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Home My WebLink AboutPermit Building 2003-10-29 (2) I . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54 I -726-3676 Fax 54 I -726-3769 Inspection Line SITE ADDRESS: 6694 Jacob Ln ASSESSOR'S PARCEL NO.: 1702341109700 PROJECT DESCRIPTION: SFR . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00425 ISSUED: 10/29/2003 APPLIED: 05/3012003 EXPIRES: 04/29/2004 VALUE: $ 184,530.00 Springfield TYPE OF WORK: Single Family Residenee TYPE OF VSE: Owner: GORDAN BRET EVANS Address: 85865 RIDGEWAY RD PLEASANT HILL OR 97455 Contractor Type General Electrical Mechanical Plumbing I CONTRACTOR INFORMATION I Contractor GORDON BRET EVANS STEVE HAVCK PACIFIC AIR COMFORT INC DON CLEWIS License 102721 147618 39237 33076 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I R-3 V-I VN 3 SETBACKS Front yard Setbaek: Side I Setbaek: Side 2 Setbaek: Rearyard Setback: Solar Setbacks: 18.00 5.00 7.00 80.00 45.00 BUILDING INFORMATION I # of Stories: 2 Height of Structure 31.00 Type of Heat: Forced Air Elect Water Type: Electric Range Type: Electric Energy Path: Path I I DEVELOPMENTINFORMATION I Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Floodplain 2 New Residential Phone Number: 541-746-4803 Expiration Date 10/20/2004 04/30/2005 03/25/2004 06/10/2005 Phone 541-746-4803 541-221-2665 541-672-9510 541-688-1931 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 10,800 1,059 1,196 832 Yes 18.00 REQUIRED PARKING Total: 2 Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk T.vp.~:reqU\res yoU t,o Fullv Improved \ON:oregon r,,, e on Utiht)Curbside 5' Storm Sewer Available: Yes AliENI . D8&,~~.P!itlt!j/O'r!1iQf g e s~~fl!\and Gutter Special Instr,c1;'.n: WORK follOW r.ules :nter.lhose rules ar 952-00 MOl . SHtlll EXPIRE If 1HE 1 lotificat'0;_~01_0010 thrO~gh ~~~e rules; Notes: lH\S PERMII UNDER lHIS PERMII IS NO n OAR 90~ may obtain COP\~~e telephone tlU1HOR\lED OR \S tlBtlNOONEO FOR 0090'1\:,ng the center. (Notue't'\I'Ity Notification COMMENCED \00 ca " Oregon tlN1' 180 0"1' PER . , number for the. 1_RnO_<l<I?-2344). r.t:'lr'\t~l' ICo Paee I of5 ~ , ~ Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Dwellines Garaee 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 Annexed 2000 Building Permit Copy 1st @ 75 cents Curbcut Permit Dryer Vent Exhaust Hoods Furnace - up to 100,000 btu Plan Review - Planning PW Mull 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 Sanitary/Storm 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 Total Amount Paid . . Ll1 f OF 1)rKll~Gt<lJ!,LJJ Building/Combination Permit PERMIT NO: COM2003-00425 ISSUED: 10/29/2003 APPLIED: 05/30/2003 EXPIRES: 04/29/2004 VALUE: $ 184,530.00 I Valuation Deserintion I $ Per Sq Ft or multiplier $74.60 $19.60 Square Footage or Bid Amount 2,255.00 832.00 Value Date Calculated $168,223.00 $16,307.20 $184,530.20 05/30/2003 05/30/2003 Total Value of Project !?pp<. P\&iiJ Amount Paid $547.24 $10.00 $144.99 $101.49 $306.00 $8.00 $-1.41 $841.90 $15.00 $75.00 $6.00 $9.00 $12.00 $59.00 $-30.00 $106.00 $95.00 $464.67 $611.28 $10.00 $34.83 $332.86 $105.99 $50.70 $727.42 $164.89 $75.00 $789.24 $50.00 $24.00 $1,000.00 $6,746.09 Date Paid Receipt Numher 5/30/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 10/29/03 2200200000000000958 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 1200200000000002388 Paee 2 of5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Initial Review Plannin!! Review Plannin!! Review Public Works Review Public Works Review Public Works Review Structural Review StrueturaI Review . 05/30/2003 05/30/2003 08/18/2003 08/08/2003 08/12/2003 08/22/2003 05/30/2003 07/18/2003 I Plan Reviews I 05/30/2003 APP 08/08/2003 WE 08/18/2003 APP 08/11/2003 WI 08/13/2003 APP 08/22/2003 APP 06/26/2003 WE 08/08/2003 WE Pa!!e30f5 . CITY OF SPRlNGFmLu Building/Combination Permit PERMIT NO: COM2003-00425 ISSUED: 10/29/2003 APPLIED: 05/30/2003 EXPIRES: 04/29/2004 VALUE: $ 184,530.00 LLH EMM EMM VRJ VRJ VRJ DLM DLM Called owner left message 6/3/03. Need LDAP submittal. House is too tall. On no build no fill line. Developer needs to complete curb per settlement agreement. Garage setback must be 18' from property line as indicated on plot plan. Also refer to notes in red on plot plan. Called owner on 8/15/03 and left messge. Need to know how setback issues will be resolved before issuing. Owner changed house to post and beam in order to comply with 30' maximum height. Owner will shorten garage 2' to meet 18' setback and shorten rear of house 2" to accomodate siding and trim. No portion of building below 8' allowed in 5' easement. Owner will trim tail~ on rear of cantilevered second story to aecomodate gutters. No portion of any building shall extend over the No Build Line. See enclosed map and Judgement of Dismissal with easement document. Waiting for Site PlanlBuilding Permit approval from Ken Vogeney. All PW's fees and notes are attached to permit. Ken Vogeney has approved building permit 8/12/2003. Ken V ogeney reviewed and approved revised site plan 8/22/2003. See documents for letter requesting add'l information. Received designer's response to request for additional information from the designer. Submitted information has incorrect designs for structural members. Called designer and requested revised structural information that will coordinate truss loads and supporting beams in garage area. . . CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2003-00425 ISSUED: 10/29/2003 APPLIED: 05/30/2003 EXPIRES: 04/29/2004 VALUE: $ 184,530.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 08111/2003 08111/2003 APP DLM Received revised calculations from designer. Verifled revised beam size and new footings in garage. 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. 1 Site Inspection: To be made after excavation but prior to setting forms. 2 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 3 Footiug: After trenches are excavated. 4 Foundation: After forms are erected but prior to concrete placement. 5 Post and Beam: Prior to Iloor insulation or deeking. 6 Floor Insulation: Prior to decking. 7 Shear Wall Nailing: Before covering sheathing with finish materials. 8 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 9 Wall Insulation: Prior to cover. 10 Ceiling Insulation: Prior to cover. I I Drywall: Prior to taping. 12 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 13 Final Building: After all required inspections have been requested and approved aud the building is complete. 14 Underlloor Plumbing: Prior to insulation or deeking. IS Underlloor Drain: Prior to cover or placement of concrete. . 16 Rough Plumbing: Prior to cover and including required testing. 17 Water Line: Prior to filling trench and including required testing. 18 Sanitary Sewer Line: Prior to filling trench and including required testing. 19 Storm Sewer Line: Prior to filling trench. 20 Final Plumbing: When all plumbing work is complete. 21 Underlloor Mechanical. Prior to insulation or decking and including required testing. 22 Rough Mechanical: Prior to Cover 23 Final Mechanical: When all mechanical work is complete. 24 Temporary Electric: Approval required prior to Utility Company energizing pole. 25 Rough Electric: Prior to Cover 26 Electric Service: Approval required prior to utility company energizing service. 27 Final Electric: When all electrical work is complete. 28 Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 29 Curbcut - Standard: After forms are erected but prior to placement of concrete. Paee 4 of5 . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2003-00425 ISSUED: 10/29/2003 APPLIED: 05/30/2003 EXPIRES: 04/29/2004 VALUE: $ 184,530.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordanee with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work deseribed herein, and that NO OCCUPANCY will 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 this project. 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 will remain on the site at all times during construction. )~p~ //J -,;L9-03 ./ . Owner or Contractors Signature Date Paee 5 of5 . '".r!!tJ(fVJ~~'\iJ' 225 5~ STREET, SPRINGFIELD, DR 97477 Estimated Base Flood Elevation & Disclaimer For property located at "t!f1 JAc/).dS lAtye , Springfield OR The calculated Base Flood Elevation (BFE) for lot# M, Levi Landing - Second Addition is 5'"A:l,2, feet above mean sea level, based on the current FEMA datum information. The floor level of the residence to be placed on the lot must be certified at least one foot above the Base Flood Elevation as indicated above. (Please nole - Ihe City's surveyed benchmark dalum informalion and Ihe FEMA benchmark dalum are nollhe same for Ihis area. Add O.30ft 10 Ihe City's benchmarks 10 adjusllo Ihe FEMA benchmark elevations. ) The estimated base flood elevations in this area are based on interpretation of scientific and engineering evaluations known to the city at this time. Larger floods can and will occur on rare occasions. Flood heights may be increased by human-made or natural causes. The City's estimation of a base flood elevation does not imply that land within this area will be free from flooding or flood damages or that conformance with the requirements of.the City will protect the property from flooding or flood damages. The City, its officers, agents and employees shall not be liable for any flood damage that may result from estimation of base flood elevation or any other administrative decision made regarding administration of the City's Floodplain Development Code. The developer of this property may elect to perform additional scientific and engineering studies for consideration by the City to further refine the estimated base flood elevation for this property. The developer of this property may also elect to undertake additional development and construction measures in addition to those required in article 27 of the Springfield Development Code designed to avoid or 'minimize the potential for flood hazards and damage. Such additional measures are subject to City approval. Acknowledgment: I hereby acknowledge receipt of a copy of this document: Name(print)~ j~: _~ ~dop 13 l!f/IIJ11S Signature A~h^ ,~~ Date //1. '/_~O-03 :(This copy to be signed by Owner's authorized agent and retained in City addrefs me) I . CITY OF Sl'tdrnGFIELD, OREGON 0 ~,.i~~ ~ 6~'1i 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3~l\9-'~90c' ~ . ~. ELECTRICAL~'ERMrr APP ICATION, '0c''1i~~:o.,;,'0 ~ .' ~ ~ City Job Number . ~ Date /19.12. l' -1, '7 . ~"'''~~00~'' ./ ./ , . Y-'". .w,,; 1:(\0 /" 1. I, LOCA1'IONOF INSTALLATIONc c 3. ~'cOMPLEfE,FEE'StJ.lMUL"-,..d"EL'"'U'(' \ a....~, 1''1iyr'~/~;~~'. ~ t I' '.,~ ,..,y" ',". LEGAL DESCRIPTION A. N.ew Resident!~!"g Single or,j\1ulti-Family per dwelling,unit;" V,(YL:Yn , 3s..,...., 5 I' . . d " iTI *" ,II I ll\ <j '1"0. C. Temporary Sen'Ices or Feeders. " , j I ']orllo.W -:.:;--..........,~...:~ fOIl,Qw rules adopted by the nr.enon Iltililll 10- I -,Inqtit-"tinnronto Th 'InsTallatlOn~~ l!I'ationorRelocation f' , . ". ose rUles are "et torth in O~R 952-001-0010 thro,-,W,q 6~J!f&5!1'-~01. $ 50.00 Constr. Contr. Number I c...j'1.~!!(~ YnlJ m"~f nht".in copAAl&l'Il~IPllig~tTPs $ 69.00 I.J- calling the center. (Note~9\e"-mmpl'l8PIeAinps $100.00 Expiration Date _~ q - 30 r;'~M tho "regon Utjjitqt~jjill1pli<llnIOOO Volts see "B" above. Signature of Supervising Electrician Center is 1-800-D~:r:~al\iijjrc:i.."uitsC" ~, v ~ j08?' QOD\dQ.Ml.+ T~ re DOD tr nsfera and expire if work is not started withl 80 days of issuance or if work is Suspended for 180 days. . OB DESCRIPTION 2. I CONTRACTOR INSTALLATION ON1Jt.1 Electrical Contractor 51EJC 1f1:l-Uc.lL Address f3;l,g !/b'11. .5+ 5 City <;i7ri/? -ff el J ~~ \ - 9lbbS Phone Supervisor License Number Expiration Date 9) Address City {WJL, DL 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 ",'>' Service Included ...,0" I / ()fo. (X) !lS.trJ 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each ManufacI'd Home or Modular Dwelling Service or Feeder 1 5 $ 19.00 $106.00 $50.00 B.I Services or Feeders :.. IJlsiaIlation,Alterati~n~ or ~eloc:itfon: ' .1 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolls Reconnec1 Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ,.. .... .< I . ..' , . ~P() '..'.., I New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with,- Service or Feeder Permit $ 43.00 $ 3.00 E. I. Miseellal\~O~s\~erV'ice,'ieede~ilOt illcl~ded)' -Each Installationl Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.1 $uBTOtAL OE~oVi 1~C11. cr> ..~.5,) ,!) ~. If) ~u>? 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 1-03.doc . CITY OF SPRINGFIELD SYSTEMS DEVELOPMEN_ORKSHEET JOURNAL OR JOB NUMBER: Com2003-00425 NAME OR COMPANY: Gorden Bret Evans LOCATION: 6694 Jacob Lane TAX LOT NUMBER: 17023411 tI 9700 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' 0 LOT SIZE (SF): I. STORM DRAINAGE o r- ICIl P-l 'I@ I~ I~ CIl ~ o ~ DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE I I 2721.50 I $0.290 = I $789.24 . I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUSS.F. I x I COSTPERS.F. I x I DISCOUNTRATE I I DISCOUNT I 0.00 $0.290 I I 50% = I $0.00 ITEM I TOTAL - STORM DRAINAGE SDC '$789.24 I 2, SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I COST PER DFU I 27 I $22.64 B. IMPROVEMENT COST: I NUMBER OF DFU's I x COST PER DFU I 27 $17.21 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, ], TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I '9.57 I I I B. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I I 9.57 I I I ITEM 3 TOTAL - TRANSPORT A nON SDC $1,075.95 x I COST PER TRIP x INEWTRIP FACTOR I I $17.23 I 1.00 x I ' COST PER TRIP , INEWTRIP FACTOR I I $76.01 I 1.00 ~ , $892.31 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU , I I $332.86 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I I $34.83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SOl = , SUBTOTAL (ADD ITEMS I, 2, 3, & 4) = , n' ADMINISTRATIVE FEE: ISUBTOTAL I x ADM. FEE RATE I~ I I $3,133.78 I 5% I TOTAL SANITARY ADMINISTRATION FEE: I, TOTAL TRANSPORTATION ADMINISTRATION FEE: [Virginia Jurasevich 8/11/2003 PREPARED BY DATE $789.24 1070 $611.28 1091 $464.67 1092 $164.89 11093 I $727.42 I 1094 I I = $332.86 I 1054 I . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE, FOR REMODELS, CALClILA TE ONL V THE NET ADDmONAL FIXTURES) NO. OF FIXTURES DRAINAGE II UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 = 6 I IDRINKING FOUNTAIN 0 0 1 = 0 I IFLOOR DRAIN 0 0 3 = 0 I IINTERCEPTORS FOR GREASE lOlL I SOLIDS I ETe. 0 0 3 = 0 IINTERCEPTORS FOR SAND I AUTO WASH I ETe. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 ICLOTHESW ASHER I MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EAt 0 0 6 = 0 IMOBILE HOME PARK TRAP P PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRlG I WATER STATION I ETe. 0 0 1 = 0 IRECEPTOR FOR COM. SINK I DISHWASHER I ETe. 0 0 3 = 0 ISHOWER, SINGLE STALL 1 0 2 = 2 ISHOWER, GANG (NUMBER OF HEADSl 0 0 2 = 0 ISINK: COMMERCIALlRESlDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LA VATORY 1 0 2 = 2 ISINK: SINGLE LAVATORYIRESlDENTIAL BAR 2 0 1 = 2 URINAL. STALL! WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE [NST ALLA T[ON 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 27 .EDU (EQuh'alent DwellinJ?: Unit) is a discharne eQuivalent to a sinJ?:le family dwellinJ?: unit (20 DFUs) set at 167 sllons per day MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 CREDIT RA TE/$ 1,000 I ASSESSED V AWE 54.92 $4.92 $4.83 $4.77 $4.64 S4.47 S4.30 $4.09 53.78 53.41 52.98 $2.52 $2.06 $1.64 $[.45 $1.31 $1.13 $0.97 $0.82 $0.63 $0.4 [ $0.22 $0.04 I i I I I I I IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR o 2000 CREDIT FOR LAND (IF APPLICABLE) VALUE 11000 CREDIT RATE $35.37 x $0.04 = , $1.41 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE 11000 CREDIT RATE $0.00 x $0.04 o TOTAL MWMC CREDIT = $1.41 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number . COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 COM2003-00425 .- Payments: Type of Payment Check ." 1h~". MI.!'...".".,",',",",.....,...,..",.,...;.... ....~:.. '.. ' " ", ., ",,<::;,.' ....':.. Receipt #: 1200200000000002388 Description ' Addressing Assignment Willamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Building Permit 3 Baths One & Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent -Mechanical Issuance Fee- + 7% Slate Surcharge + 10% Administra1ive Fee Plan Review - Planning Sidewalk Permit Curbcut Permit PW Mult Disc - 2nd Permit Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvemen1 SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC SaniIary/Storm Admin SDC Transpo Admin Annexed 2000 SDC Transpo Reimbursement Copy 1st @ 75 cents Received By dim Check Number Batch Number Authorization Number Paid By BISMARK MORTGAGE CO 52372 " City of Springfield Official Receipt Development Services Department Public Works Department Date: 10/29/2003 12:03:I7PM Amount Paid Item Total: 8.00 1,000.00 106.00 95.00 50.00 841.90 306.00 12.00 24.00 9.00 6.00 10.00 101.49 144.99 59.00 75.00 75.00 (30.00) 789.24 611.28 464.67 72 7.42 332.86 34.83 10.00 105.99 50.70 (1.41) 164.89 15.00 $6,198.85 How Received Amount Paid In Person Payment Total: $6, I 98.85 $6,198.85