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Home My WebLink AboutPermit Building 2011-6-22 . . SP1~~~L~ ~.=+ ... J3.;.'~' ~ ,So ~ ORCGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01496 IVR Number: 811100536762 www.ci.springfield.or.us 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 06/22/2011 ISSUED: APPLIED: 06/22/2011 06/20/2011 EXPIRES: VALUE: 12/18/2011 $222,652.42 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residenlial New single family dwelling- SAMEAS 6190 Grayslone SITE ADDRESS: 6100 Grayslone LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343303000 PROJECT DESCRIPTION: Phone Number: OWNER: ADDRESS: BRUCE WEICHERT CUSTOM HOMES INC 3073 SKYVIEW LN EUGENE OR 97405 CONTRACTOR INFORMATION Contractor Type General Contractor Electrical Contractor Mechanical Contractor Plumbing Contractor Contractor Name BRUCE WIECHERT CUSTOM HOMES INC L & E ELECTRIC INC COMFORT FLOW HEATING CO STEVEN R JOHNSON Lie Type CCB CCB CCB CCB BUILDING INFORMATION # of Units: # of Stories: 2 Height of Structure: 26 Type of Heal: Forced Air Gas Waler Type: Gas Range Type: Gas Hazmat: No Occupancy Type Construction Type Occupancy Type Construction Type R-3 Type VB U Type VB 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: # of Bedrooms: 3 Sprinkled Building:' No Fire Alarms: No Energy Palh: Path 1A Gas-fired An furnace with min. ENTlON:re r'f 0 . Notification C:n~ted by the Orego . . Enginln.I;!.4R;lP52-001_0oil~ose rules are set forth Fill v~g~ You may obtain ro~gh OAR 952-001_ Flood ~Uio!J.Ute centeliN :~tet~ of the rules by Land II1Umllwr40r the Or on ~i" e telepho~e Retaining WallCenter Is 1 'eJO_33~~ty Notification . Soils Report Required: No 2344). Site Information I Lic No Lic Exp Phone 101717 09/16/2012 541-686-9458 105475 03/30/2012 541-933-2598 460 06/27/2013 541-726-0100 65065 03/12/2012 541-342-3765 I Lot Size: 19653 Sq FI 1 sl Floor: 2054 Sq F12nd Floor: 242 Sq Ft Basement: Sq FI Garage: 630 Sq FI Carport: Sq FI Olher: 0 Occupancy load: 2008 NOTICE: '. .,. THIS PERMIT . >.' \~~",.:;~<,,:.,.< AUTHORIZ SHALL EXPIRE 1FT . . ;~~1;WENC~g g~~~~~~~;ERM~~:~;{ 80 DAY PERIOD ONED FOR, _.: Springfield Building Permit 6/22/2011 11 :29:42AM Page 1 of6 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01496 IVR Number: 811100536762 Issued 06/22/2011 ISSUED: APPLIED: 06/22/2011 06/20/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenler@ci.springfield.or.us EXPIRES: VALUE: 12/18/2011 $222,652,42 SITE ADDRESS: 6100 Graystone LOOP. Springfield. OR 97477 ASSES OR'S PARCEL NO: 1702343303000 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential New single family dwelling- sAMEAs 6190 Graystone Frontyard Setback: 20 Interior Setback: 23 sideyard Setback: 23 Rearyard Setback: 70 Solar Setback: 30 DEVELOPMENT INFORMA TION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of lot Coverage: Highest point on structure to north property line: 3 Yes 21.5 24 REQUIRED PARKING Total: 2 Handicapped: Compact: Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Descriotion R-3 1 & 2 family U Utility, misc. Springfield Building Permit PUBLIC IMPROVEMENTS ~ Valuation Description Tvpe of Construction VB VB Unit Amount Unit Tvoe 2.054.00 Sq Ft 630.00 Sq Ft 6/22/2011 11 :29:42AM Sidewalk Type: DownspoutfDrains: ~ Unit Cost 96.83 37.72 Value 198,888.82 23,763.60 222,652.42 Page 2 of6 S~i~N~~L.~ ~.i!_''''''' '+fit.L<,.'.~ . <:'""Jfi0 "'OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01496 IVR Number: 811100536762 225 Fifth St 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 06/22/2011 ISSUED: APPLIED: 06/22/2011 06/20/2011 EXPIRES: VALUE: 12/18/2011 $222,652.42 SITE ADDRESS: 6100 Graystone LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343303000 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential New single family dwelling- SAMEAS 6190 Graystone FEES PAID ~ Descriotion Amount Paid Date Paid ReciD! # Residential Fire (.05 Per Sq Foot) $134.20 06/22/2011 2011001715 Structural Building Permit Fee $1,209.36 06/22/2011 2011001715 Address Assignment, each new or change $38.00 06/22/2011 2011001715 Willamalane fees - Single family detached $3,409.00 06/22/2011 2011001715 Same as Plan Review Submittal $250.00 06/22/2011 2011001715 Residence wiring 1,000 sq. ft. or less $134.00 06/22/2011 2011001715 Eac~ added 500 sq. ft. or portion $100.00 06/22/2011 2011001715 Tem,,- s!.rvices 200 amps or less _ $6300 06/22/2011 2011001715 One o~TwoFami~LD:v~lIir:~ ",ithI'N9..Bat~ _._.__ _. .. _ ~374.0~__ __ .E~22/2011..... ___2011~'!.122.5_ Furnace. uP!9 100,000 B!.~_____.____,,_ $17.00 06/22/2011.. __~110017~ Air conditioner $17.00 06/22/2011 2011001715 '0'_'_~_.' Range hood/other kitchen equipment $13.00 06/22/2011 2011001715 Flue vent for water heater or gas fireplace $9.00 06/22/2011 2011001715 Single.duct exhaust (bathrooms, toilet compartments, utili $36.00 06/22/2011 2011001715 Gas Piping up to 4 outlets $14.00 06/22/2011 2011001715 First Appliance Fee $79.00 06/22/2011 2011001715 Residential Fire (.05 Per Sq Foot) $12.10 06/22/2011 2011001715 SDC: Total Transportation Administration Fee $132.05 06/22/2011 2011001715 Planning - Major Review. City $211.00 06/22/2011 2011001715 SDC: Total Sewer Administration Fee $451.12 06/22/2011 2011001715 Sidewalk up though gO Feet . $88.00 06/22/2011 2011001715 CurbC-~UDri~-;;;;;;;Y:;StCui.-----_.._--_._-- _._- ... .--.- -$8800.--- 06/22/201-1---.." 2011001715 MultiP'leP'-r-;;;it Discount (Max 2) ____.~~__ 06/22'i2011-~'' 2011001715 Overwidth / Second Driveway $45.00 06/22/2011 2011001715 SD~ Reimbursement Cost. Storm Drainage $97696 06/22/2011 2011001715 SDC: Improvement Cost. Storm Drainage $1,421.45 06/22/2011 2011001715 SDC: Reimbursement. Transportation SDC $207.76 06/22/2011 2011001715 SDC: Reimbursement. Transportation SDC $289.31 06/22/2011 2011001715 SDC: Improvement. Transportation SDC $1,811.51 06/22/2011 2011001715 SDC: Reimbursement Cost - Local Wastewater $3,688.16 06/22/2011 2011001715 SDC: Improvement Cost..: Local Wastewater $1,800.12 06/22/2011 2011001715 SDC: Reimb~rsement C9st - MWMC Re~ional Waslewal, $101.97 06/22/2011 2011001715 ~DC: 1'2'.E!'9~~rTl~~ M~~~egional Wastew~ter ~ $1.333.57 06/2~?O_II._...___ 2011001715 SDC: Compliance Cost - MWMC Regional Wastewater SI $22.63 06/22/2011 201100171"5' SDC: Administrative Fee. MwMC Regional Wastewater :-- ---$10.'00 06/22/201"1--" --=- ~011 001715 Admin fee (10% of applicable!ees) $14.63 06/22/2011 2011001715 ?t~~of Oregon..S,u,:"harge (12!<>of..applicable _~e~___________$3~:~~__ ___~ 06/33/2011 .. ___ .. __ 2611001715 Springfield Building Permit 6/22/2011 11 :29:42AM Page 3 of6 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01496 IVR Number: 811100536762 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 06/22/2011 06/20/2011 Issued 06/22/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us EXPIRES: VALUE: 12/18/2011 $222,652.42 SITE ADDRESS: 6100 Graystone LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343303000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New single family dwelling- SAMEAS 6190 Graystone Tec~nol~~y fee (5% of.Eerm~. total) $114.72 06/22/2011 Total Amount Paid $18,934.46 2011001715 Plan Review ~ Deoartment Received Comoleted 06/2012011 Result Approved Due Date 06120/2011 Public Works Review 06/20/2011 Comments: Storm water to tap provided Reviewer Kaye Wilson Planning Review 06/20/2011 06/20/2011 06/20/2011 Review Comments: This is not an Express Permit. Building permits in MountainGate require full review. FpPIiCatiOnAcceptance . 1;'00/2012011:',061201201 1,' '06/20/2011 . ,APplisation'Acc~jOd,.' "Chris~~~p~nter~, I" " .'~ ~ ,. t . . ,. _ - '"" .0. j':'..... L. _ "^...._ ...;. ___,~.._.., _, ....___ __'---_----1.._"1..... _".. . Planning Review 06/20/2011 06/20/2011 06/21/2011 Approved Tara Jones Comments: *Place orange construction fencing to the dripline of the existing tree line. No construction activities are allowed in this area unless a plot plan locating the existing trees is provided. "'Choose street trees from the ,list of "Native trees in Hillside Development" on page 4 of the street tree handout. IStr.u.ct.ur~I.R"eVie~: 061201i~11 ~~EJ!:0!~~:1::'.0612zTzOj 1; ,APf6~ed,~~~:h:~.y,~.\?t1ri",.Si!file,~tei:,c;C0c\'r:;' .. t " . '.','" ".;:";j """ "fu~","~ ~L-:;2;:.i~~_t-:>~:';",;;hj,:1"f<.,;i __~ -c,;Y':'''\'iFii:.,-;'''t''::;-'' Permit Issuance 06/22/2011 06/2212011 06/22/2011 Issued David Bowlsby Springfield Building Permit 6/22/2011 11 :29:42AM Tara Jones ,. ,'" '~l " ""-"- ... ";;"'-0: ~I Page.4 of 6 S~~I~...~.FIEL~ ~~7'. ...... ^" ~..1 . ~,..~ ~REGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01496 IVR Number: 811100536762 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitce nter@ci.springfield . or. us PROJECT STATUS: STATUS DATE: Issued 06/22/2011 ISSUED: APPLIED: 06/22/2011 06/20/2011 EXPIRES: VALUE: 12/18/2011 $222,652.42 SITE ADDRESS: 6100 Graystone lOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343303000 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential New single family dwelling- SAMEAS 6190 Graystone INSPECTIONS REQUIRED ~ Inspections 1020 Zoning/setbacks 1090 Street Trees 1110 Footing 1120 Foundation Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. 1170 Post & Beam Post and Beam: Prior to floor insulation or decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1260 Framing 1410 Underfloor insulation 1420 Insulation Vapor Barrier 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling 1520 Interior Shearwall Ceiling Insulation: Prior to cover. Shear Wall Nailing: Before covering sheathing with finish materials. 1530 Exterior Shearwall 1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Underiloor Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Rough Gas: After line is insta1Jed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. 1999 Final Building 2200 Undertloor Mechanical 2210 Underfloor Gas 2260 Gas Service 2300 Rough Mechanical 2310 Rough Gas 2995 Final Gas 2999 Final Mechanical 3130 Footing/Foundation Drains 3170 Underlloor Plumbing 3200 Sanitary Sewer Underfloor Plumbing: Prior to insulation or decking. Sanitary Sewer Line: Prior to filling trench and including required testing. Springfield Building Permit 6/22/2011 11:29:42AM Page 5 016 SP. R~,H,~,F",IEL~~ ~'~' . f?!.'~ ....,~OREGON www.ci.springfield.or.U5 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01496 IVR Number: 811100536762 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 06/22/2011 ISSUED: APPLIED: 06/22/2011 06/20/2011 EXPIRES: VALUE: 12/18/2011 $222,652,42 SITE ADDRESS: 6100 Graystone LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1702343303000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New single family dwelling- SAMEAS 6190 Graystone 3315 Water Line 3400 Storm Sewer Storm Sewer Line: Prior to filling trench. 3411 Perimeter Rain Drains 3500 Rough Plumbing 3999 Final Plumbin9 4000 Temporary Power Service 4225 Service or Feeder Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construct7 vi bJ-- to /z- ~./ ! '( '-' Owner or Contractor Signature Date 1160 UFER Ground Springfield Building Permit 6/22/2011 11 :29;42AM Page 6 of 6 5:0-. )'>'-L Structural Permit ApplicatioD_ a..S bJ10 G, '(I;..., sto-- c:- 225 Fifth Stn:et. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-J689 .-.....~ ~~;,_lL .: 'if... " ;;,." . . ''''''''_ -'-'.__" '-, ....\..c... DEPARTMENT i,iSEONL . .. ..'>"" ","'.1':'.'.'_"', ._........''-.!>. CI ry OF SPRINGFIELD, ORHiON Pennit no.: 5 f ( - I Lf'10 Date: U 2-0 I 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 ror 180 days. Date: . ,E'$CHE'Di.iLE~<;I;;' , tValiilH,~"'fii . i~~~uq;~,!,\;:.(:~;j:i;, _ 'fl (a) Job description: /'J1c:V 5"1 N~U::: pC"A,M./ '-'I Occupancy Ie.. LA Construction type: vB Square reet: Cost per square root: Other information: Date: Dyes DNo Type oCHeat: }f-J t=b IZLCO /9; d.- E rgy Patb: I A- D alteration (b) Foundation-only permit? o addition DYes .2- '2.. @lIfo t..~, ;J- .. ", ~ fj~~l~;~\:!~:::~{(:~:~.t Cu~b.., 1lo,w2\ ]:)V'- /...'" Slate:O<L ZIP:q7~"1 Fax: 3'1 - 336 z- GOM ""5-1 ~.-.I" t Tota'vllluation: "z. BuildiiiRfe~!ti?'~{,\!(."" (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 or rees above (20 tbrough 2d): '~;'i>j~q (a) Plan review (65% x permit ree [2a)): (b) Fire and life safety (40% x permit fee [2aJ): (c) Subtotal orre.. above (30 and 3b): '4. MI!li:~liii'IJeiiusfeei/" ,', ' (a) Seismic fee. 1% (.01 x permit fee [2.)): S TOTAL ree. and .urcharge. (2ei-3c+4a): S . '; '.:..\t~1:~}~:1::;?;t~t::~~~::"" } -; J ';) o ~ s /"2C1'f s s S/'f - Sign here: ~ it ':,COi["t;t ,:li' Businessname: \1:.vUI.< \J;l!"I....~ Address: '3 073 S II ~; eoN City: ~" e...... Phone: .W b cl'1 S ' E-mail: Wi e"k-.t \-.0 ,'l-t'S @ CCB license no.: 10 I ) ( 7 Print name: W(,~ Ioy,,,, s Name Eleelrical j,... r:: Plumbing 5Jc...; Mecbani<al CF/-I ;1hf.::":,. HI '11 ~ l> ~ ~l-n ", 7l.b.-%o Electrical Permit Application 225 Fiftb Street. Springfield, OR 97477.PH(54I)726-J753tFAX(541)726-J689 s. PRINa........~""".. . A.. tLa~, . ~~........ .... ,.>!""Cj"1~ ,65. ,.,., ~~t;.~~n~"~MoQ,..,'" -.ti'{ bEPARlNiENl USE ONLY Date: ~ CITY OF SPRINGF'IELD, OREGON This permit is issued 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. .' LOCAL. \30VERNMENl APPROVAL ...... '.... ". ',"':'.!"; FEE SCHeDULE . . '. Zoning approval verified? DYes ONe N~~~er of}nspe~tio~s ~~~ ,ite.~: ( ). Qty. Cost Total ea. cost I' .: . CA TEGORY01' CONSTRUelION: Residential, per unit, service included: Iii Residential I 0 Government I 0 Commercial 1,000 sq. ft. or less (4) ( $134.00 $/3'( ~;iQ{~X'J.O$'SIT~: INFORNiATIONIANOI'LOeA'tiOi'.h:.,c':, Job site address: Moo '" YCu./St..w.... Each additional 500 sq. ft. or portion 1 $ 25.00 $/OlJ thereof City:S \? (:: \? State!"y{.-- I ZIP: '1' rt ~ I) Limited energy (2) $ 32.00 $ Reference: \ t1 D /-. : ... ....0 I Taxlot.:O Each manufactured home or modular $ 63.00 $ ( . .' DE CRIPTION: OF WORK ' ..: ',,:. .t'. dweliing service or feeder (2) . ..f:.U'( ,Q.)lr a N'\t 11 ]v) ;) 0 h d-U'Hri Services or feeders: installation. alteration, relocation C\, lo~P~gO~E~ '" 200 amps or less (2) $ 81.00 $ 201 to 400 amps (2) $ 95.00 $ Name: e,'('\/u W, t'c..h.W\ C....s.ftl... . 40 I to 600 amps (2) $158.00 $ Address: 307 ~ S)Cl.iv,ew )/oJ 601 to 1,000 amps (2) $205,00 $ City: (ul< ~ State: Oil- I ZIP: ''17'/0) Over 1,000 amps or volts (2) $469.00 $ Phone:SW~bll6 Of'151r I Fax: ~y/-'3Y' ,~36 'Z- Reconnect only (2) $ 63.00 $ E-mail: IN, ~c..\"~~l-- \,,(J~5 €} Co Ikt:-"'sf ' IV c. t Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less (2) I $ 63.00 $03 owned by me or a member of my immediate family. This 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 401 to 600 amps (2) 479.540(1) and 479.560(1). $128.00 $ Signature: Over 600 amps or 1,000 volts, see services or feeders section above '. CONTRACTOR INSTALLATION. - " Branch circuits: new, alteration, extension per panel Business name: I-~e ~/-ec;i'V: c... a. fee for branch circuits with purchase of a service or feeder fee: Address: q Z g ~ 3 -::5ov-es Ac.(e5 Each branch circuit $ 6.00 I $ City: S'flf\~ I State: 0 l't. I ZIP: q 7 n'Z b. Fee for bnlnch circuits without purchase of a service or feeder fee; Phone:S't/ -Sll - 41"1 ! I Fax: C)4ff 413 - LJI M First branch circuit (2) . $ 55.00 $ E-mail: Each additional branch circuit $ 6.00 $ CCB license no.: I OS 4 7S'"' BCD license no.: '-'593.::- Miscellaneous fees: service or feeder ~ot included Signing supervisor's license no.: '-1/7'1-~ Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor: /;' C Oe....oval~.... Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervisor: (,,' ('oJ t )~() \J-6~ Signal circuit or a limited-energy panel, $ 63.00 $ alteration. or extension (2) . :Q~l Each additional inspection: (I) $58.00 $ .~ "1~: ".. ::y;:,{};;,......'..Apf.'LI.~ANt..USE<.. ..' ','::.'::::':.':..' ~~ (A) Enter subtotal of above fees $2Cf7 e- (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) $ 5)'(;','1 \9~~ (C) Technology Fee (5% of [A]) $ /415 TOTAL fees and surcharges (A through C): $ ,?ijJrj - ~ 440-2584,J (9108ICOM) ~?, willamalane t-w Park and Recre'ation District Job. No. ~ II - /Ll C( ~ PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-December 31, 2011 NAME: '8w c 1-1 ADDFlESS: 3d7 j!;"tZ\t Vi't::i.:,' crTv: t\A..4 ':- PHONE: {octo. S-OS D .... -"STATE~o:;.L' ZIP:'17'f/.{~--- LOCATION OF PROPOSED BUILDING SITE: Street Address:. a Ice> c; r2.~ 'ISTZ>/'-l t:. LP Plat Name:""",; ~~ Tax Lot Number: , I {j '1- ~l{J''S' 0 ~ 1. DEVElOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UN/TS.:,..-I B. Single-Family Attached NO. O~ UNITS C. Multi-Family Apartment NO. OF UNITS D. Single Room Occupancy NO. OF UNITS X $3,409 per unit = $ 1l..( ocr X $3,404 per unit = $ X $2,800 per unit = $ X $1,400 per unit = $ . E. Accessory Dwelling Unit NO. OF UNITS X $1,705 per unit = $ '2;-SDCCREDIT-(lf applicable.SDE payer mustfurnishproof of credit approval.) 3. TOTAL PARK AND RECREATION SDC ASSESSED ($ !J , - $~lfD<7 ~ City of Springfield 6> I~ II Date of building permit submittal ~ City of Springfield ({' 1 ;:2.:2-1 I / Date of building permit issuance ~ST\N.:~LD ....~.~'.5:t...,~ ~."''''''' =""" OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 8t Springfield,OR 97477 541-726.3753 811-SPR2011-01496 6100 Gravstone LOOP perm itcenter@ci.springfield.or.us www.ci.springfield.or.us RECEIPT NO: 2011001715 RECORD NO: 811-5PR2011-01496 fDESCRI~TION " (' :.::,.'~':" . i'.,:i:':i:,~...::::...:!A(')(')oUN:rlcODE7' . T' ,;, '. _:':'!!.dress Assignment, each new or change ,_____ 224,00000-425602 _ Admin,f.:e (1 0% c:r.~!,,~able.!ees) _ , _,,,,_ .._, __.,}24'~00~~4266~_,____ ___ _,_ Air conditioner 224,00000,425604 -----~_._._-~ Curb CuVDriveway 1st Cut 201,00000,428060 Each added 500 sq. ft. or portion 224,00000,426102 First Appliance Fee 224,00000,425604 Flue vent for water heater or gas fireplace 224-00000-425604 Furnace, up to 100,000 BTU 224,00000,425604 Gas Piping up to 4 outIets .,_",...224-00000-425604 Multiple Permit Discount (Max 2) 201,00000,428060 ~<2.ne or Two Family Dwelling with Two 8ath 224,00000-425603 ~.~rwidth 1 Second Driveway ,__,___,__,,,, 201,00000,428060 Planning' Major Review, City 100-00000,425002 _,~ange hoodlother ~itchen equip':'!."!_______ 224-00000,425604 Residence wiring 1 ,000 sq. ft. or less 224,00000,426102 Residential Fire (.05 Per Sq Foot) 100,00000,424005 SDC. Administrative Fee, MWMC Regional Wastewater SDC 611,00000,426604 SDC. Compliance Cost, MWMC Regional Wastewater SDC 444,00000,426607 SDC: Improvement, Transportation SDC 447,00000-448027 SDC: Improvemen~ Cost, Local Wastewater 443,00000-448025 SDC: Improvement Cost, MWMC Regional Wastewater SDC 445,00000,448025 _ SDCclmprove-'!'ent Cost, S.!~~ain~_,__,,,_ u, ",440:90999:448028 SDC Reimbursement, Transportation SDC 446,00000,448026 SDC: Reimbursement Cost, Local Wastewater 442,00000,448024 SDC: Reimbursement Cost, MWMC Regional Wastew~er SDC 444,00000,448024 SDC: Reimbursement Cost, Storm Drainage 441,00000-448029 SDC: Total Sewer Administration Fee 719,00000,426604 SDC: Total Transportation Administration Fee 719-00000-426604 Same as Plan Review Submittal 224,00000,425602 ---_._-~ Sidewalk up though gO Feet 201,00000,428060 Single-duct exhaust (bathrooms, toilet compartments, utility roor 224-00000-425604 State of Oregon Surcharge (12% of applicable fees) 821,00000,215004 Structural Building Permit Fee 224,00000-425602 Technolo9.Y fee (5% of permit total) 100,00000,425605 ~'2'p services 200 amps or less 224,00000,426102 Willamalane fees, Single family detached 821,00000,215023 TOTAL DUE: U~AYMEN:T"typ'E:; 1'"':;p.,t.:'(ofl:=j:A~sHIER'DBowLsB,(:; :,iL~~COJ'JiM!:t:j'[S~~,."" . ~~, .;, ,: Credit Card bwch DATE: 06/22/2011 ',.":AMOUN'tDUE 38.00 14.63 17.00 8800 "~-,-_.._" 100.00 79.00 9.00 17.00 14.00 ,30.00 374.00 45.00 211.00 13.00 134.00 ~-~._.~-'..._. 146.30 10.00 22.63 1,811.51 1,800.12 1,333.57 1,421~:, ._",_.,_ 497.07 3,688.16 101.97 976.96 451.12 132.05 250.00 88.00 36.00 247.84 1,209.36 114.72 63.00 u u:J,<\()9()0 18,934.46 AMOUNTI~:A.JIL'::, ""_2,,J 9,500.00 'C'I , . . RECEIPT NO: 2011001715 RECORD NO: 811-SPR2011-01496 DATE: 06/22/2011 rOEstRlftTION~:' :_~-:"". .';"'!..p-"';,i~;'F" ~.. ~''',5."~;;,~. . -'Y.. ACC0UN;f'::CO[)E~.< ie''''>," AMo.UNtD.UE Address Assignment, each new or change 224-00000.425602 38.00 Admin fee (10% of applicable fees) 224.00000-426605 14.63 Air conditioner 224-00000-425604 17.00 _Curb CuVOriveway 1st Cut 201-00000-428060 88.00 _ _E.a~~dde~OO sq. !!...o.':,port.i.on. .... _._._...__.3.~4-00000-426102 100.00 _First ~EI~~ Fee 224-00000-425604 79.00 ~.~e vent for water heat~)l~~!irepla~. 224-00000-425604 9.00 __ Furna.':':..:.':'p to ..1.00,000 BTU 224-00000-425604______...2Z:.ClQ..____ ___ Gas Piping up to 4 outlets 224-00000-425604 14.00 Multiple Permit Discount (Max 2) 201-00000-428060 -30.00 One or Two Family Dwelling with Two Bath 224-00000-425603 374.00 Overwidth / Second Driveway 201-00000-428060 45.00 Planning - Major Review - City 100-00000-425002 211.00 Range hood/other kitchen equipment 224-00000-425604 13.00 Residence wiring 1,000 sq. ft. or less 224-00000-426102 134.00 Residential Fire (.05 ~~ Foot) 100-00000-424005 146.30 .......J'DC: Administrative Fe~ :.~WMC Re)lional Wastewater SOC 611-00000-426604 _1.O,:Q0__ __.!?OC: Co",J'Ii~ce Cost_~~WMC Regional Wastewater SDC 444-00000-426607 22.63 SOC: Improvement - Transportation SOs:." 447-00000-448027 __ _ _~~._.. SOC: Improvement Cost - Local Was~_",!'le~_______ 443-00000-448025 1,800.12.____ SOC: Improvement Cost - MWMC Regional Wastewater SOC 445-00000-448025 1,333.57 SOC: Improvement Cost - Storm Drainage 440-00000-448028 1,421.45 SOC: Reimbursement - Transportation SOC 446-00000-448026 497.07 SOC: Reimbursement Cost - Local Wastewater 442-00000-448024 3,688.16 SOC: Reimbursement Cost - MWMC Regional Wastewater SOC 444-00000-448024 101.97 SOC: Reimbursement Cost - Storm Drainage 441-00000-448029 976.96 SOC: Total Sewer Administration Fee 719-00000-426604 451.12 --.-- .__SOC: Total Tr~.~spo~~tion Administration Fee 719-00000-426604 132.05 Same as Plan Review Submittal 224-00000-425602 250.00 -'-~-'-~ ~-~-- ",.,-_.,-~--'.'---,'_._,~._~ "._ Sidewa~~ though 90 Feet..__.____...._._____ 201-00000-428060 ._.____ 88.00 Single-duct e?5haust (bathrooms, toilet compartments, utility roo~_224~OOOgO-425604 36,00 State of Oregon Surcharge (12% of applicable fees) 821:00000-215004 247.84 Structural Building Permit Fee 224-00000-425602 1,209.36 Technology fee (5% of permit total) 100-00000-425605 114.72 Temp services 200 amps or less 224-00000-426102 63.00 Willamalane fees - Single family detached 821-00000-215023 3,409.00 TOTAL DUE: 18,934.46 '. c, A",.C9J!1!.flili;,,!I.S,": ,,- ';'.'7,.: =<.7' ,',AMOUNT'PAID.-'" ;:j L~A?OVII:Ni~rXeE""~ ~ '1f::~:.;g~Y9~ /rCASHIER;,D8()W~SBY' Cash bwch inc 20660 9,434.46 TOTAL PAID: 18,934.46