The URL can be used to link to this page

Home My WebLink AboutPermit Building 2011-7-5 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00724 IVR Number: 811129643870 www.ci.springfield.or.us permitcenter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/05/2011 ISSUED: APPLIED: 07/05/2011 05/02/2011 EXPIRES: VALUE: 12/31/2011 $170,714.28 (11D,1\-\ ') o.i\ SITE ADDRESS: 1130 S 40th CT, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802061417000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - SAME AS S1 0-00569 PROJECT DESCRIPTION: OWNER: ADDRESS: MIKE BLANKENSHIP CORPORA nON m M \ ~ -I04l6146TIIAV[[ GolP~ "U\LJfS ~ \F' PlJ,Alll-JPWA98374 ~~l"il'\C\(\f'\d OR... Ci.1416 I' J CONTRACTOR INFORMATION Phone Number: Contractor Name DOUGS PLUMBING INC GERARD ELECTRIC COMFORT FLOW HEATING CO MIKE BLANKENSHIP GORP Contractor Type Lie Type PLUMBING ELECTRICAL CCB CCB BUilDING INFORMATION ~ # of Units: 1 22.75 Forced Air Gas # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: lot Size: Sq Ft 1 st Floor: 1548 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: 552 Sq Ft Carport: Sq Ft Other: 334 Occupancy Load: Living: 1548 sJ. Occupancy Comments Construction Type Occupancy Type Construction Type Occupancy Comments Occupancy Type Construction Type Occupancy Comments Occupancy Type # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Type VB R-3 Type VB Garage: 552 s.f. Gas Gas U Type VB Porch: 168 s.f. 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: ATTENTION: Oregon law requires au to ~~::~~a~~~s adopted by the Orego: Utility in OAR 952-g;1~~Or'1 oThhose rules are set forth o a' t rough OAR 952-001- OvO.. You may obtain copies of the rules b calling the center (Note' the t I h Y n t%1o!b . , e ep one um C' r the, Oregon Utility Notification ~nter IS 1-800-332-2344). U 3 No Path 1 A Gas-fired furnace with min. AFUE of 90% ~ Site Information Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: NOTICE: ':,'<..., THJS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1 of 6 Springfield Building Permit 7/5/2011 B:44:43AM SP~IHG..FIEL.~ .- ""-" ' (:,'!<~ ",',;'" OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00724 IVR Number: 811129643870 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 07/05/2011 ISSUED: APPLIED: 07/05/2011 05/02/2011 EXPIRES: VALUE: 12/31/2011 $170,714.28 SITE ADDRESS: 1130 S 40th CT, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802061417000 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - SAME AS S10-00569 Frontyard Setback: 13.8 Interior Setback: 12 Sideyard Setback: 6.9 Rearyard Setback: 23.7 Solar Setback: 12.5 DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: . Paved Drive Reqd: Yes % of Lot Coverage: 25.6 Highest point on structure to north property line: 23 REQUIRED PARKING Total: 2 Handicapped: Compact: Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Description R-3 1 & 2 family U Utility, misc. Springfield Building Permit PUBLIC IMPROVEMENTS i Sidewalk Type: Downspout/Drains: , Valuation Description Tvpe of Construction VB VB Unit Amount Unit Tvoe 1,548.00 Sq Ft 552.00 Sq Ft Unit Cost 96.83 37.72 Value 149,892.84 20,821.44 170,714.28 7/5/2011 8:44:43AM Page 2 of6 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00724 IVR Number: 811129643870 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 07/05/2011 ISSUED: APPLIED: 07/05/2011 05/02/2011 EXPIRES: VALUE: 12/31/2011 $170,714.28 SITE ADDRESS: 1130 S 40th CT, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802061417000 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - SAME AS S10-00569 FEES PAID ~ Descriotion Amount Paid Date Paid Reciot # Same as Plan Review Submittal $250.00 05/02/2011 2011000848 SOCTmp-rov-~~ent'":Tr-anspOrtafun-SOc----'-~-'*~---- --_.~ $T811.51------07105/2011 - _.- --~2011001860 SDC: Reimbursement Cost - Loc~1 W;;;;;;;"'ater $3,161.28 -~~'07/ci5/2011--- 2011001860 ~-~- -- --- SDC: Improvement Cost. Local Wastewater $1,542.96 07/05/2011 2011001860 SDC: Reimbursement Cost. MWMC Regional Wastewat, $101.97 07/05/2011 2011001860 SDC: Improvement Cost. MWMC Regional Wastewater ~ $.1 ,333.57 07/05/2011 2011001860 SDC: C~mpliance Cost. MWMC Regional Wastewater SI $22.63 07/05/2011 2011001860 SDC: Administrative Fee - MWMC Regional Wastewater: $10.00 07/05/2011 2011001860 SDC: Total Sewer Administration Fee $377.47 07/05/2011 2011001860 ---,---,-- SDC: Totai Transportation Administration Fee $134.74 07/05/2011 2011001860 Sidewalk up though 90 Feet ~88.00 07/05/2011 2011001860 Curb Cut/Driveway 1 st Cut $88.00 07/05/2011 2011001860 St~ctu~1 Build,-,,~'Pe~':'lt F~_ ~_~__~=- -$997:"12-' 07/05/201; 2011001860 ~dd!ess Assig!,_~ch ne~_or ch~_nge $38.00 07/05/20~__.___~02200186~ Willamalane fees - Single family detached $3,409.00 07/05/2011 2011001860 Planning. Major Review. City $211.00 07/05/2011 2011001860 One or Two Family Dwelling with Two Bath $374.00 07/05/2011 2011001860 Furnace. up to 100,000 BTU $17.00 07/05/2011 2011001860 Vent for appliance other than furnace $9.00 07/05/2011 2011001860 Range hood/other kitchen equipment $13.00 07/05/2011 2011001860 ~~gle.duct exha.us! (bathroofTI~:t~ilet compartments, utili S37.00 "... ...... 07/05/2011 2011001860 Heat pump .___._____.~__ $17.00 07/05/2011 2011001860 Water heater $17.00 07/05/2011 2011001860 --'---- First Appliance Fee $79.00 07/05/2011' 2011001860 Reside-;;;;aIFire COSPerSq-Footj"- -.-- -..- $121.70 --07/05/2011'-----2011001860 G;;;f;;P;;;g'~-p to4'o~tlets . - . -- -----.----.------$:i5oo-~-- -- oiiosiz011----- -.----ZO:'1601s60 Residence wiring 1,000 sq. ft. or 1;~-----~----.----$134.00 07/05/2011'~" 2011001860 Each added 500 sq. ft. or portion-- $75.ciii-..-----ii7765i2oiT------- 2011001860 Temp services 200 amps or less $63.00 07/05/2011 2011001860 State of Oregon Surcharge (12% of applicable fees) $222.93 07/05/2011 2011001860 Technology fee (5% of permit total) $102.09 07/05/2011 2011001860 SDC: Reimbursement - Transportation SDC $497.07 07/05/2011 2011001860 S~<:;.c'mprov~s:..o~f:.1>.t,,'!!'..Praina~e .__.._~~..._~__~_.... 07/05/2011 2011001860 Ad~i!:, fee (~% of a~plicable fees) $12.17 07/05/2011 2011001860 ~~ursement ~ost - Storm Drainage $718.18 07/05/2011 2011001860 ~Itple Pe.'.~i!.Eisc~"!,~Jf;1~~3) $.30.00 __..._~05/2011 __ ~11001860 Total Amount Paid $17,126.92 Springfield Building Permit 7/5/2011 8:44:43AM Page 3 016 S:~~~.fIE.~ ~~ ~OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-5PR2011-00724 IVR Number: 811129643870 www.ci.springfield.or.us 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 07/05/2011 ISSUED: APPLIED: 07/05/2011 05/02/2011 EXPIRES: VALUE: 12/31/2011 $170,714.28 SITE ADDRESS: 1130 S 40th CT, Springfield. OR 97477 ASSESOR'S PARCEL NO: 1802061417000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - SAME AS 510-00569 PROJECT DESCRIPTION: Plan Review ~ DeDartment Application Acceptance Received Due Date 05/02/2011 05/02/2011 Comoleted 05/09/2011 Result Application Accepted Initial Review 05/09/2011 05/09/2011 05/09/2011 Approved Reviewer David Bowlsby David Bowlsby !Pla'nriing Reviev/' {"-;' ,,' 05/9~~>2pt1:~/' 051?~[?.911::ii,b51f112Q1,t,.:7'~ppfoYed.'r,::-<-,,,~-' .4 ",:~~Tara~;don~,s' ~'" tr~:._~' ,_~~:.~_ '~'3~":~~~___*~=~,1.~_~ ,~~\ ?:',0'~;:?-_'~~~1~'-:,..~ ~:t.~; -;~;::" ;~~3,~ ,~:~~,,~~",::_~.;~ .' I ,---,~ Structural Review 05/09/2011 05/09/2011 05/12/2011 Add'llnfo Required Kip Kaufman Comments: 1) 4075# point load on 3'-0" span beam requires upsizing beam from 4"xB"DF#2 to 4"x12"DF#2 or engineered beam. Provide new beam calculation. 2) Provide column size, post cap and post base for rear covered porch. StructuraIReview_c.c _ .. 05/09/2011'05/09/20Jt" 05/13/201.1. . Apprpved"-, '.,::.': :;t '>Kip'Kaufman ':'~""" ,,;'" ~~"":"~~" .c',"~.:~t\;:c=~'~; :-:'~~',k',:;'~::~~~~;':','~~~~'.'+~:,,:.%l",~ .7" ;,,' Permit Issuance 05/13/2011 05/13/2011 07/05/2011 Issued Springfield Building Permit 7/5/2011 B:44:43AM I Chris Carpenter Page 4 of 6 S~:~N~~E~~ L~,!lY ~OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00724 IVR Number: 811129643870 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pe rmitcenter@ci.springfield,or,us PROJECT STATUS: STATUS DATE: 155 ued 07/05/2011 ISSUED: APPLIED: 07/05/2011 05/02/2011 EXPIRES: VALUE: 12/31/2011 $170,714.28 SITE ADDRESS: 11305 40th CT, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802061417000 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - SAME AS 510-00569 PROJECT DESCRIPTION: INSPECTIONS REQUIRED ~ Inspections 1020 Zoning/setbacks 1090 StreetT rees 1110 Footing 1118 Footing Drain 1120 Foundation Footing: After trenches are excavated. 1160 UFER Ground Foundation: After forms are erected but prior to concrete placement. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 1220 Underfloor traming 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1370 Masonry Veneer 1410 Underfloor insulation 1420 JnsuJation Vapor Barrier 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling 1520 Interior Shearwall Ceiling Insulation: Prior to cover. Shear Wall Naillng: 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. Underfloor 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 Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. 1999 Final Building 2200 Underfloor Mechanical 2210 Underfloor Gas 2260 Gas Service 2300 Rough Mechanical 2995 Final Gas 2999 Final Mechanical 3130 Footing/Foundation Drains Springfield Building Permit 7/5f2011 8:44:43AM Page 5af6 SPi'~. :~EL~ ~,~ ~OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00724 IVR Number: 811129643870 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfleld.or.U5 PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 07/05/2011 05/02/2011 EXPIRES: VALUE: 12/31/2011 $170,714,28 , 07/05/2011 SITE ADDRESS: 1130 S 40th CT, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802061417000 PROJECT DESCRIPTION: SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential Single family residence - SAME AS S10-00569 3170 Underfloor Plumbing 3200 Sanitary Sewer 3315 Water line 3400 Storm Sewer Underfloor Plumbing: Prior to insulation or decking. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. 3411 Perimeter Rain Drains 3500 Rough Plumbing 3999 Final Plumbing Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete, 4000 Temporary Power Service 4225 Service or Feeder 4500 Rough Electrical 4999 Final Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Final Electric: When all electrical work is complete. 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 '""-;,,~d 7/dll Owner or Contractor Signature Date Springfield Building Permit 7/512011 8:44:43AM Page 6 of6 Electrical Permit Application .CITY"OE:SPRINGEiF;LDr~ORE:GoN:~~ : .",., _ , . d_, '".~ "., ~~ _ ~ ~.....-.= 'rt ..V .:;;" ...~ <; I .<t. .. ~ . ~ \. ~ _ . ~,. -. ',' 225 F;fth Street. Springfield, OR 97477 +PH(541)726-3753+ FAX(541)726-3689 " ' DEP.f.RTMENT USE ONLY Permit no.: (' 72/-( Date: 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. .'," . ,- :~"OC~L:;'GOVERIIIMEIIIT\Ap.PROVA8;r,,:'ii1.'t:'"!;'!.;': Zoning approval verified" 0 Ves 0 No ;" ,:!i':\/"('l.CArEGORY&Of LCONSTRUCTIOI'lS~' . o Residential 0 Government 0 Commercial ~>>~f"'ol3iSIJE'~INl;<:jRNiIl.TIOJilrAN[j~1l0:C'A1iION~lo/,?:-(;t' Job site address: II 0 S- '--I d I Name: ZIP: '1'lY '1 r City: Phone: E-mail: 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) and 479.560(1). Signature: CONTRACTOR INSTALLATION: Business name: Gr,.L'\.tIev- S'-'T - G6h!J....d..[jeci Address: .3 951 ;-Ja. ~ if... /(d City: 5', PI ci State6 e.. Phone: 4/- "7c.fr -2S'f6 E-mail: CCB license no.: BCD license no.;26 -u<l C. Signing supervisor's license no.: ;S S~ S Print name of signing supervisor: G a A III e.,,- Signature of signing supervisor:A $\\~ j-~ 440-2584-J (9/08/COM) ~~~~';'~:<'Jk?l~~li?if~~1i:~~r~~;~~;P:{F,EE'~SCH.E.[j_U l3.I;~~i~~~i~lK~2~~*~'~ .,N ~_~i~,~r' ~,f;J~.~P~~j~~!~,~' -,~~:~,,~ti_~:; ~ ')1:>~i.:'.19!r': . CostL!..Total . ~'!i-- - ':,' 1, '.:. c-ost. .' ;l_ ~a." , , -- '. Residential, per unit, service included: 1,000 sq. ft. or less (4) ( $134.00 $(J't Each additional 500 sq. ft, or portion ,~ $ 25.00 $ 7<) thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services 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 J ,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) / $ 63.00 $ /. 1 201 to 400 amps (2) , $ $ 87.00 401 to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, 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 'Jot 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: (I) $58.00 $ ,~;,;~~i~~m~~~~:,0%;~lAReOTc:ANT~~Ds--E!:;~~Ztf.:{f;~~;~!~it~j-;;;:f~t~j~,>'~~;; (A) Enter subtotal of above fees $ (Minimum Permit Fee $58.00) 212- (B) Enter 12% surcharge (.12 x [A]) $ 52 ".3 (C) Technology Fee (5% of [A]) $ fJ 0.0 --- TOTAL fees and surcharges (A through C): $ :3/3'-i 'DEPARTMEl'hUSEONL y ;:!L~O 72 Y Structural Permit Application - 225 Fifth Street. Springfield. OR 97477 + PH(541)726-3753 + FAX(541)726-3689 Date: S This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days nfis suspended for 180 days. . ,,;k; i"i"i!~0cAi::9Qy'E~~rJi~NTA:AP'B(!i:>Y4~lM',lp~~:~~1!iliJ.t@f:1 This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Date: Zoning approval verified: DYes D No Property is within flood plain: DYes D No l~~;~f~<g~ATE:J:;i:>~Y#'PFJ'\'c:P(ij~TBUCjf:iQN~;\f~~i;1l:;4l,ibf?~i D Residential D Government D Commercial :~;;)'il~ii!,;t:iir9B}SI;i'~;fNF,9RMAil(jN'ifAI'lIif'~9t:AtTQl'lv];ltti\;~\,: Job site address: .f} . City: Subdivisio Reference: Name: Address: City: Phone: 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 701.010. Sign here: " ',.. Business name: Address: City: Phone: E-mail: CCB license no.: Print name: State: Fax: ZIP: Signature: l~~~i~~\~10~~i~~~.SQB:G,<DN:mt<AGJ9R"UN~.()J~MA2t!J~f~N~~~?;~~$~! Name CCB License Number Phone Number Electrical Plumbing Mechanical ;~? ;:;, > ~;rz:.~,I~:f-"~;\'::':;,~=rn;:i;~'iF~'g:~S-C~'-~QUL~1~:.,,!: ~ ,,;...., :'f1:~&~t~~tJ91fii'[(o~r,in-~i)gR~~tt4lITI~~~k't~~;';i?~~:;d;~~i:i{tt~'~J;~~t:F~t,t~*~i.~:~~; (a) Job description: Occupancy J Construction type: Square feet: Cost per square foot: Other information: Type of Heat: Energy Path: o alteration D addition DYes (a) Pennit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) $ (d) Enter 12% surcharge (.12 x [2a+2b+2c]): $ Cj7 r (e) Subtotal of fees above (2a through 2d): $ ;J:'~"""~"-''''''ik''{-'''Ji%'''~~_.~~T~~~'''-~i:iWAf~,.~r''~:n~ ,,~.,...._' - '.r:.' '~~"'f'M!"'>_y,."i/;'X ~}~:;i.~!,~#j~~ft~,w}f~~~,~~f~1ti~n;;#f~~~~?1B~~' .~~,.:~!T "~~~~~~itti/!~ (a) Plan review (65% x permit fee [2a]): $ Z-~ (b) Fire and life safety (40% x permit fee [2a]): $ (c) Subtotal offees above (3a and 3b): $ ;t~~'Mf!f~~!n(rr:e9:tr~rt~f~i~~t.l:~fl~t;;1~i~~~~~_*{~~?~~~t~:_;~~~~%tii':r 'S%:"\:"C~:,' (a) Seismic fee, 1% (.01 x permit fee [la]): $ . TOTAL fees aud surcharges (2e+3c+4a): $/'1/7 T1 z&-~;2$4G 2@--02--ff3 1'ur a:11 b~willamalane .,~ Park and Recreation District Job. No. . Sl ( - '721-( PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-December 31, 2011 NAME: 5-L.Nv1::.:'2'1061i1P ADDRESS:QOG ~1Z::(V ~(1 CITY: ~Ph-0 PHONE: STATE:.a2'h- ZIP: '71L!t; f . LOCATION OF PROPOSED BUILDING SITE: Street Address: (( 30 <). f.JD~ c-,,' Plat Namlt.":r' ",-IV r-~ ( l_r- Tax Lot Number: / c::fCJ2. Xi Y //ODc) 1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.) A. Single-Family Detached NO. OF UNITS / X $3,409 per unit = $ 7y () ( r B. Single-Family Attached NO. OF UNITS X $3,404 per unit = $ C. Multi-Family Apartment NO. OF UNITS X $2,800 per unit = $ D, Single Room Occupancv NO. OF UNITS X $1,400 per unit= $' --- E. Accessorv Dwelling Unit NO. OF UNITS X $1,705 per unit = $~ 2. SDC CREDIT (If applicable. SDC payer must furnish proof of credit approval.) ($ # (' 3. TOTAL PARK AND RECREATION SDC ASSESSED $ 3Y'{) I' - C;-/'2- 1 / ( Date of building permit submittal - City of Springfield "~ ~.. . ' ~------ '7'/)"" 1 J(, Date of building permit issuance City of Springfield . S~4~N. ~,~ .'~~ ..c -,,~ OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541-726-3753 www.cLspringfield.or.us 811-SPR2011-00724 1130 S 40th OT permitcenter@ci.springfield.or.us RECORD NO: 811-SPR2011-00724 DATE: 07/05/2011 -:~: -~-'-F4.~ '. .~.;'ACCO:\JNTlcobE':,F~.-'-AMOUNT"DUE_______\" 224-00000-425602 38.00 224-00000-426605 12.17 201-00000-428060 88.00 224-00000-426102 75.00 224-00000-425604 7900 ,___'~_.'___M'._'~__ Furnace - up to 11!.9,00~_E!.l2:!.-__..,.________,__,..3.~4.-0Q~~O:.4.3~6_~ _ ___.'__. 17.00 Gas ':iping up to 4 outlets _.._... ....___ ..3.3.4-00000-42560.4.______ ,__ 35.00 Heat pump 224-0000,9-425604 _ _..._ 17.00 MUltiple Permit Discount (Max 2) 201 ;0.0000,428060 -30.00 One or Two Family Dwelling with Two Bath 224-00000-425603 374.00 ~nning - 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 PerSq Foot) 100-00000-424005 121.70 SDC: Ad~inistrative Fee, MWMC Regional Wast,,~er SDC.. 611-00000-426604 10.00 _SDC: Complia~ce Cost - MWMC Regional Wastewate!~E......_ 444-0.0000-426607 22.63 SDC: Improvement - Transportation SDC ..____..4.47~1!.9OO.~480E__._._.__ .. _____.1 ,811.51 SDC: Improvement Cost - Local Wastewater . ...__._.4.43-00000-448025 ___ _.__~_42.9~___ SDC: Improvement Cost - MWMC Regional Waslew.':~c.SDC 445-00000-448025 1,333.57 SDC: Improvement Cost - Storm Drainage' 440-00000-448028 1,044.93 SDC: Reimbursement - Transportation SDC 446-00~00~~___.__ 497.07 SDC: ~:~~bur~.~ Cost - ~~."I Wastewater_...._._._____,....4..4.3..:00000~48024:_.. ._.___... 3,161.28 SDC: Reimbursement Cost - MWMC Regional Wastewate~ SDC 444-00000-448024 101.97 SDC: Reimbursement Cost - Storm Drainage 441-00000-448029 718.18 SDC: Total Sewer Administration Fee 719~00000-426604 377.47 719-00000-426604 134.74 201-00000-428060 88.00 224-00000-425604 27.00 821-00000-215004 222.93 "'---'~ 224-00000-425602 997.72 ----'~_._-_.__.._- 100-00000-425605 102.09 224-00000-426102 63.00 224-00000-425604 9.00 224-00000-425604 17.00 821-00000-215023 3,409cOO TOTAL DUE: 16,876,92 LY..AVMENT TYPE-::.....' 'pAVOR ':1Y,9fsHiER.Ci,A~RENTER: ~_CbMMENtS:tt:;;"'. ",' '-~'j:"A'M()UN:rP,4JD." Check MIKE BLANKENSHIP Also covers LDP2011-00025 $16,876.92 CORPORATION RECEIPT NO: 2011001860 [DESCIM.nbN."" ....'..&,bdI.,y,."".0;..::;::;:.,.: Address Assignment, each new or change Admin fee (10% of applicable fees) Curb Cut/Driveway 1 sl Cut Each added 500 sq. ft. or portion First Appliance Fee I sac: Total Transpo~ation A~ministra~i"on Fee ~idewalk up thougt1..92..1:'eet _~~e-duct exha~st (bc~throoms, toilet ,:9mpartments, utility roor _e_State of Oregon Surcharg!:.Jl~~of ap'~,cable fees) Structural Building Permit Fee Technology fee (5% of permit total) Temp servi~es 200 amps or !ess Vent for appliance other than ~rnace Water heater Willamalane fees - Single family detached 13374 TOTAL PAID: $16,876.92 SPRIN.GFIE~ ..~. , "~' ri!!J; ,~ OREGON WWN.ci.springfield,or.us TRANSACTION RECEIPT 811-SPR2011-00724 1130 40th CT CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541.726.3753 permitce nter@ci.springfield.or.us RECEIPT NO: 2011000848 RECORD NO: 811-SPR2011-00724 DATE: 05/02/2011 lllE'SCRIe.fl()N:,':'" '0';,."/):;;r~ '";\c;:.~~,,,T:,;" ~J;2:1:r::::;,,,,f":!'<<CCOllNfccODE;~;;h:_3ciiAMOUNf~[)UE:"""_C .-.^ - i Same as Plan Review Submittal 224-00000-425602 250.00 TOTAL DUE: 250_00 L~AYI'v1_E~'r~'lxeI:L-~ ':~A'f9R}hcAi",ER/NM'ACHAD6,;:~,}~.'*iI;;_Qlvi'M.E~J:$~{:;';:~., ...<-- --: AMOUNT pAID '.;, >c .\1 Check MIKE BLANKENSHIP 250.00 13320 CORPORATION TOTAL PAID: 250.00