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Home My WebLink AboutPermit Building 2011-9-2 t. \ v 5T~~. FIELD. ~L~ ~OREGON 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01926 IVR Number: 811' 18157027 www.ci.springfield.or.us permilcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 09/02/2011 ISSUED: , APPLIED: 09/02/2011 08/11/2011 EXPIRES: VALUE: 02/28/2012 $30,000.00 SITE ADDRESS: 608 CLOVERLEAF LOOP, Springfield, OR 97477, ASSESOR'S PARCEL NO: 1703224207300 PROJECT DESCRIPTION: Expand living rooms of residential care facility Phone Number: OWNER: ADDRESS: CLOVERLEAF PROPERTIES LLC 611 N CLOVERLEAF LOOP SPRINGFIELD OR 97477 SCOPE: Family Room WORK INVOLVED: Addition TYPE OF STRUCTURE: Commercial Contractor Type General Contractor Contractor Name JEFF JOHNSTON CONSTRUCTION INC CONTRACTOR INFORMATION ~ Phone 541.914-8044 Lie Type CCB Lie No 154575 Lic Exp 03/10/2013 BUILDING INFORMA TION ~ # of Stories: Height of Structur~: Type of Heat: Water Type: Range Type: Hazmat: # of Units: o Construction Type Occupancy Type Occupancy Comments Type VB SR-4 279 Lot Size: Sq Ft 1st Floor: 279 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Electrical Specialty Code Edition: Springfield Fire Code Edition: ATTENTIO~I: ('Irg~0n Iq'l-I r"'lf'lIlires VOU to Mechanical Specialty Code Editio'n:~IOW r. . ":~ cf":",r tsCl ., J [, ~::T '""I U~imy N I" .'. . ~-, '.' ,- .-., --" '[Itorth Municipal I Development Code' 0 t.'C.~lC. " __. " :: I ? ~ ~_' ., ,," inO~.;~:~-,~-.";.-(.' l' .....- C",c.,?oP'/-.001- Plumbing Speclal~ Code EdlllO-V090. Y0l1 - ~:"l\' ()',..,,!;" . :)...... - ~;;t. ulBS by Residential Specialty Code Editionbal';rv 'r.. :t 1. c', t,.' 's... 1~'lqe Structural Specialty Code Edition:.lumbci '2010. -), "c.. " '):i:;~o.tlon # of Bedrooms: Sprinkled Building: Yes Fire Alanns: Yes Energy Path: :,.:\ Site Infonnation Engineered Fiil: . . Fill Volume: ATTENTION: Oregon law requires you to Flood Hazard Area:fo:low ~I:'~' adooted "y th~ Oregon Utility Land Hazard Area:Not!r;~,IOr. C l.lL , T' ,!'~~ [I 'IE:~ Rre set forth Retaining Wall: in OAR 802-001.001 U to,; ~L -J" O.\R 952-001- Soils Report Requii'd\O, You may obtain copies oi the rules by calling the center. (Note: the telephone number for the Oregon Utility Notitication Center is '-800-332.2344). Springfield Building Permit 9/2/2011 2:01 :57PM , I v....",...., '.... . .....-- --- .- NOTICE: K THIS PERMIT SHALL EXPIRE IF THE WORT AUTHORIZED UNDER THIS PERMIT IS NO COMMENCED OR is ABANDONED FOR ANY 180 DAY PERiOD. r'C ~.~ . r"" H;-Jl~~~:. K '''IS PF.RMIT SH,~Ll ['f"'''': 'F THE WOR . 'I,'I.CD 1.J1'c ';\lIIT IS NOT GO,ljivltl~[;m uti I~ ",-"",wul~cD FOR ANY 180 DAY PERIOD. Page 1 of 5 .. sp. RIN.G.FIE~D .~ ii~: i..r:h ,,\. OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SpR2011-01926 IVR Number: 811118157027 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 ISSUED: APPLIED: 09/02/2011 08/11/2011 EXPIRES: VALUE: 02/28/2012 $30,000.00 09/02/2011 SITE ADDRESS: 608 CLOVERLEAF lOOP, Springfield, OR 97477: ASSES OR'S PARCEL NO: 1703224207300 PROJECT DESCRIPTION: SCOPE: Family Room WORK INVOLVED: Addition TYPE OF STRUCTURE: Commercial Expand living rooms of residential c~re facility Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVElOPMENTlNFORMA TION ,~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd:! % of Lot Coverage: Highest point on structure. to north properly line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Descriotion Bid Tvoe of Construction NA Unit Amount Unit Tvoe 30,000.00 Bid Unit Cost 1.00 Value 30,000.00 30,000.00 Springfield Building Permit , 9/212011 2:01 :57PM Page 2 of 5 ) SPRINGFIE~ Ilk -~ ~'~'. 'OREGON 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01926 IVR Number: 811118157027 www.ci.springfield.or.us permilcenter@ci,springfield,or.ws PROJECT STATUS: STATUS DATE: Issued 09/02/2011 ISSUED: APPLIED: 09/02/2011 08/11/2011 EXPIRES: VALUE: 02/28/2012 $30,000_00 SITE ADDRESS: 608 CLOVERLEAF lOOP, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1703224207300 PROJECT DESCRIPTION: - Expand living rooms of residentia.' c~re facility SCOPE: Family Room WORK INVOLVED: Addition TYPE OF STRUCTURE: Commercial FEES PAID ~ Description Structural Plan Review Fee Commercial - - ~ire, Life, Safety Plan Review Commercial Fire (.10 Per Sq Foot) Technology fee (5% of permit total) Admin fee (10% of applicable fees) Planning - Minor Review - City Branch circuits without service or feeder - 1 5t circuit Branch circuits without service or feeder - each additional State ofOreg_on Surcharge (12% of applic'!.':I,,_~ees) Technology fee (5% of permit total) Building Permit Fee SDC: Total Sewer Administration Fee S~C: Improvement Cost. Storm Drainage sac: Reimbursemqnt Cost - Storm Drainage State of Oregon Surcharge (12% of applicable fees) Total Amount Paid Amount p'aid $207.25 ._--,----- $127.54 $2790 . $15.94 $2.79 $119.00 $55.00 $6.00 $7.32 ---$3.0s- $318.85 $10.49 -'--l---~------"-- $124.38 $85.50 $38.26 $1,149.27 Date Paid 08/11/2011 ---------------. 09/02/2011 09/02/2011 09/02/2011 09/02/2011 09/02/2011 09/02/2011 09/02/2011 09/02/2011 --""-."- 09/02/2011 09/02/2011 09/02/2011 09/02/2011 09/02/2011 09/02/2011 Springfield Building Permit 9/2/2011 "12:01:57PM ReciDt # 2011002229 --- 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 2011002385 Page 3 of 5 . -;; SPRIN G.FIE~ .-' ,"- ""- ..C, ,S, ,,' ""'" . .5\ OREGON CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2011-01926 IVR Number: 811118157027 permitcenter@cl.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 09/02/2011 ISSUED: APPLIED: 09/02/2011 08/11/2011 EXPIRES: VALUE: 02/28/2012 $30,000.00 SITE ADDRESS: 608 CLOVERLEAF LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703224207300 SCOPE: Family Room WORK INVOLVED: Addition TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Expand living rooms of residential care facility Plan Review ~ Deoartment Application Acceptance Received Due Date ComDlete~ Result 08/11/2011 08/11/2011 08/17/2011 Application Accepted Reviewer David Bowlsby InitiaJ'R.eview;,> , ~ 08m/201:.1. '08{,Hl201,1 ", v ..r,~" .'j">;~." " .D.V~~~~lsby ,}:- . Public Works R.eview 08/17/2011 08/17/2011 08/22/2011 Comments: Storm water to tie into existing Approved Kaye Wilson ,-----.--- ---".~. .~...,.---_._------.....- ,Structural Review ' . 08/1712011" 08/1712011 08/23/2011 f W~iting internal 'CtlTiS'Carpenter~' , _.-:..___......:-__~~_.~~-"-__. ~\V' '" _fli ~_. _':"'_..~__~i...~__.;___,-.",,_..._~:~'.___._~____;;_____ Fire Review 08/17/2011 08/1712011 08/26/2011 Approved Giibert Gordon Comments: Plans Review: addition of 194 sq. ft. to Building 604 and 279 sq. ft. to Building 608 dining areas. Job #SPR2011-01927 and .01926. Occupancy Classification: SR.4. Construction Type: V.B sprinklered (NFPA 130). Plans reviewed under the 2010 Springfield Fire Code and 2010 Oregon Structural Specialty Code. Historical note: Original buildings were reviewed under the 1988 Uniform Building Code/1990 Oregon Structural Specialty Code and the 1988 Uniform Fire Code/1989 locally adopted Oregon Fire Code as an SR-2 occupancy (more that 5 residents classified as Slow for evacuation purposes). Extend sprinkler coverage as needed to meet the requirements of 2007 NFPA 130, Standard for the Installation of Sprinkler Systems in One and Two Family Dwellings and Manufactured Homes. Call th.e ins~~~on line at 541-726-3769 for anY-2p~Ever inspe~tions of changes to the~prinkler system. Planning Review' ,,_' ',' 08/17/2011 .'Y081171201'1 '.'08/3,1/201\' Appr'oved '",;:c, , ,;;-,. Liz.Mill," ...':,. " . ". ~, . ..' .' ._"_ _.. ... " ',"',1 . ..; '-'!i< ..." ....', CommentS:_ Received deed restrtctionori 8l31l11. See an.:?ched do~ul)1ent. . ty1odificaliorilo.site plan"added:t.o Site Plan'Reviewfile .. _ 90.09142 tog~!ber wittidee~ restrictioD;~ u_:.~~~ . _....." Structural Review 08/17/2011 08/17/2011 09/01/2011 Approved Chris Carpenter Comments: Deed restriction received. -I I I --, Permit Issyance 09/01/201.1 09IQ)l2011, , 09/02/20111 'O';c - .Ff" ','.:::! Issued . .."..r....~..... .t. : Chr!s;..~~rpenter,: ; ~:;. Springfield BUilding Permit 9/212011 2:01:57PM Page 4 of 5 . , .. SP~~~G.=.L.~ ~,~ ~OREGOt-l www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01926 IVR Number: 811118157027 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 09/02/2011 ISSUED: APPLIED: 09/02/2011 08/11/2011 EXPIRES: VALUE: 02/28/2012 $30,000.00 SITE ADDRESS: 608 CLOVERLEAF LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703224207300 SCOPE: Family Room WORK INVOLVED: Addition TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Expand living rooms of residential care facility INSPECTIONS REQUIRED I Inspections 1020 Zoning/setbacks 1110 Footing Footing: After trenches are excavated. 1260 Framing Foundation: After forms are erected but prior to concrete placement. Slab: To be made after all insJab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspectio~: Prior to cover and after all rough in inspections have been approved. 1120 Foundation 1150 Slab/Flatwork 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. Roof Sheathing Final Building: After all required inspections have been requested and approved and the building is complete. 1630 Roof Sheathing 1999 Final Building 1460 Insulation 1800 Emergency Egress 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 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 agr~e to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. ~ I~ r---- Owner C t ct~r Sign re ,q - ;;.. ~ I / , Date Springfield Building Permit 9/2/2011 2:01 :57PM Page 5 of 5 'Structural Permit Application " DEPARTMENT USE ONLY '.;~.' ",-,:l.- . ,:'" ...,':f . ~.. '. ; ;+_'3l-~.' ,:~~.",,:,:;,.~. :'-:1. ");4.,. . '~;~~::'~J;'~rE'\Z9f S?R!NGFIELD;',Q.R~GONii-!'.~.;;." " ':.;,"..: Date: This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days ofiss suspended for 180 days. tiOCA~ '9QYE.~NM~NtMgR9.it_~Lll;>/:~:;\:~:iM,g This project has final land-use approval. Signature: Date: This project has DEQ approval.. Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: 0 Yes 0 No ~~1.<<'1!&~~{GATE:_9.Q~Yk(iF~G,9N~i~tj_c,ml.9'N:~::~i;;~t~,~~ij~~'1i; Residential 0 Government 0 Commercial ~'/ :':;c: ..;:.iOB .SlrE, iN~9RMAfl0N~ANDjEocAiffQNh:..t~~'?\.\; Job site address: " 1"1 r e L-. City: - t . 'j :z,. 225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(54 1)726.3689 Subdivision: Reference: 1 '() 'J Name: 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: CONTRACTOR ,INSTALLA'f1QN: .:,' Business name: j e... 0 Address: S Print name: Signature: Name Electrical Plumbing Mechanical Permit no. fll +-/12b f '\. - .-' '." .",')' '.FEE'SCHEDULE""'" ~.'" (a) Job description: R trlC. Occupancy ~ f Cost per square foot: Other information: Type of Heat: Energy Path: o new 0 alteration (b) Foundation-only permit? Total valuation: 2faddition . Dyes G31<"0- b ;f~'~;""~.i;ltI 4 ~n i( t ~'e.~;~t~)~',~{rji~~(f?ii~} ~[i:)~~~~~.?~~::(6,t,~~~ ~.':~? ' (a) Permit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): (e) Subtotal of fees above (2a through 2d): $ , ' " $ S " ']$f~~i-~m-fey~~",jt~~~~wJ~P!'~~fjfJ:~~~~~~$f~ij~f~JA~~4~tt~~f}.i (a) Plan review (65% x permit fee [2a]): $ (b) Fire and life safety (40% x permit fee [2a]): $ '(e) Subtotal of fees above (3a and 3b): $ ~;~~!M.is~celi.~_rr'~:~Jr$.jt~~~}l~~~;;~'~;:E~~x\(J~{J.:;C;~:.~:~? ~,:-' (a) Seismic fee, 1 % (.01 x permit fee [2a]): S TOTAL fees and surcharges (20+3c+4a), $ s Electrical Permit Application : 225 Fifth Street. Springfield, OR 97477.PH(541)726-3753+FAX(541)726-3689' DEPARTMENT USE ONLY Pennit no.: 5'/1 - ('72 &> Date: 'is! II This permit is issued under OAR 9]8-309-0000. Permits are no~transferable. Permits expire if work is not started within ]80 days of issuance or if work is.suspended for ]80 days. ,. ';COCAVC;;OVERNMENTAPP,ROVAI.>," Zoning approval verified? 0 Yes 0 No ;:, ',.'CATEGORy"bFiCONSTRl!.JCnON"'~" , o Residential 0 Government ~mmercial ~~fiil1'!,JOB~$ITl:i INFQRMA!IONfAN[ji::u;bJ:AT,ioN~i!'\l~;:;; () ~ CL.OJc:X..Lt="" r: u<> City: State: iJ>L-- ZIP:cr;r..t7') ~ Taxlot. DESCRIPTION: OF WbRK .' t+ f) n:?2. C / IU-IA ( T J /-i:Jvz- City: ZIP: Q7Y1 Phone: E-mail: This installation is being made on residential or fann property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479,560(1). Signature: . CONTRACTOR INSTALLATION Business name: Sn\JE HAVG/C Address: ,0, lSC),<"113(;/ City: u~ Phone:S", ~I- Zc.c.5 E-mail: SlfUe. ttflu fl- ces license no.: 147(,,18 Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: Jffl;Jc):. ~<l/ ~0::~~ ~ 440-2584-J (9/08/COM) {.:";,;-:.,.: ::~::'~~~13<~if1{~'!Vf:;:':~irI5E'i::'fSP' HEDlJ@E:!(;~r:;'i.~r~;{~f.1W~~f}~~t~~1?F$ Num~er ?finspectlo'ns per it~~.'(.) Qty. Cost . TTotal , ea. . cost Residential, per unit, service included: 1,000 sq. ft. or less (4) $134,00 $ Each additional 500 sq. ft. or portion $ 25,00 $ thereof Limited energy (2) $ 32,00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 201 to 400 amps (2) $ 96.00 $ 40 I to 600 amps (2) $158.00 $ 60 I to 1,000 amps (2) $2,05.00 $ 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 $ 20 I to 400 amps (2) $ 87.00 $ 40 I 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) I $ 55.00 $CS' - Each additional branch circuit / $ 6.00 $ (0 - Miscellaneous fees: service or feeder ~ot 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 aaditional inspection: (1) $58.00 $ /t:~'~~~$1-~~f~~8r1~~~A~"~jjTtAN~t~~,:USEV~:~~{:~t.::!:~J~:~;.;~::'.~i~;:~;;;~'~'~,: ,::_,", (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ fR{O~ (B) Enter 12% surcharge (.12 x [A]) $ ') T.Z.... (e) Technology Fee (6% of [A]) $ 70S- TOTAL fees and surcharges (A through C): $ 7(""IT . , ~' I.. COVENANT v1I\ l eJ4 JA. 6 L H;VD M4--N (Please Print) BEING THE RECORD OWNER(S) of all of the following describea property located in the CitY of Springfield, or its urbanizable area, in the County of Lane, State of Oregon: I See A~achment A IN CONSIDERATION FOR the issuance of a Building Permit by the City of Springfield which allows the owner(s) to construct a structure, over th" common property line ,of two or more abutting lots, record owner(s) do hereby make the following covenants (for the good and safety of the public, in compliance with the Springfield Development Code and the buiiding regulations of the City of Springfield), covering the above described real property, specifying that this covenant shall constitute a limitation to run with the land and shall be binding on all persons claiming under them, and that the covenants shall be for the be'nefit of present and future owners of said real property, BE IT. HEREAFTER KNOWN and agreed that: 1. The land described in Attachment A which i'ncludes 2 or more lots, must either hereafter be sold together without separation of the lots or portions thereof as a single unit of land so long as the structure is constructed over the common property line(s) of the abutting lots; or 2. Prior to the sale of the lots individually, the structure shall be removed, and a finding made by the , City that there is no violation of any applica~le setback regulations applicable at the time of sale. IN WITNESS WHEREOF, the ?;cytl-, day of ' A / undersigned have caused this instrument to be executed this 20~. Lane Counly Clerk Lane Counly Deeds and Records ~~ 1l.~J~J~D Owner' 11111111111111111111111111' II 11111111111111111111 $47,00 01241686201100393960020021 08/31/2011 11:11:40 AM RPR-REST Cnl=1 Sln=15 CASHIER 01 $10.00 $10.00 $11.00 $16.00 STATE OF OREGON) ) ss. County of Lane ) !2Ai-h ON THIS.....v day of Public, the within named m i (Jr.() L) h.- LAD) -U ~ \- ' H L><d \Y\CL() , . 201.1-. personally appe,ar~d before me, a Notary acknowledged the foregoing to be their voluntary act and deed. WITNESS my hand and seal this day and year last written above. C*~ ~. fV\. (\~ . OIr DlALBEAL rfotary Public for Oregon ,/ C&TIImIOIMY , NOTARY PUIlJC .~ My Commission Expires: mC\.ll '3) ?tl/~ COMMISSION NO....,. I } MY :::OMMISS'()!:IEXPIRES MAY 31, 31114 A copy of this recorded document must be i:'eturned to the City of Springfield, Development Services Department, 225 Fifth Street, Springfield, OR 97477. deed rest. haus pi ~ ' > I , I I I EXHIBIT A . I J--~ PARCEL I: 7, 8, 9..10, 11, 12, 13, 14 and 15!, GRANADA PHASE II, as platted and recorded in File 73, Slides 108, 109 and 110, Lane Cou~ty Oregon Plat Records, in Lane County, Oregon. . I PARCEL II: Lots 74, 75 and the Southerly 15 feet of76, GRANADA PHASE II, as platted and recorded in File 73, Slides 108, 109 and 110, dne County Oregon Plat Records, in Lane County, Oregon. , I ALSO: Lots 16 and 17, GRANADA PHASE II, as platted and recorded in File 73, Slides 108, 109 and 110, Lane County Oregon Plat Records, in Lane County, Oregon. . I ALSO: Lot 76, GRANADA PHASE II, as pla~ed and recorded in File 73, Slides 108, 109 and 110, Lane County Oregon Plat Records, in"Lape County, Oregon. SAVE AND EXCEPT THEREFROM the Southerly 15 feet. I ALSO: Lot 77, GRANADA PHASE II, as platted and recorded in File 73, Slides 108, 109 and . . I C 110, Lane County Oregon Plat Records, in Lane ounty, Oregon. .. EXH,IBIT A ~ . \ . , S.PRIN.G FIELfij lit ~- $1 .. .t~ 'OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011~01926 608 CLOVERLEAF LOOP CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541.726.3753 permitcenter@ci.springfield.or.us AC.CQUNI:.C.ODE - .., AMOUNT~DUE 224-00000-426605 2.79 224-00000-426102 55.00 224-00000-426102 6.00 224-00000-425602 318.85 100-00000-424005 27.90 224-00000-425602 127.54 100-00000-425002 119.00 440-00000-448028 124.38 441-00000-448029 85.50 719-00000-426604 10.49 821-00000-215004 45.58 100-00000-425605 18.99 TOTAL DUE: 942.02 L~t<XMEt.jLiy~E~~t<Y_O~ '. CASHIER, CCARPENc~~~C:()MMENI.S:L-~' ~ _ '- . ~.: AMOUNTPAID Check Gateway Assisted Living 942,02 58398 RECEIPT NO: 2011002385 lDESCRI~TlbN Admin fee (10% of applicable fees) Branch circuits without service or feeder - 1 st circuit RECORD NO: 811.SPR2011.01926 DATE: 09/02/2011 Branch circuits without service or feeder - each additional Building Permit Fee Commercial Fire (.10 Per Sq Foot) Fire, Life, Safety Plan Review Planning - Minor Review - City SDC: Improvement Cost. Storm Drainage SDC: Reimbursement Cost - Storm Drainage SDC: Total Sewer Administration Fee State 01 Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) TOTAL PAID: 942.02 www.ci.springfield.or.us I TRANSACTIO~ RECEIPT I 811-SPR2011-01926 I 608 CLOVERLEAF LOOP I , CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 SPR~NG__. FIE~ ~A" "'t;.~ . .... 'OREGON permitcenter@ci.springfield.or.us RECEIPT NO: 2011002229 RECORD NO: ,811-SPR2011-01926 lDESCRIP..TION '-.;.. .C..!,.' ACCOUN;tCODE Structural Plan Review Fee Commercial 224-00000-425602 ." ____u _.. ...____________....______, DATE: 08/11/2011 AMOUNT.DUE 207.25 207.25 AMOUNT PAID. '. 207.25 J TOTAL DUE: L~...XMEt~J..IY~E~...Y.Q~ASHIER: CCARPENTER -~CQMMEI'IIS~ .' Credit Card JEFF JOHNSTON CONSTRUC' 357506 TOTAL PAID: 207.25