Loading...
HomeMy WebLinkAboutPermit Building 2007-1-9 .CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2006-01382 ISSUED: 01/09/2007 APPLIED: 10/26/2006 EXPIRES: 07/09/2007 VALUE: $ 227,062,00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 568 Ethan Ct ASSESSOR'S PARCEL NO.: 1703221207300 Springfield TYPE OF WORK: Singie Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - Breanne Commons lot 15 Owner: MIKE GANSEN CONSTRUCTION COMPANY Address: 362 HWY 99N STE 2 EUGENE OR 97402 Contractor Type General Electrical Mechanical Piumhing I CONTRACTOR INFORMATION I Contractor License MIKE GANSEN CONSTRUCTION COM PAN 92159 MAG ELECTRIC INC 149834 , HOME COMFORT HEATING & AIR 84164 HOME COMFORT HEATING & AIR INC 84164 BUILDING INFORMATION I # or Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: 2 Height of Structure 24.50 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Gas Energy Path: Path 1 Sprinkled Building: nla I R-3 U VB 3 I DEVELOPMENT INFORMA TlON I Frontyard Set hack: Side 1 Sethack: Side 2 Sethack: Rearyard Sethack: Soiar Sethacks: 18.00 7.00 16.00 14.60 25.00 Overiay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Residential Expiration Date 06/14/2009 12113/2009 06/25/2007 06/25/2007 Phone 541-463-1000 541-461-0387 541.345-2838 541-345-2838 Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: 5,227 1,402 770 440 2 Yes 38.60 REQUIRED PARKING Total: 2 Handicapped: Compact: Sidewalk Type: Fully Improved Yes ~\ Storm Sewer Available: Speciali\ilnstruction: UJICE: Notes: TH ,~io-rinito,.pp~oved systemJ!er plans.JLP AUTHOF1'ZED "nf\LL eXPIRE IF THE WORK COMMENCED ~~DER THIS PERMIT IS NOT ANY 1 BD DAY PER:~;,BANDONED FOR Curbside 5' DownspoutslDrains: Curb and Gutter All t:I\IIIUI~.VIW8"'"'<'''' "''lUll'"'' you t" follow rules adopted by the Oregon Utili y Notification Center. Those rules are set Ie rtl in OAR 952-001-0010 through OAR 952-0 )1 0090. You may obtain copies of the rule~ b: calling the center. (Note: the telephonf . number for the Oregon Utility Notificatic n Center is 1-800-332-2344). Paee 1 or 4 Status Issued 225 Fifth Street, Springfield, OR 541.726-3753 Phone 541.726-3676 Fax 541-726.3769 Inspection Line Description Tvpe or Construction V Woud Frame Garaee Dweilines Garaee Fee Description Plan Review Residential -Mechanical Issuance Fe..... + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge 2 Baths One or Two Family Addressing Assignment Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fixture Furnace - up to 100,000 btu Gas Fireplace Gas Outlets 1-4 Plan Review Major - Planning PW 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 Temp Power 200 amps or less Vent Fan Willamalane Single Family . I Valuation Descriotion I $ Per Sq Ft or multiplier $99.00 $26.00 Square Footage or Bid Amount 2,178.00 440.00 Total Value or Project F'pp<. PIiaJ Amount Paid $638.07 $10.00 $170.26 $94.98 $125.73 $254.00 $31.00 $981.65 $80.00 $6.00 $9.00 $130.90 $28.00 $12.00 $15.00 $4.00 $198.00 $.30.00 $106.00 $76.00 $554.14 $728.74 $10.00 $961.52 $91.61 $150.37 $67.82 $836.32 $189.58 $80.00 $991.91 $50,00 $30.00 $1,000.00 Date Paid 10/26/06 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 119/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9107 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 1/9/07 119/07 1/9/07 1/9/07 1/9/07 1/9107 1/9/07 Paee 2 or 4 .CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-01382 ISSUED: 01109/2007 APPLIED: 10/26/2006 EXPIRES: 07/09/2007 VALUE: $ 227,062,00 Vaiue Date Calculated $215,622.00 $11,440.00 $227,062.00 10/26/2006 10/26/2006 Receipt Number 1200600000000001573 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 1200700000000000024 . .CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01382 ISSUED: 01109/2007 APPLIED: 10/26/2006 EXPIRES: 07/09/2007 VALUE: $ 227,062,00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541.726-3769 Inspection Line Total Amonnt Paid $8,682.60 Plan Reviews I Initial Review 10/31/2006 APP SKG LDAP Review 1211312006 12113/2006 10 BRC Contacted Mike Gansen and let him know an LDAP was needed at the time the building permit is issued. Plan nine Review 10/31/2006 12/13/2006 APP TAJ Public Works Review 10/31/2006 12/1212006 APP JLP Storm to approved system per plans,JLP Structural Review 10/31/2006 11/08/2006 10 LLH Forwarded to Tom Rogers ror review Structural Review 11108/2006 01/09/2007 APP DJB Forwarded to Tom Rogers for review today 11/8/2006. Approved 010207 by Tom Rogers. To Requesl an inspection call the 24 hour recording al 726-3769. All inspection requesled 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, I Rp.nuil'"lflolrl Tnsnections I ErosionlGrading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewaik - Curbside: After rorms are erected but prior to placement of concrete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Ufer Electrical Ground: Install ground rod at rooting and call for inspection in conjunction with rooting andlor foundation inspection, Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insuiation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: 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. Finai Building: After all required inspections have been requested and approved and the building is complete. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill, Uriderfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Paee 3 of 4 _~.'AI!"..!F,I...~'~.jiI.'. .. 'WIt . [:eM n i .-: -..' j . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01382 ISSUED: 01109/2007 APPLIED: 10/26/2006 EXPIRES: 07/09/2007 VALUE: $ 227,062,00 Status Issued 225 Firth Street, Springfield, OR 541.726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Rough Plumbing: Prior to cover and including required testing, Shower Pan. Prior to covering and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete, Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Gas: After line is installed and required testing and capped ir not attached to an appiiance. Gas Service: After line is installed and line has been connected to a minimum or one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Final Mechanical: When all mecbanical 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 certify that all inrormation hereon is true and correct, and I rurther certiry that any and all work perrormed shall be done in accordance with the Ordinances of the City of Springfield and the Laws or the State or 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 Sarety. I rurther certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I rurther 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 roperty, and the approved set or plans will remain on the site at all ~~ c/ Owner or Contractors Signature ~ 9- 07 Date Paee 4 of 4 . A, CITY OF SPRINGFIELD SYSTEMS DEVELOPME~ORKSHEET JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: . TAX LOT NUMBER; DEVELOPMENT TYPE: NEW DWELLING UNITS .1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F, x I COST PER S.F. I I CHARGE I 2955.50 I $0.336 = I $991.91 I RUNOFF ROlJfED 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 I 0.00 I $0.336 I 50"10 = I ITEM I TOTAL - STORM DRAINAGE SDC S991.91 ~ A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 28 B. IMPROVEMENT COST: I NUMBER OF DNs I x I 28 $19.79 ITEM 2 TOTAL - CITY SANlT ARY SEWER SDC 2 SANITARY SEWER - CITY C0M2006--01382 Mike Gansen 568 Ethan Ct 1703221207300 SINGLE FAMILY RESIDENCE 1 BUILDING SIZE (SF: 1 100 ~ Cl o U p:: I~ G gj 1992 LOT SIZE (SF): 5153 DISCOUNT $0.00 S991.91 11070 COST PER DFU $26.03 = , S728.74 11091 = , = , $554.14 1092 I l SI89.58 11093 $1,282.88 . ., 3 TRANSPORTATION A. REIMBURSEMENT COST. I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I 9.57 I I I I $19.81 . 1.00 B. IMPROVEMENT 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 $87.39 1.00 ITEM J TOTAL - TRANSPORT A nON SDC = , $1,025.90 $836.32 1094 4, SANITARY SEWER - MWMC . A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I I $91.61 = $91.61 11054 B. IMPROVEMENT COST: II INUMBER OF FEU's I x ICOST PER FEU I 1 I $961.52 = $961.52 1 105S MWMC CREDIT IF APPLICABLE (SEE REVERSE) SO.OO 1 1054 MWMC ADMINISTRATIVE FEE $10.00 1 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =1 SI,063.13 I SUBTOTAL (ADD ITEMS I, 2, 3, & 4) ~ , $4,363.82 I - - .2..,ADMlNISTRATTVE FEE: I SUBTOTAL x I ADM. FEE RATE I': CHARGE I $4.363.82 I 5% $218,19 TOTAL SANITARY ADMINlSTRATlON FEE: 150.37 11079 TOTAL TRANSPORTATION ADMINlSTRATION FEE: $67.82 11078 Jeff Prociw 12/1212006 TOTAL SDC CHARGES' =, $4,582,01 'I PREPARED BY DATE I . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FlXTIJRE UNITS I (NOTE. FOR REMODELS. CALCULATE ONt Y TIlE NET ADDmONAL FIXTURES) NO. OF FIXTURES DRAINAGE II UNIT FIXTURE FIXTURE TYPE NEW OLD EQUlV ALENT UNlTS BA TIITUB 2 0 3 = 6 I DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 .3 = 0 I INTERCEPTORS FOR GREASE / OIL I SOLIDS / ETC. . 0 0 3 = 0 I INTERCEPTORS FOR SAND / AlITO WASH / ETC. 0 0 6 = 0 I ILAUNDRY TUB 0 0 2 = 0 I ICLOTIlESW ASHER / MOP SINK 1 0 3 = 3 I CLOTIlESWASHER - 3 OR MORE (EA) 0 0 6 = 0 I MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG / WATER ST AnON / ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 = 3 I SHOWER. SINGLE STALL 0 0 2 = 0 I ISHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0 I ISINK: COMMERCiAiiRESIDENTlAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = I 0 I~INK: WASH BASINIDOUBLE LA V A TORY 0 0 2 = I 0 I SINK: SINGLE LAVATORYIRESIDENTIAL BAR 4 .0 1 = I 4 ,I URINAL. STALL I WALL 0 0 5 = I 0 TOILET. PUBLIC INSTALLATION 0 0 6 = I 0 I TOILET. PRIVATE INST ALLA TION 3 0 3 = I 9 I MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 28 -EDU (Equivalent DweUin~ Unit) is B discha~ eauivalent to a sinldt:: family dwelli~ unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE r YEAR CREDIT RATElSI,OOO II ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2 BEFORE 1979 $5.29 (Enter I for Yes, 2 for No) 1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 2 1980 $5.19 (Enter I for Yes. 2 for No) 1981 $5.12 BASE YEAR 1979 1982 $4.98 1983 $4.80 CREDIT FOR LAND (IF APPLICABLE) 1984 $4.63, VALUE/lOOO CREDIT RATE 1985 $4.40 $0,00 x S5.29 = I SO.OO 1986 $4.07 1987 . $3.67 CREDIT FOR IMPROVEMENT (IF AfTER ANNEXATION) 1988 $3,22 VALUE /1000 CREDIT RATE 1989 $2.73 $0.00 x $5.29 = I 0 1990 $2.25 1991 $1.80 1992 $1.59 TOTAL MWMC CREDIT = SO.OO 1993 $1.45 1994 $1.25 1995 $1.09 1996 $0.92 1997 $0.72 1998 . . $0,48 1999 $0.28 2000 $0.09 2001 $0.05 [..,\)%/01 . ~ ,::p~b..-,...~~)'.:'Z! ,; ~":c~) ,">-,...'i i'!~"1.t::;:, ,~r"",J"'l '~:-::l:t;';,,: .' -.., ~'~'l,. ~;.:::;f'..,~,-,'1 ~- 11{'~, ~~~'1~~~~~:L. ~ ..f~l Date 1- q,.. ;)001 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-37SJ . FAX: (541)726-3689 ELECTRICAL PERMIT APPUCATlON City Job Number pln'Za:Jc...~ rJ I'7.{J.z-' Installation, Alteration or Relocation . 200 Amps or less I $'50.00.: \D,e'o 201 Amps to 400 Amps '$ 69.00 401 Amps to 609~1ffl'CE: $100.00 D.<;t:~~cii~;fil~~i!k1i~~_.!11JiJ~~~ -- ". .. "'~flr.mffitti'iI1rS"~tli1;ll' I I d~JtN New AJteratio"'n~I'Extension ,Rer,!:aoeIABA, IS NOT ...,'" "'''~'''..LU Un I~ "'Dn~'I:D FO One Circuit ANY 1110 0 dY P['"' _ , $ 43~O()- R / Each Additional Circuit or Willi n, u u. Service or Feeder Pennit $ 3.00 ; f\TI~I'"''..''''' L... ""'L'::!"U.~'~SYOU(() .~." ./ f II~: e~.. ~~(S~~1Jf'ef.iS:-1Fotl~~itm'id~) ;itteJ. .".st':li~in,~~ ./ N~ificatlOriC-e'nter:I"fjbmfifes'i:rf'e''SEft'f6ftt''"--~>:., . ., .II :1 in OAR &9!!Pi9!iip'iglJ1!QjIlhrough OAR 952-001 $50.00 .h":" 0090. ,,~~R!!tjitte~l;igbtil)glpies of the rules b'$ 50.001)."\ cal1il~~fJ!netgytR;Cs!deiitiaile telephone - $ 25.00 ;,' numt:tiniited Bliefgy,~mlrIe\\jlkiY NotificatiOn $ 45.00 ~_,,'.-..:_ 1 ",,".~q?-?3441 Mlnimu'm Electric Permit Inspection Fee Is $45,00 + Surcharges 4. ~lst~'~':1E~OE'a:Bcf$lU.i~1~tifi~ ~Jfi"""~*""~"'~:~~;':WIfV.lt.~....Ji.i~(:' . .Ki~ 21 2,00 / 6 , S"? 21.20 11,(,,0 I. ..:tbljiFiiON!oF.~iNSTX11p4fiiJN~~if!{Ji.~ 1l~~O::ii;'~~~""'.-.:i.,,".."l'r'''''I'~;I'''-''"'''''.ljtt,~ s-,,~ Iflk... C,7 LEGAL DESCRIPTION /-+0> 22/2.. 01-300 JOB DESCRIPTION 1}..2f~ &)1- /k.r;c.6ArL/. i r~~"<<r Permits are non-transrerable and npire If work Is not started wltbln 180 days of issuance or if work Is Suspended for 180 days, ~n:z.;~\,t.."...:.o~'~.;oNd"~"'::';'sr~',;;;,''''~'_-<,_''''''~''''''''''''''U' 2, ~%!l'a~g;m&i!!i~~:!!!...11gJJNi.01\{I!,Y; . Electrical Contrnctor Address aCEd. , City ~"(;1IL Phone Supervisor License Number 1../1 'f,2 5 I()-I -D7 , . Constr. Contr. Number I yq Y. ~ l' /~ fJ''''/tJCJ E<piration Date E<piration Date. , Signature orrupe,iviSing Electrician VJvt c;t ~' A- '\ \./ / """- Inspection Request: 726-3769 3, WOOMPilE7E!FEErSeHEl:)ffi;E1il1ffi'b"""r~w.:~m~ ~..-,-~~-_....,'"_..,,~~--~~~~~~...~~ A, ,~~RgYat.liWif~sj;r'.g i~~}1Kmtj:F:ii~i~~~;td#t1i.lm""""g'u'~ii'!'~>;1.i .-<-~......~~~ "."""'.'llO.io:,;j~~~,~.~.~~~I;:~..;w.l~ Service Ioeluded 1000 sq. ft. or less Bach additional 500 sq. ft. or portion thereor Each Manufact'd Home or . Modular Dwelling Service or Feeder 'f $106.00 /(>(.'00 $ 19.00 ~.OO $50.00 ~~~'~""L~~rf'l.1"":<l\~~~"'f(~.~~~~~"r! B. ~~~eryl~~,_!t~tfry2iE!~~~~~1~r:~!!2..~~~~,m~~~~M~~;~i 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsIVolts Reconnect Only $63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00_ .. C ~:ro-4'!"'''-'1.:'''''-'';=~=~S~~...~~~~/..~.t'''''';F' '-.' a'..~.-t""1'~~..'El~~~~~--.~,t:figmi4 .!:~R~ary.;_~!'YI.~~L9.r::~~t;~~ .. ~iff,'~~g.~tt'... '.:.7;:'; ~ (9% State Surcharge 10% Administrative Fee !{t'fO'f-llf-"1 ecJ, ~Joq Y ~ ',' --r;;s;:.rVc(T:Y!lUildmg Forms'Elcclrical Pemritl~~E'7 C. . "'L;:'! ~.,._._' ~" ' l' .' . "' ~--- . - , /.. _.:./ -.,.,1 --,-,~''-'''''._' - <;ijaof Springfield Official Receipt _Iopment Services Department Public Works Department 225 FiftIi Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-0 13 82 COM2006.0 1382 COM2006-0 1382 COM2006-0 1382 COM2006-0 1382 COM2006-01382 COM2006.01382 COM2006-0 1382 COM2006-01382 COM2006-01382 COM2006-01382 COM2006-01382 COM2006-01382 COM2006-01382 COM2006.01382 COM2006-01382 COM2006-0 1382 COM2006-01382 COM2006.01382 COM2006-01382 COM2006.01382 COM2006-0 1382 COM2006-01382 COM2006.01382 COM2006-01382 COM2006-01382 COM2006-0 1382 COM2006-0 1382 COM2006-01382 COM2006-01382 COM2006.01382 COM2006-0 1382 COM2006-0 1382 Payments: Type of Payment CreditCard Cash cReceintl RECEIPT #: 1200700000000000024 Date: 01/09/2007 Description Addressing Assignment Willamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee - Residential Sidewaik Permit Curbcut Permit PW 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 Plan Review Major. Planning Building Permit 2 Baths One or Two Family Fixture Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Fireplace -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By MIKE J, GANSEN MIKE J. GANSEN Item Total: L"heck Number Authorization Received By Batch Number Number How Received njm njm 009072 009070 In Person In Person Payment Totai: Page I of2 3:00:24PM Amount Due 31.00 1,000,00 106.00 76.00 50,00 130,90 80.00 80,00 (30.00) 991.91 728,74 554.14 189.58 836,32 91.61 961.52 10,00 150,37 67,82 198,00 981.65 254,00 28,00 12,00 30.00 9,00 6.00 4.00 15.00 10.00 94.98 125,73 170,26 $8,044.53 Amount Paid $8,000,00 $44.53 $8,044.53 1/912007 RECEIPT #: .1200700000000000024 .e: 01109/2007 3:00:24PM Job/Journai Number Description Amount Due COM2006-01382 Addressing Assignment 31.00 COM2006-01382 Willamalane Single Family 1,000,00 COM2006-01382 Residence Wiring 1000 Sq Ft 106.00 COM2006.01382 Residence Wiring Ea Addtl 500 76,00 COM2006-0 13 82 Temp Power 200 amps or less 50,00 COM2006.0 13 82 Fire SF Fee - Residential 130,90 COM2006-0 13 82 Sidewalk Permit 80,00 COM2006-01382 Curbcut Permit 80,00 COM2006-01382 PW Disc - 2nd Permit (30.00) COM2006-01382 Storm Drainage Impervious Area 991.91 COM2006-01382 Sanitary Sewer - Reimbursement 728.74 COM2006-0 1382 Sanitary Sewer - Improvement 554.14 COM2006-01382 SDC Transpo Reimbursement 189.58 COM2006-01382 SDC Transpo Improvement 836.32 COM2006-01382 SDC MWMC Reimbursement 91.61 COM2006-0 13 82 SDC MWMC Improvement 961.52 COM2006.0 1382 SDC MWMC Administration 10,00 COM2006-0 1382 SDC Sanitary/Storm Admin 150.37 COM2006-0 1382 SDC Transpo Admin 67,82 COM2006-0 13 82 Plan Review Major - Planning 198.00 COM2006.01382 Building Permit 981.65 COM2006-01382 2 Baths One or Two Family 254,00 COM2006-01382 Fixture 28,00 COM2006-01382 Furnace - up to 100,000 btu 12.00 COM2006-0 1382 Vent Fan 30.00 COM2006-01382 Exhaust Hoods 9.00 COM2006-01382 Dryer Vent 6,00 COM2006-0 1382 Gas Outlets 1-4 4,00 COM2006.0 1382 Gas Fireplace 15,00 COM2006-0 1382 -Mechanical Issuance Fee- 10,00 COM2006-01382 + 5% Technology Fee 94,98 COM2006-01382 + 8% State Surcharge 125,73 COM2006-01382 + 10% Administrative Fee 170,26 Item Totai: $8,044.53 Payments: Check Number Authorization Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Cred itCard MIKE), GANSEN njm 009072 009070 In Person $8,000.00 Cash MIKE), GANSEN njm In Person $44.53 Payment Total: $8,U44.53 cReceiotl Page 2 or2 1/912007