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Home My WebLink AboutPermit Building 2006-7-14 _.CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00758 ISSUED: 07/14/2006 APPLIED: 06/20/2006 EXPIRES: 0111412007 VALUE: $ 133,284.00 l~ ~'~r:JJ.~.~,':!::'~1 '~.,' h . 'I I ! t 'Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4590 Daisy St ASSESSOR'S PARCEL NO.: 1702324309600 TYPE OF WORK: Single Family Residence I TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - Andrews Acres lot 3 Residential # of Units: 1 # of Stories: 1 . Primary Occupancy Group: R-3 Height of Structure 16.50 Secondary Occupancy Group: U Type of Heat: orced Air Electric Primary Construction Type " VN Water Type: _ Electric -- - Secondary Construction Type: . Range Type: Electric # of Bedrooms: 3 Energy Path~l ' Path 1 , ATTENTION: n"::>,..,,,~ ,. Sprinkled Building: n/a j\:~::~~~/UIC~ adOpted by-thi;OEYEEQPMENT INFORMATION I , l, L..<.:! Ion Center Th '~~""'Y '~l (:~\n ?>2-001-00'1 0 t~r.~e rules are set forth . , Frontyard Setbac.k:l.nJ m-"y bt ' l1.00Jgh OAR 90~elil,ay Dlst: , " 0 am ~ ~ . ' v Vv 1- 4 Side 1 Setback:; }', !~) the center (~~;ooes of the n!1/~~r~}L Trees Rqd: Side 2 Setba~~.:ltniJ; j for th ' 8100: the te/ep~~,.r~(J urive Rqd: : Yes Rearyard Setback: C,.., t ~ Oreg(}I1I.OO.ility Notific?7o, of Lot Coverage:i NOTlC~~.70 Solar Setbacks: uil er IS 1-80CO~0.02-2344) cHlon .': THIS PERMIT SH . ,\1 , AI t !:vnlnr- ,.. _I I PUBLIC IMPROVEME~TS 12~~~UE~~~D UNDER THIS' PE'RM;YCI~v~;; :, ANY SidewalkDT9.~e!S ABANDONED F,DQ . Fully Improved J I uv Uf\Y ~f:RIOD (5iJtbslde 5' Yes 'DownspoutslDrains: Curb and Gutter Owner: MIKE BLANKENSHIP Address: 8063 THURSTON ROAD SPRINGFIELD OR 97478 I' CONTRACTOR INFORMATION I Contractor Type General Mechanical Plumbing Contractor MIKE BLANKENSHIP CORP JUNG ENTERPRISES INC DOUGS PLUMBING INC License 78966 102455 110163 BUILDING INFORMATION I Subdivision Not Accepted Street Improvements: Storm Sewer Available: Special Instruction: " Notes: No connection to Sanitary/Storm Sewer until Council acceptance of project Pae:e 1 of 4 Phone Number: 541-747-0145 Expiration Date 01/09/2008 10/04/2006 11/24/2007 Phone 541-912-4582 541-937-2688 541-688-3385 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 5,219 1,236 420 REQUIRED PARKING Total: 2 Handicapped: Compact: , _~"'i~N,g!lI~~' " " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Dwellines Garaee V Wood Frame Garaee Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 8% State Surcharge 2 Baths One or Two Family Addressing Assignment Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Furnace - up to 100,000 btu Heat Pump Plan Review Major - Planning PW Disc - 2nd Permit (Street) Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo I~provement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Willamalane Single Family Total Amount Paid . I Valuation Descri~tion I $ Per Sq Ft or multiplier $99;00 $26.00 Square Footage or Bid Amount 1,236.00 420.00 Total Value of Project ~ Amount Paid Date Paid $439.50 $10.00 $112.00 $82.97 $254.00 $31.00 $676.15 $80.00 $6.00 $9.00 $82.80 $12.00 $12.00 $198.00 $-30.00 $381.40 $501.40 $10.00 $865.31 $82.03 $116.09 $66.92 $805.70 $182.69 $80.00 $831.64 $50.00 $18.00 $1,000.00 6/20/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 7/14/06 $6,966.60 Paee 2 of 4 .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00758 ISSUED: 07/14/2006 APPLIED: 06/20/2006 EXPIRES: 0111412007 VALUE: $ 133,284.00 Value Date Calculated $122,364.00 $10,920.00 $133,284.00 06/20/2006 06/20/2006 . Receipt Number 1200600000000000915 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 1200600000000001070 J , ~'i~Ii.I"~g~~~~e; , I, . .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00758 ISSUED: 07/14/2006 APPLIED: 06/20/2006 EXPIRES: 0111412007 VALUE: $ 133,284.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Plan nine Review 06/22/2006 06/23/2006 I Plan Reviews I ' 06/23/2006 APP 07/12/2006 APP LLH TAJ Existing Street trees may be counted for the required street trees Public Works Review Structural Review 06/23/2006 06/23/2006 07/06/2006 07/05/2006 APP OK JAP RJB To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. 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. 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including req~ired 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. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Paee 3 of 4 . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line " .CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-00758 ISSUED: 07/14/2006 APPLIED: 06/20/2006 EXPIRES: 01114/2007 VALUE: $ 133,284.00 Status Issued Final Mechanical: When all mechanical work is complete. 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. Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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 ofany 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 tha II required inspections are requested at the proper time, that each address is readable from the street, that the permit car is ocated at the front of the property, and the approved set of plans will remain on the site at all times during constr 7!rr/b I Date Owner or Contractors Signature Pa2e 4 of 4 J . ZON ' L.,lX- INITIALS' I\J M. DATE 1-1 y..-~ SOURC~fQ \ 5 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number I"'CJ.-... 7~ -(J)? sg !~.; :: .">f''';<;:';~ ";'~.~',\. '.: '. .....\.?;....:,.:'..;..,:., ::";~....~-<,l:.~~.,->:).::.:,...:,.;..~,'.,,:-i~;~~_..<.~:<~.1.t(A..l 1. ,~i.l:,PS1Ilg~qfJ/X~TN1J1!JJ!.9lfe~~\g:1~:~tsR?~~~ LEGAL DESCRIPTION 11 D~ 3~ 430'1bOo , tfs1.l) 'PA'~ \~( . , JOB DESCRIPTION t/~ s-FfL Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ',.~/ ~ .:..\~. ,;>;:;~.~.'}~\'$;;]!~y ;., .':;' ,'y.; ~. :!,..~'r~'" ~r:.\i.~;d: ";'~5':}~.:-C;!~j;-j: :;. ~~7,:; ':1 ;\:/'~~'.Yif{\l::':i.~\~:0;',~'-1;>, ~iCONTRA.'CTOR'INSTALEATION.() 'LY,\'; 2. :,;,~.- ~~':". ~t;~.:d~.~>~:~'~';~~;': ..'i;;..'.....:,~S.~\~,'!;:-..:: :~,.:j:'!'t?t:ih\,~~,';.1.,)~.>t~~,~,.~.Z'.;.5~,~:,ii;'.;. .~..:.-J;,,\:;KL\./;f) Electrical Contractor Address / ~ne City Date l::~\ 'tr. .\~l1~~~...:. ",~~ .' ~.. ,,~~""...;[r.<'''?'?'4ff.~,,~;;;~~,':~~~~::'}t~;~r:,-t. ':: ~:-J:t~7>?:-:.';". ~]~~::~~'~~k-)'):\'.~~:::'~~:"~'~ <.:/~..,~ 3. ;",(JQll,!PLET.E-FE,EBQHE.DpLE,B :LQI1.:"J'<'?;:,; .,',<.'c;,N;K~o.:",:: ~\1 1l.....:...'!:;.~~w.:t..~f...'!!.7:: ~_.;.<~ .~.,:.. 'M.~~~i..'.'~~~.J<~~'4 .;:..;-,..^:':'. _:.';';,";;J., .~,,~..'~''l' .-;.~:. ..;.. ':",~_-;.;.~~~"'\:X~;.t~"".1..1"~ ~::'i.l~::, \-.i....; ..~lf >..;)~. ;'l'~ ~~::.',\:t~ <:~~~~;~':.~;";'~''J;\l::~r-. :~;::..t\r~:rt,~\~~~~ry;':;'l;';""i'''-*~:r&~j ..~ ;: :;J ~)~,:::~'l::~'.\:~~:'~: ':':~~,Y':"1J~-t"':r;r' ~.'''i~'''-~~ " A. ~}~,e":'R.~sid.t;ri t!~L,::~ i.ilg'~.'o~"l"Iu!t,FF:a ".1, ily';per~(J ,,'cIJ !hg ~~!t;{,i' ........;.......~,.tt:....:,....,:.:... ~..I_\"",.....,..~...t-':.., l_.~.......,...~... .~.~....__.~..... ~!:;....."........!..:. wM..').;....t.............'-...;~?'_..)i..:j."'t:-.-:.._;,,!,..... .' .. . .;.'.._",:,,-,Jr. 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 $106.00 $ 19.00 $50.00 . Ff/~~:!'~':~:.':.\~.~:;~:;&;tP:~{.'<(.~~:ir::~~f; <~~,;:~~5}\;'~~!;'c'" t:; j,\:E;'i~'i~;r:::;i:\' .~?~C':.~.t~,: r;;~~~,:-;t.:'\. ~:~: ~t ~~J,,\:~;"i'Q:/i~.--:':'~ -:r'; B. r;~Ser,;ices' o[,Feede'ts":J rfst.:i II atiolf;Arh~ra,tioi~s'or,Rel ocat ioil: "/ ~~~: ~i~~~~~~,,-?>'_1 ~~~~ k'".. . :..::')i.:('!~;~t!..:~,:.,.;~~,'iJ:.: ~;::.:::; ~,.,:\1 :....\.,<~~..:. "\j;Llb~' :1.u'S~",'''' .~"l: ~~ .: '".it:? :~,2.'\.::.~'/,ttL~.:: ~ ~, ?::+~~:\~J:" "'::.!..:. ~{, 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Re 1h,.:-~~efi1y $ 63.00 , $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ') Expiration pate constr~ntr, Number // ....Expiration Date Signature of Supervising Electrician Owners Name ,N1 L!tL Address . -C<~~ 3 City ~/W . IJUJtp ..:4t- ~s1/)J . j;J ~lf'/~/9'r Phone OWNER INST ALLA nON The installation is being made 0 property I own which is not intended for sale, lease rent. Inspection Request: 726-3769 rct,:?s\"~"'~),r~'t~:.t,.-~~':""1"~~~:rs'1'fI'r'::~1'=S{' .f.'<"-:U:.R,~"\,, ,....;..~'r"\~ r-:''.;:I''~ .:....."""':...:-:-' .;",,"~""""",:r:-:"'l-';'7.;""""""J'~'-''''''''''''';:1 C r':'"T'.':. .,,-,',.' ).~"':<j.''f. "'."(S.. '~.K"'l.:.~....~"',:,,,,! .':"i>."" F',''f!.''~d'':'''~'''):\~<.l>(~, .,.....~,.". ".(!. '..\'J.",.;),-'f .'lj'-::","".''''~' L,~' '.0,:(,,1" ......~ "..f'"........'.),:.~ .,..;,' ~'emporarv' elWlcesor ee ers .">'i<" \"'''' :.ii"'.''''- '. y~' -, .. ,,', '. -. ~r:...,,:,. _~ . ".,~'.~ '.. .._ .;.-i.""".....! :'41'" ...... ; .,o.- '>'J.."'l~' ',......... ~ ~,. ...,_ '\'?-,::,;" ~\)~. .,)'. '!.'r,,~'~.:1., '(~ ..,;,<-'~,~,::->~'7i:>,1: 1;~r.t;i i,:\",\:,~.~ i ~1;..l,~.':::h~~"~.~~''''''''I,..:_{';",,_.~~..........~.............;........,'l'::~.-o.,l,.:.l--.''~",, ...\.o_.l.~. ,:I........:,.......,. ..._..,,~,.;l.._~ ""....... - "--.t'<ol-~._.',.:....'- ............~ Im:tllIllltion, Altp.."'ti9o-orIte1ocation '( 200 Amps or less 20 I Amps to 400 Amps . 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. "", . .,....;..~.'If..'.~. ,.,.. H" :., ~"l'j'.~~~."i{,v;:~r'\ ,. 1;":' ",!,,~,,:;~~t-"';C'Y'.'1""""~.),.'4/J-...,"';"'~\~'~~~V"''''1'::r'''''' '~~(..t:t:".r-rl !:/ ,".:'V..;' ....'.':. .~"^,.\. . .:~.;.,~"i,';"~" '..t~"i&-::~" ':~'~;;:~" t .,'t:,.J/:'> .~')f.!V:"''t .J;.;>~~~,'-i~ 'l!~,j:'f~' l'';''''tc.:<:'-'O;>';~ '\, ...,,~ ' : . D ,"'~Branch,GlrcUJts !;-,j," J:l""''''''.'''t?'";":,,~,\,,\,,,.,, "'Y.'~"i ',/ :";.,:;,,r ....\;',.J~~"..:l . ~~'tU~~'~~,,:~'.~;~ ,~:i::.t;.~~W~\.<\.i&%;{ 't 'r~~G~~\~E.C} ,~~:i!(~~:~v~~:S.:t~'i}:._tt}:~...~'.2! ~!r:~L~Yi:~L. $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel , One Circuit Each Additional Circuit or with Service or Feeder Pennit $ 43.00 $ 3.00 fi~~?'~;;t~.';~ ~~~I"'-:J<<~~'~;~'!,~i~~t~t:~\~{~F5:~}~~~s~\;}.!'~;;'~:~:;:(~'~'J--..::~,;~':.~' ':~~~S'.~.t~,:_,,~.-:;,r~;~",-.~ E. trMisceHaIle6u.s,J S~rvi~e/f eeder ,Jlofincl ude~);':Ea'ch, Ili'sta Ua tion ,.', ;;,,:,',;6. ':~~4.!'~."':":tir~t:.~~:-!;'.~1~:"""..J,;:.ll';:' _";,}.>o.~'i.:.:.~':.: ,._l:,~~,~~:,,,::>.:.::~'::.t.r.....t.;'.4-,"~'C~;:;II:.::J.~..:.":.~G~:~;:lI.~~':..'~-l..1'~ Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25,00 $ 45,00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~~;f .X~~~~ ;:A';;.~':~ ~~!,~~~~~~~~;?;~;f~~~,J;:r?f;t~~(~:~~A::~[~P.,~~~.~)~~~::~??~~ 4. i~BU1JT.OTALJJJt.A,BOYE ';i':.~:)~,.,,;' <,4.r~'."'<'I:,'~"I."~ ih~~"ti?~~':;:);i;:,~.;:~.~)'~~~~J~~~~~,t;;ti;ft~ ~:~: '!;;-,~::f~t':L'1Ll\~2,~;~;;=.1~i~~ :}:"~l:'{:i:~-" CJl) .00 ~,() 0 c:; . cO S~_OV 8% State Surcharge , 10% Administrative Fee TOTAL Shared Drive(T,)/Building Fonns/Electrical Pennit Application I-06.doc I \: . . . DRAINAGE FIXTURE UNIT (DFU) CALCULA nON TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT; DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONL Y THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIV ALENT UNITS I BATHTUB 1 0 3 = 3 IDRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC, 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC, 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 = 3 ISHOWER, SINGLE STALL 1 0 2 = 2 ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 IURINAL, STALL! WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INST ALLA TION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 20 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE I I I I I I I YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,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 ELGlBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? (Enter I for Yes, 2 for No) BASE YEAR o o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0.00 x $5,29 = , $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0,00 x $5.29 = , o TOTAL MWMC CREDIT = , $0.00 , . . ' 225 Fifth Street Spribgfield, Oregon 97477 541-726-3759 Phone *. f Springfield Official Receipt opment Services Department Public Works Department RECEIPT #: 1200600000000001070 Date: 07/14/2006 1 :09:15PM Job/Journal Number Description Amount Due COM2006-00758 Addressing Assignment 31,00 COM2006-00758 Willamalane Single Family 1,000.00 COM2006-00758 Temp Power 200 amps or less 50,00 CO M2006-007 5 8 Fire SF Fee - Residential 82.80 CO M2006-007 58 Building Penriit 676,15 COM2006-00758 2 Baths One or Two Family , 254,00 COM2006-00758 Vent Fan 18,00 COM2006-00758 Exhaust Hoods 9.00 COM2006-00758 Dryer Vent 6.00 COM2006-00758 Heat Pump, 12,00 COM2006-00758 Sidewalk Permit 80.00 COM2006-00758 Curbcut Permit 80.00 COM2006-00758 PW Disc - 2nd Permit (Street) (30,00) COM2006-00758 Storm Drainage Impervious Area 831,64 COM2006-00758 Sanitary Sewer - Reimbursement 501.40 COM2006-00758 Sanitary Sewer - Improvement 381.40 COM2006-00758 SDC Transpo Reimbursement 182.69 COM2006-00758 SDC Transpo Improvement 805.70 COM2006-00758 SDC MWMC Reimbursement 82,03 COM2006-00758 SDC MWMC Improvement 865.31 COM2006-00758 SDC MWMC Administration 10,00 COM2006-00758 SDC Sanitary/Storm Admin 116,09 COM2006-00758 SDC Transpo Admin 66,92 CO M2006-007 58 Plan Review Major - Planning 198,00 COM2006-00758 Furnace - up to 100,000 btu 12,00 COM2006-00758 -Mechanical Issuance Fee- 10,00 COM2006-00758 + 8% State Surcharge 82,97 COM2006-00758 + 10% Administrative Fee 112,00 Item Total: $6,527.10 Payments: Check Number Authorization Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Check MIKE BLANKENSHIP Ikw 10259 In Person $6,527,10 Payment Total: $6,527.10 \ cReceint I Page 1 of 1 7/14/2006