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Home My WebLink AboutPermit Building 2006-9-6 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2006-01074 ISSUED: 09/06/2006 APPLIED: 08/18/2006 EXPIRES: 03/06/2007 VALUE: $ 28,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 388 Q St ASSESSOR'S PARCEL NO.: 1703262405700 Springfield TYPE OF WORK: Tenant Infill TYPE OF USE: Alteration PROJECT DESCRIPTION: Tenant infill for "Contours Express" a women's workout location Commercial Owner: WATSON-ALBERTS LLC Address: 875 FAIRWAY VIEW DR EUGENE OR 97401 Phone Number: 954-1978 Phone Number: 465-8139 I CONTRACTOR INFORMATION I Contractor Type General Electrical Contractor BINEHAM CONSTRUCTION JB ELECTRIC License 76336 104929 Expiration Date 10/24/2009 03/14/2008 Phone 541-484-9405 541-687-5770 BUILDING INFORMATION I # of Units: Primary Occupancy Grou,p: Secondary Occupancy GrO'lP: Primary Construction Type Secondary Construction Type: # of Bedrooms: B # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: SprinkleeJ Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,740 VB n/a I DEVELO~MENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Fullv Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' To Storm Sewer Notes: Paee 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Estimate Tvpe of Construction Estimate Fee Description Plan Review Comm/Ind/Public + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Addressing Assignment Building Permit Copies - Ea Addtl @ 50 Cnts Ea Copy 6th @ 75 cents Fire SF Fee - Non-Residential Plan Review Fire & Life Safety SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Total Amount Paid . I Valuation Description I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 28,000.00 Total Value of Project ~ Amount Paid Date Paid $157.27 $41.60 $12.10 $19.36 $31.00 $241.95 $2.50 $0.75 $174.00 $96.78 $10.00 $573.61 $54.65 $200.55 $2,749.45 $623.26 8/18/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 $4,988.83 I Plan Reviews I Paee 2 of 4 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2006-01074 ISSUED: 09/06/2006 APPLIED: 08/18/2006 EXPIRES: 03/06/2007 VALUE: $ 28,000.00 Value Date Calculated $28,000.00 $28,000.00 08/18/2006 Receipt Number 1200600000000001292 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 2200600000000001244 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: cOM2006-01074 225 Fifth Street, Springfield, OR ISSUED: 09/06/2006 541-726-3753 Phone APPLIED: 08/18/2006 541-726-3676 Fax EXPIRES: 03/06/2007 541-726-3769 Inspection Line VALUE: $ 28,000.00 Fire Department Review 08/21/2006 09/06/2006 OK GRG Plans Review: Tenant InfilI. Job #COM2006-01074. Occupancy Classification: Occupancy Classification: B. Construction Type: V-B. 1500 sq. ft. Provide fire extinguishers with a minimum rating of 2-A:I0-B:C every 75 feet of travel distance. The top of the extinguisher(s) shall be between 3 and 5 feet above finished floor (2004 Springfield Fire Code 906). Exit signs shown on Plan Sheet E1.1. Will verify on inspection. Emergency egress lights shown on Plan Sheet E1.1. Will verify on inspection. Provide address numbers on back door. Initial Review 08/21/2006 08/21/2006 APP LLH Addressing fee and fire fee applicable. First time lease space improvement. Plan Review Comments 08/31/2006 10 JMP WE. Received responses to structural comments. Called John Demers about incomplete special inspection forms and missing reflected ceiling plan. Plan nine Review 08/21/2006 08/29/2006 APP EMM Windemere Real Estate office Public Works Review 08/21/2006 09/01/2006 APP CJS SDC's paid previously under COM2004-01509 for general office building; added SDC's for health/fitness club; attached to PRJ2004-00039 09/01/06 CJS Structural Review 08/21/2006 08/25/2006 WE JMP See attached documents for 9 structural comments faxed to John Demers. Structural Review 09/06/2006 09/06/2006 APP JMP Received the previously missing reflected ceiling plan and the completed special inspection forms. SUB Review 08/21/2006 08/25/2006 APP JF 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. Paee 3 of 4 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2006-01074 ISSUED: 09/06/2006 APPLIED: 08/18/2006 EXPIRES: 03106/2007 VALUE: $ 28,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I ReQuired Inspections. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Ceiling Grid: After drywall approval but prior to cover. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. SUB Final: After all required energy inspections have been requested and approved. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. SUB Ceiling Grid: Interior Lighting 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 insp_ecti~are requested at the proper time, that each address is readable from the street, that the permit card is located at rfront of the property, and the approved set of plans will remain on the site at all times during construction. Q~ C1 Ihl7PO b l l Owner or Contractor Date Paee 4 of 4 Cily of Springfield Community Services Division 225 Fifth Str~et Springlield, 'OR 91477 Telephooe: (541) 726-3759 Fax: (:541) 726-3639 Cotv\2.0blP -0\(>"4- Building Perin it IJ %13016V Dale W\ rdo lY\e't"'C.. \-:J:... Project TItle 6~% Q ~~ ~~f1_\l\.~'n Project Address . "'jl . Spe4!1al Insputl~nand Testing To appliWll1s of PJOjl:tls requiring ",. ~":.J inspection Of testing as per Section 1104 Qf (he O~g()tl. Structural Specialty Code. l'lease review she in.l"c.......lion below. Whcil you have tini!>h~, acknowledg~ an un&rsumding oflnc: i~(lrmaiiGn by sianine below, and return tbis form to lbe City. . BDORE A PDtMIT CAN liE ISSUED: The owner or owncrts rcp'tcsenfative, on tile advice ol'the responsible Pmjl:(:t Engineer Or Architect, shall complete, sign, and submit to the City for Mview and approval this form eolJlpleted on 'boththl: ~nt and back. The owna and General Contractor, where applicable. shall also acknowlcdjtc the following conditions. applicable lo Speda1 Inspection. aDd/or T esUng. . l. Contr.ti;Wr is ~pou$ibt.. tt;r propeT n.otifieation tor tlte Inllpeetl~ t;f Tesling ofiWin61istea. 2. Testing laboratory lllWl take appropriate samples and rranlljlOn them 10 their laboJalOry for JI<\Ip'" evaluation or testing. . Copies ofatllaborat<llY"'r~,.ls and inspecticns are to be sent to 1heCity by theTClltingAttC11cy. 3. Special Insp<<tion Agency III to submit names and qllBlificatiotls ofon.l\itt; Special 1:"",1" ....tors to the City fhr....!'...", ,..1. 4. ~Jleci;d Tnllpl!Ctor shall provide inspection repOI1S !tl the building official of all ltl~tll)n acliv ities. $. Conlra<:tor is-Icsponsible to review the City approved plans for additional i nlipectiQI1 Q~ tE:$ting requirements fbi'l m~y be noted. 8EFORE A CERl'IFICATE OF OCCUPANCY WILL BE fSSlJED: .1'he Special Inspection Agency sban submit to the Building Official a statement thalllU items requiring i~ti()n have been fulfilled and TepOl1ed iUld were tQ the best of the inspector's knowledge. in conformance witb the apptovcd plans, specitiGations and appJi<<lbfe WOfkmlln~jp ptOvi,ioDs Tlln$IB itEm1.'" not fl:.oded and/of inspected shall be norM in the statement The report is to be submitted to tbe City prior to a request for final i~lil>ns. . ACKNOWLEDGEMEN,?--- M(Lti P6'A)eLL ""- Owner Name (Printed) ~OWt1er S~tgna . - JdoY\ \){~. '. . E1\ztnuror Arcbitect Finn (Printed) Ellgi~o~ Architec JRnature \="~~ t1:ft~u.+-m~.~~ T~ting La.boc~ NIU11.~ (Printed) T~l!tingLaboratory Rep. Si~..l".... ~~~~ ~;~~ Gen. Conltactor Finn Name (Printed} General C~otr;.-oi Signature \"=t;\ T~J,.~^r'(:'L.~~1h 'LVt,,~/1di# j _.~pectl~~oAgen.:r Namo ~~} . l InSp.~eo SiB!:. / . '~-. ~\i?; ~~~-) l \; r \' ~/ BU1JaiiigOfficlAl Namt: (Pnnted) n~ltllllg OffiCial SlgnQfure Reintorced Concrete, Gunite, Grout and Mortar: Concrete Gunite Grout Mortar I I 1 I I I I 1 .1 Precast/Pre-stressed Concrete: 1 Piles Post-Tens Pre-Tens I Cladding SMOKE CONTROL: _ Leakage testing Control Veritication ROOFING: Insulation installation/R- Value* Test strips/seams SPECIAL INSPECTION AND TESTING SCHEDULE Aggregate Test of Mix Design Reintorcing Test Mix Design-Weighmaster Cert.* Reintorcing Placement Continuous Batch Plant Inspect. Inspect Placing Cast Samples Samples (Pickup/Delivered) Compression Test* Aggregate Tests Reintorcing Tests Tendon Test Mix Designs* Reintorcing Placement Insert Placement Concrete Batching Concrete Placement Installation Inspection Cast Samples Pick-up Samples Compression Tests FIREPROOFING: Placement inspection Density tests Thickness tests Inspect batching ADDITIONAL INSRUCTlONS, OTHER TEST, & INSPECTIONS: Le;),"~ 6.1./\ C/ I. GRADING, EXCAVATION, AND FILL Acceptance tests * PSF Establish final grade Fill placement inspection/continuous Soil Density I I. I I I I STRUCTURAL STEEL/WELDING: Sample and test (list spccitic members below) Shop material identification (mill cert) Weld inspection Shop Ultrasonic inspection. Shop High Strength Bolting Shop A325 N A490 N Metal deck welding inspection Reinforcing Steel welding inspection Reinforcing steel mill certilicate Metal stud welding inspection Concrete insert welding inspection Moment resisting stecl frames F F Field Field Field . x X I 1 1 I. STRUCTURAL WOOD: Shear wall nailing inspection Shear wall anchors Inspection ofGlu-lam fab. * T/C psi I nspection of truss joist fab. Sample and tcst componcnts Pabrication welding of steel acccssories MASONRY . Special inspection strcsses uscd* r m r g Preliminary acceptance tcsts (masonry units, wall p.risms) Subsequcnt tests (mortar, grout, tield wall prisms) Placcment inspection of units, and reintorccment Masonry, mortar, grout, and rcintorcing stcel certiticates Form Complctcd by: ft#, Date q.- 6-D ~ "PROVIDE STRENGTH REQUIRED BY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION OF VALUES .. . . A IT ACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER C0M2006-0 I 074 NAME OR COMPANY: Contours Express (Alberts Commercial Mall) LOCATION: 388 Q St. MAP & TAX LOT NUMBER: 17 03 26 24 05700 DEVELOPMENT TYPE: New Tenant Infill (women only gym) NEW DEVELOPED AREA (S.F.): 1,740.00 lTE: 492 EXISTING DEVELOPED AREA (SF): 1,740.00 ITE: 710 TOTAL IMPERVIOUS SURFACE (S.F.): LOT SIZE (S.F.): I. STORM DRAINAGE storm drainage charges paid under COM2004-01509 IMPERVIOUS SQ. FT. $ 0.336 PER SF x 2. SANITARY SEWER-CITY A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) TOTAL STORM DRAINAGE SDC:I sanitary sewer charges paid under COM2004-01509 o x $ 26.03 PER DFU o x $ 19.79 PER DFU $ 45.82 TOTAL LOCAL W ASTEW A TER SDC:' 3. TRANSPORTATION. transportation charges paid under COM2004-01509 for general office bldg. BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 1.74 x 32.93 B. IMPROVEMENT COST: 1.74 x 32.93 EXISTING A. REIMBURSEMENT COST: -1.74 x 11.01 B. IMPROVEMENT COST: -1.74 x 11.01 x $ 19.81 PER TRIP $964.82 1 0.85 NTF x x $ 87.39 PER TRIP $4,256.20 1 0.85 NTF x x $ 19.81 PER TRIP ($341.56)1 0.9 NTF x x $ 87.39 PER TRIP $ 107.20 ($1,506.75)1 0.9 NTF x 4 SANITARY SEWER - MWM~ NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's B. IMPROVEMENT COST: NUMBER OF FEU's TOTAL TRANSPORT A nON REIMBURSEMENT SDC: TOTAL TRANSPORT A nON IMPROVEMENT SDC: TOTAL TRANSPORTATION SDC:' $ 3,372.71 I MWMC charges paid under COM2004-01509 for general office bldg. 1.74 x $83.76 PER FEU $145.741 1.74 x $879.10 PER FEU $1,529.63 I EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's - 1.74 B. IMPROVEMENT COST: NUMBER OF FEU's - 1.74 MWMC CREDIT IF APPLICABLE (SEE REVERSE) x $52.35 PER FEU ($91.09)1 ($956.03)1 x $549.44 PER FEU TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: TOTAL MWMC SDC:I $ 638.26 SUBTOTAL (ADD ITEMS 1,2,3, & 4) r $4,010.97 I 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) $ 4,010.97 x 5% , $200.55 TOTAL TRANSPORTATION ADMINISTRA nON FEE: TOTAL SEWER ADMINISTRA nON FEE: ~-""/~~A Eng. Tech. III 9/1/2006 DATE TOTAL SDC CHARGES COM2006-01074, Contours Express (Watson-Alberts LLC), 388 Q 51. $0.00 I $4,211.52 1 JULY 2004 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) New Tenant Infill (women only gym) FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN, FLOOR SINK INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB CLOTHES W ASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (1 PER TRAILER) RECEPTOR FOR REFRlGERA TOR/W A TER ST A TION/ETC. RECEPTOR FOR COMMERCIAL SINK! DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLE LA V ATORY/RESIDENTlAL BAR URINAL, ST ALUW ALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDU'S* FIXTURES UNIT NEW OLD EQUIVALENT 3 1 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 TOTAL DRAINAGE FIXTURE UNITS= *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXA TION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 RATE PER $1,000 ASSESSED VALUE $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXA T10N DATE) COM2006-01074, Contours Express (Watson-Alberts LLC), 388 Q 51. YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 RATE PER $1,000 ASSESSED VALUE $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 $0.00 $0.00 $0.00 x x CREDIT TOTAL .. DRAINAGE FIXTURE UNITS o o o o o o o o o o o o o o o o o o o o o o o o $0.00 $0.00 $0.00 1 JULY 2004 . AITACHMENT A ~ CITY RINGFIELD SYSTEMS DEVELOPMENT CHARG~SHEET JOURNAL OR JOB NUMBER: C0M2004-01509 NAME OR COMPANY: Alberts Commercial Mall LOCATION: 380 Q St MAP & TAX LOT NUMBER: 17 03 26 24 05600/05700/01720 DEVELOPMENT TYPE: General Office ~~~~ing __'__ NEW DEVELOPED AREA (S.F.): 34,99600 EXISTING DEVELOPED AREA (S.F.): 1 TOTAL IMPERVIOUS SURFACE (S.F.): "" 40,353 ITE: ITE: LOT SIZE (S.F.): 710 210 71,438 I. STORM DRAINAGE 40,353+20,820-2,439 IMPERVIOUS SQ. FT. 58,734.00 $ 0.310 PER SF x TOTAL STORM DRAINAGE SDC:J 2. SANITARY SEWER-CITY A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) 95 x $ 24.04 PER DFU 95 x $ 18.28 PER DFU TOTALLOCALWASTEWATERSDC:' $ $18,207.54 4,020.471 $ 4,020.47 3. TIANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 34.996 x 11.01 x $ 1830 PER TRIP x 0.9 NTF 1$ 6,345.39 I B. IMPROVEMENT COST: 34.996 x 11.01 x $ 80.72 PER TRIP x 0.9 NTF 1$ 27,992.62 I EXISTING A. REIMBURSEMENT COST: -1. 000 x 9.57 x $ 1830 PER TRIP x 0.9 NTF 1$ (157.60)1 B. IMPROVEMENT COST: -1. 000 x 9.57 x $ 80.72 PER TRIP x 0.9 NTF 1$ (695.26) , TOTAL TRANSPORTATION REIMBURSEMENT SDC: $ TOTAL TRANSPORTATION IMPROVEMENT SDC: $ TRANSPORTATION SDC:' $ 33,485.131 $ 4. SANITARY SEWER - MWMC NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 34.996 x $46.88 PER FEU B. IMPROVEMENT COST: NUMBER OF FEU's 34.996 x $494.46 PER FEU EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's -1. 000 x $82.03 PER FEU B. IMPROVEMENT COST: NUMBER OF FEU's -1. 000 x $86531 PER FEU MWMC CREDIT IF APPLICABLE (SEE REVERSE) I $ 1,640.44 I I $ 17,304.19 1 I $ (82.03) I I $ (865.31)1 $ TOTAL MWMC REIMBURSEMENT FEE: $ TOTAL MWMC IMPROVEMENT FEE: $ MWMC ADMINISTRATIVE FEE: $ TOTAL MWMC SDC:' $ 16,589.58 1 $ SUBTOTAL (ADD ITEMS 1,2,3, & 4) '$ 72,302.721 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) $ 72,302.72 x 5% $ 3,615.14 TOTAL TRANSPORTATION ADMINISTRATION FEE: $ TOTAL SEWER ADMINISTRATION FEE: $ steveV'v w. 1SelAucirtJ 1SGlrV'ves 9/1/2006 SJ6fiit({r?P-lmfM:'A1~Ilts Commercial Mall, 380 Q St DATE TOTAL SDC CHARGES 75,917_861 1$ 1 JULY 2004 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) Alberts Commercial Mall FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB CLOTIIES W ASHER/MOP SINK CLOTIIES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (1 PER TRAILER) RECEPTOR FOR REFRIGERA TOR/W A TER STATION/ETC. RECEPTOR FOR COMMERCIAL SINK! DISHW ASHER/ETC. SHOWER SINGLE STALL SHOWER GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIDOUBLELAVATORY SINK: SINGLE LAVATORY/RESIDENTIAL BAR URINAL, ST ALL/W ALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: FIXTURES NEW OLD ] 2 4 o o o o o 8 ] I3 NUMBER OF EDU'S* UNIT EQUIVALENT 3 ] 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day TOTAL DRAINAGE FIXTURE UNITS= ol DRAINAGE FIXTURE UNITS -3 2 12 o o o o o o o o o o o o o 7 5 72 o 95 o o 95 CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY YEAR RATE PER $],000 YEAR RATE PER $],000 ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE 1979 or before $5.29 ]992 $1.59 1980 $5.19 1993 $1.45 ]981 $5.12 1994 $1.25 1982 $4.98 ]995 $1.09 ]983 $4.80 1996 $0.92 1984 $4.63 1997 $0.72 1985 $4.40 1998 $0.48 1986 $4.07 1999 $0.28 1987 $3.67 2000 $0.09 1988 $3.22 2001 $0.05 1989 $2.73 2002 $0.00 1990 $2.25 2003 $0.00 1991 $1.80 2004 $0.00 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE $5.29 X 268.000 $1,417.72 IMPROVEMENT (IF AFTER ANNEXATION DATE) X $0.00 CREDIT TOTAL $1,4]7.72 com2004-01509, Alberts Commercial Mall, 380 Q SI 1 JULY 2004 . ~f Springfield Official Receipt "-elopment Services Department Public Works Department 225 Fifth Street ~pringfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-01074 COM2006-0 I 074 COM2006-0 I 074 COM2006-0 I 074 COM2006-0 I 074 COM2006-0 I 074 COM2006-0 I 074 COM2006-0 I 074 COM2006-0 I 074 COM2006-01074 COM2006-01074 COM2006-0 I 074 COM2006-0 1 074 COM2006-01074 COM2006-0 I 074 Payments: Type of Payment Check cReceiot I RECEIPT #: 2200600000000001244 Date: 09/06/2006 Description Addressing Assignment Fire SF Fee - Non-Residential Copy 6th @ 75 cents Copies - Ea Addtl @ 50 Cnts Ea SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Transpo Admin Plan Review Fire & Life Safety Building Permit + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By BINEHAM CONSTRUCTION, INC. Item Total: Check Number Authorization Received By Batch Number Number How Received jmp 28049 In Person Payment Total: Page I of I 1 :46:28PM Amount Due 31.00 174.00 0.75 2.50 623.26 2,749.45 54.65 573.61 10.00 200.55 96.78 241.95 12.10 19.36 41.60 $4,831.56 Amount Paid $4,831.56 $4,831.56 9/6/2006