The URL can be used to link to this page

Home My WebLink AboutPermit Building 2008-1-25 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01249 ISSUED: 01/25/2008 APPLIED: 08/22/2007 EXPIRES: 07/25/2008 VALUE: $ 259,358.00 Status Issued 225 Fifth Street, Springfield, OR 54]-726-3753 Phone 54]-726-3676 Fax 541-726-3769 Inspection Lme SITE ADDRESS 6218 Graystone Lp ASSESSOR'S PARCEL NO 1802032202900 SPRINGFIETYPE OF WORK Smgle FamIly Residence TYPE OF USE New PROJECT DESCRIPTION Smgle famIly resldence- MtGate West lot 58 Owner GENE LOEWEN Address 2334 LOCH DR SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechamcal Plumbmg Contractor GEMSTONE BUILDERS INC BURRELL BROS ENTERPRISES INC COMFORT FLOW CRAIG ARNEY License 82340 136446 460 167015 BUILDING INFORMATION I #ofUmts Primary Occupancy Group. Secondary Occupancy Group Primary ConstructIOn Type Secondary Construction Type # of Bedrooms 1 R-3 U VB # of Stories 2 Height of Structure 28.00 Type of Heat Forced Air Gas Water Type Gas Range Type Gas Energy Path Path 1 Sprmkled BUlldmg n/a 2 I DEVELOPMENT INFORMA nON I Residential Phone Number 54]-744-1744 Expiration Date 06/17/2009 08/20/2009 06/27/2009 01/30/2008 Phone 54]-343-5788 541-747-2724 54]-726-0100 541 736-9582 Lot Size: Sq Ft 1st Floor Sq Ft 2nd Floor' Sq Ft Basement Sq Ft Garage/Carport Sq Ft Other Occupant Load' 10,430 3,026 REQUIRED PARKING Frontyard Setback 1800 Overlay Dlst HillSide Total. 2 Side 1 Setback 1660 # Street Trees Rqd 3 Handicapped Side 2 Setback. 8.00 Paved Drive Rqd Yes Compact Rearyard Setback 2800 % of Lot Coverage 3590 Solar Setbacks 4000 I PUBLIC IMPROVEMENTS I Street Improvements Storm Sewer AvaIlable Special Instruction Sidewalk Type Downspouts/Drams AI Il:lffiON: Oregon faw requires you to follow rules adopted by the Oregon Utility Notification Center. Those Nles are set forth In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the ruIea by calling the center. (Note: the telephone humber for the Oregon Utility NotJficatiOft Center Is 1.a00-332-2344). Notes. SiW@T",G)& piped to storm spfflE IF THE WORK THIS PERMn ~~~~~ ~'S PERMIT \S NOT ~~~~~~~~O OR IS ABANDONED FOR ANY 180 DAY PERIOD. Pa2e 1 of 4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01249 ISSUED: 01125/2008 APPLIED: 08/22/2007 EXPIRES: 07/25/2008 VALUE: $ 259,358.00 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme I Valuation Descriotion I A C - Reslden DwelIm2:S Gara2:e AC - ReSIdentIal V Wood Frame Gara2:e $ Per Sq Ft or multIpher $400 $10300 $27.00 Square Footage or BId Amount 2,234 00 2,220 00 806 00 Value Date Calculated DescrIptIOn Type of ConstructIOn Total Value of Project $8,936 00 $228,660 00 $21,76200 $259,358 00 08/23/2007 01/10/2008 08/22/2007 ~ Fee DescrIptIOn Amount PaId Date PaId ReceIpt Number Plan RevIew ReSIdentIal $758.55 8/22/07 1200700000000001075 -Mech Iss 2+ Apphances- $40 00 1/25/08 2200800000000000106 + 10% AdmmlstratIve Fee $178 09 1/25/08 2200800000000000106 + 12% State Surcharge $19556 1/25/08 2200800000000000106 + 5% Technology Fee $98 23 1/25/08 2200800000000000106 2 Baths One or Two FamIly $280 00 1/25/08 2200800000000000106 Addressmg ASSIgnment $35 00 1/25/08 2200800000000000106 BuIldmg PermIt $1,19564 1/25/08 2200800000000000106 Curbcut PermIt $85.00 1/25/08 2200800000000000106 Dryer Vent $700 1/25/08 2200800000000000106 Exhaust Hoods $10.00 1/25/08 2200800000000000106 FIre SF Fee - ReSIdentIal $151.30 1/25/08 2200800000000000106 FIreplace (LIsted) $17.00 1/25/08 2200800000000000106 Furnace - up to 100,000 btu $1400 1/25/08 2200800000000000106 Gas Outlets 1-4 $5.00 1/25/08 2200800000000000106 Mountamgate ImpervIOUs Area $1,495 33 1/25/08 2200800000000000106 Plan ReVIew Major - Plannmg $205 00 1/25/08 2200800000000000106 Plan ReVIew/ResIdentIal Hourly $96 42 1/25/08 2200800000000000106 PW DISC - 2nd PermIt $-40 00 1/25/08 2200800000000000106 Samtary Sewer - Improvement $51010 1/25/08 2200800000000000106 Samtary Sewer - ReImbursement $670 83 1/25/08 2200800000000000106 SDC MWMC AdmmlstratIon $1000 1/25/08 2200800000000000106 SDC MWMC Improvement $961 52 1/25/08 2200800000000000106 SDC MWMC ReImbursement $91 61 1/25/08 2200800000000000106 SDC Samtary/Storm Admm $171 91 1/25/08 2200800000000000106 SDC Transpo Admm $67.95 1/25/08 2200800000000000106 SDC Transpo Improvement $862 25 1/25/08 2200800000000000106 SDC Transpo ReImbursement $19548 1/25/08 2200800000000000106 SIdewalk PermIt $85 00 1/25/08 2200800000000000106 Storm Sewer Each Addtll00' $3200 1/25/08 2200800000000000106 Temp Power 200 amps or less $55 00 1/25/08 2200800000000000106 Vent Fan $1400 1/25/08 2200800000000000106 WIllamalane Smgle FamIly $2,303 00 1/25/08 2200800000000000106 Pa2:e 2 of 5 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01249 ISSUED: 01125/2008 APPLIED: 08/22/2007 EXPIRES: 07/25/2008 VALUE: $ 259,358.00 225 Fifth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon Lme Total Amount Paid $10,85777 I Plan Reviews I Structural Review 09/10/2007 Imtlal Review 08/23/2007 08/23/2007 APP LLH 10 -- 1/10/2008 Don Moore received reVised drawmgs and Will be adJustmg the square footage for the reSidence for the structural page on Tidemark and for the fire/lIfe safety fee PublIc Works Review 08/23/2007 08/28/2007 NOK TSS Total Impervious surfaces exceed 35% Review not approved Plannm!! Review 08/23/2007 08/29/2007 WE TAJ This on hold because of coverage Issues 1 spoke to the owner today and left a vOIce maIl wIth the contractor also Structural Review 08/23/2007 09/10/2007 10 LLH Forwarded to Shawn Eaton wIth the BUlldmg Department for review under contract with the CIty of SprIngfield Plannm!! Review 09/14/2007 09/14/2007 APP TAJ 1 received reVised site plans on 9/12 The 35% coverage for thIs lot IS met No additIonal ImpervIOus surface may be allowed. Choose street trees from the lIst of natIve trees for HillSide Development m the street tree handout PublIc Works Review 09/17/2007 09/17/2007 APP TSS Storm water piped to storm sewer Structural Review 01/10/2008 01/10/2008 APP DLM Received reVised plans & engmeermg for mmor reVISIOn to master bath, reducmg the floor area by 14 s f 1/10/08dlm To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. Pa!!e 3 of 5 ':ITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2007-01249 ISSUED: 01/25/2008 APPLIED: 08/22/2007 EXPIRES: 07/25/2008 VALUE: $ 259,358.00 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LIne ~e(]uirerUnsnections I ErosIOn/GradIng InspectIOn PrIor to ground dIsturbance and after erosIOn measures are Installed SIdewalk - CurbsIde After forms 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 footIng and call for 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 tloor InsulatIOn or deckIng Floor InsulatIOn PrIor to deckIng Shear Wall NaIlIng Before coverIng sheathIng wIth fimsh 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 Underground PlumbIng. PrIor to fillmg the trench and mcludmg reqUIred testmg Undertloor Plumbmg PrIor to msulatIon or deckmg. Rough Plumbmg PrIor to cover and mcludmg reqUIred testmg Water Lme PrIor to filhng trench and mcludmg reqUIred testmg Samtary Sewer Lme PrIor to fillmg trench and mcludmg requIred testmg. Storm Sewer Lme PrIor to filhng trench. Undertloor Mechamcal PrIor to msulatlOn or deckmg and mcludmg reqUIred testmg Undertloor Gas After hne IS mstalled and reqUIred testmg and capped If not attached to an apphance Rough Gas After hne IS mstalled and reqUIred testmg and capped If not attached to an apphance Gas ServIce After hne IS mstalled and hne has been connected to a mlmmum of one apphance mcludmg requIred testmg Presure test done at thIs pomt. Rough Mechamcal PrIor to Cover Fmal Gas When all gas work IS complete Fmal Mechamcal When all mechamcal work IS complete Temporary ElectrIc' Approval reqUIred pnor to UtIhty Company energlzmg pole. Fmal Plumbmg' When all plumbmg work IS complete Fmal BuIldmg After all requIred mspectIons have been requested and approved and the buIldIng IS complete Pal!e 4 of 5 Status Issued 2ITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01249 ISSUED: 01/25/2008 APPLIED: 08/22/2007 EXPIRES: 07/25/2008 VALUE: $ 259,358.00 225 FIfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Lme By sIgnature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certify that all mformatlOn hereon IS true and correct, and I further certify that any and all work performed shall be done m accordance wIth the Ordmances of the CIty of Springfield and the Laws of the State of Oregon pertammg to the work described herem, and that NO OCCUPANCY will be made of any structure wIthout permIssIon of the Commumty ServIces DIvIsIOn, BUlldmg Safety I further certify that only contractors and employees who are m comphance with ORS 701 005 will be used on thIs project I further agree to ensure that all reqUIred mspectlOns are requested at the proper tIme, that each address IS I eadable from the street, that the permIt card IS located at the front of the property, and the approved set of plans will remam on the sIte at all times durmg constructIOn Owner or Contractors SIgnature Date Paj!e 5 of 5 Willamalane Park & RecreatIon Dlstnct Job No ~ jf\ ., VL~ SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007 NAME 6-Pf\el~ PHONE 144. \1+', AOOREss!21>34. lcrh,TY ~.~TATEakuo Q1411 LOCATION OF PROPOSED BUILDING SITE StreetAddress ~ (\(~~ f GZl8 02'100 PlatName~t~ TaxLotNumber \~~ 1 DEVELOPMENT TYPE (Check appropnate dwelling(s) Dwelling type definitions are on the back ) A Smale-Famllv Detached NO OF UNITS \ B Slnale-Famllv,Attached NO OF UNITS C Multl-Famllv Apartment NO OF UNJTS D Smale Room Occupancy NO OF UNITS E Accessorv Dwelllna Unit NO OF UNITS WILLAMALANE SDC X $2,303 per Unit = $ fL303lxJ X $2,426 per Unit = $ X $2,032 per Unit = $ X $1~16 per unit = $ X $1,151 50 per unit = $ $ 2m3,OCJ fJ $ Yj}j)3.ci) oate\ JS, ~ 2 SDC CREDIT (If applicable) SDC payer must furnish proof of Wlllamalane Credit approval) $ 3 TOTAL WILLAMALANE NET SDC ASSESSED ~c:~ed for CffiD Development servl~rtment City of Spnngfleld '" 5 SPRINt :> ZON~ INITIALS ~~;C~ . ,.01 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 · FAX (541)726-3689 ELECTRICAL 1f.RM1T Aj'j:,LICATION City IobNumber f\. t1)~ 1 LOCATION OF INSTALLA110N: bt\~~ ~(PA.{~~ LEGAL DESCRIPTION \ 0 Z ?.oo \ 'hr '\ '\ ~ ~ \De . Each A'ddftl@?raRMfpI~A'r.t EXPI ~t:' , . ,\1) r'\. Service or.Eee~e~P.~\t... RE IF T$-IB ~V'ORK Owners Name . ~,\L)"CA} I dLtu UIIJDER THIS PERMIT IS NOT Address f}._~~ LD(.~. r'\( E Mlsc~han[oJP~Q..RR/f~~,fiam4>>~E):fF~Ch Installatwn ~ _ \,.J. J' n,W PERiOD vrr City _ Phone ~L\'4. \-W.. Pump or lITIgation $ 55 00 Slgn/Outlme Llghtmg $ 55 00 OWNER INST ALLA nON Limited Energy/ResldentIal $ 28 00 The mstallatlOn IS bemg made on property I own which Limited Energy/Commercial $ 50 00 IS not mtended for sale, lease or rent MIllImum ElectrIC Permit InspectIOn Fee IS $50 00 + sur~E (j) Owners Signature 4 SUBTOTAL OF ABOVE G. 8% State Surcharge . ~ 10% AdmmlstratIve Fee t::;. ~ 5% Technology Fee n: .1. TOTAL ~.~ Shared Dnve(T )/BUlldmg Forms/Electncal Penrnt ApphcatlOo 7-07 doc JOB DESCRIPTION - p,jt~~an~~.~ not started wlthm 180 days of Issuance or If work IS SU ended for 180 days 2. Address City \ ExpiratIOn Date InspectIOn Request 726-3769 Date 3 COMPLETE FEE SCHEDULE BELOW A Ne'\\ ResldentIal- Smgle or Multi-Family per dwelling umt Service Included 1000 sq ft orless $117 00 Each additIonal 500 sq ft or portIOA~l\q..:G'\lf!ON OreqOn la~1 $ 2100 f l' , ," .V'-!'" It:;) yOU to Eacp~~~n'{{f!bPa!Hl5ti~:eted by the Oregon Utility Modu~.atttS~l*liRJ"'-s'erl1<f€ <Tdlose rules are se$~ Fee~e/\R 952-'D01-001 0 throt;gr. CAn ~52-001~ 0.10 You may obtam caples of the -rutes b B Se~gS1Q;ti<1eed:e:1sreJ.n~~&ott.le.~8h3r\elocatIon number for the Oregon Utility Notification 200 Amps or~Slter IS 1-800-332-2344.'~ $ 70 00 201 Amps to 400 Amps $ 83 00 401 Amps to 600 Amps $13800 601 Amps to 1000 Amps $180 00 Over 1000 AmpsNolts $41300 Reconnect Only $ 55 00 C Temporary SerVlces or Feeders InstallatIOn, AlteratIOn or RelocatIOn 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps b~~ l $ 55 00 $ 76 00 $110 00 Over 600 Amps or 1000 Volts see "B" above D Branch CIrcuits New 1Jt~tatlOn or ExtenSIOn Per Panel One ClrMIICE: $ 48 00 CITY OF SP~GFIELD SYSTEMS DEVELOPMENTi);~RKSHEET JOURNAL OR JOB NUMBER C0M2007-01249 NAME OR COMPANY Gene Loewen . LOCATION ~ Graystone Loop h Zl t::> TAX LOT NUMBER 18-02-03-22~ e, 'Z- 90 0 DEVELOPMENT TYPE SINGLE F AMIL Y RESIDENCE NEW DWELLING UNITS 1 BUILDING SIZE (SF 3961 5 LOT SIZE (SF) 1 STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S F x COST PER S F CHARGE 4321 50 $0346 = $1,49533 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S F x COST PER S F x I DISCOUNT RATE I I DISCOUNT o 00 $0 346 I 50% I = I $0 00 ITEM 1 TOTAL - STORM DRAINAGE SDC 1 $1,49533 I 2 SANITARY SEWER - CITY A REIMBURSEMENT COST I NUMBER OF DFU's I x I 25 I COST PER DFU $26 83 B IMPROVEMENT COST I NUMBER OF DFU's I x I 25 I COST PER DFU $20 40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3 TRANSPORTATION A REIMBURSEMENT COST I ADTTRIPRATE x I 957 B IMPROVEMENT COST I ADT TRIP RATE I x I 957 I I NUMBER OF UNITS x I 1 I NUMBER OF UNITS x I 1 =1 $1,180 94 COST PER TRIP 2043 x I NEW lRIP FACTORI I 100 I COST PER TRIP $90 10 $1,05773 x I NEW TRIP FACTOR I 100 ITEM 3 TOTAL - TRANSPORTATION SDC = l 4 SANlT ARY SEWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's x I 1 ICOST PER FEU I $91 61 B IMPROVEMENT COST INUMBER OF FEU's' x I / 1 ICOST PER FEU I $961 52 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5 ADMINISTRATIVE FEE 'SUBTOTAL x I ADM FEERATE $4,797 13 I 5% TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE Todd Smgleton q/t:r/t;::; PREPARED BY DATE 10430 $1,495 33 $670 83 $510 10 $195 48 $862 25 [fJ ~ ~ o u ~ ~ IE-< [fJ >-< (j ~ 1070 I 1091 I 1092 1093 I 1094 ~ i = $91 61 I 1054 = 1 $961 52 1055 = , $000 1054 = 1 $10 00 1056 =1 $1,063 13 - = , $4,797 13 1= CHARGE I $23986 171 91 1079 $67 95 1078 - TOTAL SDC CHARGES =, $5,036.99 .. DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUNALENT UNITS BATHTUB 1 0 3 3 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 0 LAUNDRY TUB 1 0 2 = 2 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHES WASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRIG / WATER STATION / ETC 0 0 1 = 0 I RECEPTOR FOR COM SINK / DISHWASHER / ETC 1 0 3 = 3 ISHOWER, SINGLE STALL 1 0 2 = 2 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 ISINK COMMERCIAL BAR 0 0 2 = 0 ISINK WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 ISINK SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 IURINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 25 *EDU (Eqwvalent DwellmgUmt) IS a discharge eqwvaIent to a smgle falDlly dwelhngumt (20 DFU's) set at ]67 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE ]979 1979 1980 1981 1982 1983 1984 ]985 1986 1987 1988 1989 1990 1991 1992 ]993 ]994 ]995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $4 98 $4 80 $463 $440 $407 $367 $322 $273 $225 $180 $159 $145 $125 $109 $092 $072 $048 $028 $009 $005 IS LAND ELGlBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGlBLE FOR ANNEX CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0 00 x $5 29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0 00 x $5 29 TOTAL MWMC CREDIT = 2 2 1979 = I $000\ o $000 225 Fifth Street . . Sllrmgfield, Oregon 97477 541-726-3759 Phone C,/ 'f Sprmgfield Official Receipt D", Aopment Services Department PublIc Works Department Job/Journal Number COM2007-01249 COM2007-0 1249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-0 1249 COM2007-0 1249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-0 1249 COM2007-01249 COM2007-01249 COM2007-01249 COM2007-01249 Payments Type of Payment CredltCard Check cRecemtl RECEIPT #: 2200800000000000106 Date: 01125/2008 DescriptIOn Addressing AssIgnment WIllamalane Single FamIly Temp Power 200 amps or less Plan Review Major - Planning Sidewalk Permit Curbcut Permit PW DIsc - 2nd PermIt Mountalngate ImpervIOus Area SanItary Sewer - ReImbursement SanItary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC ReImbursement SDC MWMC Improvement SDC MWMC AdministratIon SDC Transpo Admin SDC SanItary/Storm Admin 2 Baths One or Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Fireplace (LIsted) -Mech Iss 2+ Apphances- Building Permit Fire SF Fee - ResIdential Plan RevIew/ResIdential Hourly Storm Sewer Each Addtl 100' + 5% Technology Fee + 12% State Surcharge + 10% AdministratIve Fee Paid By GEMSTONE GEMSTONE Item Total Check Number AuthOrizatIOn ReceIved By Batch Number Number How Received lIh lIh 6895 015500 In Person In Person Payment Total Page 1 of2 ] ]738PM Amount Due 3500 2,303 00 5500 205 00 8500 8500 (40 00) 1,495 33 670 83 510 10 19548 862 25 91 61 961 52 10 00 6795 171 91 28000 1400 1400 10 00 700 500 1700 4000 1,19564 151 30 9642 3200 9823 195 56 178 09 $]0,09922 Amount Paid $9,50000 $59922 $]0,09922 1/25/2008