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Home My WebLink AboutPermit Building 2007-12-6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3190 PARTRIDGE WAY ASSESSOR'S PARCEL NO.: 1703221308800 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01547 ISSUED: 12/06/2007 APPLIED: 10/12/2007 EXPIRES: 06/06/2008 VALUE: $ 56,061.00 Springfield TYPE OF WORK: Garage PROJECT DESCRIPTION: Garage addition Owner:. EUBANK CINDY L Address: 3190 PARTRIDGE WAY SPRINGFIELD OR 97477 TYPE OF USE: Addition Residential Phone Number: 541-954-6050 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I R-3 U VB # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: License Expiration Date Phone 2 22.00 Wall Heat Electric Electric Path I n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 394 18 423 I DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.40 5.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 0.00 I PUBLIC IMPROVEMENTS I Street Improvements: p' II I arfla V m&r&y'~U to Storm Sewer Al1If.t.Ij(l()N: Oregon aw req r adrl'\ .. Special I nstr~rmt:rules adopted by the Oreg 'Utility Notification Center. Those rules are set forth ... "AD O".,.J\t\1:;OOHl throu.Q.h OAR 952-001- Notes: Stoo9G.'y~~y6til~in~cfpilf!l of the rules by calling the center. (Note: .t.he tel~pho~e number for the Oregon Utility Notification Center Is 1-800-332-2344). Paee I of 4 REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Curb and Gutter NOTICE: THIS PERMIT SHA AUTHORllED UND~~ ~PIRE IF THE WORK COMMENCED OR IS ABA~ PERMIT IS NOT ANY 180 DAY PERIOD, DONED FOR CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01547 ISSUED: 12/06/2007 APPLIED: 10/12/2007 EXPIRES: 06/06/2008 VALUE: $ 56,061.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line I V llII'''.tion Descrintion I I.... I Descriotion $ Per Sq Ft or multiplier $103.00 $27.00 Square Footage or Bid Amount 441.00 394.00 Tvpe of Construction Dwellin2s Gara2e V Wood Frame Gara2e Total Value of Project L.Fpp< pqi4J Value Date Calculated $45,423.00 $10,638.00 $56,061.00 11/1412007 11/1412007 Fee Description Amount Paid Date Paid Receipt Numher Plan Review Residential $240.31 10112107 1200700000000001304 -Mechanical Issuance Fee- $20.00 1216107 1200700000000001470 + 10% Administrative Fee $65.81 1216107 1200700000000001470 + 5% Technology Fee $36.62 1216107 1200700000000001470 + 8% State Surcharge $49.31 1216107 1200700000000001470 Add, Alter, Extend Circ $48.00 1216107 1200700000000001470 Add, Alter, Extend Circ Ea Add $16.00 1216107 1200700000000001470 Building Permit $438.37 1216107 1200700000000001470 Dryer Vent $7.00 1216107 1200700000000001470 Fire SF Fee - Residential $41.75 12/6/07 1200700000000001470 Fixture $64.00 1216107 1200700000000001470 Minimum/Adjustment Mechanical $36.00 12/6/07 1200700000000001470 Plan Review Minor - Planning $116.00 1216/07 1200700000000001470 Plan Review Residential $44.63 1216107 1200700000000001470 SDC SanitarylStorm Admin $9.53 12/6/07 1200700000000001470 Storm Drainage Impervious Area $190.66 12/6/07 1200700000000001470 Vent Fan $7.00 1216107 1200700000000001470 Total Amount Paid $1,430.99 Plan Reviews I Initial Review Public Works Review 10/15/2007 10115/2007 10115/2007 10115/2007 APP NJM WE BRC Pa2e 2 of 4 Contacted Cindy Eubank (Owner, 10115) and explained that she would need approval from tbe Lane County for adding additional fixtures to tbe existing septic tank. Gave her the phone number for County. The rest of the public works reveiw is complete. Stormwater to go to weep hole in curb. SDC Worksheet attached. Routed to planning. -u;;;~..... .... i u.e.. I ~ Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01547 ISSUED: 12/06/2007 APPLIED: 10/12/2007 EXPIRES: 06/06/2008 VALUE: $ 56,061.00 225 Fiftb Street, Springfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 10/15/2007 10/15/2007 APP BRC Lane County gave approval for adding additional fixtures to the septic. BC Structural Review 1011512007 11/14/2007 APP DLM See documents for Plan review comments. Plannin2 Review 10115/2007 1111612007 APP T AJ 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. Rrrl',i:prl Tn.npr,tin~ Footing: After trencbes are excavated. Fonndation: After forms are erected but prior to concrete placement. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheatbing 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Bnilding Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: Wben 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. Pa2e 3 of 4 -'GelltHQIl'I.lill.O~,. '" ,'. ,', WIr,"~ .. Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01547 ISSUED: 12/06/2007 APPLIED: 10/12/2007 EXPIRES: 06/06/2008 VALUE: $ 56,061.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeclion Line By signature, I state and agree, that I have carefnlly 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 sball be done in accordance witb the Ordinances of the City of Springfield and tbe 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 tbat only contractors and employees wbo 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. ~ ~/~ /:!2/CJr;,/'~7 Owner or #ractors Signature Date' Pa2e 4 of 4 ZON --1.O..Q INITIALS W ' DATE "~ SOURCE ~ J(~ 22S FIFTH STREET. SPRINGFIELD. OR 97477 . PII:(S41)726-37S3 . FAX, (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number ' ~ 2m 7 ~ (j J.C; -47 -.. . 1. rr~~rlQ~~~~~:f~1fJIII ---31-5'0 /A/T~/J)f~ tiJ~ LEGAL DESCRlPTlON: " , " /70,'< 22-1? t)f9;&:JO J08DESCRlPTlON: /kb t1M~& ~/ O,r:t=rce ~e- Permits are non-transferable and expire if work is not started within 180 days of issuance or'if work is Suspended for 180 days. ~",+,{J..~'11~C~~~~?4-~-m!~""1:i'i"~",,:,,,..<r.;;'~~'t;;r.~ 2. ~1i2~~!?~fl~~~~~j[~~~ff~ Electrical Contractor I Aejdress Phone/ City Supervisor License Number Expiration Date Expiration Date Signature of Supervising Electrician Owners Name C/ IJ Ot./ L2:/A'(A-..4 }/<'" Address '3 ) 9n /A17;P/I)d'gjJ.Jfi-u City SJJr7l' Phone '7,')4 -tfo..fo ,I ' - OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. X~kh&.J~ Inspection Request: 726-3769 Date ~,.."""_"...""'~'"_.'''"'::''.._._~~'~..~. -,""~~_^^:C____...,_., _~'r'M..ttr~74i"'m'-~~.- '" -;*2!%il~?JS2;r'Jj~7;~~;2 3. '-COMPEEFE'EEES€HEDOI.E'B.EIX)W.~''''- '-'<,~:'I!ml':\.,", ~---'"~",'ca"'c;>;;v.~>>>:"'''''~'''':;:'!Risa1Y:.;<t:t~"""-'O~,,,,,,<--1"''' ~ ~",~."".,-~ T '" ..~..-=.,,~'lii"-,-~_0"~~ A. -~~~~~ii;~iliMqnER_[~)Ym~]1[~uilwJ!E]li Service Included 1000 sq. ft. or less Each additional 500 sq, ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 $ 21.00 $55,00 " rw~~~KJ0%~;.,~,.\""~"':~~"1!~lL'<~~~"~~~~t\'~;_i1fTif51Y_~~ B. ~~~~L5,;~gr~~~Y};_r1~JJJj~~~~~:f#1!~~~~~t2t~~i:?~~~" 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpslV olts Reconnect Only $ 70,00 $ 83,00 $138,00 $180.00 $413:00 $ 55.00 c. ......- -" Installation, Alteration or Relocation 2QO Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 $ 55,00 $ 76,00 $110,00 D. New Alteration or Extension Per Panel One Circuit } Each Additional Circuit or with 1- Service or Feeder Permit q-- $ 48,00 --1-8 $ 4.00 /0 'l1'~~~"T$,~';'--'f9,~_.-.1l!~Y;~:'~"~~'~~','t:--;~it-'_""---"'_'~ E %"M'" "':""'"11<""";' .c7""(~'S-"jk,. ";';"~~~"'\t;,.-F'-"~>d)''-,'E"''''h' 'T' ""t" '1'1' '":0'"",. . ,.~ lsce aneous! ervlccllccuer,jno'mc UuC :,7".ac t us a atlOn':'J ~M.'1;;;';B~f""""-~~;"'="-""'~~iili.';jJ;l'il';J;.;:0~Jt4."i~~""#~ -;Af),S'im\i~~~~t'5:~-f;.. Pump or irrigalion $ 55,00 Sign/Outline Lighting $ 55,00 Limited EnergylResidential $ 28,00 Limited EnergylCommercial $ 50,00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges ~""''''''''''~~"'''''''''''-'''''''''''~;''illlM.-''''''''_b:);:~;FAA 4- 4. '6!SUB1'O'FAL10EiABOVEl:i!:";)i!i;~!i1'Fisl!"",1"iJ;a /" {TO . ~1"..m:~W.i~lt~~'i'F~'1i;\Zi~D;7.m2m7irt'L~Ait~?~~~ to 8% State Surcharge C:::;, / 2- 10% Administrative Fee ;;.. 4,(J 5% Technology Fee =? '~.(;L Y J' TOTAL ~. 7~J~b Shared Drivc\T:)fBuilding FonnsfElectrical Pennit Application 7.07.doc CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: COM2007-01547 NAME OR COMPANY: Cindv Eubank LOCATION: 3190 Partridl{e Way TAX LOT NUMBER: ' 17-03-22-13 08800 DEVELOPMENT TYPE: Garage/Office Add, NEW DWELLING UNITS 0 BUILDING SIZE (SF: 551 LOT SIZE (SF): I, STORM DRAINAGE 6534 r- If/) 1i'S 10 u ~ ,w:.l I- I~ DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS SF x I COST PER SF I I CHARGE 551.00 I $0.346 = I $190,66 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS SF I x I COST PER S,F, I x I DISCOUNT RATE I I I 0,00 1 I $0.346 I 50% . I ~ ITEM I TOTAL - STORM DRAINAGE SDC , $190.66 I 2, SANITARY SEWER - c:rTY A REIMBURSEMENT COST: I NUMBER OF DFUs I x I 7 I DISCOUNT $0,00 $190.66 11070 COST PER DFU $26,83 $0.00 11091 B. IMPROVEMENT COST: I NUMBER OF: DFUs I, x I 7 I COST PER DFU $20.40 3, TRANSPORTATION A REIMBURSEMENT COST: I ADT TRlP RATE I x I 957 I I NUMBER OF UNITS I x I i 0 I I COST PER TRIP 20.43 x INEW TRIP FACTOR, I I 1.00 $0.00 /1092 I I $0.00 1093 ITEM 2 TOTAL - CITY SANITARY SEWER SDC ~I $0.00 B. IMPROVEMENT COST: I ADT TRIP RATE I 'x I NUMBER OF UNITS 1 x 1 9.57 I .1 0 1 I ITEM 3 TOTAL - TRANSPORT A nON SDC ~ , COST PER TRIP $90,10 $0.00 x I, NEW TRIP F ACTORI I 1.00 $0.00 1094 4 SANITARY SEWER - MWMC: A REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I 0 I I $95.35 = $0_00 11054, B, IMPROVEMENT COST: I INUMBER OF FEU's I x ICOST PER FEU I 0 I 1 $990.39 = $0.00 11055 . MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 I IOS4 MWMC ADMINISTRATIVE FEE $0.00 I 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~ , $0.00 II SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ , $190.66 5, ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE I~ CHARGE 1 $190.66 I 5% I $9.53 TOTAL SANITARY ADMINISTRATION FEE: 9,53 11079 TOTAL TRANSPORTATION ADMINlSTRA TION FEE: $0.00 11078 Billy Curtiss 10/15/2007 TOTAL SDC CHARGES =1 $200.19 II PREPARED BY DATE DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTIlRES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES) NO, OF FIXTURES FIXTURE TYPE fBAmTUB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC INTERCEPTORS FOR SAND / AUTO WASH / ETC LAUNDRY TUB ICLOTHESWASHER / MOP SINK ICLOTHESWASHER - 3 OR MORE (EA) IMOBILE HOME PARK TRAP (I PER TRAILER) I RECEPTOR FOR REFRJG / WATER STATION i ETC IRECEPTOR FOR COM. SINK / DISHWASHER / ETC I SHOWER SINGLE STALL I SHOWER GANG (NUMBER OF HEADS) I SINK: COMMERClAURESIDENTIAL KITCHEN ISINK: COMMERCIAL BAR ISINK: WASH BASIN/DOUBLE LAVATORY ISINK: SINGLE LAVATORY/RESIDENTIAL BAR I URINAL, STALL / WALL [TOILET. PUBLIC INSTALLATION ITOILET, PRIVATE INSTALLATION MISCELLANEOUS DFU TYPE NUMBER OF EDU'S NEW 1 o o o o o o o o o o o o o o o 1 o o 1 TOTAL DRAINAGE FIXTURE UNITS UNIT OLD EQUIVALENT 0-13- [ o I 1 I o I 3 I o i 3 [ o I 6 I o i 2 I o 3 o 6 o 12 o 1 o 3 o 2 o 2 o 3 o 2 o 2 o 1 o 5 o 6 o 3 20 ;EOU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwellinR unjt (20 DFU's) set 1.11 167 ,gallons per da~ DRAINAGE FIXTURE UNITS ----.- 'I = 3 = 0 I = 0 I = 0 [ = 0 I = 0 = 0 = 0 = 0 = 0 = 0 = 0 = 0 = 0 = 0 = 0 = 1 = 0 = 0 = 3 = 0 7 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE L YEAR CREDIT RATE/$I,OOO ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2 BEFORE 1979 $5,29 (Enter I for Yes, 2 for Nn) [ 1979 $529 IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? 2 Ii 1980 $5,19 (Enter I for Yes, 2 for Nn) 1981 $5.12 BASE YEAR 1979 I 1982 $4.98 I 1983 $4.80 CREDIT FOR LAND (IF APPLICABLE) [ 1984 $4.63 VALUE / 1000 CREDIT RATE [ 1985 $4.40 $0.00 x $5.29 ~ , $0,00 [ 1986 $4.07 I 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) I ]988 $322 VALUE / 1000 CREDIT RATE I 1989 $2.73 $0.00 x $529 ~ I 0 1990 $225 I 1991 $1.80 [ ]992 $1.59 TOTAL MWMC CREDIT = $0,00 I 1993 $1.45 I 1994 $125 I 1995 $1,09 I 1996 $D.92 1997 $0,72 [ 1998 $0.48 I 1999 $0.28 Ii 2000 $0,09 2001 $0.D5 -. . . . . . . . . ........ Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phoue: 503-378-4621 Web Address: www.ccb.state.or.us Permit~?..;sOI-DI5Y.7 A~dress: 3\Ojo ~..,,\-o'v\r;:,<?, ,o~^-~ IS~Uedby:\I'DCA~' ~ate: \4'\'ry.()\ 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 befiled with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: Nt. ):8: 2. I own, reside in, or will reside in the completed structure. I 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 ~ 3B. I will be my own general contractor. IfI hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my minil 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 herehy certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. X ;:fJ;;aV ~c#1R ~ . /cfo~M / '- ~gnature of permit applicant) (Date) , (White copy to issuing agency permit file, pink copy to applicant.) Property_owner. doc 06-01-04 " .~, A(C~Jirrng 3l~' 1{'qJ)ilnIr' ([J)WIl1l GerrneIr'31ll C([])rrn~Ir'31(C~([j)Ir'? INFORMATION NOTICE TO PROPERTY OWNERS r 'I, ~r -,~ J ;_\ ABOUT 9QNSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners about Construction'Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701,055(5), passed by the 1989 Oregon Legislature, 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, lEmlPRoyer ReSIPOBlsil!:llilities - .. . You will, in most inst~ces, be ruled to be an "~mployer" an<~ the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to'dQ labor in constructing or to assist in the construction or improveme~t of a residential structure, As the, employer, you must comply with the following: , , ~ Oregon's Withholding Tax Law: As an employer, you must withhold income'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 information, call the Department of Revenue at 503"3784988.- Unemployment Insurance Tax: As an employer, you are required to pay'a taxfor unemployment insurance purposes' on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for both- Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsoav.htrnll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees, If you fail to obtain workers' compensation insurance, you could be subject to'penalties and be liable for all claim costs if one of your employees is injured on the job, For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815, U.S. Internal Revenue Service: As an employer, you must withhold federal i~come 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 1-800-829-4933 or visit their web site at W\vw.irs.{!Ov. , --Other RespoBlsil!:llmtnes a~di Are~s'of COll1lce'JrJIlS Code Compliance: As the permit holder for this project, you are responsible for resolvirigany failure to meet code requirements that may be brought to your attention through inspections. Liability and Property bamage Insurance: Contact your insurance agent to see if you 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 \Je ,re~~~\-_. _~ < '-- _ ' :," " , Time: Make sure yoli have sufficient time to supervise your employees. ". \. ',. Expertise: Make sure you have the skills to act as your own general contractor, 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 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-0l547 COM2007-01547 COM2007-0l547 COM2007-0 1547 COM2007-01547 COM2007-0 1547 , COM2007-0l547 COM2007-01547 COM2007-01547 COM2007-01547 COM2007-0l547 COM2007-01547 COM2007-01547 COM2007-0l547 COM2007-0 1547 COM2007-01547 Payments: Type of Payment Check cReceintl RECEIPT #: 1200700000000001470 Date: 12/06/2007 Description , Storm Drainage Impervious Area SDC SanitarylStorm Admin Plan Review Residential Fire SF Fee - Residenlial Building Permit Fixture Vent Fan Dryer Vent Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Plan Review Minor - Planning + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By CINDY EUBANK Item Total: Check Number Authorization Received By Batch Number Number How Received LLH 1024 In Person . Payment Total: Page 1 of 1 1 :07:37PM Amount Due 190.66 9.53 44,63 41.75 438,37 64.00 7,00 7.00 36,00 20,00 48,00 16,00 116.00 36,62 49.31 65,81 $1,190.68 Amount Paid $1,190,68 $1,190.68 121612007