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Home My WebLink AboutPermit Building 2008-2-11 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00170 ISSUED: 02/11/2008 APPLIED: 02/06/2008 EXPIRES: 08/11/2008 VALUE: $ 131,740.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5755 OBSIDIAN AVE ASSESSOR'S PARCEL NO.: 1802030008400 SPRINGFIETYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: Single Family Residence TYPE OF USE: New Residential Frontyard Setback: 18.00 Side 1 Setback: 10.00 Side 2 Setback: 9.30 Rearyard Setback: 67.50 Solar Setbacks: 0.00 c- ....r I . - -\ \[ 'f ,no\( NU uliJ,\Io' EXPIKtll- \ - SUbClii~}\(f~~cW~..tR TU\S PERM\I \~LIC IMPROv-ElNIlENfUSlf' Oregon law requIres you to II ' ra~NOE \ n FOR 'VIoI..'o ; UI~S adoR.iOO-k ~ Stre1Mlnp'~Q':~t:QhQR \S ABANOOOWImproved !'lot'~'callOn Center. .ihO~~ rU~::~~~e~~iI~h Curbside 7' Stor.u(Se.U'~iWwt~~~R\OO. Yes In OKR 952-001-0(JlO>>hNm~ff@)lAN~2~ . Curb and Gutter SpeciA~-Ns18GtM. 0090, You may obtain Copies of the rules o~ calling the center. (Note: the tele hone"7 Notes: No final occupancy approval shall be granted prior tJliJ~r\W~~e~ tlItlIJtYIJWJB.. Center is 1-80Q-332-2344). Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 I CONTRACTOR INFORMATION I Contractor Tvpe Electrical Mechanical Plumbing Contractor M & W ELECTRIC INCORPORATED PACIFIC AIR COMFORT INC DENNIS SCOTT EGGERS License 67362 39237 142776 BUILDING INFORMATION' # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VB # of Stories: 1 Height of Structure 16.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Energy Path: Path 1 Sprinkled Building' nla 3 I DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Pa2e 1 of 4 Phone Number: 541-228-6935 Expiration Date 06/1912011 03/2512010 05/05/2010 Phone 541-754-6171 541-672-9510 541-459-0110 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,140 400 REQUIRED PARKING 2 Yes 17.80 Total: Handicapped: Compact: 2 .' Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00170 ISSUED: 02/11/2008 APPLIED: 02/06/2008 EXPIRES: 08/11/2008 VALUE: $ 131,740.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Dwelline:s Garae:e Tvpe of Construction V Wood Frame Garae:e $ Per Sq Ft or multiplier $105.00 $28.00 Square Footage or Bid Amount 1,148.00 400.00 Value Date Calculated Description Total Value of Project $120,540.00 $11,200.00 $131,740.00 02/06/2008 02/06/2008 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Same As $220.00 2/6/08 1200800000000000097 -Mech Iss 2+ Appliances- $40.00 2/11/08 2200800000000000178 + 10% Administrative Fee $136.78 2/11/08 2200800000000000178 + 12% State Surcharge $154.85 2/11/08 2200800000000000178 + 5% Technology Fee $83.27 2/11/08 2200800000000000178 2 Baths One or Two Family $280.00 2/11/08 2200800000000000178 Addressing Assignment $35.00 2/11/08 2200800000000000178 Appliance Vent $7.00 2/11/08 2200800000000000178 Building Permit $737.40 2/11/08 2200800000000000178 Curbcut Permit $85.00 2/11/08 2200800000000000178 Dryer Vent $7.00 2/11/08 2200800000000000178 Exhaust Hoods $10.00 2/11/08 2200800000000000178 Fire SF Fee - Residential $77 .40 2/11/08 2200800000000000178 Furnace - up to 100,000 btu $14.00 2/11/08 2200800000000000178 Gas Outlets 1-4 $5.00 2/11/08 2200800000000000178 Plan Review Major - Planning $205.00 2/11/08 2200800000000000178 Residence Wiring 1000 Sq Ft $117.00 2/11/08 2200800000000000178 Residence Wiring Ea AddtI 500 $21.00 2/11/08 2200800000000000178 Sanitary Sewer - Improvement $469.29 2/11/08 2200800000000000178 Sanitary Sewer - Reimbursement $617.17 2/11/08 2200800000000000178 SDC MWMC Admimstration $10.00 2/11/08 2200800000000000178 SDC MWMC Improvement $990.39 2/11/08 2200800000000000178 SDC MWMC Reimbursement $95.35 2/11/08 2200800000000000178 SDC Sanitary/Storm Admin $123.72 2/11/08 2200800000000000178 SDC Transpo Improvement $862.25 2/11/08 2200800000000000178 SDC Transpo Reimbursement $195.48 2/11/08 2200800000000000178 SDC Transportation Admin $73.26 2/11/08 2200800000000000178 Sidewalk Permit $85.00 2/11/08 2200800000000000178 Storm Drainage Impervious Area $699.65 2/11/08 2200800000000000178 Storm Sewer Each AddtI 100' $16.00 2/11/08 2200800000000000178 Temp Power 200 amps or less $55.00 2/11/08 2200800000000000178 Vent Fan $21.00 2/11/08 2200800000000000178 Willamalane Single Family $2,513.00 2/11/08 2200800000000000178 Total Amount Paid $9,062.26 Pae:e 2 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00170 ISSUED: 02/11/2008 APPLIED: 02/06/2008 EXPIRES: 08/11/2008 VALUE: $ 131,740.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 0210712008 Plan Reviews I APP DLM Approved as noted on teh Plans Planninl.!: Review Public Works Review 02/06/2008 02/0612008 02106/2008 02/06/2008 APP APP TAJ LKW Follow street tree plan. No final occupancy approval shall be granted prior to Public Works approval for pump station 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 I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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. Drywall: Prior to taping. 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 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. Final Plumbing: When all plumbing work is complete. Pal.!:e 3 of 4 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2008-00170 ISSUED: 02/11/2008 APPLIED: 02/06/2008 EXPIRES: 08/11/2008 VALUE: $ 131,740.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Underfloor Mechanical. Prior to insulation or decking and including required testing. Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. 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 Final Gas: When all gas work is complete. 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. 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. ~z,a~ Owner or Contractors Signature .;2 r /!-e r / Date Paj!e 4 of 4 --. ....U ....UUI \1 f\lJ IL' Ie: (FAX)JS4J74J2572 P 00J/002 ZON uJ2... INn1ALS I'J IV" A:I.. D.ATE -:J .... , I -D ~ "" FIFI1f ""'- · SPItINGmw>.llR"..,., · _~D · .,u,(54t_ ..... SOURCe Mij?SV0 ELE";J..KICALPERMlT APPLICATION r / City Job Number COPU2.L9n~ - t!7O I 7 () Date;) ( II I 0 1S' I . 3. ~~OO~~M.".'-"~ '''", ...._...:_l. ' E!",~~~~~~.... 1. rt.tC'''''''' . .: ~ 57~r~/55/6/A-A7 LEGAL DFSCRIPTION: /8&20_<60 t)9:Jf/t11 JOB DESCRIPTION: 1000 sq. .n. or less ~ , / ~?Z: r:J.... (~.4J A'~ ~ ~ Each additional 500 sq. ft. or '- Jh..)uu:,/ ~ /rL71 ~ S / /I~ ponion thereof City Phone ~s. -~ Pump or irrigation S 55.00 Sign/Outline LiGhting $ 55.00 OWNER INSTALLATION Limited EnergylR.esidential $ 28.00 't.be installation is being made: On property r own which Limited Energy/Commercial $ SO.OO is not intended for sale, lease or rent. Minimum Electric: Permit Inspection Fee is $SO.OO + SUl'l:hargcs Owners Signature: Permits arc Don-transferable and expire if work is not S'blrted within 180 days of issuance or it' work is SUSpended for 180 days. Electrical Con1ractor 1M fW ~~~ Address Nq)<<61 Hw'1' ~/..I City A\ hav'\-1 Phone 7E:1f-l..tltl Supervisor License Number f.{ .J. .., '1 s Expiration Date In -1-lolO ConstI'. Contt. Number (P 7 .$<RL I-I - ~c.o 8" Expiration Date Signature of SUpervising Ele:c::trie:ilUl J IL-- ...:::w...--- Own~Namc ~)~ &4.... . I " '. Address Inspection Request: 726-3769 ~ 7\ .A. Service Ineluded I / _ $117.00 }/7 /HJ zI . $2J.00 .Each Manufact'd HOme: or Modular Dwelling Service or Feeder $S5.00 B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps- 601 Amps to 1000 Amps Over 1000 AmpsIV olts Reconnect Only $10.00 $ 83.00 , $138~OO $180.00 $413.00 $ 55.00 InstaUatiODt AlteratioD or Relocation 200 Amps or Jess / 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see"Bn above. D. ~!EL1! \ New Alteration or ExteDsion Per Pancl -One Circuit Each Additional Circuit or with Service or Feeder Pennit $ 55.00 $ 76.00 $110.00 s-~- $ 48.00 $ 4.00 E. 4. 1.2--8% State Surcharge J 0% Administrative Fcc 5% Teclmology Fee 9~ boO z.:~ /~_ .~i} TOTAL ~ Z<t$: II Sharr:d 0ri~;)Jam1dlng FOrmslElcctrical Femut Application 7-cJ1 Aoc Willamalane Park & Recreation District Job. No._ CP, - / 71J SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007 NAME: ,~7 ,J:-lJ1Z1f/~ ADDRESS: Z4IP-t u~/:fA;ITY R~ PHONE: 222b -(p 71 ~ STATE:~ZIP: 977.)C LOCATION OF PROPOSED BUILDING SITE: Street Address: 575.<:; 0.65/tf/A-A/ /0-e. Plat Name: J/r'1#d( /11L.~~ Tax Lot Number: /~()2-CJJ O(J 1)~-f8--0 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back ) A. Sinale-Famllv Detached NO. OF UNITS :2-S/; X ~2,~er unit = $_ 2~ /3 B. Smale-Famllv Attached NO. OF UNITS X $2,426 per unit = $ C. MultI-Familv Aoartment NO. OF UNITS X $2,032 per Unit = $ D. Slnale Room Occuoancv NO OF UNITS X $1,016 per unit = $ E. Accessorv Dwellina Unit NO. OF UNITS X $1,151.50 per unit = $ WILLAMALANE SDC $. 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) $ 25/3 Development Services Department City of SprIngfield Date 5 DEVELOPMENT TYPE DEFINITIONS1 Sing~e Family...Detached Dwelling Unit Abuildmg 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 other dwelling unit or buildmg. ~~~n~Qn irlcluQes manufacture~usin9.'" -, ~~ .... . '-..; r '. -,,-,_, t. -,,'."')..'...,';:;,............ \-~ ...,.... \,' .....~-~ )-" ,-... 10 - \ _.. -..... ...: '\ ~ ~'~ It,r.,:)"j- .. Si~ie ~I!)ily At~hed Dwelling Unit _ ~:: " - \ Aportlon'of a buildlri~ consisting of~~Jrl~e roo~\j.~le'&f:l!.~}~cooking, , and plumbing facilities arranged and designed as permanent living quarters for one family or household; and which is attached to one or more dwelling units by one or more common vertlea.h$Us. :rhl~.&~fil;lItlon. ~l...~o ir.1cludes, .gut I~ not limited to "duplex", "zero lot line dwelling"': "townhods~l!l ,"and. "r6w ~o~se". W~ ~1l~ ~xC)ption of duplexes, ,..~n_g!E>>.F--a~It\~~fii<tDwelling Units typicall1' ~re separ.at~ly owned. , ..) : ,") d .).... ,-,'.) -..'\..\',) ~_ ,~/,- ""~~ ':--.. ).~'~.i " . ." .... - \'\'l'\... Multi-Family Dwelling Unit " A portion of a building consisting of one or more rooms mcluding 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~,CarTlQJpp yertical walls. Typi~My.~...e:units are in an apartment building or complex: and~are not separately owned. . Single Room Occupancy Dwelling Unit A portion of a bUilding consisting of one or more rooms including sleeping facilities with a shared or pnvate 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-family dwelling unit SDC rate. Accessory Dwelling Unit A secondary, self-contained dwelling that may be allowed only In conjunction wrth 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 sleepmg area. An accessory dwelling unit may be located within, attached to, or detached from the primary single-family dwelling. Accessory dwelling units shall be charged at one-half the single family detached dwelling unit SDC rate. .~\..........,..~~ ...JI "" ( ~~ . -~...... . Updated 2120107 1 From the WPRD Parks and Recreation SDC Resolution No. 06-07-6, October 10, 2006 6 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER COM2008-00170 NAME OR COMPANY Hayden Homes LOCATION 5755 ObsIdIan TAX LOT NUMBER 0 DEVELOPMENT TYPE Smgle FamIly ResIdence NEW DWELLING UNITS 1 BUILDING SIZE (SF: 0 LOT SIZE (SF) 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS SF x I COST PER S F f CHARGE I 2022 00 I $0 346 = I $699 65 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S F x COST PER S F x I DISCOUNT RATE I I I 0 00 $0.346 I 50% I = I ITEM 1 TOTAL - STORM DRAINAGE SDC I $699.65 , o C/) ~ Q o u ~ ~ t-< C/) ....... o ~ DISCOUNT $000 $699.65 1070 2 SANITARY SEWER - CITY A REIMBURSEMENT COST NUMBER OF DFU's x 23 B IMPROVEMENT COST I NUMBER OF DFU's x I 23 COST PER DFU $26 83 $617.17 1091 COST PER DFU $20 40 $469.29 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = I $1,086.46 3 TRANSPORTATION A REIMBURSEMENT COST I ADTTRlP RATE x I NUMBER OF UNITS. x COST PER TRIP x NEW TRIP FACTOR I 957 I I 2043 100 $195.48 1093 B IMPROVEMENT COST I ADT TRIP RATE x NUMBER OF UNITS x I COST PER TRIP I x NEW TRIP FACTOR I 957 1 I $90 10 I 100 $862.25 1094 ITEM 3 TOTAL - TRANSPORTATION SDC =, $1,057.73 , 4 SANITARY SEWER - MwMC A REIMBURSEMENT COST INUMBER OF FEU's I x ICOST PER FEU I I I I $95 35 = $95.35 1054 B IMPROVEMENT COST INUMBER OF FEU's x COST PER FEU I ] $990 39 $990.39 1055 I MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054 MWMC ADMINISTRATNE FEE $10.00 11056 I.- ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =1 $1,095.74 SUBTOTAL (ADD ITEMS 1, 2, 3, & 4)' = I $3,939.58 _._.._~--~ , 5 ADMINISTRA TNE FEE .. .... . - -_.. I SUBTOTAL x ADM FEE RATE CHARGE I $3,939 58 5% $19698 TOTAL SANITARY ADMINISTRATION FEE 12372 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE $73.26 /11078 Kaye Wilson 2/6/2008 TOTAL SDC CHARGES =1 $4,136.56 PREPARED BY DATE DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTlJRBS x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 1 0 3 = 3 ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 I MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRlG / WATER STATION / ETC 0 0 1 = 0 RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK COMMERCIAL BAR 0 0 2 = 0 SINK WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK SINGLE LA V ATORY/RESlDENTIAL BAR 2 0 1 = 2 URINAL, STALL! WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDD'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 *EDU (EQwvalent Dwelhng Urnt) IS a discharge eQwvalent to a smgle farmly dwelhng urnt (20 DFD's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 \979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $498 $480 $463 $440 $4 07 $367 $322 $273 $225 $180 $159 $145 $125 $109 $092 $072 $048 $028 $009 $005 IS LAND ELGIBLE 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 2 2 2005 CREDIT FOR LAND (IF APPLICABLE) VALUE/IOOO CREDIT RATE $000 x $000 = I $000 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0 00 x $0 00 o TOTAL MWMC CREDIT $000 = 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00170 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00 170 COM2008-00] 70 COM2008-00] 70 COM2008-00170 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 COM2008-00] 70 Payments: Type of Payment CredltCard cRecemtJ RECEIPT #: 2200800000000000178 Date: 02/11/2008 DescnptlOn Plan Review Major - PlannIng Curbcut Permit Sidewalk Permit Storm Dramage ImpervIOus Area SanItary Sewer - Reimbursement SanItary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC AdmmlstratlOn SDC SanItary/Storm Admm SDC TransportatIOn Admm BuIldmg PermIt Addressmg Assignment WllIamalane Smgle Family 2 Baths One or Two Faml]y Storm Sewer Each Addtl ] 00' Furnace - up to ] 00,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 -Mech Iss 2+ Appliances- Residence Wlrmg 1000 Sq Ft Residence Wifing Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee - Residential + 5% Technology Fee + 12% State Surcharge + 10% Admmlstratlve Fee PaId By TIM/HA YDEN HOMES Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 084430 In Person Payment Total: Page 1 of 1 9:08:19AM Amount Due 205 00 8500 8500 699 65 617 17 469 29 ]9548 862 25 95.35 99039 10 00 12372 7326 737 40 3500 2,5]300 280 00 ]600 1400 2] 00 700 10 00 700 500 4000 11700 2100 5500 7740 8327 15485 13678 $8,842.26 Amount Paid $8,842 26 $8,842.26 211 I/2008