The URL can be used to link to this page

Home My WebLink AboutPermit Building 2011-3-24 CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.d.springfield.or.us Building I Residential Permit PERMIT NO: COM2010-00190 IVR Number: 811000053375 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 03/24/2011 ISSUED: APPLIED: 03/24/2011 02111/2010 EXPIRES: VALUE: 09/05/2011 . $201,233.00 SITE ADDRESS: 2591 16TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling, lot 8 Legacy Estates OWNER: ADDRESS: PRODEN RICK S 3287 16TH ST SPRINGFIELD OR 97477 Phone Number: CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Electrical Contractor L & E ELECTRIC INC GGB Mechanical Contractor COMFORT FLOW HEATING CO GGB General Contractor RICK S PRODEN GGB Plumbing Contractor CHAPIN ENTERPRISES INC GGB BUILDING INFORMATION # of Units: u # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: 2 Construction Type Occupancy Type Occupancy Comments FG G G # 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: 001A Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 3/25/2011 8:14:19AM ( . ~A I\'Dx \ob r"\ \~_~\lv. \-VV '\ (J \~.,. +fJ('" \ /X\O'~ ~~\\~..- .\ -\.(J ~ . ~OO~ ~~~~ ~.~.\\ ~ Page 1 017 . ' www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00190 IVR Number: 811000053375 225 Fifth SI 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 03/24/2011 ISSUED: APPLIED: 03124/2011 02/11/2010 EXPIRES: VALUE: 0910512011 $201,233.00 SITE ADDRESS: 259116TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: . OWNER: ADDRESS: New Single Family Dwelling. lot 8 Legacy Estates Phone Number: Contractor Type Contractor Name CONTRACTOR INFORMATION I Lie Type Lie No Lie Exp Phone BUILDING INFORMATION I Construction Type Occupancy Type Occupancy Comments U FG Lot Size: Sq Fl1 sl.Floor: Sq Ft2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Fl Other: Occupancy Load: 7740 1277 645 # 01 Units: o # of Stories: Height of Structure: Type 01 Heat: Water Type: Range Type: Hazmat: 2 G G 401 o # of Bedrooms: 3 Sprinkled Building: N Fire Alarms: Energy Path: 001A Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal f Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Site Information I Engineered Fill: Fill VOlum~ Flood Ha i~l;!.TION: Oregon law requires you to Land Ha 9'. .~e ~Ies adopted by the Oregon Utility Retainin~ ~IPaton Center. Those rules are set forth Soils ReB~ tl~~~~Ol-0010 through OAR 952-001- u :'fou may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). NOTICE: . . . ., THIS PERMIT SHALL EXPlRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 3/24/2011 10:56:51AM Page 1 of7 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00190 IVR Number: 811000053375 225 Fifth 51 Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 03/24/2011 ISSUED: APPLIED: . 03/24/2011 02/11/2010 EXPIRES: VALUE: 09/05/2011 $201,233.00 SITE ADDRESS: 2591 16TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling, lot 8 legacy Estates DEVELOPMENT INFORMATION I Frontyard'Setback: Interior Setback: Sideyard Setback:, Rearyard Setback: Solar Setback: 18,00 16.00 11.00 50.00 Overlay Dist: # StreetTrees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: 2 REQUIRED PARKING Total: 2 Handicapped: Compact: Yes 21.70 10.50 PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: FI CG Yes Sidewalk Type: C7 Downspout/Drains: Valuation Description ~ Descrletion Tvee of Construction Unit Amount Unit Tvee Unit Cost Value Springfield Building Permit 3/24f2011 10:56:51AM . Page 2 of7 Sp:......I~.~FIE~ ~4~'~ .i'~"Zft\-~y ;-"'<.~AOREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00190 IVR Number: 811000053375 225 Fifth SI 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 03/24/2011 ISSUED: APPLIED: 03/24/2011 02/11/2010 EXPIRES: VALUE: 09/05/2011 $201,233.00 SITE ADDRESS: 2591 16TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling, lot 8 Legacy Estates FEES PAID I DescriDtion Amount Paid Date Paid ReciD! # SDC MWMC Administration $10.00 02/23/2010 1201000000000000166 SDC MWMC Improvement $1,333.57 02/23/2010 --~-"'-1'201000000000000166 SDC MWMC Reimbursement $101.97 02/23/2010 1201000000000000166 SDC MWMC Compliance Charge $22.63 02/23/2010 1201000000000000166 Residence Wiring 1000 Sq Ft $134.00 04/02/2010 2201000000000000317 :,:.5% Technology Fee $10.45 04/02/2010 2201000000000000317 + 12% State Surcharge $25.08 04/02/2010 2201000000000000317 ~sid:!'.~~ring Ea ~d~~~9~_.... $7500 04/02/2010 .2201000000000000317 Fire SF Fee. Residential $116.15 03/24/2011 2011000539 ____ _h _ __..___.. ._..___.__~___' _...._.,.__..__.,._,_._._______ ..._'___M__ ~.I:l':t~.?ne.I!cT~?Fa.~'!Y..____..._______~~OO 03/24/2011 .___ 2011000539 Vent Fan $27.00 03/24/2011 2011000539 ~*-.....- Gas Outlets 1.4 $7.00 03/24/2011 2011000539 Addressing Assignment $38.00 03/24/2011 -- 2011060539" Plan Review Residential $730.53 03/24/2011 2011000539 Sidewalk Permit $88.00 03/24/2011 2011000539 SDC Trans Improvement.Resident $708.55 03/24/2011 2011000539 SDC Trans Improvement.Resident $223.10 03/24/2011 2011000539 SDC Transportation Admin $80.33 03/24/2011 2011000539 SDC Sanitary/Storm. Admin $173.96...___ 03124/2011 2011000539 Temp Power 200 amps or less $6].00 03/24/2011 2011000539 ::..5.')I"...~':."~loSJy...f'~__._.____..._____.. $105~~__._.,<J3~2~13.~1.2..__.__ ..2~11~~05~. ~anitary Sewer :.t.~rov::.m...".'....__ ."" .._....... $661.39 03/24/.2.0.2.2.........___.._. 202.1.000539 SDC Tran Reimburs.Residential $211.21 03/24/2011 2011000539 -~--$-- --._-_.,"."'...."---_._._~ _.~--- Storm Drainage Impervious Area $943.65 03/24/2011 2011000539 Sanitary Sewer. Reimbursement $869.79 03/24/2011 2011000539 Curbcut Permit $88.00 03/24/2011 2011000539 PW Disc. 2nd Permit $.30.00 03/24/2011 2011000539 + 12% State Surcharge $210.35 03/24/2011 2011000539 Willamalane Single Family $2.858.00 03/24/2011 2011000539 Dryer Vent $9.00 03/24/2011 2011000539 Exhaust Hoods $13.00 03/24/2011 2011000539 Appliance Vent $9.00 03/24/2011 2011000539 1 sl Appliance $79.00 _"_~~/24/2011 .._...___.."_"_~011.900539 !:,Ian Review MajoL:.F:lanning $211.00 .~3/2~.z..~~.._. .____..201~O"O"~ B~g Permit $1,123.89 03/24/2011 301~.o539 Fireplace (Listed) $20.00 03/24/2011 2011000539 - ------~-- Total Amount Paid $11,753.09 Springfield Building Permit 3/24/2011 10:56:51AM Page 30f7 SP~~~G.:L~ ~~ ~OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00190 IVR Number: 811000053375 www.ci.springfield.or.us 225 Fifth St 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 03/24/2011 ISSUED: APPLIED: 03/2412011 02/11/2010 EXPIRES: VALUE: 09/05/2011 $201,233.00 SITE ADDRESS: 259116TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling, lot 8 legacy Estates Plan Review DeDartment Received Due Date ComDleted Deferred Payment Agreement 02/11/2010 Result 10 08/11/2010 02/16/2010 Deferred Payment Application Acceptance ~ Reviewer KLK Lisa Hopper Structural Review Comments: As noted on plans Plannmg'Review . ~ ," ~, '" ',';5!:>~f'f, :~.,.,' . - , ',9'~'m~~'!~.:.. Public Works Review 02/22/2010 APP LKW Comments: LDAP fee is $472.50 to be included in DPA. Storm water to curb via weep hole Permit Issuance 08/11/2010 Deferred Payment L Wells Comments: All inspections, except Finals, can be conducted. C of 0 cannot be issued until all inspections are complete and deferred ",' 11/03/2010 In Process Inspection Comments: Inspection in process Steve Graham Inspection 12/14/2010 In Process Comments: Inspection in process 1i7i~h'?; ',- ",," ':'0;';""' ~;:;::"03i09/2011:" In ~iocess!';;-'\';~ ~ '~'o'~~i~~~~~,I~pe'9ti-6n'i~~;r~~~~~:~~_ .1~~~ :'ii;;^,. - .~"~~X' $ ~.'~' T;' -' ;~ ,~.~:~ ;~~,<', Inspection 03/09/2011 In Process Comments: Inspection in process Springfield Building Permit 3/24/2011 10:56:51AM Guy Dixon .;!~~;;G~!2~n-;:. :~~C:.;"., ,~_dC] Steve Graham Page 4 of7 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00190 IVR Number: 811000053375 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 03/24/2011 ISSUED: APPLIED: 03/24/2011 02/11/2010 EXPIRES: VALUE: 09/05/2011 $201,233.00 SITE ADDRESS: 2591 16TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: New Single Family Dwelling, lot 8 Legacy Estates INSPECTIONS REQUIRED ~ Inspections 9506 Sidewalk - Setback 9504 Curbcut - Standard 3400 Storm Sewer 1540 Gypsum Board/lath/Drywall 1260 Framing Sidewalk:. Setback: After forms are erected but prior to placement of concrete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Storm Sewer Line: Prior to filling trench. 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. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Underfloor Mechanical. Prior to insulation or decking arid including required testing. 2200 Underfloor Mechanical 1170 Post & Beam 1170 Post & Beam Post and Beam: Prior to floor insulation or decking. 1120 Foundation 1410 Underfloor insulation Post and Beam: Prior to floor insulation or decking. Underfloor Mechanical. Prior to insulation or decking and including required testing. Underfloor Mechanical. Prior to insulation or decking and including required testing. Post and Beam: Prior to floor insulation or decking. Post and Beam: Prior to floor insulation or decking. Storm Sewer Line: Prior to filling trench. Foundation: After forms are erected but prior to concrete placement. 2200 Underfloor Mechanical 2200 Underlloor Mechanical 1170 Post & Beam 1170 Post & Beam 3400 Storm Sewer Shear Wall Nailing 1120 Foundation Foundation: After forms are erected but prior to concrete placement. 1829 Special Inspection 4120 UFER Ground 4500 Rough Electrical 4220 Electrical - Service Rough Electric: Prior to Cover 2260 Gas Service 2310 Rough Gas 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 Gas: After line is insta!1ed and required testing and capped if not attached to an appliance. Underfloor Mechanical. Prior to insulation or decking and including required testing. 2200 Underlloor Mechanical Springfield Building Permit 3/24/2011 10:56:51AM Page 5 of 7 SP:~~~..L~ C~ OREGOH 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: COM2010-00190 IVR Number: 811000053375 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: 155 ued 03/24/2011 ISSUED: APPLIED: 0312412011 02/11/2010 EXPIRES: VALUE: 09105/2011 $201,233.00 SITE ADDRESS: 259116TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES PROJECT DESCRIPTION: 1260 Framing 1430 Insulation Wall 3170 Underlloor Plumbing 3500 Rough Plumbing 3200 Sanitary Sewer New Single Family Dwelling, lot8 Legacy Estates Framing Inspection: Prior to cover and after all rough in inspections have been approved. WalllnsuJation: Prior to cover. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. 4000 Temporary Power Service 2210 Underlloor Gas 2300 Rough Mechanical 1260 Framing Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Mechanical: Prior to Cover Framing Inspection: Prior to cover and after all rough in inspections have been approved. 4550 Limited Energy 4220 Electrical. Service 3500 Rough Plumbing 3500 Rough Plumbing 3999 Final Plumbing 3315 Water Line Rough Plumbing: Prior to cover and including required testing. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 1999 Final Building Final Electric: When all electrical work is complete. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Final Building: After all required inspections have been requested and approved and the building is complete. 4999 Final Electrical 2995 Final Gas 2999 Final Mechanical Underfloor Drain 3999 Final Plumbing 2999 Final Mechanical 1540 Gypsum Board/Lath/Drywall Final Plumbing: When all plumbing work is complete. Final Mechanical: When all mechanical work is complete. 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 Electric: When all electrical work is complete. 4999 Final Electrical Water Line 2995 Final Gas Final Gas: When all gas work is complete. Springfield Building Permit 3/24f2011 10:56:51AM Page6of7 SP~I.NGFIE~D. . .~".. Yr1liv- ~ )0j;0,~ , ~,0f':~ OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: COM2010-00190 IVR Number: 811000053375 225 Fifth St 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 03/24/2011 ISSUED: APPLIED: 03/24/2011 02/11/2010 EXPIRES: VALUE: 09/05/2011 $201,233.00 PROJECT DESCRIPTION: SCOPE: SFD WORK INVOLVED: NEW TYPE OF STRUCTURE: RES New Single Family Dwelling, lot B legacy Estates SITE ADDRESS: 2591 16TH ST, Springfield ASSESOR'S PARCEL NO: 1703243103300 9015 LDAP Erosion/Grading Inspection Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Shear Wall Nailing Water line . 1410 Underfloor insulation 1430 Insulation Wall 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. ' Wall Insulation: Prior to cover. 1260 Framing 1540 Gypsum Board/Lath/Drywall 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. 1 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. i,- ~ ~_'2'1 ~ 'W \ ( Owner or Contractor Si nature Date Springfield Building Permit 3/24/2011 10:56:51AM Page 7 of 7 Date: J-. - J.. \... IA?' This pirrO ispR9Gii930. Permits expire if work is not started within 180 days of issuance or if work is " ,'", "..l{0,c"A~"9QYE~t>lMEN'r;;'~J;if~0'v~il;,::,;~::;~::~.~or 180 days. D P A This project has final land-use approval. Signature: This project has DEQ approvaL Signature: Zoning approval verified: 0 Yes 0 No Property is within fiood plain: 0 Yes 0 No ~(~~'i~~~~lc:A-tEQgBX~,ij)Fl;c::9@;fRi.lc:J\:'(9~'&)~~;1ii{'$U;}ifM~71W: esidential 0 Government 0 Commercial !fi!!'.~~i:,~j;;iQBiSJ,T~; .IN1f6RMAfi9N~ANQ~P5,!,:~AfI9NIL'l;~;~X~';if\; Job site address: <1 jJ. I Co TI1 t; State: (f:) \l-. \-.. Date: Date: Reference: Name: Address: City: Phone: E-mail: This installa on is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements u7Je~ ORS 70.1.010. Sign here: I ~ Print name: Signature: :~:t~:'~;~('~';;):"i:?~Tt~~~S.W~':G~~J!~ACitQf{-J~_~.O.RM_A~cQ~~:~rm~tX~J~F Name CCB License Number Phone Number Electrical Plumbing Mechanical '1lJ" - )00 ~ ~'\!XU ~ ~- S~ ~~ ')S I ':OEPARTMENTUSE ONLY' Penn it no,cW- .L-- re- 'n:c'iFEE;SCHEDurE'~"it:", _",:;'}Jr-, :~j'::S~~.t~~Ji.~v~liij,f6rlD~ti_6R~tf~~~1:J-;%~;j2~}~b~t:~?KJ1{1~~'~'l;;~'iY~G,tz~~]l}~/ Construction type: Square feet: J"''1''Z--2-.j- 4"'@.l- Cost per square foot: Other information: Type of Heat: Energy Path: o new 0 alteration (b) Foundation-only permit? Total valuation: o addition DYes DNa (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): $ $ $ (a) Plan review (65% x permit fee [2a]): $ (b) Fire and life safety (40% x permit fee [2a]): $ (c) Subtotal of fees above (3a and 3b): $ ~~~~:~!~J~ii_~n~q~~$rt~~~r~!~~~~~~~l\\Kj!(~1~~)~it;t~~_}:;~>i,;:',~~;L ......-. ';:~^'., :,'. (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): S ~ , L,~ t<o \JJou.LI') " I J D~A \ ~ p-\~ C-L>.....fa It..'\ ftD"" '*t ,,"'" \ ".. \~~ 0" f\ '/ ~ II u....1fI Electrical Permit Application "'~k'01%>><',,~" _.ii ,,,",....,.,...'" ~4,WliL~,f~-';>~.;"''''j''''~''Y''',;F~ \. -0'" ~>> ;'~I1'\Y: !lE:sP~~~Il!ll?:HD{,,()JlEG~~:,~:~ 225 F;ftb Stre"tSpdngfield, OR 97477tPH(541)726-3753t FAX(54I)726-3689 ;Ll;S^,,<;}l61,; ::'\.., rn;r:;C;;'i/70>:..,.-:' ---..iiX; . "iU!'i'" ", '<,OEF1ARTMENT USE'9.flIL Y" , '. ,",>...,\.",--";~0,,'t _~__) ~ "'... .... .)>:'/""'J70- +......., .'- r Date: ..~D tw\W-\O This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days ofissuance or if work is suspended for 180 days. LocAl.. GOVERNMENT ApPROVAL Zoning approval verified? DYes D No 7' CATEGORyi,Of7,CCONSTRUCTION..., 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) an"79.~0(Y. Signature: IL.-ll-C:> ~ L~CONTRAC:rOR"t tAl..l..A:rIONI"1~2;'!;'1;jl;ft' Vi Business name: t)W tJt1l-- Address: City: ZIP: Phone: E-mail: CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: BCD license no.: .1 ~~v....\". "2.1......... /./' c., , "\ V" ~11fL' \0>'#-'''> ~lbll'(tl- ~tfi ~\\ -~ V" 1 l~ ~~_: (!tv . t(f~< 1J'V 440.2584.J(~~ ~~ :t',' .'o'." 'i' ," FEE.SCHEDULI::' "., . . ",'". ~N4~;?~;~~!-~~~~ct~~'~s pe;,it~;.~L; ,~, :9,tY~ , ~,<:~~ .. "Total co'st ',~ Residential, per unit, service included: 1,000 sq. ft. or less (4) $134.00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Senrices 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 1,900 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary senrices or feeders: installation, alteration, relocation 200 amps or less (2) l $ .J. .ll. 63.00 $IU.l: 201 to 400 amps (2) $ 87.00 $ 401 to 600 amps (2) $126.00 $ Over 600 amps or 1,000 vol~s, see services or feeders 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 $ Ir'",,',.. .... J:>I ''Fc.I;;..,}.' (A) Enter subtotal of above fees $to~~ (Minimum Permit Fee ~58.00) (B) Enter 12% surcharge (.12 x [A]) $\.~l (C) Technology Fee (5% of [A]) $~.H TOTAL fees and surcharges (A through C): q~~ o R-~willamalane t"W Park and Recreation District Job. No. ('''Dot \~O SYSTEM' DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 NAME: ~)L; \l$Y)&(\ ADDRESS:2> 2~ . \\ Q-W-- CITY ~$-d-. LOCATION OF PROPOSED BUILDING SITE: Street Address: ~5C\ \ \\O-\-V\ ~~~ Plat Name: ~.e...CU Et:rm.--r ll.J1"ax Lot Number: \ I. 032.4-3 \ 033CO \ . . . 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) PHONE:\L\\:o .CO\o'\ STATE[)(L.ZIP: c:tl.411 A. Sinqle-Familv Detached l NO. OF UNITS X $2,858 per unit = $ 2p:i::8.c:U B. Sinqle-Familv Attached NO. OF UNITS X $3,100 per unit = $ C. Multi-Familv Apartment NO. OF UNITS X $2,641 per unit = $ D. Sinqle Room Occupancy NO. OF UNITS X $1,321 per unit = $ E. AccessorvDwellinq Unit NO. OF UNITS WILLAMALANE SDC X $1,550 per unit = $ $ ieJ5f3. CV er 2. SDCCREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approvaL) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) 0itV $ 'lfJr:::f5 ,cO . ~ ,2-A,AQU Date (oduY.e& y\w~ ~~) 5 .... '\J" '\ . '. ~.\\9'A.b\D ~ Development Services City of Springfield . . . www.ci.springfield.or.us TRANSACTION RECEIPT COM2010-00190 2591 16TH ST CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 permitce nter@ci.springfield.or.us RECEIPT NO: 2011000539 RECORD NO: COM201 0-00190 DATE: 03/24/2011 lDESCRIP..TION'. " . 0,0'" -<';;::"':~i:>t; .l,,~;'-.cfv~~;~;l~..' ,,'."' "':..ACCot.iNTiCODE'~ c.. . '0'; ~ ;,."AMOUNtDUE.. ~.u:..Y~'-;j + 12% State Surcharge 821-00000-215004 210.35 + 5% Technol09Y Fee 100-00000-425605 105.49 .~~EE!!!:nce 224-00000-425604 ~_~__ 3 Baths One & Two Family 224-00000-425603 402.00 Addressing Assignment 224-00000-425602 38.00 Appliance Vent 224-00000-425604 9.00 Building Permit 224-00000-425602 1,123.89 Curbcut Permit 201-00000-428060 88.00 Dryer Vent 224-00000-425604 9.00 . Exhaust Hoods 224-00000-425604 13.00 ,_._--- Fire SF Fee - Residential 100-00000-424005 116.15 --..-..--- -----"'^"-~------~._- Fireplace (Listed) 224-00000-425604 .............. ....20.;00...._..______ Gas Outlets 1-4 224-00000-425604 7.00 PW Disc - 2nd Permit 201-00000-428060 .30.00 Plan Review Major - Planning 100-00000-425002 211.00 Plan Review Residential 224-00000-425602 730.53 SDC Sanitary/Storm Admin 719-00000.426604 173.96 SDC Tean Reimburs-Residential 446-00000.448026 211.21 SDC Trans Improvement-Resident 447-00000-448027 931.65 SDC Transportation Admin 719-00000-426604 80.33 Sanitary Sewer - Improvement 443-00000-448025 661.39 . _ .._~~..r:I~..r,:.Se~er - Re~bur~ement .__.. .__ 442-000o.Q:i".8024 ..._.__,.__8697_9__ __. Sidewalk Permit 201-00000-428060 88.00 Storm Drainage Impervious Area 440-00000-448028 9436~___ Temp Power 200 amps or less 224-00000-426102 63.00 Vent Fan 224-00000-425604 2700 Willamalane Single Family 821-00000-215023 2,858.00. ,_ TOTAL DUE: 10,040.39 ~Yhj;MENi'TYPE~:L~,,-.P.AY6Frjb'CASHlgR;bi36wesBv1?,.st~;'l!;;COMMENTs'ii.~~il:;:4.;.: '""":-4;:;::;:..' ,''''Ar,nOlltiTgPAID ".': \'gs::::cc~':'-;~ Credit Card RICK PRODEN 9,500.00 Check 5249 PRODEN HOMES 540.39 TOTAL PAID: 10,040.39 City of Springfield Official Receipt Development Services Department Publie Works Department 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone RECEIPT #: 1201000000000000166 Date: 02/23/2010 11:36:16AM Job/Journal Number COM20 I 0-00 190 COM20 I 0-00 190 COM20 I 0-00 190 COM20 I 0-00 190 Payments: Type of Payment CreditCard cReccinl1 Description '." SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC MWMC Compliance Charge Amount Due 101.97 1,333.57 10.00 22.63 $1,468.17 Paid By RICK PRODEN Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid cjc 03552c In Person Payment Total: $1,468.17 $1,468.17 Page I of I 2/23/2010