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Home My WebLink AboutPermit Building 2007-11-13 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-01655 ISSUED: 11/13/2007 APPLIED: 11/08/2007 EXPIRES: 05/13/2008 VALUE: $ 129,044.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1679 S 58TH ST ASSESSOR'S PARCEL NO.: JASPER MDWS 5 ADD P SPRINGFIETYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Single family resid'ence- Jasper Meadows 5 lot 219 SAME AS COM2007-01639 1587 s. 57th Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 Phone Number: 541-741-2572 Phone Number: 541-228-6935 I CONTRACTOR INFORMA nON I Contractor Type General Electrical Mechanical Plumbing Contractor License HA YDEN ENTERPRISES 92208 M & W ELECTRIC INCORPORATED 67362 PACIFIC AIR COMFORT INC 39237 DENNIS SCOTT EGGERS ~ '{O\ll~176 me\" -' r1~mvtl ')I\\J~f p...rtE.Ni\O adOP S.e fU e R 952-0 . 'o\\ot-J 'i~\es cef\\teb~~~9~ ~~"e tu\es b'i 1 N~t\lCa\\Of\ OO'\.e01~t~eucw\~{)"one 26.00 'f\ CJjP..R 95~-rna~~@o'~ @Jt:~~e N6(ffi-~tJlr Gas O~' .'<0 \"e c~r dWlU\\\\~). Gas ca\\\"~ tOf \~Q!I ~2- Gas {\11rnbefCef\\tJn'lt1y ath: Path 1 Sprinkled Building: n/a Expiration Date 07/29/2009 06/19/2011 03/25/2010 05/05/2010 Phone 541-228-1081 541-754-6171 541-672-9510 541-459-0110 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: 6,305 Sq Ft 1st Floor: 1,148 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport 400 Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMA nON I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 13.00 7.00 38.50 0.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 2 Yes 24.50 REQUIRED PARKING Total: 2 Handicapped: Compact: Subdivision Not Accepted PUBLIC IMPROVEMENTS E. \f ,t\'C. \NOR" . · u'" ' P\?\~.QtJI.tI.'" -\$ ~e91 Street Improvements: Fully Improve \,\\S PERM\' Snl"\ER ,.\,\\S'-'r-cvr..J~ {OR' Curbside 7' Storm Sewer Available: Yes U1\'\OR\1.EO UNO S A.B~_~utS/Drains: Curb and Gutter Special Instruction: A. I\RW\ENCEO OR \ 0 COWl nI\'{ PER\O · Notes: No final Occupancy approval shall be grant~r~~Qo-rublic Works Approval for pump station Pa2e 1 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01655 ISSUED: 11/13/2007 APPLIED: 11/08/2007 EXPIRES: 05/13/2008 VALUE: $ 129,044.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Dwellin!!:s Gara!!:e Tvpe of Construction V Wood Frame Gara!!:e $ Per Sq Ft or multiplier $103.00 $27.00 Square Footage or Bid Amount 1,148.00 400.00 Value Date Calculated Description Total Value of Project $118,244.00 $10,800.00 $129,044.00 11/0812007 11/08/2007 ~ Fee Description Amount Paid Date Paid Receipt Number -Mech Iss 2+ Appliances- $40.00 11/13/07 1200700000000001395 + 10% Administrative Fee $135.86 11/13/07 1200700000000001395 + 5% Technology Fee $82.81 11/13/07 1200700000000001395 + 8% State Surcharge $102.50 11/13/07 1200700000000001395 2 Baths One or Two Family $280.00 11/13/07 1200700000000001395 Addressing Assignment $35.00 11/13/07 1200700000000001395 Appliance Vent $7.00 11/13/07 1200700000000001395 Building Permit $730.24 11/13/07 1200700000000001395 Curbcut Permit $85.00 11/13/07 1200700000000001395 Dryer Vent $7.00 11/13/07 1200700000000001395 Exhaust Hoods $10.00 11/13/07 1200700000000001395 Fire SF Fee - Residential $77 .40 11/13/07 1200700000000001395 Furnace - up to 100,000 btu $14.00 11/13/07 1200700000000001395 Gas Outlets 1-4 $5.00 11/13/07 1200700000000001395 Plan Review Major - Planning $205.00 11/13/07 1200700000000001395 Plan Review Same As $220.00 11/13/07 1200700000000001395 Residence Wiring 1000 Sq Ft $117.00 11/13/07 1200700000000001395 Residence Wiring Ea Addtl 500 $42.00 11/13/07 1200700000000001395 Sanitary Sewer - Improvement $469.29 11/13/07 1200700000000001395 Sanitary Sewer - Reimbursement $617.17 11/13/07 1200700000000001395 SDC MWMC Administration $10.00 11/13/07 1200700000000001395 SDC MWMC Improvement $990.39 11/13/07 1200700000000001395 SDC MWMC Reimbursement $95.35 11/13/07 1200700000000001395 SDC Sanitary/Storm Admin $123.12 11/13/07 1200700000000001395 SDC Transpo Admin $73.34 11/13/07 1200700000000001395 SDC Transpo Improvement $862.25 11/13/07 1200700000000001395 SDC Transpo Reimbursement $195.48 11/13/07 1200700000000001395 Sidewalk Permit $85.00 11/13/07 1200700000000001395 Storm Drainage Impervious Area $689.27 11/13/07 1200700000000001395 Temp Power 200 amps or less $55.00 11/13/07 1200700000000001395 Vent Fan $14.00 11/13/07 1200700000000001395 WilIamalane Single Family $2,303.00 11/13/07 1200700000000001395 Total Amount Paid $8,778.47 Pa!!:e 2 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01655 ISSUED: 11/13/2007 APPLIED: 11/08/2007 EXPIRES: 05/1312008 VALUE: $ 129,044.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Plannin2 Review Public Works Review 11/08/2007 11/08/2007 11/0812007 Plan Reviews' 11/08/2007 APP 11/08/2007 APP 11/08/2007 APP LLH TAJ LKW No final Occupancy approval shall be granted prior to Public Works Approval for pump station Structural Review 11/09/2007 11/09/2007 APP DJB SAME AS COM2007-01639 1587 s. 57th 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. ~eouire<Unsnections . Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Vfer 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. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. 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. Drywall: Prior to taping. Vnderfloor Plumbing: Prior to insulation or decking. 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. Vnderfloor Mechanical. Prior to insulation or decking and including required testing. Vnderfloor Gas: After line is installed and required testing and capped if not attached to an appliance. Pa2e 3 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01655 ISSUED: 11/13/2007 APPLIED: 11/0812007 EXPIRES: 05/13/2008 VALUE: $ 129,044.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 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 Temporary Electric: Approval required prior to Utility Company energizing pole. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Final Plumbing: When all plumbing work is complete. Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Final Building: After all required inspections have been requested and approved and the building 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 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. ~15 "~/)A~ , Owner or Co~ctors Signatur " 11-/'S~07 Date Pa2e 4 of 4 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: Com2007-01655 NAME OR COMPANY: Hayden Homes LOCATION: 1679 S. 58th Street TAX LOT NUMBER: Jasper Meadows 5th ADDSL219 DEVELOPMENT TYPE: Single Family Residence NEW DWELLING UNITS 1 BUll.DING SlZE (SF' 1548 LOT SlZE (SF): I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x COST PER S.F. CHARGE " I 1992.00 $0.346 = $689.27 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I x I COST PER S.F. x \ DISCOUNT RATE I I 0.00 I $0.346 ' I 50% = I ITEM 1 TOTAL - STORM DRAINAGE SDC I $689.27 DISCOUNT $0,00 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's I x 23 I B. IMPROVEMENT COST: I NUMBER OF DFU's I I 23 I COST PER DFU $26.83 x I COST PER DFU , I $20.40 . ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3. TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE I x 9.57 I = , $1,086.46 NUMBER OF UNITS x I COST PER TRIP 1 I 20.43 x !NEW TRIP FACTOR , I 1.00 . B. IMPROVEMENT COST: ADT TRIP RATE x NUMBER OF UNITS x I 9.57 ' 1 I ITEM 3 TOTAL - TRANSPORT A nON SDC = , 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: , INUMBER OF FEU's x I 1 COST PER TRIP $90.10 x NEW TRIP FACTOR 1.00 $1,057.73 ICOST PER FEU, I $95.35 B. IMPROVEMENT COST: 'NUMBER OF FEU's I x COST PER FEU . $990.39 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , $1,095.74 = , $3,929.20 SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) 5. ADMINISTRATIVE FEE: I SUBTOTAL I x I ADM.FEERATE I $3,929.20 I 'I 5% TOTAL SANITARY ADMINISTRATION FEE:' TOTAL TRANSPORTATION ADMINISTRATION FEE: CHARGE $196.46 u_"_.. .-..- -., 6305 $689.27 =' , $617.17 r:/1 ~ (:) 18 p::: ~ t-< r:/1, >-< o ~ 1070 1091 1092 1093 1094 1054 1055 11054 1056 I ,I I 11079 .11078 , 1 V8/2007 TOTAL SDC CHARGES Kaye Wilson' PREPARED BY. DATE $469.29 $195.48 I, $862.25 = $95.35 $990.39 $0.00 $10.00 123.12 $73.34 ,=' $4,125.66 , I DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUN ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET AuUIIIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTIJB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 J I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 LAUNDRY TIJB 0 0 2 = 0 CLOTIIESW ASHER / MOP SINK 1 0 3 = 3 ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 !RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 = 3 I SHOWER, SINGLE STALL 0 0 2 = 0 ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LA V ATORY/RESIDENTIAL BAR 2 0 1 = 2 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$l,OOO ASSESSED VALUE $5.29 $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 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0.00 x $5.29 = J $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0.00 x $5,29 o = $0.00 TOTAL MWMC CREDIT Willamalane Park & Recreation District Job. No. ~J1/D\\05) NAME. GE WORKSHEET FOR 2007 PHONE: ~~~~~ STATMCzIP:Ltllt{p LOCATION OF PROPOSED BUILDING SITE: \\Q~q S.~~~ . Plat Name. (h.. Tax Lot Number: ~ ~SC~~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back,) A. Sinale-Familv Detached \ NO. OF UNITS X $2,303 per unit = $ fL~t~.(}O B. Sinale-Familv Attached NO. OF UNITS X $2,426 per unit = $ C. Multi-Familv Aoartment NO. OF UNITS X $2,032 per unit = $ D. Sinale Room Occupancy NO. OF UNITS X $1,016 per unit = $ E. Accessorv Dwellino Unit NO. OF UNITS X $1,151.50 per unit = $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) ~ I $ ~~Q3.oo o , $?:3fBrfJ I (') I D1 $ WILLAMALANE SDC 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval.) Development Services D City of Springfield Date 5 DEVELOPMENT TYPE DEFINITIONS1 ~~~1~1 . ..~ ". J'~' , S I ~g1;~ j~ a\Tl i,ly..DE1hlched Owe \Ii n gUn it Al5uildfl'l~ or a portion of a building consisting of one or more rooms including sleeping, cooking, and plumbing facilities arranged and designed as permanent living quarters for one family or household; and not attached to any ot~er dwelling ,unit or building. This'd'efiQi~n tndiJctes'manufactured hqusing.- '~.~4" ,.,:' ," t" -,; - , ". ". .~.;-( ~': '.,: \ , ~.';:.'./ .i \ : '~"1 \~. ~ ~,". ~i~l~:na;~Yb~i~~~~~~~~~~~rl~~~I~r~roo~ r~~(.iit;;p~~~jf~~Jo~ing, : and plumbing facilities arranged and designed as permanent living quarters ior one family or household; and which is attachf;3d to one or more dwelling units by one or ~ore co~mon ve~ical walls. This definiti?JiJakJ.~~~.~e~1'.9u1ft$:"I1ot li~ited to "duplex", zero let line dwelling", "townhouse", and (raw l*1ow~e"" Wtth, the'~x~ptlon of duplexes, Singl~:"f~i~Y(-Al:ta.,~h,~Q,..~elling Units typically are separ~~ly~~~'9i _) '''It' ',' 'I II"~ " '._'. 't .', . ;.~" 1../1' I t I . " '-..' " .'j i~'"",'"./"~ _'{,._~~-#J/~._7 Multi-Family Dwelling Unit i ~ A portion of a building consisting of one or more rooms including sleeping, cooking, and plumbing facilities arranged and designed as permanent living quarters for one family or household; and which is attached to two or more dwelling units by one or mor~..t:ori1l1\oil V;ertical walls. Typically, the units are in an apartment building or complex, 8rren~te not separately owned. . Single Room Occupancy Dwelling Unit A portion of a building consisting of one or more room,s including sleeping facilities with a shared or private bath, and shared cooking facilities and shared living/activity area. This definition also includes, but is not limited to "assisted living facility." Single room occupancy dwelling units shall be charged at one-half the multi-fa'mily dwelling unit SDC rate. Accessory Dwelling Unit A secondary, self-contained dwelling that may be allowed only in conjunction wiih a detached single-family dwelling. An accessory dwelling unit is subordinate in size, location, and appearance to the primary detached single-family dwelling. An accessory dwelling unit generally has its own outside entrance and always has a separate kitchen, bathroom and sleeping area. An accessory dwelling unit may be located wi{6~tf; a1:tacf1E(1 to, or detached from the primary single-family dwelling. Accessory dwellir'1g Lin~ts'sJ1all be charged at one-half the single family detached dwelling unit SDC rate. ~..) ~:... ~, ,..., :'. , '---..!'i'.-"" ... i ,. '. ~~ L... ~. . -~, "] .. ' ),,; ';.f> Update~2J29/p( .' i ,", .~,' '--. ".# 1 From the WPRD Parks and Recreation SDC Resolution No, 06-07-6, October 10, 2006 6 - -. ~"" L..UU I \ I "1 J ,I C; I (" 12."1 ~FI1J STREEI' · SP.RII'.,0Ur.i'u.LD.OR97477 . 1'11:(541)'726-3753 . FAX: (S4l)"1U.3~ ELE.....l.tUCALr~ flPQ.l.CArrON City Job Number l'J\. \\.O-::J'C . 3. (FAX)15417412572 P.001/002 ZON [}~.~f' _ INlTIALs (~ :;:o,1\.~_ Date 11-'( 3 - 0-' 1. ~ ~. , ~nCJ:' r\ft1 10BD~C~ON: ~ ~ :V1 q S~ ro]+j Service Included , 1000 sq. ft. or Jess . Each additional 500 sq. ft. or penion thereor .Each Manufuct.'d HOme or Modular Dwelling Service or Feeder \ fJ. -- , Sl J7.00 J t1 f1) $ 2J.00 41 jLJ . ~crmits a~ Don-transferable and expire if work is Dot sblrted within 180 days of issuance or j{work is SUSpcalded for 180 dayl'lo 2. $55.00 B. Electrical Contractor 1M fW ~~~ City A \ hUIIVl/ 200 Amps or less 201 Amps to 400 Amps 401 Amps to '600 Amps 601 Amps to 1000~ Phone 7~-l.t1' I' Over~O:fA'inY{J~'i~t&f 01'\ \R\I\I ~'t}{', h ~'t'l't~'n0N'. Od~~{edb'J \~ as are set ,art -' II h' C' \as a l"' "Q:\ i-<'t!/r(c?1 r~ ~'r,p.l'\teL 'i NotH\cat\l52.'OO~ -OO~ ~ copies \ephone to - 1-l.QlU \1'\ OAf\~ II ma'J obta\~;~~'ltr Relocation OO~\)'. L 8 the cel'\ter. ~ijQ\A>>t~~'I2":~.' " , I 7 ? ,,, L ca\\lng 'or the ore ,,1I\(\~~3~-~to 400 Am ' ", \P ..> \t' ~r \ ,\S 1-~jJlUIIps ps HU . center 401 Amps to 600 Amps I.,..l-Jc.o~ ~~l(lf r!vJ-{ ~/..I $ 70.00 $ 83.00 , $138110 $180.00 $413.00 , $ 55.00 Address Supervisor License Number E...J':' ..~:on Date Constr. Contr. Number $ 55.00 s..eo.aJ $ 76.00 $II 0.00 .Expiration Date Signature of SUpervising Electrician Over 600 Amps or ) 000 Volts see "B" above. 1.I.Il" D.~ C>wncrs Signature: . A . _I .II _ New Alteration or Extension Per Panel ) / ~ -b- ~ -. One Circuit M I ,,^tv1/k""' ~ Each Additional Circuit or with · (\ 1Jl1 (;:::) Service or Feeder Permit :;]~ .%.J (~lrlfJ.f/ F. City~n()ttl. Phone ~1JCJ{dG5 . $ 48.00 $4.00 .,;.; . $ ".00 Inspection Request: 726-3769 TOTAL Shared Ori~)lamlding FOrmslE!CefriCIIIl'crmil Ajlplication 7-07.doc ~O~. $ SO.OO Fee is $50.00 ~ SURIA 111 ~al V'-/ . . - J-;t .~ ~, 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-0]655 COM2007-0]655 COM2007-0I655 COM2007-0]655 COM2007-0] 655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0] 655 COM2007-0]655 COM2007-0] 655 COM2007-0]655 COM2007-0] 655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0]655 COM2007-0 1655 COM2007-0]655 COM2007-0]655 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200700000000001395 Date: 11/13/2007 Description Plan Review Same As Plan Review Major - Planning Sidewalk Permit Curbcut Permit 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 SDC Transpo Admin Building Permit Addressing Assignment WiIlamalane Single Family 2 Baths One or Two Family Furnace - up to ] 00,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets ]-4 ~Mech Iss 2+ Appliances~ Residence Wiring] 000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee - Residential + 5% Technology Fee + 8% State Surcharge + ] 0% Administrative Fee Paid By HAYDEN ENT Item Total: Check Number Authorization Received By Batch Number Number How Received djb 0406] 2 In Person Payment Total: Page] of] 1:42:31PM Amount Due 220.00 205.00 85.00 85.00 689.27 6]7.] 7 469.29 195.48 862.25 95.35 990.39 10,00 123.12 73,34 730.24 35.00 2,303.00 280.00 14.00 14.00 7.00 10.00 7.00 5.00 40.00 117.00 42.00 55.00 77.40 82.81 102.50 135.86 $8,778.47 Amount Paid $8,778.47 $8,778.47 11/13/2007