HomeMy WebLinkAboutPermit Building 2004-1-2
.
. CITY VI' ~t'KlNljt<lJ<;LD
Building/Combination Permit
PERMIT NO: cOM2003-01245
ISSUED: 01/02/2004
APPLIED: 12/12/2003
EXPIRES: 07/02/2004
VALUE: $ 126,519.00
f
"
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4034 Douglas Dr
ASSESSOR'S PARCEL NO,: 1802061111400
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
New
Residential
PROJECT DESCRIPTION: SFR
Owner: BRUCE WIECHERT
Address: 3375 PARK HILLS EUGENE OR 97405
Phone Number: 541-686-9458
I CONTRACTOR INFORMATION I
"
Contractor License
BRUCE WIECHERT CUSTOM HOMES INC 101717
L & E ELECTRIC INC 105475
COMFORT FLOW 460
STEVE R JOHNSON 65065
I BUILDING INFORMATION I
# of Units: 1 ~*'-<# of Stories: 1 Lot Size:
Primary Occupancy Group: R-3 ~'0 ~~eight of Structure 18.00 S&Ft 1st Floor:
Secondary Occupancy Group: U-1 '\~~ ~ Type of Heat: Forced Air Gas o'5~ ~nd Floor:
Primary Construction Type VN<. #' \,><<-Water Type: Ga~'" ~~sq K'-<jJ~ement:
Secondary Construction Type: <:(~'\l~<<:' ~~'> Range Type: Elec8;R\~<l?~4>'F!l,0lIl;J'ge/Carport
# of Bedrooms: <S -!!:-~ 'N'0 Energy Path: ~t'lj '1>~~<t? 26ie!:!
~ ~ '" n,,;f ,'1>~ '$'0 ~0'" O~~~~~'rface Area:
."" -<.- ~" ~<:-., ..... J ~ .0 .'"
c<<:.' #' :.... '0~~<<::i::? 'N~' I DEVELOPMENT INFORNt.l!JiO'N.OI:O-.)~ 0'" 0 ....~o~,.
SETBA(3~8' &....,<~ '0o~~ 0'" ~ut!<.. C)'V' C:P~~0~,~":~QUIRED PARKING
~'J.S ~ ~v A" ~~ 'l>' i$l-0 c".~ ~ ~ '1'
Frontyard Seltia~k:~~':~ <:::>'?- 18.00 Overlay D~~ ~0<i> 00 ~SS ~~ ~ ~..:s ,fl' Total: 2
Side 1 Setback: '~ ~"". <0'> 15.00 # Street~,g.~'t$' $)C),~ ~ ~0"" 0CbCiJ.('!' Handicapped:
Side 2 Setback: "'0,,,,-\'" 8.00 Paved DrlV'~CIl~' ~'b' CJ0<:' 0" y(>(' Compact:
~- "I .~:....~ ,.) 0:.<:-0 . es
Rearyard Setback: 14.00 % of Lot ~~.,\.O tb~ !<.~ ':27.80
Solar Setbacks: 15.00 <:- .o.C). ~<:' &.......0 r"
,,\)- "tt; ,<\'U C
Contractor Type
General
Electrical
Mechanical
Plumbing
Expiration Date
09/16/2006
03/30/2004
06/27/2005
03/1212004
Phone
541-686-9458
541-933-2653
541-726-0100
541-342-3765
5,850
1,278
352
I PUBLIC IMPROVEMEN:fS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Fullv Improved Curbside 5'
Yes DownspoutslDrains: Curb and Gutter
NO SEWER HOOK-UP OR OCCUPANCY UNTIL PUBLIC IMPROVEMENT PLANS ARE
ACCEPTED BY PUBLIC WORKS,
Notes:
Paee 1 of 4
,
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
V Wood Frame
Garaee
Dwellines
Garaee
Fee Description
Plan Review Residential
-Mechanical Issuance Fee--
+ 10% Administrative Fee
+ 70/0 State Surcharge
2 Baths One or Two Family
Addressing Assignment
Appliance Vent
Building Permit
Curbcut - Overwidth Appl
Curbcut Permit
Dryer Vent
Exhaust Hoods
Furnace - up to 100,000 btu
Gas Fireplace
Gas Outlets 1-4
Plan Review - Planning
PW Mull Disc - 2nd Permit
Rcsidence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimhursement
SDC Sanitary/Storm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Sidewalk Permit
Storm Drainage Impervious Area
Temp Power 200 amps or less
Vent Fan
Willamalane Single Family
Total Amount Paid
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2003-01245
ISSUED: 01102/2004
APPLIED: 12/12/2003
EXPIRES: 07/02/2004
VALUE: $ 126,519.00
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$90,60
$23.80
Square Footage
or Bid Amount
1,278.00
451.00
Value
Date Calculated
$115,786,80
$10,733,80
$126,520.60
12/12/2003
12/12/2003
Total Value of Project
Fpp< PIiILI
Amount Paid
$424,71
$10,00
$117,14
$82.00
$254.00
$8.00
$6.00
$653.40
$35.00
$75,00
$6,00
$9,00
$12.00
$15,00
$4.00
$59.00
$-30.00
$106,00
$38.00
$344.20
$452.80
$10.00
$214,23
$314,63
$106,69
$53.63
$727.42
$164.89
$75.00
$978.17
$50.00
$18.00
$1,000,00
$6,393.91
Date Paid
Receipt Number
1200200000000002591
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
1200400000000000006
12/12/03
1/2/04
1/2/04
1/2104
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
112104
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
1/2/04
Paee 2 of 4
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2003-01245
ISSUED: 01102/2004
APPLIED: 12/12/2003
EXPIRES: 07/02/2004
VALUE: $ 126,519.00
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
Public Works Review
12/15/2003
12/15/2003
12/1512003
I Plan Reviews I
APP
APP
APP
12/31/2003
12/26/2003
RJB
TAJ
VRJ
NO SEWER HOOK-UP OR
OCCUPANCY UNTIL PUBLIC
IMPROVEMENT PLANS ARE
ACCEPTED BY PUBLIC WORKS.
Applicant has applied for overwidth
driveway, application is in review by
PW Transportation, 12/26/2003
Structural Review
12/15/2003
12/30/2003
APP TCM
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.
~ptl In<iwrtin'\iJ
1 Curbcut - Standard: After forms are erected but prior to placement of concrete.
2 Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
3 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor
foundation inspection.
4 Footing: After trenches are excavated.
5 Foundation: After forms are erected but prior to concrete placement,
6 Post and Beam: Prior to floor insulation or decking.
7 Floor Insulation: Prior to decking.
8 Shear Wall Nailing: Before covering sheathing with finish materials,
9 Framing Inspection: Prior to cover and after all rough in inspections have been approved,
10 Wall Insulation: Prior to cover.
11 Ceiling Insulation: Prior to cover.
12 Drywall: Prior to taping.
13 Final Building: After all required inspections have been requested and approved and the building is complete.
14 Underfloor Plumbing: Prior to insulation or decking.
15 Underfloor Drain: Prior to cover or placement of concrete,
16 Rough Plumbing: Prior to cover and including required testing.
17 Water Line: Prior to filling trench and including required testing.
18 Sanitary Sewer Line: Prior to filling trench and including required testing,
19 Storm Sewer Line: Prior to filling trench.
20 Final Plumbing: When all plumbing work is complete.
21 Underfloor Mechanical. Prior to insulation or decking and including required testing.
22 Rough Gas: After line is installed and required testing and capped if not attached to an appliance,
23 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.
24 Rough Mechanical: Prior to Cover
25 Final Gas: When all gas work is complete.
26 Final Mechanical: When all mechanical work is complete.
27 Temporary Electric: Approval required prior to Utility Company energizing pole,
28 Rough Electric: Prior to Cover
Paee30f4
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2003-01245
ISSUED: 01/02/2004
APPLIED: 12/12/2003
EXPIRES: 07/02/2004
VALUE: $ 126,519.00
,-
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
29 Electric Service: Approval required prior to utility company energizing service.
30 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 ofany structure without ermission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who e in compliance with ORS 701,005 will be used on this project.
I further agree to ensure that all qui red inspection e requested at the proper time, that each address is readable from the
street, that the permit card is 10 ted at the fro the property, and the approved set of plans will remain on the site at all
tim77Jnstrucion, "/1//0 L( .
Ow':ii;;: :r Contractors Signature Qtte /
Paee 4 of 4
CITYOFSl ~GFIELD,OREGON .,'/
225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541a~~jecl as submitted has the foilowing
ELECTRICAL PERMIT APPliCATION zoning end does not require specific land use
approval
City Job Number COVV\ 'Lao 7- 0 I ZL-( ') Date Zoning L'htL
00].,,,"; ~-n-;;ftEErsiC . -:' ,~",. _.. _:~
3, .' . ....
h,;{1I0nZea Signature
r 0 - 0 I ~ 0 L/- Installation, AJteration or Relocation
200 Amps or less $ 50.00
Constr.Contr.Number 105415 ,,<;-"',- 201 Amps to 400 Amps $69.00
.~.... ~v ,......_\
-:> tL ~ ~" 401 Amps to 600 Amps " 'f' ~ $100.00
Expiration Date ,) - 30 -o~"'~"::\;:.~ ov:r",~.~~~~~?rIOOOVoll}~Q~' , ". '" .
Signatur:r;re Of[U MIlJ'Sing EIe(]CtriCian .;$,~'<~~ D.ranelH:;imui .0 'll'J,h " ~
J, <yj,,-~J~ New AJteration or Ex~s0'u~ :("~~ '.S:'.c ~O
rr ~~ One Circuit >:-,-'Ii ~>S' ~:>:-O~.:s' :;-.0Q.JJJ.J.00
~ S- .~v ~ ' ~. Each Additional OiQ:~'POb.$l~~ 0" - 0....-.~..;:...
ownersName~f~~~~t1~~~vt C\lS~ ~<s~::.~r~~e~,!~~~ ooq:'01t~~f 3.00.,. . ...~ .
AddressS1.) f;~ ,~f,>~,1~~i \\~ E... . ,~~~~~"i).~~~~
E "-Y-:$"-~:'.~ I -"tI ~ .,:" >:- ~ _,0 ~0 l/!i ~
City ~G.PY\f. ~ <,~,I'llllne bgh-9Y~'r? Pum ilti\~~ ,Lo,'li'c1t::'O"~'! $50,00
J "~. Si W~~~0 ~0$'0/r. $ 50.00
OWNER INSTALLATION Limited~~A~~ / $ 25.00
Limited E.:s,.<!l~dle"'i[, $ 45.00
The installation is being made on ~.~~_.,/ I own which uC>ip' ..,-.lit'- '"
is Dot intended for sale, lease or rent Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
1. f:(r'olU'iiii'iMe,glfN~jiiQ~
. 1It:;."~.. -......~'WO.o,.. ~....-a... ..' rA,h:-
'40~1.,) ~ti (~ f\oJ{\"S ~v'
I -J
LEGAL DESCRIPTION
l~'o~. 01#. II' 11400
JOB DESCRIPTION
Sf r1c).~"-(!..J2..
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
':;:;lTJ"'~':;'''';;~-;:4i.j~:ftID1';;M~;i;i'~
2. . ....,"S::tiiiii:,~_~.,. ~
Electrical Contractor L.rz;'e E/Pr)nc.
Address tf..Jg5.) JcJlZeS Acre:, ed
City 'Sp ~I d
Phone '733 -JS9f3
Supervisor License Number
'1/7Lj-5
Expiration Date
Owners Signature;
Inspection Request: 726-3769
A.
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
I
$106,00
lob
3,g'
2-
$ 19.00
$50.00
B.
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
O~er 1000 AmpsIVoIts
Reconnect Only
$ 63.00
$ 75,00
$125.00
$163.00
$375,00
$ 50.00
c. "VD(lt8~iSe~~'es'toriiife~ei-~~.' '"
~..I,!,'.r';'--.R"........._......_"""''' ...~.,' . ..... .
S'O
4.lmw~~~"",
/'1'1
I '3 S-8
I 'J 'to
-Ub J.l
7% State Surcharge .
10% Administrative Fee
TOTAL
Shared Drive(T:)lBuilding FonnsIEIectrieal Pcnnit Application I-OJ.doc
CITY OF SINGFIELD SYSTEMS DEVELOPMEN_ORKSHEET
JOURNAL OR JOB NUMBER: Com2003-01245
NAME OR COMPANY: Custom Homes
LOCATION: 4034 Douglas Drive
TAX LOT NUMBER: 18020611 t11 1400
DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE
NEW DWELLING UNITS I BUILDING SIZE (SF: 1729 LOT SIZE (SF):
I. STORM DRAINAGE
5850
I
IrIl
III
10
10
I~
~
rIl
G
~
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE
'3373.00 $0.290 = $978.17 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I DISCOUNT
0,00 I $0.290 50% I ~ I $0.00
ITEM I TOTAL - STORM DRAINAGE SDC $978.17
$978,17
1070
2. SANITARY SEWER - r:ITY
A REIMBURSEMENT COST:
I NUMBER OF DFU's I x I COST PER DFU
I 20 I $22.64 $452,80 1091
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x I COST PER DFU
I 20 I $17.21 $344.20 11092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC = I S797.00
- -
3. TRANSPORTATION
A REIMBURSEMENT COST:
I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEWTRIPFACTORI
I 9.57 I I I I $17,23 I 1.00 SI64,89 1093
B. IMPROVEMENT COST:
I ADTTRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEWTRlPFACTORI
I 9.57 I I I I $76.01 1.00 $727.42 1094
ITEM 3 TOTAL - TRANSPORT A nON SDC = I S892.31
4. SANITARY SEWER - MWMC
A REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I I I I $314.63 = $314.63 I 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I I I $214.23 = $214.23 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) SO.OO 1054
MWMC ADMINISTRATIVE FEE $10.00 1056
ITEM 4 TOTAL - MWMC SANITARY SEWER So( ~ , $538.86
I
SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , $3,206,34 -I
5. ADMINISTRATIVE FEE:
ISUBTOTAL I x I ADM. FEE RATE 1= CHARGE
I $3,20634 I I 5% $ I 60,32
TOTAL SANITARY ADMINISTRATION FEE: 106.69 1079
TOTAL TRANSPORTATION ADMINISTRATION FEE: $53.63 ~ 11078
- - --
Virginia Jurasevich 12/26/2003 TOTAL SDC CHARGES = $3,366.66
PREPARED BY DATE J
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW RXTURES ;It 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 1 0 3 = 3
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
CLOTHESW ASHER / MOP SINK 1 0 3 = 3
CLOTHESW ASHER - 3 OR MORE tEA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRIG / WATER STATION / ETC 0 0 1 = 0
I RECEPTOR FOR COM. SINK / DISHWASHER 1 ETC 0 0 3 = 0
ISHOWER, SINGLE STALL 1 0 2 = 2
ISHOWER, GANG (NUMBER OF HEADS). 0 0 2 = 0
ISINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 = 3
ISINK: 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 INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 20
.EDU {Equivalent Dwe1lin~ Unit} is a disc~ eauivalent to a sinRie family dwellinJ!: uni!i20 DRJ's) set at 167 sHons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR CREDIT RATE/SI,OOO 'I I
ANNEXED ASSESSED V AWE IS LAND ELGIBLE FOR ANNEXATION CREDIT! 0
BEFORE 1979 $5.04 (Enfer I for Yes, 2 for No) I
1979 $5.04 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT! 0
1980 $4.95 (Enter I for Yes, 2 for No) I
1981 $4.88 BASE YEAR 1979
1982 $4.75
1983 S4.58 CREDIT FOR LAND (IF APPLICABLE)
1984 $4.41 VAWE/IOOO CREDIT RATE
1985 S4.20 SO.OO x S5.04 ~ I SO.OO
19S6 S3.88
1987 $3.50 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
19S5 $3.07 V AWE 11000 CREDIT RATE
19S9 $2.60 $0.00 x $5,04 0
1990 $2.14
1991 $L71
1992 $L52 TOTAL MWMC CREDIT = SO.OO
1993 $L38
1994 $1.19 I
1995 $1.03 I
1996 $0.87 I
1997 $0.68 I
1998 $0.46 I
1999 $0.27 I
2000 $0.09 I
,I 2001 $0.04 II
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-0 I 245
COM2003-0 I 245
COM2003-0 I 245
COM2003-0 1245
COM2003-0 1245
COMl003-01245
COM2003-01245
COM2003-01245
COM2003-0 1245
COM2003-0 I 245
COM2003-0 I 245
COM2003-0 I 245
COM2003-0 1245
COM2003-01245
COM2003-01245
COM2003-0 I 245
COM2003-0 I 245
COM2003-0 1245
COM2003-0 1245
COM2003-01245
COM2003-0 I 245
COM2003-0 I 245
COM2003-0 1245
COM2003-01245
COM2003-0I245
COM2003-0I245
COM2003-0 1245
COM2003-0 1245
COM2003-0I245
COM2003-0I245
COM2003-01245
COM2003-0 1245
Payments:
Type of Payment
CreditCard
8
Receipt #: 1200400000000000006
Description
Addressing Assignment
WillamaIane Single Family
Sidewalk Permit
Curbcut Permit
Curbcut - Overwidtb Appl
PW Mull Disc - 2nd Permit
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 SanitarylStorm Admin
SDC Transpo Admin
Building Permit
2 Baths One or Two Family
Furnace - up to 100,000 btu
Vent Fan
Exhaust Hoods
Appliance Vent
Dryer Vent
Gas Outlets 1-4
Gas Fireplace
-Mechanical Issuance Fee-
Plan Review - Planning
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
jmp
Check Number
Batch Number Authorization Number
Paid By
BRUCE WIECHART
000265 012603
.
. ~ ..
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 01/02/2004 3:07:26PM
Amount Paid
Item Total:
8.00
1,000.00
75.00
75.00
35.00
(30.00)
978,17
452,80
344.20
164.89
727,42
314.63
21423
10.00
106.69
53,63
653,40
254.00
12.00
18.00
9.00
6.00
6,00
4.00
15.00
10.00
59.00
106.00
38.00
50,00
82.00
117.14
$5,969.20
.
.
How Received
In Person
Payment Total:
Amount Paid
$5,969.20
$5,969.20