The URL can be used to link to this page

Home My WebLink AboutPermit Building 2007-9-17 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1881 2nd St ASSESSOR'S PARCEL NO.: 1703262401100 Springfield PROJECT DESCRIPTION: New 2 story commercial bldg Owner: R KEEPERS INVESTMENTS LLC Address: PO BOX 703 PLEASANT HILL OR 97455 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00814 ISSUED: 09/17/2007 APPLIED: 06/05/2007 EXPIRES: 04/17/2008 VALUE: $ 941,049.00 TYPE OF WORK: Retail TYPE OF USE: New Commercial Phone Number: 541-729-3418 I CONTRACTOR INFORMATION I Contractor Type Architect General Electrical Mechanical Plumbing Contractor NAGAO PACIFIC ARCHITECTURAL P.e. COLBERG COMMERCIAL INC EUGENE ELECTRIC SERVICE INC HOME COMFORT HEATING & AIR HOME COMFORT HEATING & AIR INC License Expiration Date Phone 541-687-9600 541-344-4242 541-344-3561 541-345-2838 541-345-2838 91666 90200 84164 84164 07/0812009 03/17/2009 06/25/2011 06/25/2011 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: B F-l VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 2 35.00 Electric Electric Path 1 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 78 3,888 3,888 I DEVELOPMENT INFORMATION' Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverare:NTtON' 0 egon 1aw requires you to AI I: . r url't fgJlow rules adopted by the Oreg~~ _ 1}lr I PUBLIC IMPRO~\d1~~~~~'1 ~ ';h;;U,;~wOAR 95~-o61 ~ 14M':. ....tain..nn~:~ 91 the rules by Streewml~~tnents: RE 'F THE WORK 0090. You may ~lOewan('ll ~. t I hone . [".ouIT' ~uALL EXP' calling the center. (Note, e ~ ~p , Stor~~id?~1 I:J'W:' DER TH'S PERMIT IS NOT number for theLt9~v~~lJi>.Y'a!iiIlclflcatlon Specl~~If<<~UHnD UN BANDONED FOR Center is 1-800-332"2344). COMMENCED OR IS A Notes:ANy 180 DAY PERIOD. Pae:e 1 of 5 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00814 ISSUED: 09/17/2007 APPLIED: 06/05/2007 EXPIRES: 04/17/2008 VALUE: $ 941,049.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Estimate Pavinl! Tvpe of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 792,169.00 148,880.00 Value Date Calculated Description Total Value of Project $792,169.00 $148,880.00 $941,049.00 06/29/2007 06/29/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review CommlInd/Public $2,133.72 6/5/07 1200700000000000706 -Mechanical Issuance Fee- $10.00 9/17/07 2200700000000001458 + 10% Administrative Fee $517.14 9/17/07 2200700000000001458 + 5% Technology Fee $219.69 9/17/07 2200700000000001458 + 8% State Surcharge $293.51 9/17/07 2200700000000001458 Addressing Assignment $31.00 9/17/07 2200700000000001458 Backflow Device $42.00 9/17/07 2200700000000001458 Boiler/Comp Up To 100,000 btu $48.00 9/17/07 2200700000000001458 Building Permit $2,817.90 9/17/07 2200700000000001458 Fire SF Fee - Non-Residential $777.60 9/17/07 2200700000000001458 Fixture $434.00 9/17/07 2200700000000001458 Paving $724.90 9/17/07 2200700000000001458 Plan Review Comm/Ind/Public $12.68 9/17/07 2200700000000001458 Plan Review Fire & Life Safety $1,313.06 9/17/07 2200700000000001458 Plan Review Fire & Life Safety $1,320.86 9/17/07 2200700000000001458 Plan Review/Com,Ind,Pub Hourly $45.00 9/17/07 2200700000000001458 Sanitary Sewer - 1st 50 Feet $45.00 9/17/07 2200700000000001458 Sanitary Sewer - Improvement $415.59 9/17/07 2200700000000001458 Sanitary Sewer - Reimbursement $546.63 9/17/07 2200700000000001458 Sanitary Sewer Each Addtll00' $42.00 9/17/07 2200700000000001458 SDC MWMC Administration $10.00 9/17/07 2200700000000001458 SDC MWMC Improvement $2,994.45 9/17/07 2200700000000001458 SDC MWMC Reimbursement $285.31 9/17/07 2200700000000001458 SDC Sanitary/Storm Admin $439.24 9/17/07 2200700000000001458 SDC Transpo Admin $410.58 9/17/07 2200700000000001458 SDC Transpo Improvement $5,398.50 9/17/07 2200700000000001458 SDC Transpo Reimbursement $1,223.76 9/17/07 2200700000000001458 Storm Drainage Impervious Area $6,122.26 9/17/07 2200700000000001458 Storm Sewer - 1st 50 Feet $45.00 9/17/07 2200700000000001458 Storm Sewer Each Addtll00' $84.00 9/17/07 2200700000000001458 Vent Fan $24.00 9/17/07 2200700000000001458 Water Line - 1st 50 Feet $45.00 9/17/07 2200700000000001458 Water Line - Each Addtll00' $42.00 9/17/07 2200700000000001458 Total Amount Paid $28,914.38 Pal!e 2 of 5 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-00814 ISSUED: 09/17/2007 APPLIED: 06/05/2007 EXPIRES: 04/17/2008 VALUE: $ 941,049.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review I Plan Reviews I 07/12/2007 OK GRG 06/13/2007 Initial Review 06/06/2007 06/07/2007 APP LLH Plan Review Comments 06/29/2007 10 JMP Plannin2 Review 06/13/2007 06/14/2007 APP EMM Public Works Review Public Works Review 06/13/2007 07/25/2007 06/20/2007 APP JHJ Structural Review 06/07/2007 06/19/2007 WE JMP Structural Review Structural Review 07/16/2007 07/25/2007 07/16/2007 APP 07/25/2007 APP JMP JMP SUB Review 06/29/2007 07/16/2007 APP JF SUB Review 06/13/2007 06/25/2007 WE JF See attached document for Fire Department Plans Review comments. There is an existing structure on the property with a current address of 1887. Addresses cannot be reused, so a new address of 1881 2nd Street has been assigned to this new structure. WI. Received responses from Ken Nagao. To be constructed per approved Site Plan Review DRC2006-00083. Attached SDC Worksheet. (JHJ) Scott Morris delivered revised Sheets CI-C4 (storm system revisions). Received with 3 large projects on a cart 6/13/2007. See attached documents for 11 structural comments faxed to Ken Nagao. Received final internal approval. Received revised Sheet CI-C4 from Scott Morris (storm system revisions). Received energy code forms from Ken Nagao and forwarded to Jack Foster. JMP called Ken Nagao to request missing energy code forms and correct heat pump equipment. To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. UeouireCUnsnections I Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Pa2e 3 of5 CITY OF SPRINGFIELD - Status Issued Building/Combination Permit PERMIT NO: COM2007-00814 ISSUED: 09/17/2007 APPLIED: 06/05/2007 EXPIRES: 04/17/2008 VALUE: $ 941,049.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Roofing: Prior to installing any roof covering. Roof Sheathing Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Roof Sheathing/Nailing: Before covering sheathing with finish material. Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Ceiling Grid: After drywall approval but prior to cover. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Pal!:e 4 of5 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-00814 ISSUED: 09/17/2007 APPLIED: 06/05/2007 EXPIRES: 04/17/2008 VALUE: $ 941,049.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, tha~ 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 duri~g conslr: 'ction. . I I I J ~{~,' lar0e~! (-/1-07 Own6/Contracto s Si ~ Date / Page 5 of 5 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER C0M2007-00814 NAME OR COMPANY: R K"",I''''' Investment LLC LOCATION: 1881 2nd St. MAP & TAX LOT NUMBER: 17 03 26 24 01100 DEVELOPMENT TYPE: Professional Office Building NEW DEVELOPED AREA (S.F.): 7,200.00 ITE: 710 EXlSTING DEVELOPED AREA (S.F.): 2,500.00 1 house ITE: 210 TOTAL IMPERVlOUS SURFACE (S.F.): 20,721 LOT SIZE (S.F.): 1_ STORM DRAINAGE 20721 sf (New) - 2500 sf (Existing) = 18221 sf (New Net) IMPERVlOUS SQ. FT. 18,221 x $ 0.336 PER SF TOTAL STORM DRAINAGE SDC:I 2_ SANITARY SEWER-ClTY (see reverse side) A REIMBURSEMENT COST: NUMBER OF DFU's 21 B. IMPROVEMENT COST: NUMBER OF DFU's 21 x $ 26.03 PER DFU , ! 962.22 1 x $ 19.79 PER DFU TOTALLOCALWASTEWATERSDC:! $ 3_ TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW: A REIMBURSEMENT COST: 7.20 x 11.01 B. IMPROVEMENT COST: 7.20 x 11.01 EXlSTING: A REIMBURSEMENT COST: -1.00 x 9.57 B. IMPROVEMENT COST: -1.00 x 9.57 0.9 NTF $1,413.341 $6,234.82 1 x $ 19.81 PER TRIP x x $ 87.39 PER TRIP x 0.9 NTF x NTF! $ 87.39 PER TRIP x NTF ! ($836.32)1 TOTAL TRANSPORTAT10N REIMBURSEMENT SDC: TOTAL TRANSPORTATION IMPROVEMENT SDC: TOTAL TRANSPORTATION SDq $ 6,622.261 ($189.58)1 $ 19.81 PER TRIP x x :4- SANITARY SEWER - MWMC NEW: A REIMBURSEMENT COST: NUMBER OF FEU's 7.20 x $52.3 5 PER FEU $376.92 1 B. IMPROVEMENT COST: NUMBER OF FEU's 7.20 x $549.44 PER FEU $3,955.97 1 EXISTING: A REIMBURSEMENT COST: NUMBER OF FEU's -1.00 x $91.61 PER FEU ($91.61)1 B. IMPROVEMENT COST: NUMBER OF FEU's -1.00 x $961.52 PER FEU ($961.52 )1 MWMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL MWMC RE1MBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: TOTAL MWMC SDC:1 $ 3,289.76 I SUBTOTAL (ADD ITEMS 1,2,3, & 4) I $16,996.50 I 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) $ 16,996.50 x 5% ! $849.82 TOTAL SEWER ADMIN1STRA TION FEE: TOTAL TRANSPORTATION ADMIN1STRATION FEE: $ Jesse Jones Civil Engineer, EIT 6/20/2007 DATE TOTAL SDC CHARGES $439.24 410.58 '$17,846.3T Professional Office Building DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN, FLOOR SINK INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO W ASH/ETC. LAUNDRY TUB CLOTIIES W ASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRlGERA TORIW A TER ST A TION/ETC. RECEPTOR FOR COMMERCIAL SINK! DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR. SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLE LA V A TORY /RESIDENTIAL BAR URINAL, ST ALUW ALL TOILET, PUBLIC INST ALLA TION TOILET, PRlV ATE INST ALLA TION MISCELLANEOUS: NUMBER OF EDU'S* FIXTURES NEW OLD 2 UNIT EQUIVALENT 3 1 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 DRAINAGE FIXTURE UNITS -6 o 18 o o 8 o o o o o o o -3 o o 4 o o o o TOTAL DRAINAGE FIXTURE UNITS =, 21 6 4 I 6 2 2 2 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 RATE PER $1,000 ASSESSED VALUE $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 RATE PER $1,000 ASSESSED VALUE $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 $0.00 $0.00 $0.00 x x CREDIT TOTAL $0.00 $0.00 $0.00 . <:) 1m ..... N -.J ..... '-< N C <:) Z <:) I ..... N ....J <:) I co W IS) .;> IS) .;> ....J ...., :p IS) x m IJl m ~ lU ... , ~ - (It - ~ -Z-~-ol Ditta (q..~..,.,' .. ./ ---~---- ~ .~ ....aga1. ~. ~-~~.\it . Uu," ... A..... . -~:.,......... CWIia~__ ......~ US l'Ifth 8t..... 8pMWf.... ole 'N17 .,.~: (SIt) ,26.))" rc.: (S4t) 'J'H..36tf .p.... ...,..... 1WIfG1 T..,,.....,.dJi ~I'" 'Ci...."mllll\-IMIIiIW~....... .... 4lfflt O,..~... ;,.m.~ 01'. ....... ft....h....6)~_ ..~. wtld t_IIM111 lWdtc4....wl.. ~~ar... IIt/DI"'...., .....11..,. ~1~4bb _folk Citv. aaraMA PlRNatcAN ."V.. n. ""1111 ~~_ all tht 14,,1c""""IItplMllillt, P';I4:{ b&W<' ar A..'.......1fd ........'.R.llIl..IIIIrII...drco ar .r...nIWIIWI.'...-.... t.m CO~.llltafll......... '-Ie. n.c .-MfNo.lMl C<)"WClDr. ""cw_~ IINU ............lld.lIId.lIMl,i._ditilrll...IIrabI' to ....t~."., '...... I. c9ft/fJll.11, ....."1. _ "","llkllliDII '" eM ~1I" T_.GI item. tb.... J. TeMI.. r.1la1'lllrtJ 11nII taM........ ~a...."..,. IflftAtllMic ..'*'" tbr..... .......l1li..... 1...irIs . ~1f'!8l~~"""''''' MotJertioM_... .~.... Cly., thtT....lqAatl1t1. J, ...........GfiAII!1!'f .........11_ _..~.....h.IpIdIII'n"".M 11m Clt tat...,...... .. II*'..~..... pIVV.....io".".,D .... ............. 01"" ....1*'_'Mda I. ~..,...., I. ..,IpolftIIIJc "tM'v1lloC cay GPIlnl_'~ flit ,ddllbillll\lllndan Of __ ~m. ".1 ""'...... _IIeUmA CIRT." CAmOfl OCalPAMeV W,"" .11IU1t~ 11lr lferiGl ~.tq ,lIlItIllI68llUlldla8lA.t8I& otnc;:.lI 1C"llnIat ftIII.. itc"'''....ilC .......Ql\.....n Mil"'''' r........uaa IDtft....4r_IIlIftcta'. ."'1.. ha ......r\. ....~..... Ipcl:iI__.,.d ....1d6ta,........ pftIut.... .......,.. ^_....IIIlUClr..,...... ....lI.e _18t iIt ..IIat_I. T........ b Ie '- .....111l1li.. 6dI CIIIr ,...... (",~.lIf" ht ~.... f' ACJC'IfOWJ~P. Z D C1 D o LJ D n ~ TI ~ n i ~ TI - n VI .t'>. ..... en CD -'I CD ..... .t'>. N -uS . <:) ~ 0 ..... ~ " ..... IS] <:) ..... <:) ~ "ll ~ ,r-'-' - c it "lJ 18 -i a -i D r LJ IS] ..... SPECIAL INSPECTION AND TESTli"fG SCHEDULE Reinforted Concrete, Gunile. Grout and Mortar: Concrete GUf1ite I Groul MorIaI' A,ggre~te Test of Mix Design Reinforcin~ Test r Mbc Desi~r\-\Veia:hmaster Cert.. I R.:inlorcing Placement I I ContirlUotJs Batch Plalltlnsoecl. I I Tl1sllect Placin~ I I I Cast Samples I I I Samples (Picku[)l't)eliyered) ~~!;,)~~~&fz,,~~r\<, -~=--_! Comp",~o. r",' Piles Post-Tens Pre-Tens I Cladding A!!J!re~ale Te!ts Reinfl)rciol'! Tests I Tendon Test I Mix Desif!ns. r Reinforcing Placemenl I Insert Placement I Concrete Biilching I Concrete PJ:Jcement rln~lallation InSDeclion 1 Cast Sam pres I Pick-liD Samoles , Comllressioll Tests I SMOKE. CONTROL: FIREPROOFING: Leakage lest iog Control Verification GRADINe. EXCAVATION. AND FILL Acceptance tests" l'SF Establish final grade Fill placement inspection/continuous Soil Densil)' STRUCTURAL STEEL/WELDING: Sample and tesl (list specific members below) Shop ,:,ateria~ identification (mill ce,r~,l) . X Weld Inspecllon 'f... Shop Field Ultrasonic inspection Shop .field High Stfer\glh Bolling Shop _Field A325 N X A~O NX Met<l) deck weldirlg inspt:l:tion Reintorcing Steel welding. insp.eClillll Reinforcing ~teel mill certificate Mela] !tud welding in.:lpe\.:lion Concrete insert welding inspection Moment resisting sh:el lrnmes STRUCTURAL WOOD: Shear wall nailing inspection Shear wall ane nors ll\spection ofGlu-lam fab. $ TiC psi Inspeclion of truss joist fab. Sample and lest componenls Fabricalion welding of steelllCcessories ~ . -.... f\J >-' -.... f\J ~ ~ -..J ~ 'I.D W W -..J f\J (f1 W (f1 -..J (f1 F F (') H -i -< o "Tl U1 "U ;U H Z Gl "Tl H rr1 r o PI:wement inspection Density rests Thickness tests Inspect batching M,-\SONRY Special ir\speclioll stresses used. fm- fg Preliminary acceptance tests (masonr~; units, wnll prisms) SubseqtJenltest.. (mortilr, grout, tidt.l wall prisms) Placement inspectioll oftmits, and reintorcemenl 1\:Jasonf)', mortar, grout, and rdnforcing steel certificates ROOFlNG: huulnli on installlltion/R- Vnlue' T eststripslseams ADDITIONAL INSRUCTIONS, OTHER TEST, & INSPECTIONS: ~'.a\ ""_~~\o~', ~',,,,......l { f?>~j ~lIr ~c.o,;cs\;<J.l. \ Form Completed by: Ce~\iJ 5yc;\l"t'V\ · PROVID E STRENGTH REQUIRED BY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOC,\ TION OF VA LUES Date -u D Gl rr1 ~ -..J 225 Fifth Street Springfield, Oregon 97477 541:. 726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007 -00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 CO M2007 -00814 COM2007-00814 COM2007 -00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007-00814 COM2007 -00814 COM2007-00814 COM2007-00814 Payments: Type of Payment CreditCard Check cReceint 1 RECEIPT #: 2200700000000001458 Date: 09/17/2007 Description SDC Transpo Admin Building Permit Paving Plan Review Comm/lnd/Public Plan Review Fire & Life Safety Boiler/Comp Up To 100,000 btu Vent Fan ~Mechanicallssuance Fee~ Fixture Sanitary Sewer - 1 st 50 Feet Sanitary Sewer Each Addtl 100' Water Line - 1st 50 Feet Water Line - Each Addtll 00' Storm Sewer - 1st 50 Feet Storm Sewer Each Addtl 100' Backflow Device Fire SF Fee - Non-Residential + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Plan Review/Com,Ind,Pub Hourly Addressing Assignment Plan Review Fire & Life Safety Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin Paid By ROGER D. OBERG COLBERG COMMERCIAL INe. Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 01 096C In Person ddk 1392 In Person Payment Total: Page 1 of2 10:29:03AM Amount Due 410.58 2,817.90 724.90 12.68 1,320.86 48.00 24.00 10.00 434.00 45.00 42,00 45.00 42.00 45.00 84.00 42.00 777 .60 219.69 293.51 517.14 45.00 31.00 1,313.06 6,122.26 546.63 415.59 1,223.76 5,398.50 285.31 2,994.45 10.00 439.24 $26,780.66 Amount Paid $9,500.00 $17,280.66 $26,780.66 9/17/2007