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