HomeMy WebLinkAboutPermit Building 2013-5-9 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
OREGON Phone: 541-726-3753
Building / Residential Permit • Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00488
www.spnngfieldor.gov permitcenter @spdngfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/09/2013 EXPIRES: 11/04/2013
STATUS DATE: 05/09/2013 APPLIED: 03/11/2013
SITE ADDRESS: 1814 10TH ST,Springfield,OR 97477 SCOPE: Duplex
ASSESOR'S PARCEL NO: 1703261300102 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: New duplex-Same as 1810 10th
OWNER: HIATT MICHAEL&WENDY Phone Number:
ADDRESS: 3283 JAYHAWK CRT
EUGENE OR 97405 •
_ CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor L&E ELECTRIC INC • CCB 105475 03/30/2014 541-933-2598
General Contractor MICHAEL HIATT CONSTRUCTION LLC CCB 152009 06/28/2014 541-485-0219
Mechanical Contractor MICHAEL HIATT CONSTRUCTION LLC CCB 152009 06/28/2014 541-485-0219
Plumbing Contractor KEVIN COHEN PLUMBING INC CCB • 176311 05/30/2013 541-607-9208
INSPECTIONS REQUIRED
Inspections
1020 Zoning Setbacks
1090 Street Trees
1110 Footing Footing: After trenches are excavated.
1118 Footing Drain ATTENTION: Oregon law rennirac
1120 Foundation N FouIHnMFnf.d ns ae ereced:but.prdrltcwoncrete placement.
. - 1160 UFER Ground In Qfen Ele ttiottprougd:tl Ins�ll K68n o i leci g and call for inspection in
with c, H `1.') n
• OCconjuMctipfl-,�, tfpot�jgarjdLgrfp r/ �{idn�spVtion.
calling the center. (Hole: the elepho e y
1220 Underfloor framing 9
f1Cmbc `Or tl id.a IOf I rh.l ; ;
1260 Framing • Framing POgtCtigni 0114_gr and tiffaieBTough in inspections have been
approved. u-ajz-2344).
1410 Underfloor insulation
1420 Insulation Vapor Barrier • •
1430 Insulation Wall Wall Insulation: Prior to cover.
1440 Insulation Ceiling Ceiling Insulation: Prior to cover...
1520 Interior Shearwall -Shear,Wall Nailing-, Before covering sheathing with finish materials.
001U1J AVO 08I- AN
15313 Exterior Shearwall • '` UOJ 03NOONVey RI HQ Q3ON3mh00
1540 Gypsum Board/Lath/Drywall ION Sir Ailhf 30fo pN3. �I p, rude after all lathing and gypsum
NHumbe legal e b 't9IY�rtoplastering.
'��r�ri�1 d' to
1550 Firewall Firewall: Located and construde , �ori�go� plans.
1999 Final Building Final Building: After all required inspections have been requested and approved and
' the building is complete.
Springfield Building Permit 5/9/2013 9:14:04AM Page 1 of 2
SPRINGFIELD : 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
-"'' Phone: 541-726-3753
- OREGON Building / Residential Permit. Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00488
www.springfield-or.gov permitcenter @springfield-or.gov
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
construction.`
G— Y —i
•
Owner or Contractor Signature Date
•
yi
r.. . ' .
•
-
. :'.r, b7:1�:OD' .
,..01_~1 IIt.UTE, Jt �r. I ..i J. .: t2 , t.
Springfield Building Permit 5/9/2013 9:14:04AM Page 2 of 2
•
SPRINGFIELD. CITY OF SPRINGFIELD
:�11_ '' 225 Fifth St
`OREGON TRANSACTION RECEIPT Springfeld,OR 97477
541-726-3753
811-SPR2013-00488
www.springfeld-or.gov 1814 10TH ST permitcenter@spnngfield-or.gov
RECEIPT NO: 2013000916 RECORD NO:811-SPR2013-00488 DATE:05/09/2013
•D • • • 10• z_":, `�:__i= .:±i , . # 'f CODE/TRANStCODE %. 2 r'AMOUNT DUE,':-
Address Assignment, each new or change 224-00000-425602 1020 76.00
Permit Fee Adjustment-Structural 224-00000-425602 1002 -186.08
Planning-Major Review-City 100-00000-425002 1231 211.00
Residential Fire(.05 Per Sq Foot) 100-00000-424005 9111 130.80
SDC:Administrative Fee-MWMC Regional Wastewater SDC 611-00000-426604 1189 10.00
SDC: Compliance Cost-MWMC Regional Wastewater SDC 444-00000-426607 1113 45.22
SDC: Improvement-Transportation SDC 447-00000-448027 1174 931.11
SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 1,152.74
SDC: Improvement Cost-MWMC Regional Wastewater SDC 445-00000-448025 1187 2,784.08
SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 537.47
SDC: Reimbursement-Transportation SDC 446-00000-4-48026 1173 255.47
SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 1183 2,361.83
SDC: Reimbursement Cost-MWMC Regional Wastewater SDC 444-00000-448024 1186 216.28
SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 368.96
SDC:Total MWMC Administration Fee—Local 719-00000-426604 1121 152.78
SDC:Total Sewer Administration Fee 719-00000-426604 1175 175.73
SDC: Total Storm Administration Fee - 719-00000-426604 1180 45.32
SDC:Total Transportation Administration Fee 719-00000-426604 1190 59.32
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 142.14
Structural Building Permit Fee 224-00000425602 1002 1,370.62
Technology fee(5%of permit total) 100-00000-425605 2099 63.03
Willamalane fees-Single family attached 821-00000-215023 1074 6,770.00
TOTAL DUE: 17,673.82
BAYMENSx TYPE-raP,AYOR c'ASNiERSiccgeeEN>E nCOMMENTS u AMOUNTRAID ,
Check HIATT MICHAEL&WENDY 17,673.82
352
TOTAL PAID: 17,673.82
•
•
•
•
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
OREGON TRANSACTION RECEIPT Spdngfteld,OR 87477
541-726-3753
811-SPR2013-00488
www.springfeld-or.gov 1814 10TH ST 1816 permitcenter springfield-ar.got/
RECEIPT NO: 2013000467 RECORD NO:811SPR2013-00488 DATE:03/11/2013
lel4Ydc7alllfid W ^!r _�. _}� __ .��r * . ,'ACCOUNThCODE!TRANS■CODE ?_ .'n_ AMOUNT DUE'''.
Same as Plan Review Submittal 224-00000-425602 1060 250.00
TOTAL DUE: 250.00
PAYMENTTTYPE PAYOR-`'cASNIERrCOARPENTER;,.Sn>`t%.COMMENTS,Ca!+es,a: a<a }.,,.. AMOUNT.PAID_g, r''�.
Check MICHAEL HIATT 250.00
312
TOTAL PAID: 250.00
Structural Permit Application DEPARTMENT USE ONLY
CITY OF SPRINGFIELD,OREGON i -t="---t-
Permit no.: 1?_L1
225 Fifth Street♦Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 r U 1
Date: '7 J 0 // 3
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days.
LOCAL GOVERNMENT';APPROVAL s ,`
This project has final land-use approval. - - - -
Signature: Date: FEE SCHEDULE
This project has DEQ approval. 1:Valuation information -
Signature: Date: (a) Job description: letz../pyeter
Zoning approval verified: ❑ Yes ❑No Occupancy 723 Ibf
Property is within flood plain: ❑ Yes ❑No Construction type: Uy
,e„,a it :.:CATEGORYt;OFk CONSTRUCTION s Square feet:
❑Residential ❑Government ❑Commercial Cost per square foot:
7ill JOB SITE INFORMATIO(4'N'v':AND LOCATION i" Other information:
Job site address: /f( — / Type of Heat:
City:J`/t'&i.✓ c. / tate (J G(' ZIP `]71(77
Energy Path:
Subdivision:4e,;(04--64.1,,,AWC. Lot no.:
.}-new ❑ alteration ❑addition
Reference: I Taxlot:
PROPERTY OWNER (b)Foundation-only permit? El Yes ❑No r-
Total valuation �$
Name: (.( ('c4G.-( ( t"4( - . .
7-0,• <2:.Buildingfi es s .-a -
Address: 3 Z�•i ('1 r�. K - L'T (a) Permit fee(use valuation table): $/3�
City: State: (°)(%r ZIP:�9 riOLa
/; (b)Investigative fee(equal to[2a]): $
Phone: 7 9-C7 - C2 2_( ' Fax: - - O P ( P )
/ c Reins ection $ er hour
E-maily 1 r Clnuie(a(14/4/.in mn d°/' (u5/v 'CO'yt (number of hours x fee per hour) $
This installation is being made on residential or farm property owned by (d)Enter 12%surcharge(.12 x[2a+2b4-2c]): $ /4 VV/
me or a member of my immediate family,and is exempt from licensing
requirements under ORS 701.010. (e) Subtotal of fees above(2a through 2d): S
:= e` fs r ; ' - s *F= . "3 -Kln rev e eti ,, v i1 �. }.. . 17 c,?
Sign here: r (a) Plan review(65%x permit fee[2a]): $ U q�
�
CONTRACTOR INSTALLATION:.
' (b)Fire and life safety(40%x permit fee[2a1): $
Business name:/(.t( r(G;,,,,: ( 44,-qt7 rO/(/5T
(c) Subtotal of fees above(3a and 35): $
Address: -.
,4-`1VLscellaneous fees
City: ,- 19 State: ZIP: :.
,it,'- (a) Seismic fee, I%(.01 x permit fee[2a]): $
Phone: - Fax: Incicr
E-mail: TOTAL fees and surcharges(2e+ N
34a): $
CCB license no.: r 47_ct)
Print name:/L(•r er h ;;tLGf if
Signature: /7e -//
' ' '€SUB CONTRACTOR INTORMATION,=' . :
Name I CCB License Number Phone Number
Electrical I
Plumbing I
Mechanical
•
, willannalane •
Park and Recreation District
Job. No. 93 -it
•
PARK AND RECREATION SYSTEM DEVELOPMENT CHARGE WORKSHEET
Jan. 1-Dec. 31, 2013
NAME: 1-1ffit PHONE: LlFS 57-t,
ADDRESS: 2. "X,4 piton CITY: 67,14 STATE:- J ZIP: q? 5
LOCATION OF PROPOSED BUILDING SITE:
Street address: /Y/'( 4 1T/l 7$ S
Plat name: Tax Lot Number: /70.g 2.4 I7 0002--
1. DEVELOPMENT TYPE (Refer to development type definitions on the reverse.)
A. Single-Family Detached
NO. OF UNITS X$3,410 per unit= $
B. Single-Family Attached 7
NO. OF UNITS e-2/ X $3,385 per unit= $ l9 / 20
C. Multi-Family Apartment
NO. OF UNITS X$3,021 per unit= $
D. Single Room Occupancy '
NO. OF UNITS X$1,510 per unit= $
E. Accessory 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 $ • t/ 74
GC--. 3 7( 1 /) •
City of Springfield Date of building permit submittal
•C 71 / )
City of Springfield Date of building permit issuance
SPRINGFIELD- 225 Fifth St
•
412 --a- CITY OF SPRINGFIELD Springfield,OR 97477
lit dy _ Phone:541-726-3753
. OREGON Building / Residential Permit Inspection Phone:541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00491
www.springfield-or.gav permitcenter @springfield-ar.gav
PROJECT STATUS: Issued ISSUED: 05/09/2013 EXPIRES: 11/04/2013
STATUS DATE: • 05/09/2013 APPLIED: 03/11/2013
SITE ADDRESS: 1814 10TH ST,Springfield,OR 97477 • SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703261300102 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: New duplex-Same as 1810 10th .
OWNER: HIATT MICHAEL G&WENDY K • Phone Number:
ADDRESS: 3283 JAYHAWK CT
EUGENE OR 97405
OWNER: HIATT MICHAEL&WENDY Phone Number:
ADDRESS: 3283 JAYHAWK CRT
EUGENE OR 97405
CONTRACTOR INFORMATION j
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor L 8 E ELECTRIC INC CCB 105475 03/30/2014 541-933-2598
General Contractor MICHAEL HIATT CONSTRUCTION LLC CCB 152009 06/28/2014 541-485-0219
Mechanical Contractor MICHAEL HIATT CONSTRUCTION LLC CCB 152009 06/28/2014 541-485-0219
Plumbing Contractor KEVIN COHEN PLUMBING INC CCB 176311 05/30/2013 541-607-9208
L INSPECTIONS REQUIRED
Inspections
3130 Footing/Foundation Drains
3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking.
3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing.
3315 Water Line
3400 Storm Sewer Storm Sewer Line: Prior to filling trench.
3999 Final Plumbing Final Plumbing: Wien all plumbing 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
construction. .
Owner or Contractor Signature Date
•
•
Springfield Building Permit 5/9/2013 9:18:17AM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
�= ` Elit �oH
= 225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR97477
541-726-3753
811-SPR2013-00491
w w.spnngfield-or.gov 1814 10TH ST permitcentergspringfiem-or.gov
RECEIPT NO: 2013000915 RECORD NO: 811-SPR2013-00491 DATE:05/09/2013
tf 1<aWkalga a�''>.."I':. .' •CCOUNT CODE/TRANS'CODE
bESCR PTION "a.�".�!"1'�i?sa l'� � -ly°" ms`s "� � a • � MR•"AMOUNTDUE T:i
One or Two Family Dwelling with Two Bath 224-00000-425603 1005 748.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 89.76
Technology fee(5%of permit total) 100-00000-425605 2099 37.40
TOTAL DUE: 875.16
RZINI—ENT4iTeYPE P,AYOR 4casHIERearTPEHTER' COMMENTS. AMOUNIOND
Check HIATT MICHAEL&WENDY 875.16
352
TOTAL PAID: 875.16
•
•
•
SPRINGFIELD 225 Fifth St
__stiddij
CITY OF SPRINGFIELD Springfield,OR97477
- Phone: 541-726-3753
O0.EGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
• PERMIT NO: 811-SPR2013-00489
www.springfield-ar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/09/2013 EXPIRES: 11/04/2013
STATUS DATE: 05/09/2013 APPLIED: 03/11/2013
SITE ADDRESS: 1814 10TH ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703261300102 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: New duplex-Same as 1810 10th
OWNER: HIATT MICHAEL G&WENDY K Phone Number:
ADDRESS: 3283 JAYHAWK CT
EUGENE OR 97405
OWNER: HIATT MICHAEL&WENDY Phone Number:
ADDRESS: 3283 JAYHAWK CRT
EUGENE OR 97405
CONTRACTOR INFORMATION b
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor L 8 E ELECTRIC INC CCB 105475 03/30/2014 541-933-2598
General Contractor MICHAEL HIATT CONSTRUCTION LLC CCB 152009 06/28/2014 541-485-0219
Mechanical Contractor MICHAEL HIATT CONSTRUCTION LLC CCB 152009 06/28/2014 541-485-0219
Plumbing Contractor KEVIN COHEN PLUMBING INC COB 176311 05/30/2013 541-607-9208
INSPECTIONS REQUIRED `
Inspections
4225 Service or Feeder
4500 Rough Electrical Rough Electric: Prior to Cover
4999 Final Electrical 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 fron e property, and the approved set of plans will remain on the site at all times during
construction. v
-'' 7-( 3
Owner or contractoASigatRON: Oregon law requires you to Date
follow rules adopted by the Oregon Utility •
Notification Center. Those rules are set forth NOTICE:
In OAR 952-001-0010 through OAR 952-001-
• 0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone - AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR ;:;`•`
Center is 1-800-332-2344).
",NY 180 DAY PERIOD.
Springfield Building Permit 5/9/2013 9:15:48AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
6111-
�';OREGON TRANSACTION RECEIPT 25Fiftela`oRS7477
541-726-3753
811-SPR2013-00489
viww.springeeld-ar.gov 1814 10TH ST permitcenter@springfield-or.gov
RECEIPT NO: 2013000914 RECORD NO: 811SPR2013-00489 DATE:05/09/2013
io]�.Yo1:n kdlol:M !irr.., :@ :,::'i' 'F SYJII .`-ri71 -f',ACCO NT:CODE/TRANS CODE W r`F'a'AMO NT-DUE' d
Each added 500 sq. ft. or portion 224-00000-426102 1004 50.00
Residence wiring 1,000 sq.ft. or less 224-00000-426102 1004 268.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 38.16
Technology fee(5%of permit total) 100-00000-425605 2099 15.90
TOTAL DUE: 372.06
biliF��,``
YA'IIENT, II PAYOR cgsirligr caRPENTER, COAIIMENTSWN WIOMMOUNTwPAIDA3 1,''`frr -..3i
Check HIATT MICHAEL&WENDY 372.06
352
TOTAL PAID: 372.06
SPRINGFIELD 225 Fifth St
_....a.trati
CITY OF SPRINGFIELD Springfield,OR97477
Phone: 541-726-3753
iit" OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00490
www.spdngfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/09/2013 EXPIRES: 11/04/2013
STATUS DATE: 05/09/2013 APPLIED: 03/11/2013
SITE ADDRESS: 1814 10TH ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703261300102 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: New duplex-Same as 1810 10th
OWNER: HIATT MICHAEL G&WENDY K Phone Number: •
ADDRESS: 3283 JAYHAWK CT
. EUGENE OR 97405
OWNER: HIATT MICHAEL&WENDY - Phone Number:
ADDRESS: 3283 JAYHAWK CRT
EUGENE OR 97405
L • CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No • Lic Exp Phone
Electrical Contractor L 8 E ELECTRIC INC CCB 105475 03/30/2014 541-933-2598
General Contractor MICHAEL HIATT CONSTRUCTION LLC CCB 152009 06/28/2014 541-485-0219
Mechanical Contractor MICHAEL HIATT CONSTRUCTION LLC CC8 152009 06/28/2014 541-485-0219
Plumbing Contractor KEVIN COHEN PLUMBING INC CCB 176311 05/30/2013 541-607-9208
•
_ INSPECTIONS REQUIRED
Inspections
2200 Underfloor Mechanical Underfloor Mechanical. Prior to insulation or decking and including required testing.
2300 Rough Mechanical Rough Mechanical: Prior to Cover
2999 Final Mechanical Final Mechanical: When all mechanical 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 fro of the property, and the approved set of plans will remain on the site at all times during
construction.
/... C_ P- ( 3
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to •
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth NOTICE: i:'.:....
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the r. (Note: the telephone COMMENCED OR IS ABANDONED FOR
number for the he Oregon Utility Notification
Center is 1-800-332-2344). ANY 180 DAY PERIOD.
Springfield Building Permit 5/9/2013 9:17:09AM Page 1 of 1
SPRINGFIELD • CITY OF SPRINGFIELD
kr
225 Frith St
tt OREGON TRANSACTION RECEIPT Spnngfield,OR 97477
541-726-3753
811-SPR2013-00490
www.spnngfield-or.gov 1814 10TH ST perrnitcenter @springfield-or.gov
RECEIPT NO: 2013000913 RECORD NO:811-SPR2013-00490 DATE:05/09/2013
,ili f191tl[oy; a- ,_ `rte: -, 1 7 5..ai`_' firiSACCOUNT CODEFIRANS:CODER 's: ':,3:1 AMOUNT,DUE%=
First Appliance Fee 224-00000-425604 1006 79.00
Range hood/other kitchen equipment 224-00000-425604 1006 13.00
Single-duct exhaust(bathrooms,toilet compartments, utility room: 224-00000-425604 1006 54.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 17.52
Technology fee(5%of permit total) 100-00000-425605 2099 7.30
TOTAL DUE: 170.82
'.PAYMENT•_=trs,. .PAYOR .:4.caswER ccndeexTER'42±ct4."COMMENTS '1314 4" .,f' # :: LAMOUNT PAID :, "„- 3}. l;" _
Check HIATT MICHAEL&WENDY 170.82
352
TOTAL PAID: 170.82