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Home My WebLink AboutPermit Building 2004-4-7 (2) Status Issued . . CITY VI' ~rKlNGNJ'.,LU Building/Combination Permit PERMIT NO: cOM2003-01224 ISSUED: 04/07/2004 APPLIED: 12/08/2003 EXPIRES: 10/07/2004 VALUE: $ 611,268.30 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax . 541-726-3769 Inspection Line SITE ADDRESS: 2510 Game Farm Rd ASSESSOR'S PARCEL NO.: 1703220002702 Springfield TYPE OF WORK: Office TYPE OF USE: New Commercial PROJECT DESCRIPTION: WiIlamette Dental Owner: SKOURTES EUGENE C Address: 14025 SW FARMINGTON RD BEAVERTON OR 97005 Contractor MCINTYRE CONSTRUCTION W ATERLEAF ARCHITECTURE MCINTYRE CONSTRUCTION INC 3550 10/08/2007 JB ELECTRIC 104929 03/14/2008 COMFORT FLOW ~ 460 06/27/2005 TUCKER PLUMBING~~ 109801 11107/2004 -<...4.~Hii.DING INFORMATION' ,0 ~~ ~'X'V' o~,~.::.,{;:. # of Units: ' ~ ~ ~ # of Stories: k,c,,~ rll~slZ'i:> Primary Occupancy Group: <$B~ <:( ~\J~ Height of Structure 20,gii ~('Sq,qih,Gt Eloor: Secondary Occupancy Group: ~,;:-Y::' 'iff' Type of Heat: ,00: 0,0 ~~f ~'if'F~or: Primary Construction Type C::,~ ~<<-'vN~ Water Type: ,~~ ~0 ~0c" ~B!.('~ep'l': Secondary Constructllnl J')<I!): ~~ ~ ~ ~\J' Range Type: 0(' '0'::" ~ 0 ,oS ~ CSc9 t~dil!:..l!gt;/Carport # of Bedrooms: ~r:v~<:f'~ ~ '5 & Energy Path: ~0~ 0?:> '('0"> ~cf~,iS';J..#..Q~er: ~~ ,C::,<:( ~<i;1- _-$J<.() ~ <<. ..s.9 o~~ ~ ""~ O~ ~we::ti&S'Surface Area: 9,760.00 ,')..".~ <_,-- ",r r'\'~ N ,...'\ ...'V Ci ,0 ~~"""" k .. ~ ~,*',,'Q"" . , DEVELOPMENT IjSVQR~A'lfIOH-:f' ~-iv r>.,r{J: SETBACKS <:..; .t- . ~' ~.. ,Jl ~-~! ~~'~0~r;:-.~- REQUIRED PARKING ~ ~:,.,O ~ f'.>'Ii ~~ (,0 0 9' Overlay DlSt:~.~ Q),:> 0 '$'0 ./' # Street Treef . -1,0 -s' ~ r' - ' ~....O " Paved Drive ~q Rl~' ~~ 0' r' c:s (,'I>~ % of Lot Coverage: (:ooS Contractor Type Applicant Architect General Electrical Mechanical Plumbing Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I CONTRACTOR INFORMATION , License Expiration Date Phone 503-228-7571 541-687-2841 541-687-5770 541-726-0100 541-343-8008 6,120 Total: Handicapped: Compact: 'PUBLIC Il\unuv EMENTS I Fullv Improved Yes Sidewalk Type: Curbside 5' To Storm Sewer DownspoutslDrains: Paee I of6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Medical Offices Pavine VN Use Bid Amount Fee Description Plan Review CommfInd/Public Plan Review Fire & Life Safety + 10% Administrative Fee + 7% State Surcharge Temp Power 200 amps or less -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Annexed 1996 BackOow Device Building Permit Fixtu re Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Heat Pump Paving Perm ServlFdr 200 amps or less Perm ServlFdr 401 to 600 amps Plan Review CommfIndlPublic Plan Review Fire & Life Safety Planning Final Occy Inspection Sanitary Sewer - 1st 50 Feet Sanijary Sewer - ~mprovement Sanitary Sewer - Reimbursement Sanitary Sewer Each Addtll 00' SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area . I Valuation Descrintion I $ Per Sq Ft or multiplier $85.30 $1.00 Square Footage or Bid Amount 6,111.00 90,000.00 Total Value of Project Fpp<. PiWIJ Amount Paid $1,259,15 $774.86 $5.00 $3.50 $50.00 $10.00 $394.18 $239.06 $186.00 $-139.83 $28.00 $1,937.15 $518.00 $72.00 $4.00 $2.00 $72.00 $526.65 $126.00 $125.00 $190.12 $117.00 $118.00 $45,00 $1,221.91 $1,607.44 $42.00 $10.00 $1,498.37 $2,200.62 $470.55 $997.47 $14,285.95 $3,238,35 $5,437.50 Date Paid 12/8/03 1218/03 2127/04 2/27/04 2127/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 Paee 2 of6 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-01224 ISSUED: 04/07/2004 APPLIED: 12/08/2003 EXPIRES: 10/07/2004 VALUE: $ 611,268.30 Value Date Calculated $521,268.30 $90,000.00 $611,268.30 12108/2003 03/3012004 Receipt Number 2200200000000001847 2200200000000001847 1200400000000000250 1200400000000000250 1200400000000000250 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll 00' Vent Fan Water Line - 1st 50 Feet Water Line - Each AddtllOO' Total Amount Paid . . CITY OF ~rKll~ut<lJ'.,LD Building/Combination Permit PERMIT NO: cOM2003-01224 ISSUED: 04/07/2004 APPLIED: 12/08/2003 EXPIRES: 10/07/2004 VALUE: $ 611,268.30 $45.00 $98.00 $42.00 $45.00 $28.00 4/7/04 4/7/04 4/7/04 4/7/04 4/7/04 $37,931.00 I Plan Reviews I Fire Department Review 12/11/2003 03/0212004 OK GRG Initial Review 12111/2003 12/11/2003 APP RJB Plannine Review 12111/2003 WE Public Works Review 12/11/2003 03/1212004 APP SB Revised Plan Review - Fir 12124/2003 03/0212004 OK GRG Revised Plan Review - Pia Revised Plan Review - Pu Revised Plan Review - Str Revised Plan Review - Str Revised Plan Review - S U Structural Review 12124/2003 03/18/2004 APP EMM 12124/2003 12124/2003 03/29/2004 03/12/2004 12/24/2003 03/3012004 APP APP WE SB JMP JMP 12/24/2003 12/1212003 1211212003 WE JMP Paee 3 of6 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 2200400000000000331 See attached comments. Needs to submit final site plan and then sign Development Agreement. Planner is Linda Pauly. Revised Plan Review: WilIamette Dental Clinic. Job #COM2003-01224. Occupancy Classification: B. Construction Type: V-N, non-sprinklered. 6,111 square feet. No change in plan review comments from 1/29/04 Easements need to be signed and recorded before occup~ncy issuance. JB Electric drawings EI and E2. Received revised drawings A4 and A5 and information on II items. JMP called Justin Rotherham and noted that the medical gas design is expected this week. Other outstanding items include HMIS, and easements signed and recorded. 12/12/2003 See attached fax to Dick Aanderud requesting structural calculations and special inspection and testing forms. 1113/2004 received framing and lateral load calculations. JMP called and faxed Justin to complete the special inspection form signatures and requested truss calculations. JMP faxed structural review comments to Dick Aanderud. . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-01224 ISSUED: 04/0712004 APPLIED: 12/08/2003 EXPIRES: 10/07/2004 VALUE: $ 611,268.30 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 02/25/2004 02/25/2004 WE JMP Received Electrical permit application and Drawing E2, Signature sheet of Special Inspection form, and 1/2112004 compaction inspection. Still waiting for responsl to review comments. Structural Review 03/09/2004 03/19/2004 WE JMP Received truss calculations for approval. Left voicemail for Justin Rotherham at McIntyre Construction, Inc. Still waiting on responses to Items 1,2,16,17, and 18 from February 6, 2004 preliminary structural review letter and plumbing comments from February 10, and II, 2004 faxes. Confirmed with a telephone conversation and followup fax on March 22, 2004. Structural Review 03/17/2004 03/19/2004 APP JMP Received transmittal letter from Michael J. Kaiser at Poage Engineering with 4 sheets of Revised Final Site Plans and Exhibit "A". Structural Review 04/06/2004 04/07/2004 APP JMP Justin Rotherham and Bill McIntyre called about the Medical Gas Piping plans. They asked for the permit to be issued this week with a deferred submittal on the stamped Medical Gas plans which they intend to deliver for review by this coming Friday. SUB Review 12111/2003 12/19/2003 WE JF 12119/2003 JMP called Dick Aanderud and requested all necessary code forms for Building Envelope, HV AC, and Lighting systems. 1/212004 JF requested from electrical contractor new code forms to comply with 10/03 changes in Chapter 13. Contractor to supply updated forms ASAP. 1/14/04 Pass lighting system review only. 1/20/2004 updated Aanderud on need for Building envelope and HV AC forms. SUB Review 02/25/2004 03/17/2004 APP JF Received energy code forms and Drawings MI, M2, and PI. 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. Paee 4 of6 . . CITY OF ~rKll~ljt<1J'.,LU Building/Combination Permit Status Issued PERMIT NO: cOM2003-01224 ISSUED: 04/07/2004 APPLIED: 12/08/2003 EXPIRES: 10/07/2004 VALUE: $ 611,268.30 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line l.JW,/,;rrrl Tn~ I Site Inspection: To be made after excavation but prior to setting forms, 2 Erosion/Grading Inspection: After all erosion measures are in place. 27 Sanitary Sewer Line: Prior to filling trench and including required testing. 28 Storm Sewer Line: Prior to filling trench. 29 Final Plumbing: When all plumbing work is complete. 30 BackOow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 31 Rough Medical Gas: Prior to cover and including required testing. 32 Final Medical Gas: When all medical gas work is complete and certificate is provided to inspector from verifier. 33 Rough Mechanical: Prior to Cover 34 Final Mechanical: When all mechanical work is complete. 35 Rough Electric: Prior to Cover 36 Final Electric: When all electrical work is complete. 37 SUB Concrete Slab: Prior to and following pour. 38 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. 39 SUB Final: After all required energy inspections have been requested and approved. 40 SUB Plumbing: Following City Rough Plumbing ;nspection approval and prior to cover. 41 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. 42 SUB Ceiling Grid: Interior Lighting 43 SUB Exterior Lighting 44 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. 45 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 46 Final Gas: When all gas work is complete. 3 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection, 4 Footing: After trenches are excavated. 5 Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 6 Shear Wall Nailing: Before covering sheathing with finish materials. 7 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 8 Wall Insulation: Prior to cover. 9 Ceiling Insulation: Prior to cover. 10 Roofing: Prior to installing any roof covering, I I Drywall: Prior to taping. 12 Firewall: Located and constructed according to plans. 13 Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. 14 Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector 15 Roof SheathinglNailing: Before covering sheathing with finish material. 16 Ceiling Grid: After drywall approval but prior to cover. 17 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 18 Final Fire Department. After all requirements of the Fire Department have been met. 19 Final Building: After all required inspections have been requested and approved and the building is complete. 20 Rough Grading: After gravel is in place but prior to placing concrete. 21 Final Paving: After paving is complete. 22 Underslab Plumbing: Prior to filling the trench and including required testing. Paee 5 of6 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2003-01224 ISSUED: 04/07/2004 APPLIED: 12/08/2003 EXPIRES: 10/07/2004 VALUE: $ 611,268.30 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 23 Underground Plumbing: Prior to filling the trench and including required testing. 24 Perimeter Foundation Drains: After gravel and f1Iter cloth is installed but prior to backf'ill. 25 Rough Plumbing: Prior to cover and including required testing. 26 Water Line: Prior to filling trench and including required testing. 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. (' f~/ Date own,for Contractors Signa~ Paee 6 of6 r, . ATTACHMENT A _ __ ...____ CITY 0 INGFIELD SYSTEMS DEVELOPMENT CHAR~ET JOURNAL OR JOB NUMBER COM2003-01224 NAME OR COMPANY: WILLAMElTE DENTAL GROUP LOCATION: 2510 GAME FARM ROAD MAP & TAX LOT NUMBER: 17 03 22 00 02702 DEVELOPMENT TYPE: DENTAL OFFICE NEW DEVELOPED AREA (SF): EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURFACE (S.F.): 6.120.00 720 ITE: ITE: LOT SIZE (S.F.): o 19.760 1 STORM DRAINAGE IMPERVIOUS SQ. FT. 18,750 x S 0.290 PER SF TOTAL STORM DRAINAGE SDC:' $ 5,437.50 1070 2 ~ANTTARY ~F.WF.R-l.ITY A. REIMBURSEMENT COST: . NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) - ~ t. C:,.'4i,,'-:;~ 0:1,'>." IE - - OO~ . . .' ~:'~ '1i'o"O . C ~ 71 x S 22.64 PER DFU 1,607.44 I $ 1,607.441091 , $ , $ x S 17.21 PERDFU 1,221.91 I $ 1,221.911092 71 TOTAL LOCAL WASTEWATER SDC:' $ 2,829.35 , 3 TRANSPORTATION BLOG AREA TGSF x TRlP RATE x COST PER ADT x NEW TRlP FACTOR NEW A. REIMBURSEMENT COST: 6.120 x 36.13 x S 17.23 PER TRIP x 0.85 NTF 1$ 3,238.35 1 B. IMPROVEMENT COST: 6.120 x 36.13 x S 76.01 PER TRIP x 0.85 NTF 1$ 14,285.95 1 EXISTING A. REIMBURSEMENT COST: 0.00 x 0 x S 17.23 PER TRIP x 0 NTF 1$ B. IMPROVEMENT COST: 0.00 x 0 x S 76.01 PER TRlP x 0 NTF 1$ TOTAL TRANSPORTATIONREIMBURSEMENTSDC:' $ 3,238.35 TOTAL TRANSPORTATION IMPROVEMENT SDC:' $ 14,285.95 TOTAL TRANSPORTATION SDq $ 17,524.30 , 1093 '1094 ~ ~ANITARY ~F.WF.R _ MWMr. NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 6.120 x S359.58 PER FEU B. IMPROVEMENT COST: NUMBER OF FEU's 6.120 X S244.83 PER FEU EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.000 X SO.OO PER FEU B. IMPROVEMENT COST: NUMBER OF FEU's 0.000 X SO.OO PER FEU MWMC CREDIT IF APPLICABLE (SEE REVERSE) 1 $ 2,200.62 1 1 $ 1,498.37 1 1$ 1 $ 1 $ TOTAL MWMC REIMBURSEMENT FEE: $ TOTAL MWMC IMPROVEMENT FEE: $ MWMC ADMINISTRATIVE FEE: $ TOTAL MWMC SDC:I $ 3,569.16 , SUBTOTAL (ADD ITEMS 1,2.3, & 4) I $ 29,360.31' ~ AnMTNI~TR A" TIVE FEES- BASE CHARGE (SUBTOTAL ABOVE) S 29,360.31 X 5% S 1,468.02 TOTAL TRANSPORTATION ADMINISTRATION FEq $ TOTAL SEWER ADMINISTRATION FEE:' $ (139.83) 1054 2,200.62 1054 1,498.37 1055 10.00_1056 997.47 1078 470.55 1079 steve"" w. 'Eoea""rl1 'Eoar""'" 3/1212004 c1ilJS'o\l2l?JWp.'\~m\METTE DENTAL, 2510 GAME ~ltkD.",s TOTAL SDC CHARGES 30,828.33 , $ :':~~ . . DRAINAGE FIXTURE UNIT (DFU) CALCULA nON TABLE NUMBER OF NEW FIX11JRES x UNIT EQUIVALENT ~ DRAINAGE FIXTIJRE UNTTS ~OTE: FOR REMODELS, CALCULATE ONLY TIlE NET ADDITIONAL FIXTURES) WILLAMElTE DENTAL GROUP FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASElOlUSOLIDSIETG. INTERCEPTORS FOR SAND/AUTO WASHlETG. LAUNDRV TUB CLOTHES W ASHERlMOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERA TOR/W A TER ST A TlONIETC. RECEPTOR FOR COMMERCIAL SINK! DlSHWASHER/ETG. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIOOUBLE LAVATORY SINK: SINGLELAVATORYIRESIDENTIALBAR URINAL, STALUWALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: FIXTURES NEW OLD 1 2 15 4 4 NUMBER OF EDU'S. t." " " UNIT EQUIVALENT 3 I 3 3 6 2 3 6 12 I 3 2 2 3 2 2 I 5 6 3 TOTAL DRAINAGE FIXTURE UNITS~ .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day DRAINAGE FIXTURE UNITS o o 3 o o o 3 o o I o o o 6 o 30 4 o 24 o o o o 71 CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXA nON DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y YEAR RATE PER $1,000 YEAR RATE PER $1,000 ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE 1979 or before $ 5.04 1992 $ 1.52 1980 $ 4.95 1993 $ 1.38 1981 $ 4.88 1994 $ Ll9 1982 $ 4.75 1995 $ 1.03 1983 $ 4.58 1996 $ 0.87 1984 $ 4.41 1997 $ 0,68 1985 $ 4,20 1998 $ 0.46 1986 $ 3.88 1999 $ 0.27 1987 $ 3.50 2000 $ 0.09 1988 $ 3,07 2001 $ 0.04 1989 $ 2,60 2002 $0.00 1990 $ 2.14 2003 $0.00 1991 $ 1.71 2004 $0.00 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE $0.87 x 160.724 $139.83 IMPROVEMENT (IF AFTER ANNEXATION DATE) x $0.00 CREDIT TOTAL $139.83 COM2003-01224, W1lLAMETTE DENTAl, 2510 GAME FARM RD.x1s JULY 2001 22~ ~ifth 'Street Springfield, Oregon 97477 541-726-3759 Phone . ~. Jiily of Springfield Official Receipt "elopment Services Department Public Works Department Job/Journal Number CoM2003-01224 CoM2003-01224 CoM2003-01224 CoM2003-01224 CoM2003.0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003.0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003.01224 CoM2003-0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003-01224 . CoM2003-01224 CoM2003-01224 CoM2003-01224 CoM2003-01224 CoM2003-01224 COM2003-0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003.0 1224 CoM2003-01224 CoM2003.0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003-0 1224 CoM2003.0 1224 CoM2003-0 1224 CoM2003-0 1224 Payments: Type of Payment Check 4/7/2004 RECEIPT #: 2200400000000000331 Date: 04/0712004 Description Sanitary Sewer - 1st 50 Feet Water Line - 1st 50 Feet Water Line - Each Addtl 100' Storm Sewer - 1 st 50 Feet Storm Sewer Each Addtl 100' BackOow Device 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 Annexed 1996 Planning Final occy Inspection Perm ServlFdr 200 amps or less Perm ServlFdr 401 to 600 amps Add, Alter, Extend Circ Ea Add Building Permit Paving Plan Review CommfIndlPublic Plan Review Fire & Life Safety Furnace - up to 100,000 btu Vent Fan Gas Outlets 1-4 Gas Outlets 4+ Heat Pump -Mechanical Issuance Fee- Fixture Sanitary Sewer Each Addtl 100' + 7% State Surcharge + 10% Administrative Fee Item Total: Check Number Authorization Paid By Received By Batch Number Number How Received MCINTYRE CONSTRUCTION, jmp 5411 In Person INC. Payment Total: Page I of I 2:54:32PM Amount Due 45.00 45.00 28.00 45.00 98,00 28.00 5,437.50 1,607.44 1,221.91 3,238.35 14,285.95 2,200.62 1,498.37 10.00 470.55 997.47 (139.83) 118.00 126.00 125.00 186.00 1,937.15 526.65 190.12 117.00 72.00 42.00 4.00 2.00 72.00 10.00 518.00 42.00 239.06 394.18 $35,838.49 Amouut Paid $35,838.49 $35,838.49