The URL can be used to link to this page

Home My WebLink AboutPermit Building 2011-2-23 S;~;R. .INGFI.EL.~~.. '; ., .... '-,. ~... OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00263 IVR Number: 811000053448 WNW.ci.springfield.or.U5 225 Fifth 5t 5pringfield,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 02/23/2011 ISSUED: APPLIED: 02/23/2011 03/02/2010 EXPIRES: VALUE: 02/12/2011 $152,429.00 SITE ADDRESS: 1353 S ST, SPRINGFIELD ASSESOR'S PARCEL NO: 1703252301803 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling 541-747-8704 OWNER: ADDRESS: WIRFS THOMAS G & DIAN M PO BOX 237 SPRINGFIELD OR 97477 Phone Number: CONTRACTOR INFORMATION Contractor Type Mechanical Contractor Contractor Name LOWES INEATHERIZATION INC WILLIAM A GRAY JR TOM W1RFS ENTERPRISES INC STEVEN R JOHNSON Lie Type CCB CCB CCB CCB Electrical Contractor General Contractor Plumbing Contractor BUILDING INFORMATION # of Units: 1 24.00 FE E E N Construction Type Occupancy Comments Occupancy Type Occupancy Type Construction Type Type VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: U R-3 Type VB # of Bedrooms: Sprinkled Building: Fire Alanns: Energy Path: 3 N 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 Code Edition: 001B Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: 9625 1395 460 o 2008 Site Infonnation ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 212412011 12:16:16PM Page 1 of7 S~..RIN.G...F..I..E~..D... . IE..... FA .-; '.,x..#.,,~ \tile . "OREGON 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 J Residential Permit PERMIT NO: COM2010-00263 IVR Number: 811000053448 permitcenter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued 02/23/2011 ISSUED: APPLIED: 02/23/2011 03/02/2010 EXPIRES: VALUE: 02/12/2011 $152,429.00 SITE ADDRESS: 1353 S ST, SPRINGFIELD ASSESOR'S PARCEL NO: 1703252301803 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling DEVELOPMENT INFORMATION ~ Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 30.00 5.00 9.00 68.00 Overlay Oist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage:, Highest point on structure to north property line: No 19.30 ., REQUIRED PARKING Total: 2 Handicapped: Compact: 0.00 PUBLIC IMPROVEMENTS ~ Street Improvements: Stonn Sewer: Stonn Sewer Available: ,Speciallnstructon: Subdivision Accepted: Notes: Left msg for Tom Vllirts regarding stonm water on site. His land use decision stated drywell his SITe plan stated water to swale. His options are drywell or raingarden. DRY Sidewalk Type: Downspout/Drains: Valuation Description ~ Descriotion Bid Tvoe of Construction NA Unit Amount UnitTvoe' 152,429.00 Bid Unit Cost .1.00 Value 152,429.00 152,429.00 Springfield Building Permit 2/24/2011 12: 16: 16PM Page 2 of7 Sf...IUN...G. FI.E ..~l).".'...'.. , .. ~..~ .it;1 . .OREGOH www.d.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00263 IVR Number: 81.1000053448 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 02/23/2011 ISSUED: APPLIED: 02/23/2011 03/02/2010 EXPIRES: VALUE: 02/12/2011 / $152,429.00 SITE ADDRESS: 1353 S ST, SPRINGFIELD ASSESOR'S PARCEL NO: 1703252301803 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling FEES PAID ~ DescriDtion Plan Review Residential SDC MWMC Improvement SDC MWMC Administration SDC MWMC Reimbursement SDC MWMC Compliance Charge Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Trans Improvement-Resident SDC Sanitary/Storm Admin Plan Review Major - Planning + 5% Technology Fee Fire SF Fee - Residential Building Permit Exhaust Hoods SDC Tran Reimburs-Residential Residence Wiring Ea Addtl 500 SDC Transportation Admin Curbcut Permit + 12% State Surcharge Willamalane Single Family Addressing Assignment Dryer Vent Vent Fan 1 st Appliance 2 Baths One or Two Family Residence Wiring 1000 Sq Ft Temp Power 200 amps or less Heat Pump Total Amount Paid Amount Paid $600.90 $1,333.57 $10.00 $101.97 $22.63 $1,184.05 $753.82 $573.20 $931.65 $176.01 $211.00 $97.17 $92.75 $924.46 $13.00 $211.20 $50.00 $80.10 $88.00 $197.34 $2,858.00 $38.00 $9.00 $18.00 $79.00 $337.00 $134.00 $63.00 $17.00 $11,205.82 Date Paid 03/02/2010 03/30/2010 03130/2010 03/30/2010 03/30/2010 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 02/23/2011 ReciDt # 2201000000000000184 1201000000000000277 1201000000000000277 1201000000000000277 1201000000000000277 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 2011000337 Springfield Building Permit 2124/2011 12:16:16PM Page 3 of? . CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.cLspringfield.or.us Building I Residential Permit PERMIT NO: COM2010-00263 IVR Number: 811000053448 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 02/23/2011 ISSUED: APPLIED: 02/23/2011 03/02/2010 EXPIRES: VALUE: 02/12/2011 $152,429.00 SITE ADDRESS: 1353 S ST, SPRINGFIELD ASSESOR'S PARCEL NO: 1703252301803 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling Plan Review .~ DeDartment Initial Review Received Due Date ComDleted 03103/2010 Result APP Reviewer LLH Initial Review 08/11/2010 08/11/2010 03/03/2010 Approved ...(..A....."-'''',,.. Appli~tion Acceptance 08/11/2010 08/11/2010 03/03/2010 Deferred Payment Lisa Hopper Public Works Review Comments: Storm water to rain garden per Tom Wirfs Cfura(Revi~ 03/08/2010 APP LKW Structural Review ~omments: Public Works 03/24/2010 WI KLK Deferred Payment Agreement 03/31/2010 10 DJB Inspection Comments: Inspection in process In Process . 08/11/2010 LWells Inspection Comments: Inspection in process 08/1112010 Steve Graham In Process Inspection Comments: Inspection in process Guy Dixon Springfield Building Permit 2/24/2011 12:16:16PM Page 4 of7 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00263 IVR Number: 811000053448 225 Fifth SI Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 02/23/2011 ISSUED: APPLIED: 02/23/2011 03/02/2010 EXPIRES: VALUE: 02/12/2011 $152,429.00 SITE ADDRESS: 1353 S ST, SPRINGFIELD ASSESOR'S PARCEL NO: 1703252301803 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling Inspection Comments: Inspection in process 02/24/2011 In Process Guy Dixon Inspection Comments: Inspection in process 02/24/2011 In Process SIeve Graham Inspection Comments: Inspection in process 02/24/2011 In Process SIeve Graham Springfield Building Permit 2/24/2011 12:16:16PM Page 5 of7 S..~.~ I.!N..G:..I.E.L..~..D ....~... Iii..,!.... ,-.- ,- - . h..... Il!N . OREGON CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541~726~3753 Inspection Phone: 541~726-3769 Fax: 541 ~ 726~3676 www.ci.sptingfield.or.us Building I Residential Permit PERMIT NO: COM2010-00263 IVR Number: 811000053448 perrnitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 02/23/2011 ISSUED: APPLIED: 02/23/2011 03/02/2010 EXPIRES: VALUE: 02/12/2011 $152,429.00 SITE ADDRESS: 1353 S ST, SPRINGFIELD ASSESOR'S PARCEL NO: 1703252301803 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling INSPECTIONS REQUIRED ~ Inspections 1170 Post & Beam Post and Beam: Prior to floor insulation or decking. 1410 Undertloor insulation 4120 UFER Ground 1510 UFER 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. 1430 Insulation Wall 3170 Undertloor Plumbing 3500 Rough Plumbing 2300 Rough Mechanical 4500 Rough Electrical 1440 Insulation Ceiling 1110 Footing 4120 UFER Ground 1260 Framing Undertloor Plumbing: Prior to insulatio~ or decking. Rough Plumbing: Prior to cover and including required testing. Rough Mechanical: Prior to Cover Rough Electric: Prior to Cover Ceiling Insulation: Prior to cover. Footing: After trenches are excavated. 1540 Gypsum Board/lath/Drywall Framing Inspection: Prior to cover and after all rough in inspections have been approved. 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. Post and Beam: Prior to floor insulation or decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1170 Post & Beam 1260 Framing 1510 UFER 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. Rough Electric: Prior to Cover Rough Mechanical: Prior to Cover Rough Plumbing: Prior to cover and including required testing. 4500 Rough Electrical 2300 Rough Mechanical 3500 Rough Plumbing 1110 Footing 1120 Foundation Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Springfield Building Permit 2/24/2011 12:16:16PM Page6of7 S!..Il.IN.GF.I.EL.~..... ' Iii~EaON . www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00263 IVR Number: 811000053448 225 Fiftll St Sprlngfield,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 02/23/2011 ISSUED: APPLIED: 02/23/2011 03/02/2010 EXPIRES: VALUE: 02/12/2011 $152,429.00 SITE ADDRESS: 1353 S ST, SPRINGFIELD ASSESOR'S PARCEL NO: 1703252301803 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling 182g,Speciallnspectlon 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and Including required testing. 3411 Perimeter Rain Drains 4220 Electrical - Service 3315 Water Line . By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Infonnatlon hereon Is true and correct, and I further certify that any and all work perfonned shall be done in accordance with the Ordinances oftheCIty 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 pennlssion of the Community Services Division, Building Safety. I further certify that only contractors and employees who arein 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 penn It 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 Contractor Signature Date Springfield Building Permit 2/24/2011 12:16:16PM Page7of7 ~ Structural Permit Application. - 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(54!)726-3689 This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. '!it' ':" ;.;;~ji4i;,![;6~A~,ii:j:CIYE.fiN~(giim'~ApgR9Y!\Il1~1!ft;~i;\i;~~~:ti~ This project has final land-use approval. Signature: Date: This project has DEQ approvaL Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: 0 Yes ~'No !:'1;1:;t*jf~li!%1'i4!lCAtEGdRYli0E;\c5NstRucmI0N~iPlJtZ!"tii;:f!l!Q:;' ~X~"""""'~:'llL.... '''''.>u'liiiF~.,_ ,,".. ........~ ...,,,. :. ..._~",..."~,,,l;,,... "'_ _......,.....,l.. .... ,_,..."., .... _,_ ._.~~iii''''H'''Wt1j:..'''''':t'1v.. esidential 0 Government D Commercial ll!~5;~;,';$,'tJ9~yl~.ltErINF;O~MAIr9'~~ANpri(Q:CAtTc5J>lf:!);i:~~~,~~~l Job site address: c' Y;" ~'-t . City:c.5- State: tJ--- Subdivision: .. Reference: ".., Name: .~ " P.ROPERTYQWN.E~ ,,!=-' s. Address: City: ZIP:';' ]117 1 Phone: '7 7"/7 %'l' 33 E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS }3J.:..OJO. . Sign here: [75 '. " CONTRAC\EOB,It:-\S]AtlATION;,;',.,i, . . ~ Business name: ;::.5 t,:',: r> , . ~~~, ...~ ' Address: City: Phone: E-mail: CCB license no.: Print name: ZIP: q 7 ,,7'1 State: Fax: '" Signature: :~~~~~~':~1l:0m~~gl,r~S~Q,~~G.0Nlt;R~~tt(jr{I.N~9,RMArt:IQNEB:[iJ~}~lr~~ Name CCB License Number Phone Number Electrical Plumbing Mechanical 'Z.J.. J- >f;1. - 58t-,56 .' .' .', P~PARTMENTUSEONLY' Permit no:: Cw "Zb3 Date: 3- 2.-- j.(?; '. \. ,)'~'~~1~~~~,";:;,":;:?~;;~~:\~E'E':~'S'98'~:p'i1[~~~n'J~(.;:~";i"';t;;?'~:';:,.~, _:..- "-, ~:1.'~~~Y_~.i~~~#t);rrriij;io[~a~fiQ~~~Jj~~~ht4i~,~,~,~~:i;[f{%fi;ti'i~~r{i~~,t:t~' . (a) Job description: Occupancy r<..: L. PWu..-J::..v~ Square feet: Cost per square foot: ..s,F. Other information: Type of Heat: , A o addition o Yes ONo $J5 (a) Permit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) $ $ $ (d) Enter 12% surcharge (,12 x [2a+2b+2c]): $ (e) Subtotal of fees above (2a through 2d): $ ~'3"~~~D-I'*4'25--';":;E~f":;<';""':)~jW.;f;.:iS;1:~~i;~~1;"iIi~.~~~\.;.!"i:k~&~""'(.~:~!l%E~;\1f~, t. . .~_L\,~}1.i~~XI~.W-;!.~~~~~\i1t]i:i'!<t';.~fvt~r:;%(l;~'~~mJ4~~);.:.~)::..~4~;rit&:~F~)'f(~~,~ (a) Plan review (65% x permit fee [2a]): (b) Fire and life safety (40% x permit fee [2a]): (c) Suh!o!a! of fees above (3aand 3b): (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): $ 225 Fifth Street+Springficld, OR 97477+PH(541)726-3753+ FAX(541)726-3689 $Y5E'PARTM'ENTrusEr0imY:~}! .ri;\:".,\,,~,"A;'~2~,.t">h;";1;^'j!~,~iE"F'~~;,ti<<"~::;t6*';::'\};Wt{ PerrnitnoCW~U :5 Date: 3 ~2- - LeT This permit is iss~ed under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. \l;,iis;,8f~(;[OQAi!:iG:oY;EBr\lMENm!i~~eROV;tiL:lj~~~~~ Zoning approval verified? DYes DNo ~~~.1f4-Gli'1jEQQ~t(Q~Q~ON$mB.l!J~;'l]IQNl'll\l1t1\'4~!iI ~ 'ifu"Ji~fjD';;\':-\iZ;';'IL~'g i~ ',J~O.~,'ML ~Residential I 0 Government T 0 Commercial Residential, per unit, service included: ~"r!'\fJ0BaslmEilJlI;iJF;QRM~.;(I0NrAJIlD,S11I!{oQAiliII'>Njt~ 1,000 sq. ft. or less (4) I $134.00 $\ ;:r . Job site address: 1-'355 _I". [ <' -i-Yr"r. t- Each additional 500 sq. ft. or portion 1-. $ 25.00 $50~ cJ thereof City: . '7", i-, "',' /,~{>( State;O .0 I ZIP: 1/7 <(77 Limited energy (2) $ 32.00 $ Subdivis{on\\ \ f\o 1 Lot no.: Each manufactured home or modular $ $ ~SCRIRmI0Nlill0EJ.\.WORK~~!'f~1i:!iC? dwelling service or feeder (2) 63.00 __" ~ _. ,__...k'W '.'.'. ... .._~ .. _is.'''...',,,,,, ....., _,,;. ,. ....\tr."""~d&".".,~w,<."..,'1t" C:. ;;:::: V _ \Y,.1"~ \a Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ ~ 20] to 400 amps (2) $ 95.00 $ Name: '--/'''''''A. U./I tl ,c.5 40] to 600 amps (2) $158.00 $ Address: /.:J 7< '/. 'J (0<7 601 to 1,000 amps (2) $205.00 $ City: " '" Lul State: f)/Z- I ZIP: 47'177 Over 1,000 amps or volts (2) $469.00 $ Phone: '- -7'f7 '?7 () L/ I Fax: - -74'7 FE' 33 Reconnect only (2) $ 63.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less (2) T $ 63.00 $ lD?-J ~ owned by me or a member of my immediate family. This 20] to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). 40] to 600 amps (2) $126.00 $ Signature: Over 600 amps or 1,000 volts, see services or feeders section above ~:i~~cJ5NmRA<::JliQI3.~INsMI!I!'AmIQN~~~~~1 Branch circuits: new, alteration, extension per pane! Business name: f1j II ~ CI..T;,/" a. Fee for branch circuits with purchase of a service or feeder fee: Address: ?3 7 7 c;;-f) I~ "eM ~)'d ..121 ./ Each branch circ~it $ 6.00 $ City: 0I/ij? M (J State:C!J{'e1 ZIP: 97fO 2 b. Fee for branch circuits without purchase ofa service or feeder fee: .-z/f ~, -~b 5-0 I 51// ...." /-< ~/3 ~ 3 First branch circuit (2) Phone:'7l1'/ ~()I- Fax: '7"''' - ~ $ 55.00 $ E-mail: Each additional branch circuit $ 6.00 $ CCB license no.: ;;/3~/1 BCD license no.: ;;JO /mr Miscellaneous fees: service or feeder not included Signing supervisor's license no.: qX'/J S Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: 'J>, , 1/ cP'y...... :st- Each sign or outline lighting (2) $ 63.00 $ . , Signature of signing supervisliE ~.; /.1 AYA./1 Signal circuit or a limited~energy panel, $ 63.00 $ alteration, or extension (2) .,;:...r Vf V'V'~ Each additional inspection: (1) $58.00 $ ~.\\' (A) Enter subtotal of above fees $Q.41f b (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.]2 x [AD $I}.CI. ~ r\ .~~ (C) Technology Fee (5% of [AD $ () .'?-lC " TOTAL fees and surcharges (A through C): $/ oa ( ~. '.VV. )- cJ) cf) 440-2584-J (9/08/COM) ~~. q ~-.>: --. ""'. SPI'II.G'.."'IlL.Q.~ .:0 i ai~>~ ~.'".. .- '''" ~"""..... " APPLICATION TO DEFER FEES AND CHARGES AND CONSENT TO ASSESS LIEN The owners of the property shown below hereby apply to the City of Springfield to pay the fees and charges of $ 96 0 9 ~,s deferred until final building occupancy is requested. Such fees and charges include System Development Charges assessed on the property for the City and Willamalane Park & Recreation District In the event that the real. property on which the fees have been - deferred pursuant to Ordinances 6233 and 6234 is sold or conveyed, the fees or charges deferred shall become immediately due and payable to the City of Springfield. Sale or conveyance includes either actually selling, conveying or assigning any or all of the property or any or all of the owner's interest in the property. The owners hereby apply for and consent to the voluntary imposition ofa lien for $ 960q .ZS . upon the following descnbed land in. the City of Springfield, Lane County, Oregon: 'S,trut- o /l.. '17477 , MAPANDTAXLOT 170~ZSZ3. OI~O.3 SITE ADDRESS J 553 S CITY, STATE, ZIP Spr;4+;6'/J SEE ATTACHED LEGAL PROPERTY DESCRIPTION r Bll.LING NAME JiA OIM I\- So. G- tJ \ r. rt Bll.LING ADDRESS -p 0 "& 071, Z 1.., / I Z 7 S s. Z '" J CITY Sl'(2.I....'+.t.-/d ' STATE 6 (2.cG-OAf - ZIP '7 7LI7 7 9bo9 ~ ,..e-. 960? z.:L sr FEES AND CHARGES DEFERRED RECORDING FEES $ $' TOTAL LIEN $ In addition to the fees and charges indicated above, we agree to pay the fees associated with recording the lien and removal of the lien at Lane County Deeds and Records. We are all of the legal owners of the described land or all of the contract purchasers ofrecord of the described land to which these fees and charges are applicable. We waive any and all irregularities or defects, jurisdictional, or otherwise, in any proceedings to impose, calculate and collect these fees and charges, and in the imposition and collection of the lien consented to in this application. We promise to pay these fees and charges when final building occupancy is requested or at sucb time the real property is sold or conveyed. The charges may be paid in full at any time without penalty. We understand that if there is a subsequent failure to pay the fees and charges the City shall have the right to enforce payment of the amount due in any rOanoer provided by the general law of the State of Oregon, or by the Springfield Municipal Code, including but not limited to foreclosure of the land. We acknowledge that the City has an interest in the property to collect these fees and charges, including System Development Charges, and that the City has the authority to lien the property to collect those fees and charges.- In the event of any proceeding to enforce collection or to foreclose, the entire unpaid balance andjl1 fees shall be considered delinquent and due. We also agree to pay the city's cost of collection or foreclosure and any attorney fees ecessary for such collection or foreclosure. '--r!UiWUfSG.WU'IFS ~-4 ~f> . -31'O!70W S'fI747Z70l( Print Name of OWner. Signature of Owner I Dale Phone # Phone # Print Name of Owner Signature of Owner Date Print Name of OWner Signature of Owner Date Phone # Print Name of OWner Date Signature of Owner Phone # STATE OF OREGON ) ) ss. . County of Lane ) . OFFICIAl. SEAL DEVETTE KELLY NotARY PUIlLIC - OREGON COMMISSION NO. 420351 MY ~OMMISSION 8X1'IR18 AIJG. 15, 2011 Th oregoing instrument was executed before me this day of WID. v:\Connnon\accnting\assessmt\Deferred fees contract.doc R-~ willamalane t~ Park and Recreation District Job. No. , l\\) . ~lo'b SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 NAME T\":lfi'L \\)ukl . PHONE:t.!,V&IO'\ "ADDRESS: \~\ S S. ~N1ITY~STATE:ChIP:~-r7 LOCATION OF PROPOSED BUILDING SITE: Street Address:_\ ~ ~,~ ~ _~ wP s> X Plat Name: t\.i A Tax Lot Number: ~ D 31_ S'2.~ 0 \ ~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type' definitions are on the back,) , , A Sinale-Family Detached NO. OF UNITS l X $2,858 per unit = $' !l658.CO B, Sinale-Family Attached NO. OF UNITS X $3,100 per unit = $ C, Multi-Family Apartment NO. OF UNITS X $2,641 per unit = $ D, Sinale Room Occupancy NO. OF UNITS X $1,321 per unit = $ 'E. Accessory Dwellina Unit NO, OF UNITS X $1,550 per unit = $ $ ''2.556.cD kY, WILLAMALANE SOC. 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approvaL) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) $ ,'JE68 .a.J ~ 1~/)JOU &ffi'~..~~ ,:\\~ " '3-~-\O~, Development Services , City of Springfield TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541.726.3753 www.ci.springfield.or.U5 COM2010-00263 1353SST permitcenter@cLspringfield.or.U5 RECEIPT NO: 2011000337 RECORD NO: COM201 0-00263 DATE: 02/23/2011 ItiE-scI~IBili[ON~"",'lj'iIll!~~~~~~!i:'AC:C00N1f~C1)OE~~~~1iW~:~P:iili6UNf;D(jE;:"~~~ + 12:'(0 State Surcharge 821-00000-?15004 ____ _____________. ____._____1~;_~4_____ .____.__... -.----::_5J'.._!~:~_ology !ee __________________._.______100:00000~42~~.:;____._______._______.. _________ ___~?_'1!...__ 1st Appliance 224-00000-425604 ________.______ 79.0~_____.___...__ _._--3...E'l~~~SJ'2"___"r:..Two .F..~~ily _____ .._______.3..24-000~0-425603 ______---____~7.00 ___._._ _.__,I\9.d!es~i~~ Assignmeflt._.__.._._____._______________. 224:00000-425602 _____________ 38.~______ .__.__._.~u.i.ldl~S!.!:_"'--mit ___ ......___..__ _ ._.____________________?~_.QOO'CJ.CI:i?~?O'2__ _____ _ ________ ___ _' _ _924i?_____.. _ Curbcut Permit 201-00000-428060 88.00 n. '~'."'_"_'_._.. .., .__._._.,,_'_"',,____._"._'._ ...._ ".,_p'._n_ ._....__".._n......_.,._~. ..._ ,'__e_.. . ._..___ __.._._n ".__......... ._. "' .._..." __[)ryerV-"nt ____ ___ __ ____ __' 22~:9.0()()0:~.z~ElO'~. _ 900_ Exhaust Hoods 224-00000-425604 13.00 . ,,_ ........~.. . ."._'_ ___ ....._ "" ..__o"'~ .." 0_' .'...~d. ".._ Fire SF Fee - Residential 100-00000-424005 92.75 . .. ... ___. _ .. "., _~"_ .~u ,..~."'. ,. ~..~_. ..." ..'.. . ... ..n_ ,... ....._..... ... u . ____.f:l.e~t~~':':'p.______ .____________________________~__ Z.2~:0.!lO''O''O:43~6..O'4_ .m__ ..____ _1..7_0.0._ Plan Revie_"'~aLo~:..rla~..n~n_~_.________________._____._ ._1().0-00~.!l:iZ.~002 __ .______________ ____. _ ___?~_cOo.__________. _. .._,,~~denc.:.vviri'2!1.!.!2().O"'~q Ft..__.____________~_____??_::CJ.CI.!lO'.Q:~?~1..()?__.______.___._u_. _ ____om} 3~!:J0_ .___ _____~~sJ5I'!.'::e_"Y~ng ~~~~~tI 50O'_______________________E._::.Q0.Q00-4261 02._____.__ ... ____ _'___._._ 5o.cOO.___._ '__ SDC Sanitary/S~orm Admin 719-00000-426604 ____________.__1.!.6.01_______ SDC Tran Reimburs-Residential 446-00000-448026 211.20 -.-.-'.---..--------------. ._._._--~_._-_._._-._----_. .,-.-'-.--~.---..-.---".-.-...-----~------. _..Jl~C.!~~~I.':'l_'rove.':':'~~:.~e~de~~_____.__._____._~.i!.:()000!:J-4480.?!__.__________________~~~______.. _____ ___~_[)~.I~~_n~p."--~,,~"_"_"".9_':':'i~_._____...___.______.___..___.____.___7.1 ~:0()O'O'O:~.?~6.04____. _ _.._______. .___..__........__.80.:2 0...__.. ___.__~_~.n}!~ry Se'N!!..:.I"2prove~en~_._ _._.________.... _ __d_. .. 4~~:90?_0.!l:~_i~0'?~________.._._ ._____ . 5!.3:?0 .. .._ ______ _..__S."-n.i_t~'t~e'N_-"~:Fl~i.rn..b_~~~0..ent____ _._ _ ____.._ m__ 4.4?:0.Oo..oO-~__~80.?4 __ .._ 73~8? ___~t:'_~.::in~'!.t.."2!''!..rvio'!.:'_''''..''!.a_._.__.._.________..____._._._~~:~0..CJ.CIo.:4~~??_8_..._ 1.18~o.5 ____. ._!e~?_~.~'Ner.?O? ar.nps ~r.l~ss . ____ _____. 2.?~:o.Oo.OO.-_42.6~02. .63,0.0._.. Vent Fan 224-00000-425604 18.00 ~ ..-.--."---.,-----.-----..,- ._..,~_.__._----_.,"~_.._---_.~-------_._-_. .----.--- --.--..-.-. -- ..- ~_._"',--_._..~-_._..,~._,_.....- -,----.--...,...--..., . . ..U" _\NHI~r!,,,I,,!,,,_~.!ngle Fa..ll1ii}'________...____.___________ ____8.2_1:0O'?CJ.CI:?1..502~_ ._______ _ __ 2,85800___ _ _ . _..' TOTAL DUE: 9,136.75 !f![~~Mg:f:iif.\!.~ll~&~:vcQBJd__!'~sHl'E[lliMAcHAil.~~tilfdMMENfS'ilk1\\-~~~.J2!2N:(\Il~!.P~~~~ Check TOM WIRFS ENTERPRISES INC DPA paid 9,136.75 8393 TOTAL PAID: 9,136.75 225 Fifth Street , .' ~ Springfield, Oregon 97477 541-726-3759 Phone ~~~ City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000277 . , Date: 03/30/2010 9:41 :56AM Paid By TOM OR DIANE WIRFS Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 101.97 1,333,57 10.00 22.63 $1,468,17 Job/Journal Number COM20 I 0-00263 COM20 I 0-00263 COM20 I 0-00263 COM20 I 0-00263 Description SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC MWMC Compliance Charge Payments: Type of Payment Check Amount Paid djb 6396 In Person Payment Total: $1,468.17 $1,468,17 i1.Jij\....11.\1'f7:'-:;1.. ."'.' "-"'::~"; ,.-,... ,~, /'itN .JI:{j.,!~.. ..~;.L cReccintl Page 1 of 1 3/30/2010