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Home My WebLink AboutPermit Building 2011-8-18 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01738 IVR Number: 811161494183 www.ci.sprlngfield.or.us PROJECT STATUS: STATUS DATE: Issued 08/18/2011 ISSUED: APPLIED: 08/18/2011 07/13/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726~3769 Fax: 541-726-3676 permitcenler@cLspringfield.or.us EXPIRES: VALUE: 02/13/2012 $160,000.00 SITE ADDRESS: 540 48TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051103500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New single family dwelling - Lot 4 Westwinds Phone Number: OWNER: ADDRESS: HAYDEN HOMES LLC 2464 SW GLACIER PL STE 110 REDMOND OR 97756 Contractor Type Electrical ContraCtor General Contractor Plumbing Contractor Mechanical Contractor Contractor Name GARNER ELECTRIC CO CONTRACTOR INFORMATION Lie Type CCB CCB CCB CCB HAYDEN HOMES lLC GO PLUMBING & HEATING LLC PACIFIC AIR COMFORT INC ~ Lie No Lie Exp Phone 121159 03/14/2012 503-648-4552 172526 10/11/2012 541-923-6607 193589 04/01/2013 503-507-5350 39237 03f25f2012 541-672~9510 ~ BUILDING INFORMATION Lot Size: Sq Ft 1 st Floor: 1330 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: 401 Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Electrical Specialty Code Edition: ATTENTION' 0 f ' regon law require Springfield Fire Code Edition: allow rules adopted b th 0 s you to , Motif t' y e reg on Utility Mechanical Specialty Code Editioh: Ica Ion Center, Those rules ar t f In OAR 952-001 0010 h e se orth Municipal I Development Code: 0090 v -, t rough OAR 952-001_ , IOU may obtam cop' f h Plumbing Specialty Code Edition: calling the c t les 0 t e rules by en er. (Note' the tel h Residential Specialty Code EditioriiUmber Z9P~he Oregon Uiilit ep one Structural Specialty Code Edition: Center is 1-800_332_J3~~t.lflcatlon # of Units: # of Stories: 1 Height of Structure: 18.3 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Electric Hazmat: Occupancy Type Construction Type Occupancy Type Construction Type R-3 Type VB U Type VB # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: 3 Path 2A Certified performance~tested duct system Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: No No Springfield Building Permit 8/18/2011 1:59:44PM NOTICE: THIS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1016 sp~n..G.FIEL~ .~~ n "'" ~\t;u ", ~~~-W OREGON www.ci.springfleld.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01738 IVR Number: 811161494183 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenler@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued 08/18/2011 ISSUED: APPLIED: 08/18/2011 07/1312011 EXPIRES: VALUE: 02/13/2012 $160,000.00 SITE ADDRESS: 540 48TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051103500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 14 5 5 15.11 New single family dwelfing w Lot 4 Westwinds DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Yes REQUIRED PARKING Total: 2 Handicapped: Compact: 18 PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Description Bid Tvpe of Construction NA Unit Amount Unit Tvpe 160,000.00 Bid Unit Cost 1.00 Value 160,00000 160,000.00 Springfield Building Permit 8/1812011 1:59:44PM Page .2 of 6 WWoN . ci. sprin gfield .or. U s CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01738 IVR Number: 811161494183 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 08/18/2011 ISSUED: APPLIED: 08/18/2011 07/13/2011 EXPIRES: VALUE: 02/13/2012 $160,000,00 SITE ADDRESS: 540 48TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051103500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New single family dwelling - Lot 4 Westwinds FEES PAID ~ Descrietion Amount Paid Date Paid Redet # Structural Plan Review Fee Residential $619.42 07/13/2011 2011002012 -- - -~-------._,."--~..~., ~"-,---_.- --,. - ---~-- - Air conditioner $17.00 08/18/2011 2011002271 -'--' ------.-..--.---- Range hood/o!~er kitchen equipment $13.00 08/18/2011 2011002271 Flue vent for water heater or gas fireplat:e 59.00 08/18/2011 2011002271 Single-duct exhaust (bathrooms, toilet compartments, utili $36.00 08/18/2011 2011002271 Gas Piping up to 4 outlets 514.00 08/18/2011 2011002271 First Appliance Fee 579.00 08/18/2011 2011002271 Residence wiring 1,000 sq. ft. or less $134.00 08/18/2011 2011002271 Structural Building Permit Fee $952.95 08/18/2011 2011002271 Each added 500 sq. ft. ?r portion 550.00 08/18/2011 2011002271 Admin fee (10% of applicable fees) $8.66 08/18/2011 2011002271 Temp services 200 amps or less 563.00 08/18/2011 2011 002271 SDC: Total Sewer Administration Fee $361.27 08/18/2011 2011002271 SDC: Administrative Fee - MWMC Regional \f\Iastewat~._~.___.-.s.!E.:9~.._,__.____o.~/18/2011 2011002271 SDC: Reimbursement Cost - Storm Drainage __~~~2~_ 08/18/2011 2011002271 One or Two Family Dwelling with Two Bath $374.00 08/18/2011 2011002271 Residential Fire (.05 Per Sq Foot) $86.55 08/18/2011 2011002271 Willamalane fees - Single family detached 53,409.00 08/18/2011 2011002271 Address Assignment, each new or change $38.00 08/18/2011 2011002271 SDC: Total Transportation Administration Fee $139.06 08/18/2011 2011002271 SDC: Compliance Cost - MWMC Regional ~astewater SI 522.63 08/18/2011 2011002271 SDC: Improvement Cost - Storm Drainage $787.74 08/18/2011 2011002271 SDC: Reimbursement Cost - Local Wastewater $3.249.84 08/18/2011 2011002271 __~ 0__ 0__'___" SDC: Improvement Cost - Local Wastewater $1,586.16 08/18/2011 2011002271 SDC: Improvement Cost - MwMC Regional Wastewater ~-_---~333.57 08/18/2011 2011002271 SDC: Reimbursement Cost - MWMC Regional WastewatE $101.97 08/18/2011 2011002271 --,--- SDC: Reimbursement - Transportation SDC $510.94 08/18/2011 2011002271 Curb Cut/Driveway 1st Cut $97.00 08/18"2011---- 2011002271 Multiple Permit Discount (Max 2) $-33.00 08/18/2011 2011002271 Sidewalk up though 90 Feet $97.00 08/18/2011 2011002271 State of Oregon Surcharge (12% of applicable fees) $209.03 08/18/2011 2011002271 Technology fee (5% of permit total) $97.05 08/18/2011 2011002271 !'Ianning -Major Review - City $211.00 08/18/2011 2011002271 SDC: Improvement - Transportation SDC $1,862.23 08/18/2011 2011002271 Total Amount Paid $17,088,57 Springfield Building Permit 8/18/2011 1:59:44PM Page 3 016 S~~~N~_.F IE~ ~.iA.<. ;;;;,~ .~ OREGON CITY OF SPRING~IELD Building I Residential!lpermit PERMIT NO: 811-SPR2011-01738 I IVR Number: 811161494183 www.cLspringfield.or.us 225 Fifth SI 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 08/18/2011 ISSUED: APPLIED: 08/18/2011 07/13/2011 EXPIRES: VALUE: 02/13/2012 $160,000.00 SITE ADDRESS: 540 48TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051103500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New single family dwelling -lot 4 Westwinds Plan Review Deoartment Application Acceptance Received Due Date 07/13/2011 07/13/2011 Comoleted 07118/2011 Result Application Accepted I Reviewer David Bowlsby Planning Review 07/18/2011 07/18/2011 Comments: Plot plan does not show 4' porch extension. 07/18/2011 Add'l info required Tara Jones Called today and left a message for Eric of Hayden to clarify. Planning Review 07/18/2011 Comments: 'Revised Plot plan received 7/21/11, "3' walkway is required. "Front elevations are site specific and contain required design elements, Inspectors will field check that actual elevations match submitted designs as shown on the approved set of plans. .Survey required based on minimum side setbacks. Letter is attached to Documents. pu~r!~,Works'~~~!J[,w.Y<j;';:;~"";~<'0!L1~(2~b1f::,91!1~2J)11~" '9~1.2~~9Xt;:~f~.Appi_o i",'i],<:rO~ddSiri9ieto.h.~ ;,*+c:.~ ^''t I 0-. .-,,- '-' ,'- i?<~,",<',','"".- ", ..",;~,$@"=<";J,';',;-';';,::^--" ,,' ,_ "", _,- '" "-: ':: ",,,,,(,.-:;,/,,1.''- ,,,r. ,,' '. ",'-"",,,>,,,?,',,'."i,"i.",'>,." ;"-,,:-c,..- ,,;,.' ':' "',,i.': , ' . ." , ~..' ,_ '.',~ " ,,';-,.-<, '"'-" C()mmel)ts:3f;6rjj:his\parcel'in;Westwind'Estates;Jt1is.the recommendation'tothe;B i' I --by;the.City,Engineer: Uthatihd~:: h, ""',"""" ',' "":,,,' ,:, ,:""""",+""", ':;,;";',::;h',, ". ,",' ,'-- "" . "''-:'"''-''',;.0'''';:-''''' ", ,'; "'''\''',,"'';'';;;;'0'.' ,"i" ';",'" ,'+<", :,-:",.',,,- ,,<-<:._''' Z,,' ' "",,or' ", ".i ' ' , '. ., "",+c",f;:.,"- , "g:6lin,ectionsshatl;be;madetQ.&~itaty:orstorrrrH20jj~Jj:li!l~:~Yl1!!11he.;..su dl'visi . ,ptedby"City. Council~.2:<YL:>Y ,<,...,., , Structural Review 07/18/2011 07/18/2011 0811012011 Add'l Info Required Chris Carpenter Comments: Site, elevation and foundation plans do not show 'I " ~.I Springfield Building Permit 8/18/2011 1:59:44PM Page4of6 Sj.~~.N.G._f I E,L ~ ~I" . ":~^- iFJ1; . ..^1;:~* 'OREGON www.ci.springfield:or.us CITY OF SPRING~IELD 'Building I Residentiaf!Permit 'I PERMIT NO: 811-5PR2011-01738 1 IVR Number: 811161494183 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perrnilcenter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 08/18/2011 07/13/2011 EXPIRES: VALUE: 02/13/2012 $160,000.00 08/18/2011 SITE ADDRESS: 540 48TH ST, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1802051103500 SCOPE: Single Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New single family dwelling - Lot 4 Westwinds, INSPECTIONS REQUIRED ~ Inspections 1020 Zoning/setbacks 1090 Street Trees I' 1110 Foq)ing 1120 Foundation Footing: After trenches are excavated. 1160 UFER Ground i 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/orJoundation inspection. 1220 Underfloor framing 1260 Framing , Framing Inspection: Prior to cover and atter all rough in inspections have been approved. 1370 Masonry Veneer 1410 Underfloor insulation 1420 lns~lation Vapor Barrier 1430 Insulation Wall 1440 lns~lation Ceiling 1520 InteCior Shearwall 1530 Ext~rior Shearwall 1540 Gy~sum Board/lath/Drywall I 1999 Fin';l Building I Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cov~r. Shear Wall Nailing: Before covering sheathing with finish materials. 2200 Underfloor Mechanical 2210 Und~rfloor Gas 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 t? insulation or decking and including required testing. Underfloor Gas: After line is in~talled and required testing and capped if not attached to an appliance. 2250 Gas: Piping 2260 Gasl Service 1 2300 Rou,gh Mechanical 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 Mechanical: Prior to Cover Rough Gas: After line is install~d and required testing and capped if not attached to an appliance. Final Gas: When all gas work iis complete. Final Mechanical: When all mechanical work is complete. 8f18f2011 1:59:44PM' Page 5 of6 2995 Fin~1 Gas " 2999 Fin~l Mechanical Springfield Bu:i1ding Permit I .i www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01738 lVR Number: 811161494183 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennilcenter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: Issued 08/18/2011 ISSUED: APPLIED: 08/18/2011 07/13/2011 EXPIRES: VALUE: 02/13/2012 $160,000.00 SITE ADDRESS: 540 48TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1802051103500 SCOPE: Sin91e Family Residence WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New single family dwelling. Lot 4 Westwinds 3130 Footing/Foundation Drains 3170 Underlloor Plumbin9 3200 Sanitary Sewer 3315 Water Une Underfloor Plumbing: Prior to insulation or decking. Sanitary Sewer Line: Prior to filling trench and including required testing. 3400 Storm Sewer Storm Sewer Line: Prior to filling trench. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 3500 Rough Plumbing 3999 Final Plumbing 4000 Temporary Power Service 4225 Service or Feeder 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover' Final Electric: When all electri~al 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. 1 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 constru! ~ 'D It 3//( r , Owner or Contractor Signature Date Springfield Building Permit 8/18/2011 1:59:44PM Page 6 of6 Elect~'ical Permit Applica tion I 8 DEPARTMENT USE ONLY SPRINCFIELD__~ ~I Peml11 no.: 36 -- : .-.'--;-.:,-.--:....:..:=-- 225 Finn Streett Springfield, OR 97477. PH{541 }7!6-3753. FA..X(541)T' Date: 7'~ (( This permit is issued under OAR 9J8-309-0000. Permits are nontransferable. Permits expire if \\"ork is not started \\"ithio 180 days of issuance or if \\"ork is suspended for J 80 days. . . - .- -~ LOCAL GOVERNMENT APPROVAL . ..' FEE SCHEDULE;. '."Co,;,:,; ;',;.:')";'" . p - .. . - - - Zoning approval verified? DYes DNo Nu~bcr ofinspections per item () QtY- Cost Total.' -- --- ..CATEGORYOFCONSTRUCTlON. ". ea_ cost RC5j~cntinl, per unit, service included: - -- . ,0-ResidentiaL- ,- . 1 D.Govemment, I D Commercial - I' $134.00 $:(5l( ------. ; . ...JOS'SITE'INFORMAl'ION'j>.NP'tOCAtioN ',...... ],000 sq. fie or less (4)- Ench addilional 500 sq. . --- Job sile address:-:)"-'{O- 'So . '16'r:;tr fl. or portion k $ '25:00 $)0 thereof -- City: ')\'I'-\"':>h<'\~""LD I State: rYiL I ZIP: q,..( +'0 Limited energy (2) .. - ,- $ 32.00 $ Reference: \rx 11 ~ \ \ I Taxlot.:~c::n ,... Each manufactured home or modular $ 63.00 $ ^ DESCR1PTIONOFlNORK '.' '. '.' . . dwelling service or feeder (2) !II IV IIrJ ~\. Llir ffi', 0 u W 0 f'\.~ ""( Sen'ices or feeders: installation, alteratiolT, relocation v -U Tn)~ - 8\ \y{\' "'\,,0 \ fl':::) \ 200 amps or less (2) $ 61.00 $ . 'PRQN:R'K'f OWNER' 20110400 amps (2) $ 95.00 $ Name: ~"7-:l l.f.o(\A.o?::, 40110600 amps (2) $158.00 $ Address: 7'1u.<.( 'i,,",, c.';I,.J"lI:(..\~ i'L 4J- /10 601101,000 amps (2) $205_00 $ City: ~..;\,> I State: 012... I ZlP: 'iTr-.-1o Over 1,000 Ilmps or volts (2) $469.00 $ Phone:S'{(%lc -~ I Fax: - - ReconneCI only (2) $ 63.00 $ E-mail: l~""bO{cl,,-~,..l@D I{P1Q~-~,c.O/""'- Temporary services or feeders: installatioll, alteration. reloealian This installation is being made on residential or farm property 200'nmps or Jess (.2) , $ 63.00 $~~ owned byme or a member of my immediate family. This 20].10400 amps (2) $ B7.00 $ property is not intended for sale, exchange, lease, or rent. OAR 40110600 amps (2) _479.5~(1) ~d 4,~~J). . $126.00 $ - . - Over 600 amps or 1,000 valls; see services or feeders section nbove SIgnature: . ~ CONTRACTOR INSTALLATION. Branch circuits: new, allerafion. extension per panel Business name: GQQ'C'\"" (. L~.--:-( ~,,-- a. Fee ror branch circuits with purchase of a service or feeder fee: Address:-;;t '=\ '::'I C) 'S,~. ~QR.",\<...\.>.\,,~~Q\l'L Each branch circuit $ 6.00 $ City: \-\, \ \ 'Sb ~ ~-t;:; I State: 0 ~'- \ ZIP: Cl'l\-:>..""'l.. b; Fee for branch circuits without purchase of n service or feeder fee: Phone: So"> - (.1+';;."'SS:l..\ Fox:Sc:>;, - c..~").-'l'l).S First branch circuit (2) $ 55.00 $ E-mail: C\~@' '4.o..f~'('.~ ~\...~ (<..:.<: _ C. ,,"'"'- Eoch additional branch circuit $ 6.00 $ CCB license no.: \"";l..' \ 'S "\ I BCD license no.: "3i.;,:~c.S r:c. Miscellnneous fees: senljce or feeder /lol included Signing supervisor's license no.: -S'l<::;,\ ~~ Each pump or irrigation circle (2) $ 63.00 $ Print name of signing supervisor~"" ~ Each sign or outline lighting (2) $ 63.00 $ Signature of signing supervi;;?' ... Signol circuit or Il. limited-energy panel, $ 63.00 $ ......... alteration, or el\lension (2) Each ndditionnl inspection: (1) $5B.00 $ :,,,i,':':: <:.' AppLiCANT USE'.. .' .. .' ~ (A) Emer subtotal of above fees $'}'11 (Minimum Permit Fec. SS8.0D) ,. (B) Enler 12% surcharge (.12 x [AD $ 7<] ~ ~~ ~ (C) Technology Fee (5% of [A]) $ /7- S- TOTAL fees and surcharges (A througb C): $ ~~:! 4.10-2584,J (9/0R/COM) C()~ Structural Permit Application DEP ARTMENT USE ONLY This permit is issued under OAR 918-460-0030. Permits expire ifworl( is not started within 180 days of issuance or if work is suspended for 180 days. . ,LOCAL.. GOVER~M~Nf;A~p,Rf'l;"il,\llt>c\.<i,""\' This project has final land-use approvaL Signature: Date: This project has DEQ approvaL Signature: Date: Zoning approval verified: Property is within flood plain: 0 Yes ~.\ti~,~=;:i'<f;~;7~~~~.,'cAr~,99,RY;~,G.~l~,G]iiN.~WR_:~,~,[lQ'Nl~f~k~~;;;}::j:_~~H:r~}j1~i(~! esidential 0 Government 0 Commercial ,'~uglBiSITE:. 1~ij'0RMAf\pNr;i>.NR~'4Q9;"IT9N1,\;iik;~WiT;! Job site address: 5110 'S. {/~ '7i4 City <;(I~.-iN(c (:i8-CI ZIPCf)4'}g Subdivision: t,GCS;~V.;)lN '::,", Reference: 0 2. 0:) Iraxlo!: DJ ~<:Jc::> ,PROPERTY glW['lER Name: ~O,,,...J 40""-0 Address: 2. 'I&i( <; c,) C-, '- 'k ",,!- \ '-- Ii 0 City: ",""\:\0""0'''''- State: 0 ZIP: Cf7-'Klr. Phone: 57ft- 57'>LP - 5T":\<D Fax:"n{ - '0'(- cf{~L> E-mail: CIt0-..J\\Q..\<;.i:.:i. ,'~ I H4YOe>-1'- /-J.o1,,<='b.CQ This installation is being made on residential or farm property owned by me or a member afmy immediate family, and is exempt from licensing requirements under ~S 70 J.O 10. Sign here: [ -;:r?'. 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 . CONTRACIQR:iNS'rALLATI9Ni Business name: t\,...(t')~r-..) M-o('~ Address: 'Z l...~ n-- City: ~ Y'--\.,' State: "0-- Phone: Fax: E-mail: CCBlicenseno,: /':}2.52Lo Print name: f:::,f:.J. '- ).(..e-J',.)~Q.lLil-:~ .~ Signature: ~- ~ .'..',"" ZIP: ,,V. ',' :,' ,"i;t-SQEi.C()N:]:i3.t\(;:tClR'1 N fQF{MA;fIQN}~i["'i~(f~k,:i~:fif) Name CCB License Number I Phone Number Electricnl i l.i l 01 . I C. """->.:> 2'<'_ Plumbing I 'n Qll h 0 P<.-l.I--MV" ,.J(;., Mechanical ::r '1 l~1- I~!\<..c A\.L SPRINGF,e:LO ;.., . , ~~:,t;~'i~:,.:~>.:~r, ~~~;~] i ~J~:t1tt~." '~" ~ ';;;,J,..@"-@r,..~' " Penn it no, S 11- 17 3~ Date '7 ~3 If , "FEE SCHEDULE' ,. :i:~,>.y~t9.~j'(9f"l~fo~~-ati9:ri,'.'~:.~-i",'\;, V~~ ,:~,.;, (a) Job description: S~D Occupancy 12L\..- ~ Construction type: 5 t:") Square feet: Cost per square foot: if ~-; Other information: Type" of Heat: (:.., ~ Energy Path: 21:3. new 0 alteration 0 addition (b) Foundation-only permit? 0 Yes No Total valualion: Ve"lL\F. ~S> )"T1'\i3V.'_A<2... (a) Permit fee (use valuati~m 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]): (el Subiotal of fees above (2a through 2d): (a) plan review.(650/o x permit fee [2a]): (b) Fire and life safety (40% x permit fee [2a]): . (c) Subtotal of fees above (3a and 3b): 5;:4~}/MJ~~~li~_n~9:G'~]t.~~~iM;:'~~~.\{F;~~;;:~~./1,:t?.? (aj Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): $ l7J'f ~ ~ ~iI!!m!l~!Je Job. No.511- /7"3~ PARK AND. RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-December 31, 2011 NAME: !lA-YOEk /kJ,nC.s ADDRESS:2'f~'f .$t.) ~l..V\'<.Ie.'Y.L CITY: /<cbl'lM/D PHONE: SY~ - 5'/ S-" STATE:~ ZIP: 9'1rx-, LOCATiON OF PROPOSED BUILDING SITE: Street Address: >/( ~ S. t(4!'i.. Plat Name:~UJilUl? r Tax Lot Number: /F02 (f..T/1 OJ>/C:7d 1. DEVELOPM ENT TYPE (Refer to development type definitions on the reverse.) A. Single-Familv Detached NO. OF UNITS I B. Single-Familv Attached NO. OF UNiTS C. Multi-Familv Apartment NO. OF UNITS D. Single Room Occupancy NO. OF UNITS E. Accessory Dwelling Unit NO. OF UNITS X $3,409 per unit = $ 3<<;69 X $3,404 per unit = $ X $2,800 per unit = $ X $1,400 per unit = $ X $1,705 per unit = $ 2. SDC CREDIT (If applicable. SDC payer must furnish proof of credit approval.) ($ (f $ 3"b1 3. TOTAL PARK AND RECREATION SDC ASSESSED 7 / /J / /1 Date of building permit submittal fD n f2D\l Date of building permit issuance SP~~~EL~ L~~ ~~EGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541~726.3753 www.ci.springfield.or.us 811-SPR2011-01738 540 48TH ST permilcenter@ci.springfield.or.us RECEIPT NO: 2011002271 RECORD NO: 811-SPR2011-01738 DATE: 08/18/2011 tOEsclifP..TION" ,(.,;. '.': '.:-.";i';;f:[:',:, ,;.~;;S...:E..3~AC;COl:lNitc;OOE\' .;::;::, .(-:"i';'i -AMOiJNT~O.UE . __I\dd",ss i\ssignment, each new or_chan~.:'___.___ 224-00000-425602 38.00 __~':"J2~.~f-"pr:Iicable fees) 224-00000-426605 8.66 Air conditioner 224-00000-425604 17.00 -_._._._-~ Curb Cut/Driveway 1st Cut 201-00000-428060 97.00 Each added 500 sq. ft. or portion 224-00000-426102 50.00 First Appliance Fee 224-00000-425604 79.00 Flue vent for water heater or gas fireplace 224-00000-425604 9.00 Gas Piping up to 4 outlets 224-00000-425604 14.00 Multiple Permit Discount (Max 2) 201-00000-428060 -33.00 One or Two Family Dwelling with Two Bath 224-00000-425603 374.00 _..!:Ianning.:..~ajor Review - City 100-00000-425002 211.00 Range hood/other kitchen equipment 224-00000-425604 13.00 _~-,,~i~e.!'c!:..w.!':i~~.1.,~OOsqY;."..r.I".s.~_.___ 224-00000-426102 13400 ___._ Residential Fire (.0.5 Per s.g..Foot).________....---!.oo-~.~~00-424005 ._ 86.55 SDC: Administrative Fee - MWMC R,:g.i.o~al Wastewater SDC 611-00000-426604 10.00 SDC: Compliance Cost - MWMC Regional Wastewater SDC 444-00000-426607 22.63 SDC: Improvement - Transportation SDC 447-00000-448027 1,862.23 SDC: Improvement Cost - Local Wastewater 443-00000-448025 1,586.16 SOC: Improvement Cost - MWMC Regional Wastewater SDC 445.00000-448025 1,333.57 SOC: Improvement Cost - Storm Drainage 440-00000-448028 787.74 SOC: Reimbursement - Transportation SDC 446-00000-448026 510.94 __.._~gC: Reimbursement Co~t..:..!:-~~.!"",ater 442-00000-448024 3,249.84 SDC: Reimbursement Cost - MWMC Regional Wastewater SDC 444-00000-448024 101.97 _~~eimbursement Cost - Storm Drainage __________...3..4.1-00000-448029 541.50 SDC: Total Sewer Administration Fee 719-00000-426604 361.27 - --- SDC: Total Transportation Administration Fee 719'00000.:~~Q:'...._..____. 139.06 Sidewalk up though 90 Feet 201-00000.428060 97.00 Single-duct exhaust (bathrooms, toilet compartments, utility roor 224-00000-425604 36.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 209.03 Structural Building Permit Fee 224-00000-425602 952.95 Technology fee (5% of permit total) 100-00000-425605 97.05 Temp servic,,~_~~ amps or less 224-00000-426102 63.00 Willamalane fees - Sin91e family deta_ched 821-00000-2150233,40.9,0.0 TOTAL DUE: 16,469.15 6...~~YMENJ'JiP-!'~.!~YQR~s"-sHrER' CC~~f~!ITjjB.:~.:.:::.d"(QMME~JS~Gi.:~ -..f;':~~":dL!,~~O';,:'f. Check HAYOEN HOMESLi..C .. -- 16,469.15 000622 I j ~ TOTAL PAID: 16,469.15 SPRI.NG..F IEl~.O ~1",~. ,,~ "'ft~,+ ^ OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 www.cLspringfield.or.us 811-SPR2011-01738 540 48TH ST perm itcenter@ci"springfield.or.us RECEIPT NO: 2011002012 RECORD NO: 811.SPR2011-01738 lDESCRIe.tION~T!;;.;'; ;"{~~ 0;",.';,;r-:,,-'sJ;~~i.\i_:2:::~cCOUNt~CODEc;~., .' Structural Plan Review Fee Residential 224-00000-425602 .,-..-.---".--- TOTAL DUE: ~AyMENt~tXPEP;~~AYOR ',-", '"ASf"ER:CCARPE.N+ER,-~l:' COIVIII/lENTSJ;;2;, if" p. 2'):;,,""'j. Credit Card HAYDEN HOMES LLC 099820 DATE: 07/13/2011 , !:"!~MOUNTiDU'E."-'>':;-j 619,42 619,42 AMOUNt:PAID.':,> . .' - :,' --+,,'~ $619.42 TOTAL PAID: $619.42 cO r l r