HomeMy WebLinkAboutPermit Building 2004-2-25
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY OF ~rKlNGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00121
ISSUED: 02/25/2004
APPLIED: 0112912004
EXPIRES: 08/2512004
VALUE: $ 135,384.00
SITE ADDRESS: 4039 Douglas Dr
ASSESSOR'S PARCEL NO.: 1802061110700
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: SFR -lot 8 Shady Creek, same as COM2003-01244 4026 douglas
Owner, BRUCE WIECHERT
Address: 3375 PARK HILLS EUGENE OR 97405
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'
Contractor Type
General
Electrical
Mechanical
Plumbing
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
1
R-3
U-l
VN
3
18.00
12,00
5.00
29.00
0.00
# of Stories: 1
Height of Structure 16.50
Type of Heat, Forced Air Gas
Water Type: Gas
Range Type: Electric
Energy Path: Path 1
I DEVELOPMENT INFORMATION I
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Residential
Phone Number: 541-686-9458
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
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor,
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
5,850
1,360
400
2
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
Yes
30.00
I PUBLIC IMPROVEMENTS'
Street Improvements: 0 n IF "11,r,r" , IIrAS 'd/oU to Sidewalk Type: .
ATTENTION: regon Y" mpro~e UtTt CurbSide 5'
Storm Sewei'Availa~le:adopted by the Oregy~s Ii Y DownspoutslDrains: Curb and Gutter
Special In1~hct1~t~b;cer~.9..!l~.~ER.. HO~~!!pJ~R ts'CCUPANC~tJ~~E:"UBLIC IMPROVEMENTS ARE
~otlflca 52_001~S9;EJ'if:IW.~Y. p.tJBueWORK'S (See n c~.rl\....Hllb~tl~~m~,pt1J.l'~WO~~us),
Notes' n OAR 9 " s of the rules \ I ttilVlIl::JH I
. ~090, You may obtal~~of'~the telephone AUTHORiZED UNDER THIS PERMIT IS NOT
calling the center, 0 ~tility Notification COMMENCED OR is ABANDONED FOR
number,!~~~~~;~~~~~~_::I~2_2344\. ANY 180 DAY PERiOD.
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
Dwelllnes
Garaee
V Wood Frame
Garaee
Fee Description
Plan Review Same As
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7%. 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 Mult Disc - 2nd Permit
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 SanitarylStorm Admin
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
Sidewalk Permit
Storm Drainage Impervious Area
Vent Fan
Willamalane Single Family
Total Amount Paid
.
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$92.40
$24.30
Square Footage
or Bid Amount
1,360.00
400.00
Total Value of Project
Fpp<. PIi4.I
Amount Paid
$100.00
$10,00
$115.07
$80,55
$254.00
$31.00
$6.00
$682.65
$35.00
$75.00
$6.00
$9.00
$12.00
$15.00
$4.00
$71.00
$-30.00
$106,00
$38.00
$344.20
$452.80
$10.00
$214.23
$314.63
$99.46
$54.11
$727.42
$164.89
$75.00
$843.32
$18.00
$1,000.00
$5,938.33
Date Paid
1/29/04
2125/04
2125/04
2/25/04
2125104
2125/04
2125/04
2/25/04
2125104
2/25/04
2125104
2125/04
2125/04
2125/04
2125/04
2/25/04
2125104
2125/04
2125/04
2125/04
2/25/04
2125104
2125/04
2/25/04
2/25104
2/25/04
2/25/04
2/25/04
2/25104
2/25/04
2125104
2125/04
Paee 2 of 4
. Ull' OF ~rtOl~GFIELD
Building/Combination Permit
PERMIT NO: COM2004-00121
ISSUED: 02/25/2004
APPLIED: 01/2912004
EXPIRES: 08/25/2004
VALUE: $ 135,384.00
Value
Date Calculated
$125,664.00
$9,720.00
$135,384.00
01129/2004
01129/2004
Receipt Number
1200400000000000128
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
1200400000000000242
.
.
. CITY 01< ~rKll~uJ<1ELD
Building/Combination Permit
PERMIT NO: COM2004-00121
ISSUED: 02/25/2004
APPLIED: 0112912004
EXPIRES: 08/25/2004
VALUE: $ 135,384.00
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
01/30/2004
01/30/2004
0113012004
I Plan Reviews I
01/30/2004 APP
02/20/2004 APP
02/0712004 APP
LLH
TAJ
VRJ
NO SEWER HOOK-UP OR
OCCUPANCY UNTIL PUBLIC
IMPROVEMENTS ARE
ACCEPTED BY PUBLIC WORK'S
(See Ron Sather for Public
Improvement Project status).
Approved for 30' max. driveway
throat 2/612004.
Structural Review
01130/2004
02120/2004
OK
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.
~ Rpt1l~p..tinn< I
1 Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
2 Curbcut - Overwidth: After forms are erected but prior to placement of concrete.
27 Final Mechanical: When all mechanical work is complete.
28 Temporary Electric: Approval required prior to Utility Company energizing pole.
29 Rough Electric: Prior to Cover
30 Electric Service: Approval required prior to utility company energizing service.
31 Final Electric: When all electrical work is complete.
3 ErosionlGrading Inspection: After all erosion measures are in place.
4 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation Inspection. .
5 Footing: After trenches are excavated.
6 Foundation: After forms are erected but prior to concrete placement.
7 Post and Beam: Prior to Ooor insulation or decking.
8 Floor Insulation: Prior to decking.
9 Shear Wall Nailing: Before covering sheathing with finish materials.
10 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
11 WaU Insulation: Prior to cover.
12 Ceiling Insulation: Prior to cover.
13 Drywall: Prior to taping.
14 Final Building: After all required inspections have been requested and approved and tbe building is complete.
15 UnderOoor Plumbing: Prior to insulation or decking.
16 UnderOoor Drain: Prior to cover or placement of concrete.
17 Rough Plumbing: Prior to cover and including required testing.
18 Water Line: Prior to filling trench and including required testing.
19 Sanitary Sewer Line: Prior to filling trench and including required testing.
20 Storm Sewer Line: Prior to filling trench.
21 Final Plumbing: When all plumbing work is complete.
22 UnderOoor Mechanical. Prior to insulation or decking and including required testing.
Paee 3 of 4
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00121
ISSUED: 02/25/2004
APPLIED: 0112912004
EXPIRES: 08/25/2004
VALUE: $ 135,384.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
23 Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
24 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.
25 Rough Mechanical: Prior to Cover
26 Final Gas: When all gas work is complete.
By signature, I state and agree, that I have carefully examined the completed application and do bereby certify that all
information hereon is true and correct, and I further cert' that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the L s of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any str ure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and e oyees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all re uired' spections are requested at the proper time, that each address is readable from the
=c7Tr~.~ ." · r~,,"oo ,..~, ... ...,,; ;;~: ~.,... ...,.., ~
Owner or Cohtractors~gnature Date
Paee40f4
"o~O;e
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'};~ \0>~
J>~~<t}~C
~ ~~
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-36r:'0o.~'\.. ..
~LECTRICAL^~RfI/l.AAPPLICATION :. /. ~/-- _L ..,<-Q,t~~..<-O
CIty Job Number l..U.lIl.lll ~.. 0011J. Date 2-/ 2.. .) /(::/ '7 \0,,"0 .l'
, '<.,<::-e ~,~.\\'<.'~
I, ~ L~0TI~~ OFiN~iALI~~'JcjN 3, ,?:OAiifL~TEi:EE ~p"Ul"e'_"-~0-"
LE~~~RI~.l ~ A, ~~e'Y Re~ide];tial- Singl~:~~~W:~-::''1ilY ~Fdw,~lIin~~~it.
~\\ \~\t)O
JOB DESCRIPTION " ^ 1000 sq. ft. or less
- . f)_.:.' ~ Each additional 500 sq, ft. or
~~ l -\! 1:JLU> portion thereof
~~ non-tr erable an~XPire if work is . ~h Manufact'd Home or
not started within 1 days of issuance or if work is fo ~wel1ing Service or $50 00
Suspended for 180 days, IV"" -J lv/V'" '
"'lll ,... 'vr.
'0 .. -- - - ,~ .. .~,' - - -- II/a qq"o..,"",I'lC/," eOo/). - . . .- -,
2. ,_~ON"!~f!?R ~::;;~r~N.?;L!. 0~9~~~~~~~~t~~q~~~:n"A~te~~"i~ns _~r.R~lo~~tion:
Electrical Contractor ~ C [; LR L::f-.I.l.bl/ll a//II/~ ~b2.N",& fl1 :Se rlJl. rego') YOIJ '0 $ 63.00
f11ber ~ldOlOj>&~I1' eoS I'lre ~ Ufllt1j, $ 75,00
Address ~OILf SD-<'.(lUr Hi\rlOw ~~ffRUrf)!&~":Jfl~o~"IF19S;ffOI:/IJ $125,00
I _ 6o'f3AiDry;:tfrw~~ fefhe ru/- -007, $163.00
Phone YE),:> - 30lt 2... Over 10001J(1J.gj'5!}{fytvo'et>110t:VtS 6J $375,00
Reconnect Only .:!~ J f/flel'll!. .." $ 50,00
/. 01)
. - 'CITY OF S.t-~UNGFIE~D, OREGON : l)'"
.. '.
. ..
Service Included
$106.00
\(jQ ,CO
38,01
\
1-
$ 19.00
City _?c JC\ Q t1 f<
I
Supervisor Licen~e Number
1-//7'-1- 5
10/1/olf
, ,
Expiration Date
\'n'SY'(S
5/30/0Lf
,
':""T" "'~'-~'~"'" ,~.-__- -"'-',-'-~--."--'
c. jTemi>~rary Services or Feeder!(:: ~
...... l,.,(,.",~__.. " "_ _' _. _.'._.' '.~ _ __~ ~'"--'..;..,
I"7<<{lat~~teration or Relocation
2(frflj.,<in#l:'IJ, less $ 50.00
d'1f{~!J~60brl';ff $ 69.00
A ~#6,rpW. hf60Qj~~p'sL EXPI $100.00
A/v 1 Cr:n tn);. R[ I~
. ~verfli?<M'!'!p~ )~OO Vql~ ~e "B'T.mWi
D, Brancl.'ViA<;"~D' IIBA"Tln '/[fTMI,., Dill?
.. -, .' ...."tJ,. 'D ,rVUNr-'S N: 'I
New Alteration or Extension Per Pa% 0,.
One Circuit $ 43.00
Each Additional Circuit or with
Service or Feeder Pennit $ 3.00
Expiration Date
Constr, Contr, Number
Signature of Supervising Electrician
~Q[)~ ~~
Owners Name &uc.-e.. "-U,:ernpd
Address 3"2.'"'\'5 ~ V \-\\ ~\"
City 4 f'9- Phone ~.Q4::8
OWNER INST ALLA TION
E. Mi~cella'1eous (Servi~e/feeder not included) -Each Installation.
c,' . _,-, "'..i~'~'.~..~""'-" ;... .:..~_.,~ ~,,-,,,,_~'';''.;:~':'''".........:.;..: _'._ .:._. !
The installation is being made on property I own which
is not intended for sale, lease or rent.
Pump or irrigation
Sign/Outline Lighting
Limited EnergylResidential
Limited EnergylCommercial
$ 50,00
$ 50,00
$ 25.00
$ 45.00
Minimum Electric Permit Inspection Fee is ~5,OO + Surcharges
........ -.. ,
-~.;;;',," ,;
\44 p6
\ () .O~
\4:AO
\lo~
Owners Signature:
4, : 'SUBTOTAL OF ABOVE
7% State Surcharge
10% Administrative Fee
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building Forms/Electrical Pennit Application I~03.doc
. ' .
CITY OF SPRINGFIELD SYSTEMS DEVELOPMEN:rwORKSHEET
JOURNAL OR JOB NUMBER: Com2004-00121
NAME OR COMPANY: Bruce Wiechert
LOCATION: 4039 Douglas Drive
TAX LOT NUMBER: 18020611 tll1300
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS I BUILDING SIZE (SF' 1360 LOT SIZE (SF):
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE
I 2908.00 I $0.290 = I $843,32 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCfED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F, I x I DISCOUNT RATE i I DISCOUNT
I 0,00 I $0.290 I 50% I ~ I $0,00
ITEM 1 TOTAL - STORM DRAINAGE SDC $843,32
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x I COST PER DFU
I 20 i I $22.64
B, IMPROVEMENT COST:
I NUMBER OF DFU's I x COST PER DFU
I 20 $17.21
ITEM 2 TOTAL - CITV SANITARV SEWER SDC =,
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRIP RATE I x I NUMBER OF UNITS I
I 9.57 i. i I
B.IMPROVEMENTCOST:
I ADT TRIP RATE I x I NUMBER OF UNITS I
I 9.57 I I I
ITEM 3 TOTAL. TRANSPORTATION SDC
$797,00
x I COST PER TRIP x INEW TRIP FACfORI
I $17.23 i 1.00 =
x I COST PER TRIP x INEWTRIPFACTORI
I $76.01 I 1.00
= , $892,3 I
4. SANITARY SEWER. MWMf:
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I I I I 5314.63
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU J
I I I $214.23 l
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL. MWMC SANITARY SEWER SD<
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4)
5. ADMINISTRATIVE FEE:
ISUBTOTAL I x I ADM. FEE RATE 1=
I 53,071.49 I 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
Virginia Jurasevich
PREPARED BY
2/7/2004
DATE
5850
$843,32
$452,80
$344,20
$164,89
$727,42
=
$314,63
,,-.
'"
~
Ci
o
- u
~
~
E-
'"
~
o
gj
1070
1091
I
11092
11093
I
11094
1054
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE; FOR REMODELS. CAlCUlA IE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES
UNIT
FIXTURE TYPE NEW OLD EQUIVALENT
I BATHTUB 0 -
1 3 =
IDRINKING FOUNTAIN 0 0 1 =
I FLOOR DRAIN 0 0 3 =
IiNTERCEPTORS FOR GREASE lOlL 1 SOLIDS I ETC. 0 0 3 =
IiNTERCEPTORS FOR SAND IAUTO WASH 1 ETC. 0 0 6 =
I LAUNDRY TUB 0 0 2 =
iCLOTHESW ASHER I MOP SINK 1 0 3 =
ICLOTHESW ASHER - 3 OR MORE CEA) 0 0 6 =
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 =
iRECEPTOR FOR REFRIG I WATER STATION iETC. 0 0 .1 =
IRECEPTOR FOR COM. SINK I DISHWASHER I ETC. 0 0 3 =
ISHOWER, SINGLE STALL 1 0 2 =
ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 =
IS INK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 =
ISINK: COMMERCIAL BAR 0 0 2 =
ISINK: WASH BASINIDOUBLE LA VATORY 1 0 2 =
ISINK: SINGLE LA V ATORY/RESIDENTIAL BAR 1 0 1 =
IURINAL, STALL I WALL 0 0 5 =
ITOILET, PUBLIC INSTALLATION 0 0 6 =
ITOILET, PRIVATE INST ALLA TION 2 0 3 =
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 =
TOTAL DRAINAGE FIXTURE UNITS
.EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
CREDIT RA TE/$I ,000
ASSESSED VALUE.
$5.04
S5.04
$4.95
54.88
$4.75
$4.58
$4.41
$4.20
$3.88
$3.50
$3.07
$2.60
$2.14
SUI
$1.52
$1.38
$1.19
$1.03
$0.87
$0.68
$0.46
$0.27
$0.09
$0.04
=
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
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
CREDIT FOR LAND (IF APPLICABLE)
VALUE 11000 CREDIT RATE
$0.00 x $5.04
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE 11000 CREDIT RATE
$0.00 x $5.04
TOTAL MWMC CREDIT
DRAINAGE
FIXTURE
UNITS
3
o
o
o
o
o
3
o
o
o
o
2
o
3
o
2
1
o
o
6
I
I
I
I
I
I
;/
I
o
20 ~
o
o
1979
~ ,
so.oo
o
$0.00
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
Job/Journal Number
COM2004-0012l
COM2004-00l21
COM2004-00121
'COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-00121
COM2004-0012l
COM2004-0012l
COM2004-00121
COM2004-0012l
COM2004-0012l
COM2004-0012l
COM2004-0012l
COM2004-0012l
COM2004-00 121
COM2004-00 121
.
Payments:
Type of Payment
CrcditCard
"~'''.,-' .
lit'..',...............',.".,........:..
... . .^' -'.'CC'" . ~ :,
f"". 1
", '--.'.~. .......-:.-'
Receipt #: 1200400000000000242
Description
Addressing Assignment
Willarnalane Single Family
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Sidewalk Permit
Curbcut Permit
PW Mult 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 Sanitary/Storm Admin
SDC Transpo Admin
Curbcut - Overwidth Appl
Plan Review - Planning
Building Permit
2 Baths One or Two Family
Furnace - up to 100,000 btu
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Gas Fireplace
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
dIm
Check Number
Batch Number Authorization Number
Paid By
BRUCE WIECHERT
000306 029493
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 02/25/2004 8:43:34AM
Amount Paid
31.00
1,000,00
106,00
38,00
75.00
75.00
(30,00)
843,32
452.80
344.20
164.89
727.42
314.63
214,23
10.00
99.46
54,11
35.00
71.00
682.65
254,00
12,00
18,00
6,00
9.00
6.00
4.00
15.00
10,00
80.55
115.07
$5,838.33
Item Total:
How Received
In Person
Payment Total:
Amount Paid
$5,838.33
$5,838.33