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Home My WebLink AboutPermit Building 2007-6-19 . . CITY OF SPRIl'i\J"l~LD Building/Combination Permit PERMIT NO: COM2007-00500 ISSUED: 06/19/2007 APPLIED: 04/05/2007 EXPIRES: 12/19/2007 VALUE: $ 500,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 3310 Gateway St ASSESSOR'S PARCEL NO.: 1703222001700 Springfield TYPE OF WORK: Retail TYPE OF USE: New PROJECT DESCRIPTION: Retail building shell which will include 3310-3316 Gateway Commercial Owner: NEWGA TE LLC Address: 840 BEL TLINE RD STE 202 SPRINGFIELD OR 97477 Phone Number: 541-284-0624 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone Genenil MEGA PACIFIC CO 63108 01/16/2008 503-238-3772 Designer MILDREN GROUP 503-244-0552 Electrical NEW WAY ELECTRIC INC 51088 06/27/2007 541-686-2365 Mechanical MICHAEL SCOTT GRIFFIN 150189 01/2312008 54 I -942-8339 Plumbing RA YMIE JASON HOYT 157734 11/17/2007 541-689-4235 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: B M IIIB # of Stories: 1 Height of Structure: 25.00 Type of Heat: Water Type: \:j<(;..'f.. Range Typ,;: ,\\'"- ~ ~\:j\ Energy.~~tli: '\' \S Sprhil<led .BliiI1Iing~\)<(;... n/a ~\\.v .\c.'(V..<.~, Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 5,693 Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ...\~\\~~~I"DEVEbOPMEN\t;iNFORMATION I '" \\\S ~S ~\1..'"-\) u\)~ \'0 {~. REQUIRED PARKING , ;:;,,\\'0 ~\.,y'-\:j gt~rih Dist: Total: ~. ~~S \:j~#StreetT..eeSRqd: H,~l!i')'IPpl!il: \;'0 c{ \ 'Q\) Paved Drive Rqd: Oregon law reC'Comeacttllit'{ \>o~ % of Lot Covera~~nENiIOt.t do ted b'{ the ore~r~ 'set tanh talloW l~I~~apnt~l. ihOS~. :~~e~p.f\ 952-0~:,: . I PUBLIC IMPROVEMEr;-is;"952-001-0Ul':';'~;pies at the \~~~e' roil.:! obtaI It. tile telep . 0090. 'Iou .S'dewalk.Type:.e. .I.t" Notilicatlon ailing the lP ,,- ,pann UtI I, ) c ber \IJoWii);~utg1D,=~i.!'.!:'2.344 . . n\.l[1l center is 1- uu Street Improvements: Storm Sewer Available: Special Instruction: Notes: Paee I of 5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line Description Estimate Tvpe of Construction Estimate Fee Description Plan Review Commllnd/Puhlic SDC Transpo Improvement -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Addressing Assignment Boiler/Comm 15-30 HP Boiler/Comm 30-50 HP Building Permit Fire SF Fee - Non-Residential Gas Outlets 1-4 Miscellaneous Plumhing Plan Review Fire & Life Safety SDC MWMC Administration Total Amount Paid . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00500 ISSUED: 06/19/2007 APPLIED: 04/05/2007 EXPIRES: 12/19/2007 VALUE: $ 500,000.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 500,000.00 Value Date Calculated Total Value of Project $500,000.00 $500,000.00 04/05/2007 Fpp< pqillJ Amount Paid Date .Paid 4/5/07 6/1107 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 6/19/07 Receipt Numher $1,212.67 $10,000.00 $10.00 $258.80 $ t 00.93 $161.49 $31.00 $60.00 $44.00 $1,865.65 $569.30 $4.00 $45.00 $746,26 $10.00 1200700000000000367 1200700000000000669 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 1200700000000000783 $15,119.10 I Plan Reviews I Paee 2 of 5 . . \..11 i' OF ~rKll'lt.l'lt<,LD Building/Combination Permit Status Issued PERMIT NO: COM2007-00500 225 Fifth Street, Springfield, OR ISSUED: 06/19/2007 541-726-3753 Phone APPLIED: 04/05/2007 541-726-3676 Fax EXPIRES: 12/19/2007 541-726-3769 Inspection Line VALUE: $ 500,000.00 Fire Department Review 04/09/2007 06/01/2007 OK GRG Plans Review: Shell building for up to six retail spaces with pre-assigned address numbers 3310 through 3316 Gateway Streets. Job #COM2007-00500. No occupancy for this permit. Proposed occupancy classifications: B/M/S-1. Construction type: m-B (not sprinkle red) 5700 sq. ft. Non-separated Use: no rated separations required per OSSC Table 302.3.2. Cover sheet replaced to more accurately renect non-sprinkle red building (original cover sheet taken from Newgate building submittal). 1. Provide address numbers in contrasting color from the background positioned plainly visible and legible from the street or road fronting the property (2007 Oregon Structural Specialty Code 501.2 and 2007 Springfield Fire Code 505.1). This only needs to be one address at this time due to the shell phase of this project. 2. Above the main exit door, provide sign stating "THIS DOOR MUST REMAIN UNLOCKED DURING BUSINESS HOURS" ifkey locking hardware is employed (2007 OSSC 1008.1.8.3, exception 2,2). Initial Review 04/06/2007 04/09/2007 APP LLH Plannin!! Review 04/09/2007 04/10/2007 APP EMM Public Works Review 04/09/2007 04/10/2007 APP JHJ Attached SDC Worksheet. (JHJ) Structural Review 06/14/2007 06/14/2007 APP JMP Received structural responses from Whitney Boss. Structural Review 04/09/2007 04111/2007 WE JMP See attached documents for 10 structural comments faxed to Jack Kriz. SUB Review 04/19/2007 05/15/2007 APP JF Forwarded energy code forms to Jack Foster from Whitney T. Landes, CPo Pa!!e 3 of5 . . CITY OF ~rKll~\..-NJ'..LU Building/Combination Permit Status Issued PERMIT NO: COM2007-00500 ISSUED: 06/19/2007 APPLIED: 04/05/2007 EXPIRES: 12/19/2007 VALUE: $ 500,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SUB Review 04/09/2007 04/16/2007 WE JF See Item 4 of JMP's attached structural comments for the request for the energy code forms and information, 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. ~prlln~.npr:tinn", I Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. 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. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved, Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover, Roofing: Prior to installing any roof covering. Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Structural Concrete: In excess of 2500 psi, To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector. ' Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector, Final Fire Department. After all requirements of the Fire Department have been met, Final Building: After all required inspections have been requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Pa~e 4 of5 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00500 ISSUED: 06/19/2007 APPLIED: 04/05/2007 EXPIRES: 12/19/2007 VALUE: $ 500,000.00 Status Issued 225 Fifth Street, SpriDgfield, OR 541-726-3753 PhoDe 541-726-3676 Fax 541-726-3769 IDspectioD LiDe SaDitary Sewer LiDe: Prior to filliDg treDch aDd iDcludiDg required testiDg. Storm Sewer LiDe: Prior to filling treDch. FiDal PlumbiDg: WheD all plumbiDg work is complete, Backnow Device: Prior to coveriDg aDd provide a copy of the test report OD site at the time of iDspectioD. Rough Gas: After liDe is iDstalled aDd required testiDg aDd capped if Dot attached to aD appliaDce, Gas Service: After liDe is iDs tailed aDd liDe has beeD cODnected to a minimum of one appliance inclnding required testing. Presure test dODe at this point. Rough MechaDical: Prior to Cover Final Gas: WheD all gas work is complete, Final MechaDical: WheD all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility compaDY eDergizing service. Final Electric: When all electrical work is complete. UDderslab Plumbing: Prior to filling the trench and including required testiDg. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection, SUB FiDal: After all required eDergy iDspections have been requested and approved. By sigDature, I state and agree, that I have carefully examiDed the completed application aDd do hereby ce.rtify that all information hereoD is true and correct, aDd I further certify that any and all work performed shall be dODe in accordance with the Ordinances of the City of SpriDgfield aDd the Laws of the State of Oregon pertaiDiDg to the work described hereiD, and that NO OCCUPANCY will be made OfoDY structure without permissioD of the Community Services DivisioD, Building Safety, I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used OD this project. I further agree to ensure that all required iDspectioDs are requested at the proper time, that each address is readable from the street, that the permit card is located at the froDt of the property, aDd the approved set of plaDs will remaiD on the site at all tiZ:?~ . 0&/;9/07- Date I. ~ Owner or Contractors Signature , Paee 5 of5 , .~ ". " if ('I ~.: ", N <> j.. 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II" "",oms", The ~",,, it '0 be .;"mill<cllO t1i. Qly I"i.. 10 . ",.,'ell for fin," In'I,,,,li,.,. ~~TS Wnu 1</..".( .I~dj AN ENC./,J-a:~. efl3ln".. A'<AiI"'; rim, (r.h''''d) \ {" T. tiog-tlrb-.l"blfY Nlme (Pri<1"d) ~A.<. PA(..t Ftc '0,.. ~M'l1IT Fii ",N.",e (P,h.d) !>31/ t'i.rrol~<tlre., IU:f NMos /PIhlt<d) \"5~l. lhllldirrt OI11-c)" Nltrue ~A:~ l:f.Llboratory Rrp, SiaM.Oll' C. ,,-, " ~ ,~ '0 c' CD -.1 ~ r1 0"< IT 1: (Jl tV ~ r: ~ 'r (Jl ~ r ... ~ --J ... . 0"< --J ~ 0"< W '- Il> X g V '" ,~ C1: ~ ~ ." (f) H ~ " ~ Ie . r,c ~ , , ~ 'C C '" ." D G) l'l '" tV " "'- "" loJ M e (!) <> <T Cijl ll. SI'~;CIAL INSPECTION AND nSTfNG SCHEDULE , Rcinforcc:d Concrele. Guoile. Grout and Mort~..-: l C!)ncr~(c I Gunite j Gl'ollt : Mortur , :~-+--I . ~.: ./ I ~: I I L !..::.~C I Pn~castlPre-slrcSstd Concrelr:: ~ Piles Posl- Te-=-l Pre",:~ns CRADlNG. J;XCA V ATION, ANI.IIIILI, --L:.._ Accepta!l(:e tests '". PSF . ----C_ E".blish final gnlde r'. rill placement inspectiun/continuous C Soil Density Afjtrep.nte Test of Mix Design' Rt:jJ\forcin~ Tt:sl Mix Dcsig,n-WeimlnaslerCt:rI," I Jteinforcine Placement COlltillllOUS Oatell Plant Insoect I !llsm:.c:f PfacinR I Cast StuT1~les I Samvte.s WickulJlDelivcn:dl COlnprr:sslon Test. . STRUCTUIlAL STEEUWEU)lNC: Sample al)d tesl (list specific members belol,\') Shop lTHlt~rial idcnfitic.ation (mill cert) Wdd inspection _Shop ~Fir:ld Ultrasonic inspoctiOIl _Shnp _Pietd High SLrength nollirlg_~ShoJ) ~Fj~Jd . AJ25 LN' X A490 N' -X Melal Llr.:dc welding ir\spcction - Rcinlorcil\g Sled welding inspecrion Reinforcing s~eel mill cerlificate Metal swd' wl~lding inspection COllcrcle insen welding illspectiQn Momenl resisting sled trnme.s L>F _P- -E- I.J" _C ._~ , -----E-... _.P_ ...d/tt:.... . en w I- <T ~ U o en lJ1 <T Claddin. I ~~reg:l!e Tests ReintbrcinE! Tests Tendon Tesl Mix Dc.s~gns+ ReinfolCirl2. prriccmenl Inserl Placement [ Concrete OatchinJ! [ Conclet.e PlnC~~llt [ Installarion Insncclion . J Cnsl Sam"r "-' ___I Pick-tltI SamDJes ComOf~sjon Tests 0" I _F ._F Z <I I 0- G' '" <or 8 '" z ..., u '" ~ --j r STlWCrURAL WOOD: I{ ~ " Slll.ar wall nailing inspection She.ar wall anchors Inspection ofGlu.lam fHb. ~ TIC psi ,::;,' Jnspedion oftlllssjoist mh. Sl1mv[~ tllld test cum poncnts Fabrication welding of steel acces.sorics MASONRY. . ~i (;- Sp,ciaJ i""pection slresses ".ed'~I'n1 1000 "g ,--- Preliminary aC(;cpt3flce tests (masonry units, wail priSIllS) c.- Suhscqucl1f tests (mortar, grouf, field wall prisms) r _ pract:ITlellt in.spection ofunitz, and reiltforcement -l!-- M~onry. mortar, grout, find r~infofcing sleet ccrlilic~lles !. SMOKE CONTROL: t'lfWPIlOOFINC: . '" e '" "" LD '" LD ~ I "" <P '" ~ cD ,- I '" ...; "" ~ LD '" :;) "" 01 ...; ...; <> ...; e ...; ...; ,- r- e "" e "" .. (" " --. '" ...; e ...; " .'- "' '. cD C "" Lr:otnge b:sling Cuntrol Ycrifil;;.atjon o Plucc:menl inspection Den.sity tcst~ 1l1ickness !t:sts Inspect batchil~g ROOFING: In:ml;nlion inslaJlnljl,)l1/R-Vlllue" Test srfipslseams I ADDITIONAL INSRUCfJONS, OTHER TESI', & INSrIJ:CTIUNS: Form Completed by. CHFH€7I€ '7rrH!K.. Dale tl/l/67 __t: :; tcNflNIIlDU$; f'~ fD/D/J/L R~E/III!F >IfEET 71?/. Foil !2El;lAIIZEP rf'Rt/tL INSI'FlnON> 7fJvv jb.12!J7....2lJiLt7- ~tff/T7lh. IF flN/1 D/SCf!..D..!l:Nft..F'; Bm.../mv' 77tJ5 f't;RM rlN" T7tt 5PR-4/tr.. /N5PR-nQA/ T/mu tr14":3" NO!T1? 117ft INSPFZ-TTM/5 PFTml--tF'P aN 7,e/ SH/]H PI2EV/flL. . . 'PUOYIlJE STIU:NCTIf I{EQumED IlY A'{CIHTIJ:C1' OR F.NGINEER on CONTIV\CT f)OCIJMENT l.OCATlON 01' VALlJES CITY OF SPRINGFIELD SYSTEMS DEVEWPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER C0M2007-00500 NAME OR COMPANY: Newgate LLC (Shell Building) LOCATION: 3310 Gateway St MAP & TAX LOT NUMBER: 1703222001700 DEVELOPMENT TYPE: New_ LLC (Shell Building) NEW DEVELOPED AREA (S.F.): 5.700.00 EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURFACE (S.F.): I STORM DRAINAGE IMPERVlOUS SQ. FT. . . R~rtrrnc::t COM2006-008S8 C0M2007-o0307 lTE: lTE: LOT SIZE (S.F.): 814 UANITARY SEWER-GITY (see reven;e side) A. REIMBURSEMENT COST: NUMBER OF DFU's 0 B. IMPROVEMENT COST: NUMBER OF DWs 0 Credit 89920.46-641.48=89278.98 r~maiDing x No New Impervious Area $ 0.336 PER SF TOTAL STORM DRAINAGE SDC:, Will Submit With Tenant lofill Referenee COM2006-00858 x $ 26.03 PER DFU x $ 19.79 PER DFU TOTAL WCAL WASTEWATER SDC:! $ >> 88 >> e ~ 8~. O~l.l.,W $0.00 $0.00 ~ - ~ '~.g u 0 "''-' 1178 $0.00 1183 $0.00 1184 $0.00 ~ x $ 19.81. PER TRIP 0.75 NTF l..IBAN~PORT illQl,! BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW: A. REIMBURSEMENT COST: 5.70 x 44.32 B. IMPROVEMENT COST: 5.70 x 44.32 EXISTING: A. REIMBURSEMENT COST: 0.00 x 0 B. IMPROVEMENT COST: 0.00 x 0 x 0.75 $3,753.36 ~ $16,557.61 ~ NTF $ 87.39 PER TRIP x x x $ 87.39 $ 19.81 PER TRIP x o $0.00 I x NTF ! PER TRIP x .0 NTF ! $0.00 , TOTAL TRANSPORTATION REIMBURSEMENT SDq TOTAL TRANSPORTATION IMPROVEMENT SDC:! TOTAL TRANSPORTATION SDC:I $ 20.310.971 4_ SANI1.:ARY SEWF.R . ~ NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 5.70 x $26.17 , PER FEU $149.17 ~ B. IMPROVEMENT COST: NUMBER OF FEU's 5.70 x $274.72 PER FEU $1,565.90 ~ EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU $0.00 ~ B. IMPROVEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU $0.00 , MWMC CREDIT IF APPLICABLE (SEE REVERSE) , TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRA llVE FEE: TOTAL MWMC SDC:! $ 1,725.07 I SUBTOTAL (ADD ITEMS 1,2,3, & 4) -, $22,036.04 I ~AnMrN"TRA.TIVE FEES. BASE CHARGE (SUBTOTAL ABOVE) $ 22,036.04 x 5% , $1,101.80 TOTAL SEWER ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMIN]STRATION FEE: $ Jesse Jones Civil Engineer, EfT TOTAL SDC CHARGES 4/1 0/2007 DATE $3,753.36 $]6,557.6] $20,310.97 $0.00 $149.17 $1,565.90 $10.00 $1,725.D7! I $0.00 1175 1,101.80 1190 $23,137.84 1173 1094 1054 . 1186 1187 1189 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS !NOTE: FOR REMODELS. CALCULATE ONl. Y THE NET ADDITIONAL FIXTURES) New.ate LI,C (Shell Buildin.) FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN, FLOOR SINK INTERCEPTORS FOR GREASFJOIUSOLIDSIETC. INTERCEPTORS FOR SAND/AUTO WASHlETC. LAUNDRY TUB CLOTHES W ASHERlMOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERA TOR/W A TER ST A TIONIETC. RECEPTOR FOR COMMERCIAl.. SINKJ DlSHWASHERlETC. SHOWER, SINGL.E STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL. RESIDENTIAl.. KITCHEN SINK: COMMERCIAl.. BAR SINK: WASH BASINIDOUBLE LAVATORY SINK: SINGLE LAVATORYIRESIDENTIAI.. BAR URINAL, STALUWALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDll'S' FIXTURES UNIT NEW OW EOUIVALENT 3 1 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 DRAINAGE FIXTURE UNITS o o o o o o o o o o o o o o o o o o o o o TOTAL DRAINAGE FIXTURE UNITS =, 0 .EDU (EQuivalent Dwellin~ Unit) is a discharge equivalent to a single family dweUing.!20 D!:!:!l... set at 167 gallons per day CREDIT CALCULATION T ABL.E: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN T ABL.E, CALCULATE CREDITS SEPARATELY YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 RATE PERSI,OOO ASSESSED VALUE S5.29 S5.19 S5.12 $4.98 $4.80 $4.63 $4.40 $4.07 S3.67 S322 $2.73 S2.25 SI.80 CREDIT FOR PARCEL OR LAND ONl. Y IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 RATE PER SI,OOO ASSESSED VALUE x x CREDIT TOTAL SI.45 SI.25 SI.09 $0.92 SO.72 SO.48 S0.28 SO.09 SO.05 SO.OO SO.OO SO.OO SO.OO SO.OO SO.OO ., 225 'Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 COM2007-00500 Payments: Type of Payment Check cReceintl . .~ Wit. ~ of Springfield Official Receipt _elopment Services Department Public Works Department RECEIPT #: 1200700000000000783 Date: 06/19/2007 Description Addressing Assignment Fire SF Fee - Non-Residential SDC MWMC Administration Miscellaneous Plumbing Plan Review Fire & Life Safety Building Permit Boiler/Comm 15-30 HP Boiler/Comm 30-50 HP Gas Outlets 1-4 -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By NEWGATE LLC Item Total: Check Number Authorization Received By Batch Number Number How Received djb 5373 In Person Payment Total: Page 1 of I 8:06:14AM Amount Due 31.00 569.30 10.00 45.00 746.26 1,865.65 60.00 44.00 4.00 10.00 100.93 161.49 258.80 $3,906.43 Amount Paid $3,906.43 $3,906.43 6119/2007