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Home My WebLink AboutPermit Building 2008-2-11 Status Iss u ed CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00047 ISSUED: 02/11/2008 APPLIED: 01/11/2008 EXPIRES: 08/11/2008 VALUE: $ 263,364.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2809 GAME FARM RD ASSESSOR'S PARCEL NO.: 1703224106400 SPRINGFIETYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Single family residence - Cline Subd lot 5 Owner: JORDAN & JORDAN CONSTRUCTION LLC Address: 3520 CELESTE WAY EUGENE OR 97408 Phone Number: 541-688-3998 I CONTRACTOR INFORMATION _ Contractor Tvpe General Electrical Mechanical Plumbing Contractor License JORDAN & JORDAN CONSTRUCTION INC 176193 DEANS ELECTRIC 99579 COMFORT FLOW 460 GPC ENTERPRISES INC 136043 Expiration Date 05/14/2009 06120/2008 06/27/2009 01/29/2009 Phone 541-688-3998 541-935-5303 541-726-0100 541 -345-193 1 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VB L...Q,lJIJ"l}I~GJN~~~l}'f~TIO,~JurreS' you fo follow rules. adopted by the orj90 Uti~' . Notl#c~I~WUEnter. Those rules r t fI ot SIze: in oAff~-~tm.ff8JU1rou9h 0 2-0 Ft 1st Floor: GG90TYmiPIrM9l\Sbt~Un copies of th f~les Ft 2nd Floor: eaMfttJttfle~te(. (Note: the te one Ft Basement: fili~1QTm8:0feg()n Utility Ndtiftbatio~q Ft Garage/Carport EneChmfe,ijs 1..ao0-332-23.f41j11 'Sq Ft Other: Sprinkled Building' nTa Occupant Load: 13,866 1,702 554 543 3 I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 70.00 10.00 10.00 24.00 32.50 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: 2 16.00 Notes: Private access and storm easements I PUBLIC IMPROVEMENTS I Nti,~. . Sidewalk Type: Fullv Improved THIS PERMIT S Yes AUTHORIZED U HALL EXP~~WfflWt COMMENCED O~~~~~HlS PERMIT IS NOT ANY 180 DAY PERIOD. ANDONED FOR Curb and Gutter Street Improvements: Storm Sewer Available: Special Instruction: Pa!!e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction A.C. - Residen DwelliDi!:s Gara2e AC - Residential V Wood Frame Gara2e Fee Description Plan Review Residential -Mech Iss 2+ Appliances- + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee 3 Baths One & Two Family Addressing Assignment Appliance Vent Boiler/Comp Up To 100,000 btu Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fireplace (Listed) Furnace - up to 100,000 btu Plan Review Major - Planning Plan Review Residential Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Improvement SDC Transpo Reimbursement SDC Transportation Admin Storm Drainage Impervious Area Storm Sewer Each Addtll00' Temp Power 200 amps or less Vent Fan Willamalane Single Family I Valuation Description I $ Per Sq Ft or multiplier $5.00 $105.00 $28.00 Square Footage or Bid Amount 2,256.00 2,256.00 543.00 Total Value of Project ~ Amount Paid $760.88 $40.00 $207.19 $231.84 $111.10 $337.00 $35.00 $7.00 $14.00 $1,209.96 $85.00 $7.00 $10.00 $139.95 $17.00 $14.00 $205.00 $25.59 $117.00 $84.00 $550.91 $724.50 $10.00 $990.39 $95.35 $156.58 $862.25 $195.48 $69.78 $1,098.27 $32.00 $55.00 $28.00 $2,303.00 Date Paid 1/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11 /08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 2/11/08 Pa2e 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00047 ISSUED: 02/11/2008 APPLIED: 01/11/2008 EXPIRES: 08/11/2008 VALUE: $ 263,364.00 Value Date Calculated $11,280.00 $236,880.00 $15,204.00 $263,364.00 02/08/2008 01/11/2008 01/11/2008 Receipt Number 1200800000000000030 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 2200800000000000181 CITY OF SPRINGFIELD. Status Issued Building/Combination Permit PERMIT NO: COM2008-00047 ISSUED: 02/11/2008 APPLIED: 01/11/2008 EXPIRES: 08/11/2008 VALUE: $ 263,364.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Amount Paid $10,830.02 I Plan Reviews I Initial Review 01/1512008 01/15/2008 APP Public Works Review 01/15/2008 01/16/2008 APP LKW Private Sanitary and access easements Planninl! Review 01/15/2008 01/24/2008 APP T AJ Structural Review 01/15/2008 02/0712008 APP DLM See documents for Plan review comments 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. ~e(]llire<UnSDections 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. 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. 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 required testing. Pal!e 3 of 4 CITY OF SPRINGFIELD. Building/Combination Permit Status Issued PERMIT NO: COM2008-00047 ISSUED: 02/11/2008 APPLIED: 01/11/2008 EXPIRES: 08/11/2008 VALUE: $ 263,364.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Shower Pan. Prior to covering 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. 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. 4~aA Ow~ or Coilt'ractors Signature 'Z-J!-D"'2J Date Pal!:e 4 of 4 JOURNAL OR JOB NUMBER NAME OR COMPANY LOCATION TAX LOT NUMBER DEVELOPMENT TYPE NEW DWELLING UNITS 1 STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S F x I COST PER S F. CHARGE I 3174.00 I $0346 I = I $1,09827 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS SF x I COST PER S F x I DISCOUNT RATE I I o 00 $0 346 I 50% I = I ITEM 1 TOTAL - STORM DRAINAGE SDC I $1,098.27 I 2 SANITARY SEWER - CITY A REIMBURSEMENT COST NUMBER OF DFU's x 27 B IMPROVEMENT COST I NUMBER OF DFU's I x I 27 I CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET COM2008- Jordan & Jordan 2809 Game Farm Road 1703224106400 Smgle Family ReSidence 1 BUILDING SIZE (SF' 2799 LOT SIZE (SF) 16117 rfJ ~ Ir::l I. 0 I~ ,~ rfJ ,...... o ~ DISCOUNT $000 $1,098.27 1070 COST PER DFU $26 83 $724.50 1091 COST PER DFU $20 40 $550.91 1092 =1 ITEM 2 TOTAL - CITY SANITARY SEWER SDC $1,275.41 3 TRANSPORTATION A REIMBURSEMENT COST I ADT TRIP RATE x I NUMBER OF UNITS x COST PER TRIP x /NEW TRIP FACTOR I 957 / 1 2043 I 100 $195.48 1093 B IMPROVEMENT COST ADT TRIP RATE x I NUMBER OF UNITS x I COST PER TRIP x I NEW TRIP FACTOR 957 I 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 x ICOST PER FEU / 1 I $95 35 = $95.35 1054 B IMPROVEMENT COST INUMBER OF FEU's I x COST PER FEU I 1 $990.39 $990.39 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054 MWMC ADMINISTRATIVE FEE $10.00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, $1,095.74 SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I $4,527.15 5 ADMINISTRATIVE FEE I SUBTOTAL x I ADM FEE RATE 1= CHARGE I $4,527 15 I 5% $226 36 TOTAL SANITARY ADMINISTRATION FEE 15658 r1079 TOTAL TRANSPORTATION ADMINISTRATION FEE $69 78 11078 Kaye Wilson 1/15/2008 TOTAL SDC CHARGES =1 $4,753.51 PREPARED BY DATE DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOJE FOR REMODELS, CALCULA JE ONLY THE NET ADDmONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 2 0 3 = 6 I DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 0 0 3 = 0 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC 0 0 1 = 0 RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 SHOWER, SINGLE STALL 1 0 2 = 2 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK COMMERCIAL/RESIDENTIAL KlTCHEN 1 0 3 = 3 SINK COMMERCIAL BAR 0 0 2 = 0 SINK WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 SINK SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 = 2 URINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 27 *EDU (EqUivalent Dwellmg Umt) IS a discharge eqUivalent to a smgle falmly dwelling urnt (20 DFD's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED V ALOE $529 $529 $519 $512 $498 $480 $463 $440 $407 $367 $322 $273 $225 $180 $159 $145 $125 $109 $092 $072 $048 $0.28 $009 $005 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 CREDIT FOR LAND (IF APPLICABLE) V ALOE /1000 CREDIT RATE $000 x $000 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) V ALOE / 1000 CREDIT RATE $000 x $000 TOTAL MWMC CREDIT = 2 2 2004 = I $000 o $000 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION i / City Job Number C 8' - 000 41 Date ~ 2,.. '6 g // ~~."~'-"l; ",~'lmt>>V-")-"M"'I""..;/'~ ",. ,-' ':- ",.., ,"... "'" '-"o1V ;~"'.:).."'-- '" 'c>''''''''~ '.;~i '. 3. OMPLETE;1!1!,1!;SCHEDuLE,BELfJW "" "'" , ~" >^ ~"" ~"-~",,,-..>...'> "~,:,,-,,,,:_,.^.~,,_.:..~,,",~ -:"', "'-,.,.' ..~",,- Installation, Alteration or Relocation 5)" 200 Amps or less I $,..50-:00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 NOTlr:ee.~?!? ~T.l?,,~,~: 1000 Volts see "~" above. Signt.e OfSUjfmng :ITan j) . I~~~~~~f.YE'1RfsI6;,ll4fBwl1AK \) ---r.. l) 1--- COMME'2~,rfzrMJ~ THIS PERMIT IS NOT $ 43.00 J ,. I /' AN[? 8oT!fm:&li~~~i'fffi FOR $ 3.00 Owners Name )' Ho--- 0.- t'f' r~....... La.....~,. ermIt Address :3S- 2 0 Ur( 0") k:- t~~1 E. 2il~]~i~~;ililsi~~~d~f:i~~i~~~d?'~~i:(~~~~J Citytu. s t;?/€ Phone t:,y-y - '5 ~. ~ t' Pump or irngatIon $ 50.00 , SIgn/Outline LIghtIng $ 50.00 Lnmted Energy/ResldentIal $ 25.00 LImIted Energy/CommerClal $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ~-t~ """1""""1W'''~ ~ '-"-c:.-".~~"",.~~..{>...,~. ,...,--,-.)/-"",-l;'/"'f"~Y'i'~"'lt>! 1. ~ LOCATIO~OF INSTAllATION"".! ',~\\~'.'~ .".~;-~h~~~';';W'<:'l'.h,~"-'~ ~._ii/if'''' ~_~,<F-;~''',"'4V~~~.:n'.. "?5t1t'\.iJ Z80 i GANte-pM~ LEGAL DESCRIPTION 170S22Cf( 06'-(00 JOB DESCRIPTION > F-IL LN"t o/Le- $ / e-~ I Permits are non-transferable a6d expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. V~~r1 'l!(.:-'/;~""';'7':." "-""--,~~,!:~-:' j~' -flfj'-'4'f..t>i'--ilf~~~;q :;e~:=b=rV~~~{~ Address V, 0 \ S"j': ~(tZ~ CIty . cz. V1 P)tJ e/ Phone ~ 3:; ~ 5'50 ?, SupeJ"Vlsor LIcense Number ExpIratIon Date 1 (:) / 0 sC6 !f-"\ c; ( ?-oo / Constr Contr. Number q9 r:')~ ExpIratIon Date (-10 ~J..OO5? OWNER INST ALLA TION The mstallatIon IS bemg made on property I own wlnch IS not mtended for sale, lease or rent. Owners SIgnature: Inspection Request: 726-3769 ; A. ~~fi~~id:iilr~t~~~'iii;~2M'Ji'ti:F~ffiilil~~~"!ci~; ~~-Jit:.t;A\, -""" .>I," ,:,:"~"":''''''''''~'""" "..g r_'~_~_:':'.:) :"'(""-"__~1_~,n "~}P.iSi:'#~"""-~'.'< Service Included / 117 1000 sq. ft. or less -$106:00 /f7 Each addItional 500 sq. ft. or t/ --z.( ~r portion thereof ~.OO Each Manufact'd Home or Modular Dwelling Service or $50.00 Feeder M'; - i~ '{~~ ~??l; 'f ::~\;' h>'li"';}~;~:>-~,,-.,r,*~ ?;:~~-\j~:;,41-W1<"" >>.t"i~-t-,;-1?-N B. '~ 'It~IitAJteratiQiis::or."Rel(}cation::',;:' ~l {\I ~ ";.1'"V_M:.~~~f0f"'t}~/>"'tr:"","__):%~~f Z'_"1~>~ I~'t.;:~;; [) Cc-nllt. Tt :,"" '~iJlegO'1IJtI11~ '':::oo^Il'Pl''~~'OOiO -"8 /,,/es arp. <::of fdr .00 098Pt~i11fOO~~nr~~O.UGh OAR 952-otJ1..00 FAllk'lQ,,~f 9e01"PfNot~l.et::;~h Of the rUles~,5.00 IID'thoet or t~.n . e if:~'eph 601 Anm~fa ~UtJcYA~ UtilIty Nen onf$163.00 Over 1000 Am-P~1%PO-332-234.4.).1 I"'QuoJ375.00 Reconnect Only $ 50.00 '1} 'X1:'-;J,.>-}@?~~;,rr,-1f';<^;'-'';; - '~""'''.j:''''''''''4,~ ''''''~f'J'IW''f;'''''''~f-- ~'"' C. ~~E2~!y.:S~~}S~~:.?~J1'~'~; )S- 4-'1)'''-l>~;Af' "~'--;~;::-""'" ~t.,.t-r"~~~'*'t~- i )\r"--...'>~" ~'.;.-,~ r~~ --,.--........, 4 :;;"L;JjLV'T"kr"OF A DOVE^' ::::",:;:;;";.:;;,',': .^ " ,~ . ":"~~.., ~. '~\., .,." "PC c', , ~ ~,.,:.,,""'~1:, .>::'?"'.~."""w.ki-~"~","61.N,1>-~~1~,,,~~" 25b '3072.. ? r f::;I:) /Z~ 1~1o State Surcharge 10% AdmInIstratIve Fee f6fAL T~l+t'€e j >Z)~ Shared Dnve(T )/Bulldmg Forms/Electncal Permit ApphcatlOn 1-03 doc Willamalane Park & Recreation District Job. Nc{' f\mJ C'i/J<'''' <:YYJ,4-1 SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME:2JaC1=c0 ~ '\;C\>flr'l Co0~' ADDRESS:3"):;l(j (; k:;m IAl~I1YYL.~J/ LOCATION OF PROPOSED BUILDiNG SITE: Street Address:,AX<"Pt (~8 'th.r2.-1\A- eD Plat Name:( l _\ Y"\Jt b-L6 Tax Lot Number: PHONE: STATE{)2.ZIP: q 1 40~ :&s 1. DEVELOPMENT TYPE (Check appropriate dwelling(s) Dwelling type definitions are on the back. ) A. Sinale-Familv Detached NO. OF UNITS X $2,513 per unit = uv $ d303, B. Sinale-Familv Attached NO. OF UNITS X $2,726 per unit = $ C. Multi-Familv Aoartment NO. OF UNITS X $2,323 per unit = $ D. Sinale Room Occuoancv NO. OF UNITS X $1,162 per unit = $ E. Accessorv Dwellina Unit NO. OF UNITS X $1,257 per unit = $ d.X(' uO $ . 5, WILLAMALANE SDC 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willarnalane Credit approval.) $ $ d~3.00 3. TOTAL WILLAMALANE NET SDC ASSESSED . SDC reduced for Credit) Z I II,Zo~8 Date 5 225 Fifth Street Springfield, .oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 COM2008-00047 Payments: Type of Payment CredltCard Check cRecemtl RECEIPT #: 2200800000000000181 Date: 02/11/2008 DescnptlOn Temp Power 200 amps or less WIllamalane SIngle FamIly AddressIng AssIgnment FIre SF Fee - ResIdentIal 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 TransportatIOn AdmIn Curbcut PermIt Plan RevIew Major - PlannIng 3 Baths One & Two FamIly Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu BOIler/Comp Up To 100,000 btu Vent Fan ApplIance Vent Exhaust Hoods Dryer Vent FIreplace (LIsted) ~Mech Iss 2+ ApplIances~ Plan RevIew ResIdential BUIldIng PermIt ResIdence Wifing 1000 Sq Ft ResIdence Wifing Ea Addtl 500 + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstratIve Fee Paid By SCOTT JORDAN JORDAN AND JORDAN Item Total: Check Number AuthonzatlOn ReceIved By Batch Number Number How ReceIved dJb dJb 7453 957071 In Person In Person Payment Total: Page I of2 11:30:27AM Amount Due 5500 2,303 00 3500 13995 1,098 27 724 50 55091 195 48 862 25 9535 99039 10 00 156 58 6978 8500 205 00 33700 3200 1400 1400 2800 700 10 00 700 1700 4000 2559 1,209 96 II 7 00 8400 III 10 231 84 207 19 $10,069.14 Amount Paid $9,50000 $56914 $10,069.14 2/1 1/2008