRINGFIETYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Single family residence - Mt Gate lot 93 Owner: MIKE AND JAMI HAWLEY Address: 4109 FORSYTHIA ST SPRINGFIELD OR 97478 Phone Number: 541-513-5731 Contractor Type General Electrical Mechanical Plumbing I CONTRACTOR INFORMATION I ~~", requi~S ~Ou to Contractor ' TENTtON:OregIJiCerrse rgm1rnmtlJl Date Phone BRANDON PATRICK MO&f<<,w ru\_ adopte~~ihe ~re ra $t1iMlWl7 541-729-5504 OWNERO~. ation'center. Those ru es a 952-001 SUNSET ELECTRIC IN~O~ 952-001-00t~gB'59'~gh o~. ~e~reS1~8 RS PLUMBING CONTRA~~..Gtnll mav_o~~~~,~~;,~ ~~,...~~.Q~i008 I BUlLDIfflIli!I~IlORNf~n Utmty NotificatiO~ number 101 1I1 . 0-332-2344). # of Stories Center IS 1-80 2 Lot Size: Height of Structure 33.50 Sq Ft 1st Floor: Type of Heat: Forced Air Gas Sq Ft 2nd Floor: Water Type: Gas Sq Ft Basement: Range Type: Gas Sq Ft Garage/Carport Energy Path: Path 1 Sq Ft Other: ~ri'i'et~uilding: n/a. Occupant Load: - -~'l.I:""'p.~~ t.t'J~,r,tl~'^,OnK I DEVELOOMEN1lllmF6RM'A'1rON . RMlT IS NOT AU'rnUKILt:U UI'lULI\ 11 \10 E kEQUlRED PARKING <1YQtM~btlC.ED OR IS ABAN~N~~e FOR Total: 2 #~me~ !f@e~qdERIOD. 3 Handicapped: Paved Drive Rqd: Yes Compact: % of Lot Coverage: 14.00 541-915-4883 541-461-4714 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VB 4 20,693 736 1,838 353 468 575 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 28.00 15.00 45.00 Subdivision Not Accepted Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I Fully Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' To Storm Sewer Notes: Per Denny W. No Final Occupancy until subdivision is accepted by city council. Storm drainage to storm lateral provided.JLP Paee 1 of 5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction AC - Residential Use Bid Amount Deck V Wood Frame Gara2e Use Bid Amount A.C. - Residen Bid Amount Deck/Balcony Dwellin2s Gara2e Patio/Porch Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge 3 Baths One & Two Family Addressing Assignment Appliance Vent Boiler/Comp Up To 100,000 btu Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Furnace - up to 100,000 btu Gas Fireplace Gas Outlets 1-4 Mountaingate Impervious Area Plan Review Major - Planning Plan Review Residential PW Disc - 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01133 ISSUED: 10/17/2006 APPLIED: 08/31/2006 EXPIRES: 04/17/2007 VALUE: $ 296,497.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $4.00 $1.00 $18.00 $99.00 $26.00 $1.00 Square Footage or Bid Amount 2,927.00 7,841.00 443.00 2,574.00 468.00 1,980.00 Value Date Calculated $11,708.00 $7,841.00 $7,974.00 $254,826.00 $12,168.00 $1,980.00 $296,497.00 10/16/2006 10/1612006 10/16/2006 10/16/2006 10/16/2006 10/16/2006 Total Value of Project ~ Amount Paid $712.01 $10.00 $207.14 $110.05 $149.83 $306.00 $31.00 $6.00 $12.00 $1,205.90 $80.00 $6.00 $9.00 $198.50 $12.00 $15.00 $4.00 $988.39 $198.00 $71.83 $-30.00 $106.00 $95.00 $672.88 $884.90 $10.00 $961.52 $91.61 $165.20 $66.56 $836.32 Date Paid Receipt Number 8/31/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 Pa2e 2 of5 1200600000000001359 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01133 ISSUED: 10/17/2006 APPLIED: 08/31/2006 EXPIRES: 04/17/2007 VALUE: $ 296,497.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SDC Transpo Reimbursement Sidewalk Permit Storm Sewer Each Addtll00' Temp Power 200 amps or less Vent Fan Willamalane Single Family $189.58 $80.00 $28.00 $50.00 $18.00 $1,000.00 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 10/17/06 Total Amount Paid $9,558.22 I Plan Reviews I Initial Review Planninl! Review 09/01/2006 09/01/2006 09/01/2006 09/29/2006 APP LLH APP T AJ Public Works Review 09/01/2006 08/09/2006 APP JLP Structural Review 09/01/2006 10/10/2006 APP DLM 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 2200600000000001452 Fence the rear of the ot as marked on the plot plan with orange construction fencing. Keep all construction activity out of this area. Place orange construction fencing to the driplines of the two oaks on the east side of the lot. Follow the tree protection guidelines in the MtGate Development Plan restrictions attached to the building permit. Plant native street trees from the hillside list in the street tree handout. Per Denny W. No Final Occupancy until subdivision is accepted by city council. Storm drainage to storm lateral provided.JLP See documents for Plan review comments To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. Ueouire~nsnections . Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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. Temporary Electric: Approval required prior to Utility Company energizing pole. Pal!e 3 of 5 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2006-01133 ISSUED: 10/17/2006 APPLIED: 08/31/2006 EXPIRES: 04/17/2007 VALUE: $ 296,497.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Vfer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Vnderfloor Plumbing: Prior to insulation or decking. Vnderfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Vnderfloor Mechanical. Prior to insulation or decking and including required testing. Vnderfloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Pae:e 4 of 5 Status Iss u ed CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-01l33 ISSUED: 10/17/2006 APPLIED: 08/31/2006 EXPIRES: 04/17/2007 VALUE: $ 296,497.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 v~on't'"c:~o~~ 1~{a,{ 10 It'! ~(p OV' 'nefor Contracto;s ~ig~ \ Date I ( f } Pal!e 5 of 5 Construction Contractors Board 700 Summer St NE S,uite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us ~~. .,~...i";1 Permit #:CO 1M z.o-<5I~ C) II 'J -:r Ad~ess: f4 3 t{' ~+-. ~4 E 'DG Date: 10/17;;6 Issued by: , Statement: Information Notice to Property Owners About Construction Responsibilities. Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: ~l. ~2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ~3A. My general contractor is _~~--- \,AA l5' ^l/~ (Name) }3gbZZ (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. 6 ,3B. I will be my own general contractor. OR If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the pame of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. (' ~'~IW(lAL------ m/l1/ao . / / (Sign~ture o~it applicant) / {(Date) V, ~ecopy to issuing agency permit file, pink copy to, applicant.) Property_owner. doc 06-01-04 , ' ' ,Acting 'ill'S )( '()l~fr}OWn"General ContractO]f.?:. . _ ~ ...... - ~'. ~ _ '. ~ .t:.. -I. ~ - INIFORMATIONNOTICE"TO PROPERTY OWNER'S , ASOWT CONSTRU,CTION RESPONSIBILITIES ,';'.: ;:.c ,~- \,"\'-',-'- , , ..... .. . .~ " NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. :-----.-:--~--- -,-~----~-- ~ '." :';' .~. - - ~". . .:..,---..------ If you are acting as yoUr own contractor to constructa' new home or'~ake 'a substantial implovement' to a~ ,existing structure, you can prevent many problems by belp-g' aware of the followi,ng'respbnsibilities and, concerns. :' EmpRoyeJr ResPo.~sibi1litfi~s You w-ill"in most instances,.be ruled t~ b~ an "emP'!~yer" ,and_the cOI.1tractorsyo~ c.on1;ract with will be '~employees"if you use contractors not licensed with ,the Construction Contractors.,Board to do,labor in constructing or to assist in the cons~ction or impr~vemeIlt of a residentiaf structure. A~ the employer~ y~u mlls,t compiy with the following: . .. .' . .' . . - " :'. . . . ~ . Oreg~Hn's Withholding Tax Law:' As an' employer, yo~ ~Inustwithhold inco~e' taxes from employee wages at the time employees are paid. You will be liable for the tax payments even ,if you don't actually withhold the tax from your employees. For more Informatioti;'c~l1the Department 'of Revenue 'at 503-378-4988.'" -. " Unemployment Insurance'l'ax: As an employer, you ,are re'quired to pay a tax for unemployment insurance purposes-~ on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. ~ - . , The Oregon ',Business Identification Number (BIN) is a combined. number for ,both' Oregon ,\y~thho1ding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or \vww.dor.state.or.us/formsnav.htmll for the. ~ ' . ' . I'" .'. . . appl Vp'l ~ate. forri1s~ ~ ~ ". ,; )'-~ -. -' J' f~ " \... -. ',' .' . . '--:.. ~ ._...J -....... .r' . -J . _.'. \,~ . . . .. . ~ --..~.' : ~ , ..:" Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insuiince, you' could be subject to penalties and be Hable for all d~imcosts if one of your employeis~ is injured on the '. job. For' more information, call the Workers' Compensatio~ DiVision' at the '-Department of Consumer and Business Services at 503-947-7815.' U$. Internal Revenlle Service: As an employer, you must withhold federal income tax 'from employees' wages, You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the , 'IRS at, 1.:.800-829-4933 'or visit their web site atwwwoirs;'l!ov; ,,' . - "".." .. ': . , " -Other ResponsibiUti~s;."a~(t~Ar~asofConcerns " " , ~' Code Compliance: As the permit holder for this project, you are responsible for resolving' any failure to'meet code requireme':lt~ that m~y be b:r:ought t~ your attenti~n throu~h i~~~~~ti,~~s. '. ". - .' ~ '. '. ""'~"~!.~,..'.'. ..__ ._ _~", ;.....";"..,,., :... ..t'," .... ...:.. ..^":_.........._....., LIability and Property Damage Insurance: Contact your"tnsurance'agent to see If you have'adequate Insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. . -"'.. - Time: Make sure Y01.l nave sufficient time to supervise your erriployees. . -I'. . "'r : ""- . . _ \ "".' ,", ~ '. '. . ,.'. " . '. ; ~,:.,~ ,:. .'.- '~:-'~; '.~ ,.\\;"., "~". .', ", Expertise: Make ,sure you 'have the-skills to' act asyour owngeneralconthictor: to'coordinate1the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perf9rm the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 1:4140, Salem, OR 97309-5052. . ...... . (_I ~:; : J . , .' "; ", - Property _ owner.doc 06-01-04 ZON ~ INITIALS N Y'-"\ DATE ~O& SOURCE 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL l!f.RMIT ~LICATION City Job Number ~\.Q , \ t J) ? Date 10 .- 1 '7 -' d.p 1. ,.OCATION OE'1NS~1f~~{~2Ji>. ; 3. ~'1.A.~(e'E5r'~~~ J "310C,:C'C70,,:wwi"CC:.?w LEGAL DESCRIPT]ON: (I, _ ~A. ~~~!~~~tial- Singl,e or ~Iu!t!-F ;1 ~~ervl~ (ncluded ' J~ ~ESCRIPTION: . \, . ~![2f6 6~000 sq. ft. or less U\\'{}\~. \OJn\ \'J ?es t-IPJY{J :::0~~::~1500 'q. ft. 0' permit~ ~r: ~n-transferable and e~ire if work is Each Manufact'd Home or not started within 180 days of issuance or if work is Modular Dwelling Service or Suspended for 180 days. Feeder $106.00 _.._-~~., ng nni~~ \ri 0, oJ ~es. \ D $ 19.00 $50.00 / 200 Amps or less /i ^Ii" 201 Amps to 400 Amps IV; 1'0ijo /'~1t0 I Amps to 600 Amps Ii) Oi}~. 1Iy "l.It~mps to 1 000 Amps Phone OA OAl,9Cii}OI) &t<i. t-OO.06Amps/VOlts ~.yO 9$ ~o~t ~y I)", CCiIlt~J.ol.l ~'OO'i~'I)I& &0' Ict1ly 'Il} 6 '{) II). ~ ,'; ~ '0,. & C~ G6t;'i; ~o "1.I~ ~&~ Yo 0&1)" I~& -f 1(~l\lJa€\9D,.~,rallPJJ: JV;ri,..~dfa\9on \ 1& . O'~J'lt. JOlt;!.. 0,., &:'.~/" ~'.s 1 ~~ffi};'~pr~~1' ~ B .s&I/, 'fly $ 50.00 er IY. '2bJb~~j,~~R ~ll :S-~-a Oil! $ 69.00 /"y/ 40 1 )?rl.../~M(f~Jlsl.t/&C\ '0, $100.00 Expiration D te 4/1':8 P,('o~ "<r\? 70~i~o \)6 Co, l,ya ''Y41; ~v~r 600.r6f~~~~~olt(see "B" above. of supervj')Pt~~~~ D. h;~r-anEnl(Jir~"".i!l, 1&0 /1IC'!,O'O tll/I{)!:.. New Alteration or Extension Per Panel ()1L Of ~~ :.rP//\ One Circuit . ~ 'S\, ,'~"I:->~E"achAdditional Circuit or with ~ \'1\ ) () l- '(1-1, , Service or Feeder Permit Owners Name \\I\.. ~t J \. ~ L" . 'l' /1tJ, Address ~\O~ R\~J-\N ~f()~ City -~ t'(\ G.~Jd Phone ~3 513\ - Pump or irrigation $ 50.00 \" \\" Sign/Outline Lighting $ 50.00 OWNER INST ALLA nON Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 M:.n;::ms::::::,::::lt In'ptttinn Foe ~ $45.00 + S~1'~~(~ 10% Administrative Fee 11 5% Technology Fee - A. : on 6D~.13, B. City ~ $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Expiration Date $ 43.00 $ 3.00 Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 8-06,doc CITY OF S~GFIELD SYSTEMS DEVELOPMENV:"'X:>RKSHEET 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 IMPERV]OUS S.F. x I COST PER S.F. CHARGE I I 2945.00 I, $0.336 - I $988.39 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERV]OUS S.F. x I COST PER S.F. x I DISCOUNT RATE I I I 0.00 I $0.336 I 50% I = I ITEM 1 TOTAL- STORM DRAINAGE SDC '$988.39' 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's x , 34 B. IMPROVEMENT COST: . NUMBER OF DFU's 34 COM2006-01133 Mike & Jami Hawley, 6434 Forest Ridge Dr o SINGLE F AMIL Y RESIDENCE 1 BUILDING SIZE (SF: COST PER DFU $26.03 x ITEM 2 TOTAL - CITY SANITARY SEWER SDC $19.79 B. IMPROVEMENT COST: I ADT TRIP RATE x I NUMBER OF UNITS x I COST PER TRIP I 9.57 I] '$87.39 ITEM 3 TOTAL - TRANSPORTATION SDC = , $1,025.90 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's x COST PER FEU I 1 $91.61 B. IMPROVEMENT COST: INUMBER OF FEU's I x I I I 3, TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x I 9.57 I I NUMBER OF UNITS x I I 1 I ICOST PER FEU I $961.52 I MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , 5. ADMINISTRATIVE FEE: I SUBTOTAL x ADM. FEE RATE I $4,635.20 5% TOTAL SANITARY ADMINISTRAT]ON FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Jeff Prociw PREPARED BY 9/8/2006 DATE 2441 r:rJ p.:j Cl o u ~ p.:j f-< r:rJ ...... c.:> ~ LOT SIZE (SF): 20893 DISCOUNT $0.00 $988.39 1070 $884.90 1091 $672.88 1092 =, $1,557.78 COST PER TRIP $19.81 x NEW TRIP F ACTORI 1.00 J 1093 $189.58 x INEW TRIP FACTOR I 1.00 $836.32 1094 = $91.61 1054 = $961.52 1055 $0.00 11054 $10.00 1056 $1,063.13 $4,635.20 CHARGE $231.76 ]65.20 11079 $66.56 , 1078 TOTAL SDC CHARGES =, $4,866.96 I II . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIX1lJRES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 = 6 DRINKlNG FOUNT AlN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0 I LAUNDRY TUB 1 0 2 = 2 I CLOTHES WASHER I MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 I MOBILE HOME PARK TRAP (1 PER TRA1LER) 0 0 12 = 0 IRECEPTOR FORREFRlG I WATER STATION I ETC. 0 0 1 = 0 IRECEPTOR FOR COM. SINK I DISHWASHER I ETC. 1 0 3 = 3 ISHOWER, SINGLE STALL 2 0 2 = 4 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 I SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 SINK: SINGLE LA V ATORY/RESIDENTIAL BAR 2 0 1 = 2 URINAL, STALL I WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 34 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$l,OOO ASSESSED VALUE $5.29 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4AO $4.07 $3.67 $3.22 $2.73 $2,25 $1.80 $1.59 $1A5 , $1.25 $1.09 $0.92 $0.72 $OA8 $0.28 $0.09 $0.05 = IS LAND ELGlBLE FOR ANNEXATION CREDIT? (Enter] for Yes, 2 for No) IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? (Enter] for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE I 1000 CREDIT RATE $0.00 x $5.29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE I 1000 CREDIT RATE $0.00 x $529 TOTAL MWMC CREDIT 2 2 1979 =1 $0.00 o $0.00 225 ,Fifth Street > Sprmgfield, Oregon 97477 541-726-3759 Phone Ca of Springfield Official Receipt ~Iopment Services Department Public Works Department Job/Journal Number COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-0] 133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-0] 133 COM2006-01133 COM2006-0] 133 COM2006-01133 COM2006-01133 COM2006-0] 133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-0] 133 COM2006-0] 133 COM2006-01133 COM2006-01133 COM2006-0 1133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 COM2006-01133 Payments: Type of Payment Check cReceint I RECEIPT #: 2200600000000001452 Date: 10/17/2006 Description Addressing Assignment WilIamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit Mountaingate Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Plan Review Major - Planning Fire SF Fee - Residential Plan Review Residential Building Permit 3 Baths One & Two Family Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu Boiler/Comp Up To 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Fireplace ~Mechanical Issuance Fee~ + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JAMI HAWLEY Item Total: Check Number Authorization Received By Batch Number Number How Received djb 2052 In Person Payment Total: Page 1 of 1 2:53:51PM Amount Due 31.00 1,000.00 106.00 95.00 50.00 80.00 80.00 (30.00) 988.39 884.90 672.88 189.58 836.32 91.61 96] .52 10.00 165.20 66.56 198.00 198.50 71.83 ],205.90 306.00 28.00 12.00 12.00 18.00 6.00 9.00 6.00 4.00 15.00 10.00 110.05 149.83 207.14 $8,846.21 Amount Paid $8,846.21 $8,846.21 10/17/2006