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HomeMy WebLinkAboutPermit Building 2005-7-28 Status: Issued 225 Firtb Streel, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line .. .; CITY OF SPRINGFIELD . Building/Combination Permit PERMIT NO: COM2005-00761 ISSUED: 07/28/2005 APPLIED: 06/20/2005 EXPIRES: 01/28/2006 VALUE: $ 210,620,00 SITE ADDRESS: 582 Etban Ct ASSESSOR'S PARCEL NO.: 1703221207500 Springfield TYPE OF Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - breanne commons subd lot 17 Owner: SCarT JORDAN Address: 3520 CELESTE WAY EUGENE OR 97408 I CONTRACTOR INFORMATION' Contractor License JORDAN & JORDAN CONSTRUCTION LLC 155313 I BUILDING lNJ<uKlYlATIONI-O teQUu'" J '~i\~ 1 ~fl~am~ Olegon \.l \ottn 2 ~~\Otl: 5~~"i \ne ~es ale set ~90 ~o'tl tU\eS .!Xf,~ o'(m'i'f: tUgh ($9t~8~ 61'S l.Ion CW~lb$eou ~ \\'Ie to "'as tlo\ifICa: "2~1~~?ies 0 le?\'IOl'ill Ot>-p. 9.. 'a\J\"..':' S', . \\'Ie \e " ....2.u{;.ty \1'3 90 '(ou ~e~r.li..lII\l\e\ili\"i tlo\l\\.d'lii 1 00 "l\ili~~~~~~~~~;~ ~'\2-z344)' nla \'II-tJEVEi~~~T INFORMATION' Contractor Type General # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Conslruction # of Bedrooms: Front yard Selback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 15,00 14,00 7.00 21.00 20.00 Overlay Dist: # Street Trees Paved Drive Rqd: % of Lot Coverage: Residential Phone Number: 541-688-3998 Phone Number: 541-221-3409 Expiration Date 04/3012007 Phone 541-688-3998 Lot Size: S,1 S3 Sq Ft 1st Floor: 815 Sq FI2nd Floor: 1,047 Sq Ft Basement: Sq Ft Garage/Carport 480 Sq Ft Other: 160 Occupant Load: 2 Yes 25,20 REQUIRED PARKING Total: 2 Handicapped: Compact: Subdivision Not Accepted IPUBLIC IMPROVEMENTS' Street FuUvImproved ;~~\t~l:: SUA,Sidewalk:Type:,E WORK , S I)~RIVIIT 11 LL eM '''~.. " Sto S A'I bl Y Th\ 1_ D -,"~ "~t!:iD' ""bi'S NOT C b G rm ewer val a e: es, ' ORiZE:D UNDl!, !l'.",nspou '" ra s ur and ulter Special Instrucllon: AUl ~ NeED OR IS ABANDONED FOR COt\invIE N N b k C'I' tilPbliI .,,,,'n"n~VD~gdlb()[\bC' S . . otes: 0 00 -up to lty n.raslructure un u c mprovemenls\accepte ' y I e Ity; torm dramage piped to curb face 612112005 CAS Description I Valuation Descriotion I S Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction 1 or 4 Value Date Calculated Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line A,C, - Residen Deck/Balconv DweUlnes Garaee AC - Residential Deck V Wood Frame Garaee Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge 3 Baths One & Two Family Addressing Assignment Appliance Not Listed Building Permit Dryer Vent Exhaust Hoods Furnace - up to 100,000 btu Gas Fireplace Gas Outlets 1-4 Gas Outlets 4+ Heat Pump Plan Review Major - Planning Plan Review Residential Residence Wiring 1000 Sq Ft Residence Wiring Ea AddU 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbnrsement. SDC SanitarylStorm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer Each Addtll00' Temp Power 200 amps or less Vent Fan WUlamalane Single Family Total Amount . $4.00 $17,00 $96.00 $25.00 . CITY OF SPRINGFIELD . Building/Combination Permit PERMIT NO: COM2005-00761 ISSUED: 07/28/2005 APPLIED: 06/20/2005 EXPIRES: 01/28/2006 VALUE: $ 210,620,00 1,959,00 160.00 1,959,00 480,00 $7,836.00 $2,720,00 $188,064.00 $12,000.00 $210,620,00 06/24/2005 06/24/2005 06/24/2005 06/20/2005 Total Value or Projecl Fees Paid I Amount Paid $559.91 $10.00 $156,54 $109,58 $306.00 $31.00 $9.00 $926,40 $6.00 $9.00 $12.00 $15,00 $4.00 $1.00 $12,00 $103.00 $42,25 $106,00 $57.00 $457.00 $601.00 $10.00 $865,31 $82.03 $122.29 $63.79 $772.49 $175.13 $758,57 $28.00 $50,00 $24.00 $1,000,00 $7,485,29 Date Paid 6/20/05 7/28/05 7/28105 7/28/05 7/28/05 7/28105 7/28/05 7/28105 7/28/05 7/28/05 7/28/05 7/28105 . 7/28/05 7/28/05 7/28/05 7128/05 7/28105 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28/05 7/28105 7/28/05 7/28/05 7/28/05 Receipt Number 1200500000000000877 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 1200500000000001104 2 of 4 v . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00761 ISSUED: 07/28/2005 APPLIED: 06/20/2005 EXPIRES: 01/28/2006 VALUE: $ 210,620.00 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Planning Review 06/2112005 07/15/2005 I Plan Reviews I 06/21/2005 APP 07/15/2005 APP LLH TAJ Planning Review 06/21/2005 07/1512005 WE EMM Public Works Review 06/21/2005 06121/2005 APP CAS Structural Review 06121/2005 06123/2005 APP JB Structure shifted 3' to the south ror solar setback. Scott Jordan approved and verified this and west side setback of 7', Left message for Scott Jordan regarding solar and interior sIde setback. LM No hook-up to City Inrrastructure until Public Improvements accepted by the City: Storm drainage piped te curb face 6/21/2005 CAS Approved as noled on plans To Request an inspection caD the 24 hour recording at 726-3769. A1iinspection requested.before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. wiD be made the following work day, i Reouired I nsnections , Erosion/Grading Inspection: Prior to ground dIsturbance and after erosion measures are Installed. Ufer Electrical Ground: Install ground rod at footing and call ror 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 Nalling: 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, Perimeter FoundatIon DraIns: Arter gravel and ruter cloth Is instaUed but prior to backfill, Underfloor Plumbing: Prior to InsulatIon or decking. Rough Plumbing: Prior to cover and including required testing, Water Line: PrIor to filling trench and Including required testing, Sanitary Sewer Line: Prior to ruling trench and including required testing, 3 of 4 r; . . CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00761 ISSUED: 07/28/2005 APPLIED: 06/20/2005 EXPIRES: 01128/2006 VALUE: $ 210,620,00 Storm Sewer Line: Prior to filling trench, Final Plumbing: When all plumbing work is complete, UnderOoor Mechanical, Prior to insulation or decking and including required testIng, UnderOoor Gas: After line is installed and required testIng and capped if nol attached to an appliance. Rough Gas: Arter line is Installed and required testing and capped if nol 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 certiry that all Information hereon Is true and correct, and I further certify that any and all work performed shall be done In accordance with Ihe Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining 10 the work described herein, and that NO OCCUPANCY wiD 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 Ibis projecl, 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 wID remain on the site at all ti~ dU,ringjonstructlon. . ~ .... / .--- ----=---~ .<-\ . 1/ z;; 0 J Owner or Contractors Signature Date 4 of 4 ~9~~~:C~~~S 225 FIFI"H STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541l'~&\9 0 , ,(\' ELECTRICAL PERMIT APPLICATION t~;9<0"'" ,/-ot.,(\Q, . City Job NumberCA6c'ZOO\ -~O Date 6 - z.o --0 \" . a\V,e .. 3. ~~'COMPLETh!fFEE~eifEDal~k"~.6~1k~j\}:\i~~~~<}~!R:~:';~ ~.I~~Jd.:.:;:"~i ". .~..:,"~y..~.:~~.__~~~_..u i:.~~_,_.....1-,-;...:.;""%~..L' LEGAL DESCRIPTION "1:?rdi4N C 0__" -10 f JOB DESCRIPTION .s....~/~ L.L ~,c't:~e' Permits are non-transre~able and expire if work is Each Manufact'd Home or not started within 180 days or issuance or ir work is Modular Dwelling Service or .. Suspended for 180 days. Feeder _ 0 ' 2 ~coNiRACfroRiNSTAELATidNY)NL:Y.1 B. I :Serficis,~'he~d~r;-- i:l.<taB:U\l,It~~ietati~<<-s':7;rReJ~;',tio;j': ,'~ . 1~..,~,,~...J1,...,: ....L""'ti..<;;"t_~~~ 1.~~< ,I ,PI' '" ."'.' ,....,""-'-,- _\ ~!teq~ _ (\:)\\\\W..~\:,,~'::-~.I).i~~~ A J. r1 - r ....,.- , oregon 3 e oregOf\ \ lottO Electrical Contractor 1f1011P. r'Jf.cm c.. . J..tA.C- --<-~~ll\PS.8r..t~ '0'1 to 'es ate se _ ,,"~. $ 63.00 , "'l\P",,,,e.ao'l' "s..er\l\ ~95"- () I 4f' r, \\o-H(jtl"''\!P.srttetPII~~s gO Op.: . \O~ h\(. $ 75.00 {')r1)'MF r:(. IJ'J "'Oo'\f\c\i.ll~~l~~W~\eso\\"el~";",,_ $125.00 J ,.. ". 00;'2.-\)\l\ . cO.. \e\tll"'- i" a Ci Ii C-J 0 \f\ o~ t":t\:rnl~~Oll%UN.", \Oe \\1\.,...\\01' $163.00 Phone lY 0 . ( '1 :J CP 009(b)~Cjl~IW9~1v~i;U\\\\\'J \-\~, $375.00 ~~fli~\llPteg _'3'32-2'::/' '" $ 50.00 (\1.If(\'oet at is ,_800 c. ffT~@~::f~;s~r:Yic.eS:O}_:Feed-ets:' .:t. 'r ,.. '- "'J..-r<;'. ,:';~di?1 ~-'" -~~ 1. ~~2:.0rtio~Qf!'/iJ:;~T}iii~:;"lHlfl-;:ili~ 582- e-ltt At-.... CA- /7 Address 4;)t? ( ....- City t,(~~1P- Expiration Date '-lIon ~ (,. JO/~ (5(, .0 t ~- / f.j 6"'1 ~ (, lo/~ or;, ( Supervisor License Number Constr. Contr. Number Expiration Date ~ Signature of Superyising Electrician' ~.dol- Owners Name .5::c..e;tf "J" .... d.^,,- Address '5 ~z..c> G:,-fC""S >t:rL./A-, Phone b'r~ - :s 71"1 City f-u.(-aVC OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A. ~N-~i~:m.~i~:~~~i;r~Si~~~~'~i:ul1irFa~;iI'Y~~e/~~II~~~UQ:lft~J~,~ b.~;''''''''''''-''~'::''''':::!;;''_''.~"-~~~,_';:.~L.-;4- ,~_"".,~"."..::.: ..:l~--....,_ ~..~':I'..~~': Service Included I J lOCo 5' $106,00 1000 sq. ft, or less Each additional 500 sq. ft, or portion thereof $ 19,00 $50.00 Installation, A1ter~tion or Relocation 200 Amps or less I $ 50,00 20 I Amps to 400 Amps $ 69,00 40 I Amps to 600 Amps $100,00 Over 600 A'l'e;; or 1 O~O V OilS see "B" ab?ve~_ __ _ D. N1Br~ii'~~~,Cir6i.it~;.~~)~:\.. ",.,~, ~'~'>~' .-; :~<.k~~lrt ..~~~, .":"~~;'~'-' ,1 ~.. -~-:.. -'. . " '" 'W''\1"'''~:!.d:i' ,. . New Alteration or !'xtension p\':t~.\ie'j\t. t.~w.\\ yi) \'I\J One CircuitQ'\C~' ~~\\ S\\f>.\~ ~I-\\S ? $,t'bo611l- Each Additional 8irg.ilQr, with') ",0 'I'\U0'< """v' ~'-''" v ~ 'S "u" $ 3 00 Service or FeedwPennit. \) all- \ . f"f.k' '~~~~I~~'r.I::\S;h:1:?~~\9~' '. . ,~'.,. '.'" 'I E. ~.~Ii,s,c.ellaIieO~I>~!~,!!,d~r.'l!'t tJi<:1ti!I.ed)_::'J;:ac~ In.sta!!~.!!~1I , S"'D Pump or irrigation SigrilOutline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50,00 $ 50.00 $ 25.00 $ 45,00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. I_SUBJ;diAE8'FABO:vE: .. "..,-~ !,,~,~,,; '~:"A'..;"'';'~iI~...", ,:' ;:.~.-:, '... .>"~:":.i..:.3~~.-i.'i'i Z ( -; IV'7f "21 .70 Z-L( <7 2-( 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FonnslElectrical Pemlit Applicution 1-03.doc = . CITY'OF StlNGFIELD SYSTEMS DEVELOPME.ORKSH_EET JOURNAL OR JOB NUMBER: COM2005-0076I NAME OR COMPANY: Jordan & Jordan LOCATION: 582 Ethan Court TAX LOT NUMBER: Breanoe Commons Lot 17 DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' 2342 LOT SIZE (SF): .I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I CHARGE '2447.00 '$0.310 = I $758.57 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 0,00 $0.310 I 50% I = I ITEM I TOTAL-STORM DRAINAGESDC $758.57 5153 1 ICIl u..l 10 1,0 I~ I~ CIl a :;2 DISCOUNT $0.00 $758.57 11070 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x 25 I COST PER DFU $24,04 J TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIPRATE I x I 9.57 I $601.00 11091 I $457.00 1 1092 I -, 8. IMPROVEMENT COST: 1 NUMBER OF DFU's I x I 25 I $18,28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , $1,058.00 I NUMBER OF UNITS I x I I I I I COST PER TRIP $18.30 x 1 NEW TRJP F ACTORI I 1.00 I $175.13 11093 8. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP I 9.57 I I I I' $80.72 ITEM 3 TOTAL-TRANSPORTATION SDC = , $947.62 1....Sf\NITARY SEWER. .....WMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x I I I x INEW TRJP FACTORI I 1.00 I $772.49 1094 ICOST PER FEU $82.03 = $82.03 1054 8. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I $865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = $865.31 1055 50.00 I 1054 $10,00 11056 = , $957.34 = , $3,721.53 I~ CHARGE I $186.08 122.29 1079 $63.79 11078 TOTAL SDC CHARGES = $3,907.61 ------ SUBTOTAL (ADD ITEMS I, 2, 3, & 4) 5 AOMINISTRATIVE FEE: ISUBTOTAL x I ADM. FEE RATE I $3,721.53 I 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Cheryl Slaymaker 6/21/2005 PREPARED BY DATE . . .. '. DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIX11JRE UNITS (NOTE. FOR REMODELS, CALCULATE ONI. Y THE NET ADDITIONAL FiXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBA11ITUB 2 0 3 = 6 l I DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 CL011IESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRlG I WATER STATION / ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 I SHOWER. SINGLE STALL 0 0 2 = 0 I SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0 ISINK: COMMERCiAiJRESIDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 2 0 1 = 2 I URINAL. STALL / WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 25 J .EDU (Equivalent Dwelling Unit) is B discharRC equivalent to a single family dwelling unit (20 DFU's) set at 167 Rallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE BEFORE 1979 1979 1980 1981 1982 1983 i984 1985 i986 1987 1988 1989 1990 1991 1992 1993 i994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED V AWE $5.29 $5.29 $5.19 .$5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0,28 $0.09 $0.05 YEAR ANNEXED IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 rorNo) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATE $0.00 x $5.29 = , $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $5.29 o TOTAL MWMC CREDIT = $0.00 225 Fifth Street Springfield, Oregon 97471 ' 541-726-3759 Phone . ~ .....kity of Springfield Official Receipt .evelopment Services Department Public Works Department Jf'b/JOIIrnal Number COM2005-00761 COM2005-0076I COM2005-0076I COM2005-00761 COM2005-0076I COM2005-0076\ COM2005-00761 C:pM2005-0076I COM2005-0076I COM2005-00761 COM2005-0076I COM2005-0076I COM2005-0076\ COM2005-00761 COM2005-00761 COM2005-0076I COM2005-00761 COM2005-00761 COM2005-00761 COM2005-00761 COM2005-00761 . C~M2005-00761 COM2005-0076I COM2005-00761 qbM2005-0076I COM2005-0076I COM2005-0076I COM2005-0076I COM2005-0076I COM2005-00761 COM2005-00761 COM2005-00761 P:ayments: , TWe of Payment CreditCard " :i . '. I 7/28/2005 RECEIPT #: 1200500000000001104 Date: 07/28/2005 DescrIptio. Addressing Assignment WilIamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less SDC MWMC Administration Plan Review Residential Building Pennit 3 Baths One & Two Family Stonn Sewer Each Addtl 100' . Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Outlets 4+ Gas Fireplace Heat Pump Appliance Not Listed -Mechanical Issuance Fee- Plan Review Major - Planning SDC Sanitary/Stonn Admin SDC MWMC Improvement SDC MWMC Reimbursement Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement Stonn Drainage Impervious Area SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement + 7% State Surcharge + 10% Administrative Fee Paid By SCOTI JORDAN Received By djb I of I 1Iem Total: l.:heck Number AuUlortzation BoIcb Number Number How Received 882886 In Person Payment Total: 2:02:30PM Amoont Due 31.00 1,000,00 106,00 57,00 50,00 10.00 42.25 926,40 306,00 28,00 12.00 24.00 9.00 6,00 4.00 1.00 15,00 12,00 9.00 10.00 103.00 122.29 865,31 82,03 457.00 601.00 758.57 63.79 772.49 \75,13 109,58 156,54 $6,925,38 Amount Paid $6,925,38 $6,925.38