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Home My WebLink AboutPermit Building 2007-10-23 _f} G~) ~lD./ftV ~t) \~~~ 0'~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4186 CAMELLIA ST ASSESSOR'S PARCEL NO.: 1702323303402 Springfield PROJECT DESCRIPTION: Garage conversion Owner: FRECHETTE BRIAN J Address: 1876 HEITZMAN WAY EUGENE OR 97402 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 TYPE OF WORK: Garage Conversion TYPE OF USE: Alteration Residential I CONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone General OWNER Electrical SPRINTER ELECTRIC INC. 174458 02120/2009 541-521-9058 Mechanical OWNER Plumbing G & C VENTURES LLC 157056 11/03/2007 541-544-5258 BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: VB 2 2 21.00 Wall Heat Electric Electric nent Path n/a Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: 4 ATTENT\ON: Oregon ~a~::6~t ltJPU~:\jVIPROVEMENTS I Street Impr~~R6W~leS adoPte~h:se rules are set forth Sidewalk Type: '" tif'~f:l.tjgn Center. hOAR 952-001- NOTICE Storm Sewe:r~lV~~115~_001-001 0 throu.g the rules by : Downspouts/Drains: Special Inst~o~W.nyOU may obtain COPI~~h~f telepho~e THIS PERMIT SHALL EXPIRE IF THE WORK . 0 calling the cen~r. (~I~t~tility Notification AUTHORIZED UNDER THIS PERMIT IS NOT Notes. number for the, ~~~OO-332-2344). COMMENCED OR IS ABANDONED FOR Center IS ANY 180 DAY PERIOD. Pa!!:e 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Gara!!e Conver. Gara!!:e Fee Description Plan Review Residential ~Mech Iss 2+ Appliances~ + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Dryer Vent Exhaust Hoods Fixture Fixture Minimum/Adjustment Mechanical Plan Review Minor - Planning Sanitary Sewer - 1st 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Vent Fan Water Line - Ist 50 Feet + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Residence Wiring 1000 Sq Ft Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $76.00 Square Footage or Bid Amount 929.00 Value Date Calculated Total Value of Project $70,604.00 $70,604.00 09/11/2007 ~ Amount Paid Date Paid Receipt Number 1200700000000001181 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 1200700000000001197 3200700000000000697 3200700000000000697 3200700000000000697 3200700000000000697 $323.98 $40.00 $74.44 $43.02 $59.55 $498.43 $7.00 $10.00 $16.00 $80.00 $26.00 $116.00 $50.00 $244.85 $322.00 $10.00 $961.52 $91.61 $46.89 $87.50 $862.25 $195.48 $7.00 $50.00 $11.70 $5.85 $9.36 $117.00 9/11/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 9/14/07 10/23/07 10/23/07 10/23/07 10/23/07 $4,367.43 I Plan Reviews I Pa!!:e 2 of 3 CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Planninl!: Review 09/11/2007 09/11/2007 APP TAJ MDR density allows an additional unit. 4 off street parking spaces are required and shown on the plot plan. 09/11/2007 09/11/2007 APP EW 09/13/2007 09/13/2007 APP DLM Public Works Review Structural Review 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. ReQuired Insoections I Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. 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 Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. 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, 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 Contractors Signature Date Pal!:e 3 of 3 .City of Springfield Electrical Authorization To Begin Work E-mailedTo:Sprinter5c@yahoo.com Receipt # EC519126 10/22/20075:50:08 PM Check on status of permit By Phone: (541)726-3753 or Email: permitcenter@ci.springfield.or.us o New construction [2U Addition/alteration/replacement Description Qty. Ea. Total [Xl 1 or 2 family dwelling o Multi-family o Commercial/Industrial 11,000 sq, ft, or less lEa, addl 500 sq, ft, or portion I-Limited energy, residential (with above sq, ft.) I-Limited energy, multifamily residential,(with above s9' ft.) , t.~$~i~~~il6R.i@?ffi7l':raiinm:i1j~ftit~t;l!~i'!!!i;^N;Q/O~1:I~lItio\i:,:\y.lk :2_:~.J'h',"':;i"dmi@J0b,U~%:i~iW<'llldibwm",*>>="'''"''t'"'-''"',y""",-_-,,"",,_,,,,_,,,,,,,_,~,,,-,,__ _,'."._' -,J",,, 'J0;,,&:r,,:h"x",1K~'''r;,,)hji",,', -^~-,,"-.-,,^_,.-, _,' , '_ ,_ : ,_, _,_"-,, ^ ,,.. $117,00 $11700 I I I IJObno.: !JObaddress: 4186 CAMELLIAST I City/State/ZIP: SPRINGFIELD, OR 97478-5951 I Suite/bldg.lapt.no.: I Project name: Cross street/directions to job site: 200 amps or less 1201 amps to 400 amps 1401 amps to 599 amps I Subdivision: I Tax map/parcel no.: 1702323303402 I Lot no.: 200 amps or less 1201 amps to 400 amps 1401 amps to 599 amps Fee for branch circuits with above service or feeder fee, each branch circuit. B, Fee for branch circuits without service or feeder fee, first branch circuit; each addl branch circuit Contractor has made the existing garage into a living residence that will have it's own service, Name: Jeremy Cooper Phone: (541) 743-1213 IFax: (541) 895-2207 I Email: Sprinter5c@yahoo.com Service reconnect only I Each manufactured or modular dwelling, service and/or feeder I Pump or irrigation circle I Sign or outline lighting Signal circuit(s) or Iimited- not offered online at this jurisdiction energy panel, alteration, or extension, I EI. lie. no.: C256 Business Name: SPRINTER ELECTRIC INC Contact: Jeremy Cooper Address: 82924 FLORENCE AVE City/State/ZIP: CRESWELL OR 97426 Phone: (541)7431213 IFax: (541)8952207 I Email: Sprinter5c@yahoo.com I Metro lie. no.: 54] 743-1213 I City lie. no.: Creswell I Supervising electrician's lie. no.: 1871 S I Supervising electrician's name: DAVID GADOMSKI I I I I · City Of Springfield Subtotal $1 State Surcharge (8% of permit fee) $9.36 City Of Springfield fees' $17,55 TOTAL PERMIT FEE $143,91 10% Local Admin Fee; 5% Local Technology Fee Upon review and approval by your local jurisdiction, your permit will be e-mailed or faxed within one business day, with instructions on how to schedule your inspection. NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained. The local building department may determine that an Authorization To Begin Work is null and void if it does not meet applicable land use laws and local ordinances. This Authorization To Begin Work must be posted at the job site until replaced by a Permit. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01384 COM2007-01384 COM2007-0 1384 COM2007-01384 Payments: Type of Payment ONLINE CHGS cReceintl RECEIPT #: Description Residence Wiring 1000 Sq Ft + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By ONLINE PERMIT CHGS 3200700000000000697 City of Springfield Official Receipt Development Services Department Public Works Department Date: 10/23/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received DDK Page 1 of I ONLINE SPRINTER Online ELECTRIC Payment Total: 9:08:40AM Amount Due 117.00 5.85 9.36 11. 70 $143.91 Amount Paid $143.91 $143.91 10/23/2007 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4186 CAMELLIA ST ASSESSOR'S PARCEL NO.: 1702323303402 Springfield PROJECT DESCRIPTION: Garage conversion Owner: FRECHETTE BRIAN J Address: 1876 HEITZMAN WAY EUGENE OR 97402 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 TYPE OF WORK: Garage Conversion TYPE OF USE: Alteration Residential I CONTRACTOR INFORMATION I # of Stories: 2 Lot Size: Height of Structure: 21.00 Sq Ft Ist Floor: Type of Heat: Wall Heat Sq Ft 2nd Floor: Water Type: Electric Sq Ft Basement: Range Type: Electric Sq Ft Garage/Carp'ort you to Energy Path: nent Pft.9.0N:ScNgatfIklW requtres Uti\ity Sprinkled Building: 1\, bfJ'4' ~ lli~dlRro'JbJJdl\t: Oregon h *"I\P.Y' rules auup ~~'es are set fort I DEVELOPMENT INFORMA TroN~~~~.oo1~010'throU9h 0':e:;;3 ~ . . ~ You may obtalRGOO~~'~fI(9lJtfOMtG UUVV. h centet Ei\lOle:-U'i 6lAcation Overlay Dist: ca"'ng t e Or~ Btf~tn\ty NOUll 4 # Street Trees Rqd: number for the.. 1 . t1~). Paved Drive Rqd: Center Compact: . % of Lot Coverage: Contractor Type General Mechanical Plumbing Contractor OWNER OWNER G & C VENTURES LLC BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VB 2 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I NOnCE: ' THIS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR . ANY 180 DAY PERIOD. . Notes: Paee 1 of 3 License Expiration Date Phone 157056 .11/03/2007 541-544-5258 Sidewalk Type: Downspouts/Drains: Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description Tvpe of Construction Gara{!e Conver. Gara{!e $ Per Sq Ft or multiplier $76.00 Square Footage or Bid Amount 929.00 Value Date Calculated Total Value of Project $70,604.00 $70,604.00 09/11/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $323.98 9/11/07 1200700000000001181 -Mech Iss 2+ Appliances- $40.00 9/14/07 1200700000000001197 + 10% Administrative Fee $74.44 9/14/07 1200700000000001197 + 5% Technology Fee $43.02 9/14/07 1200700000000001197 + 8% State Surcharge $59.55 9/14/07 1200700000000001197 Building Permit $498.43 9/14/07 1200700000000001197 Dryer Vent $7.00 9/14/07 1200700000000001197 Exhaust Hoods $10.00 9/14/07 1200700000000001197 Fixture $16.00 9/14/07 1200700000000001197 Fixture $80.00 9/14/07 1200700000000001197 Minimum/Adjustment Mechanical $26.00 9/14/07 1200700000000001197 Plan Review Minor - Planning $116.00 9/14/07 1200700000000001197 Sanitary Sewer - Ist 50 Feet $50.00 9/14/07 1200700000000001197 Sanitary Sewer - Improvement $244.85 9/14/07 1200700000000001197 Sanitary Sewer - Reimbursement $322.00 9/14/07 1200700000000001197 SDC MWMC Administration $10.00 9/14/07 1200700000000001197 SDC MWMC Improvement $961.52 9/14/07 1200700000000001197 SDC MWMC Reimbursement $91.61 9/14/07 1200700000000001197 SDC Sanitary/Storm Admin $46.89 9/14/07 1200700000000001197 SDC Transpo Admin $87.50 9/14/07 1200700000000001197 SDC Transpo Improvement $862.25 9/14/07 1200700000000001197 SDC Transpo Reimbursement $195.48 9/14/07 1200700000000001197 Vent Fan $7.00 9/14/07 1200700000000001197 Water Line - 1st 50 Feet $50.00 9/14/07 1200700000000001197 Total Amount Paid $4,223.52 Plannin{! Review 09/11/2007 I Plan Review~ 09/11/2007 APP T AJ MDR density allows an additional unit. 4 off street parking spaces are required and shown on the plot plan. Public Works Review Structural Review 09111/2007 09/13/2007 09111/2007 09/13/2007 APP EW APP DLM Pa{!e 2 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01384 ISSUED: 09/14/2007 APPLIED: 09/11/2007 EXPIRES: 03/14/2008 VALUE: $ 70,604.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. LReauired Insoections I Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. 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 Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. 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, 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. h. --:>/~_~ Owner or Contr~rs Signature ' 9;4~7 v Date Pal!e 3 of 3 Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: COW\ z..o-o "7 - (.) /3 g 'f Lfl ~ b CAc,1/\ r=( It 9i ~ Dare: ,;1- cr/;y/c? / Address: Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will befifed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: __ p). 62. - I own, reside in, or will reside in the completed structure. '1 understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. o 3A. My general contractor is (Name) (CCB #) - I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. /' OR 4:J 3R- I will be my own general contractor. _ If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. 1fT change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that! have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side ofthis form. 6-,/~ ~~/ (Signature #rmit applicant) - (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 06-0 1-04 , - ". , A~tirtg a~ 'Ytiur~Own General Contractor? ;.... \. ~ ." . . , . . 1 ,,"! ~ "INFORMATION-NOTICE TO PROPERTY OW"NERS ' ABOUT-CONSTRU~TI,ON RESPONSIBllITIES- ~ ~..'.. M . . \ ' . , . . ~ " . \ ' - - _:.',:. NOTE: This Information Notice to Property Owners about Construction"Responsibllities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. .;' .' ~ . ' . ." _. ".t If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware ,of the following responsibilities and concerns. Employer Re~ponsibiliti~s You will, in most instances, be ruled to be an "employer" "and the contractors .you contract with will be "employees" if YOUl,lse contractors not licensed with the Construction Contractor:s Board to do labor in constructing or to assist in the construction Qrimprovement ofa residential.stru.ctur~. As the employer, yo~.mus,t comply wi~h the follow,ing: , . ' Oregon's Withholding Tax Law: As an ~p10yer, you must withhold i~come taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more infonnation: call the'Department of Revenue at 50j~378-4988. " " " Unemployment Insurance Tax: As an employer; you are required topay,a tax for unemployment insurance purPoses' on the wages of all employees. For more information, call the Oregon Employment Department at 503~94 7 -1488. The Oregon Business Identification Number (BIN) is a combined number, for, both Or~gonWithholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or \-vww.dor.state.or.us/formsnav.htmll for the appropriate forms. Workers' Compensation Insmnince: As an employer, you are subject to the Oregon Workers' Compensation Law, and mU$t obtain workers' compensation insuran,?e for your e~pI.oxees. If)'ou fail to obtain workers' compensation insurance, you could be subject to penalties and 'be lii:ible for all cliiimcosts ifon'e ofyotir employees is injured on the . job, For more information, call the Workers' Compensation Di\risionat the Department of Consumer 'and Business Services at 503-947-7815. " U.S. IntemaD Revenue Service: As an employer, you must withhold' feder-al income tax from, employees' wages;'",- You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-'80'O-829-4933or"Nisit their web site at,Vl\V,v.irs.l!ov. , :0 .' .- , ,Other Re~polI1l~ii\blUhne~. anldl;,Area~of. C(()Jl]CeiIlllS Corllc Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. . .' ., . . Liability and Property Damage InsUllrance: Contact your insurance agent to see if ybti have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must b~ redon~; :, - ';'~~ '>. Time: Make sure you:.have sufficient time to supervise your employees., ' Expertise: Make sure you have'the skills to act as y~;;t own general contr~iCtor, to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner. doc 06-01-04 225 Fift.h Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 CO M2007 -01384 COM2007-0 1384 COM2007-01384 COM2007-0 1384 COM2007-01384 COM2007-01384 CO M2007 -01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 COM2007-01384 CO M2007 -01384 COM2007-01384 COM2007-01384 Payments: Type of Payment Check cReceintl RECEIPT #: 1200700000000001197 Date: 09/14/2007 Description Plan Review Minor - Planning 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 SDC Transpo Admin Building Permit Fixture Water Line - 1st 50 Feet Sanitary Sewer - 1st 50 Feet Vent Fan Exhaust Hoods Dryer Vent Minimum/Adjustment Mechanical -Mech Iss 2+ Appliances- Fixture + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By BRIAN FRECHETTE CORP Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1001 In Person Payment Total: Page I of I 11 :38:03AM Amount Due 1\6.00 322,00 244,85 195.48 862.25 91.6\ 96\.52 10.00 46,89 87.50 498.43 80.00 50.00 50,00 7,00 10,00 7,00 26.00 40,00 \6.00 43,02 59,55 74.44 $3,899.54 Amount Paid $3,899,54 $3,899.54 9/14/2007