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