HomeMy WebLinkAboutPermit Building 2007-4-26 (2) Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . .CITY OF SPRINlJ1<lJ!.LU Building/Combination Permit PERMIT NO: COM2007-00457 ISSUED: 04/26/2007 APPLIED: 03/28/2007 EXPIRES: 10/26/2007 VALUE: $ 291,758.00 SITE ADDRESS: 6251 GRA YSTONE LOOP ASSESSOR'S PARCEL NO.: 1802032202000 SPRING FIE TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Single family residence- Mt gate ph4A lot 28 Contractor License Expiration DatK RIVER VALLEY BUILDERS INC f\'i'\CE: 134566 0\\'3,( 1\4/,~tI!oili)"" G & E ELECTRIC INC ~\I'. \,~4jM\\.\. E.'i-r eR'~~~q\1,7NQi MIDWAY MECHANICAL INC 'HIS ~\\'I'ME05~,\-!i~t.R ,HIS I' 01!2P12,.68fl. ALAN DOUGLAS HAlMA r.l\If101'Ih)63~~1I1c:. t\BI\NOi4)~V29ho08 .... ... . f. -. BUILDING l~mRj\h:i::iQNrl.RIQD. (i.N~ IOU UP- # of Stories: 2 Lot Size: Height of Structure: 32.50 Sq Ft 1st Floor: Type of Heat: Forced Air Gas Sq Ft 2nd Floor: Water Type: Gas Sq Ft Baseme!!laS 'IOU \~ 'i Range Type: Gas S~d.'t~r-;Pe')e~ij\'lU\\I t 732 Energy Path: . ...I:p~WOte~ \W\~p't9 etG se\ ,on Sprinkled BUilding:~~~,~\li a~~~ uB/Wt~~p.va. 9S~-.?~~ I DEVELOPMENT INFO~t!JN'..~~.oo.' ~q,~~\&S 0' \\:o.;ona . \l'IOI\\-.~~ f(le.'l o~\e\~tolO\~Q.l1tR~O\\(It~G Overlay Dist: 0090.'fO\l{fitJSi&l'\e:~O\llAA\\\\\'; ~44). 2 # Street Trees Rqd: ca\\\tI9t'Ot\\'lllO ~.?oo~'pped: Paved Drive Rqd: nutl\'t)e ,,_~\" . Compact: % of Lot Coverage: 20.50 Fully Improved Yes Owner: RIVER VALLEY BUILDERS Address: PO BOX 832 SWEET HOME OR 97386 Contractor Type General Electrical Mechanical Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 44.00 40.00 36.00 33.00 52.00 Subdivision Not Accepted Street Improvements: Storm Sewer Available: Special Instruction: Phone Number: 54 I -726-0330 I CONTRACTOR INFORMATION I . Phone 541-760-7881 541-967-7045 541-928-2423 541-967-7686 I R-3 U VB 23,035 2,542 3 I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspoutsffirains: To Storm Sewer Notes: For this parcel in Mt. Gate West, it is the recommendatiou to the Building Division, by the City Eugineer: "that final occupancy should not be given until the subdivision is accepted by City Council". Storm H20 to designated lateral.JLP 4/8/07 Pace I of5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvoe of Construction A.C. - Residen Dwellines Garaee AC - Residential V Wood Frame Garae:e Fee Description Plan Review Residential -Mechanical Issuance Fee- + 100/0 Administrative Fee + 5% Technology Fee + 8% State Surcharge 3 Baths One & Two Family Addressing Assignment Appliance Vent Boiler/Comp Up To 100,000 btu Building Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Furnace - up to 100,000 htu Gas Outlets 1-4 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 Storm Drainage Impervious Area Storm Sewer Each AddtllOO' Temp Power 200 amps or less Vent Fan Willamalane Single Family Total Amount Paid . I Valuation DescriI)tion I $ Per Sq Ft or multiplier $4.00 $103.00 $27.00 Square Footage or Bid Amount 2,542.00 2,542.00 732.00 Total Value of Project F"pp<. PIia,I Amount Paid $773.27 $10.00 $180.44 $82.03 $131.25 $306.00 $31.00 $6.00 $12.00 $1,189.65 $6.00 $9.00 $163.70 $12.00 $4.00 $653.09 $858.88 $10.00 $961.52 $91.61 $201.32 $64.14 $836.32 $189.58 $1,708.29 $28.00 $50.00 $18.00 $2,303.00 $10,890.09 Date Paid 3/28/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 4/26/07 Paee 2 of5 .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00457 ISSUED: 04/26/2007 APPLIED: 03/28/2007 EXPIRES: 10/26/2007 VALUE: $ 291,758.00 Value Date Calculated $10,168.00 $261,826.00 $19,764.00 $291,758.00 03/28/2007 03/28/2007 03/28/2007 Receipt Number 1200700000000000341 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 1200700000000000466 . -iJ:iI~' Ia' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Plannine Review 03/29/2007 03/29/2007 Public Works Review 03/29/2007 Structural Review 03/29/2007 I Plan Reviews I 03/29/2007 APP 04/17/2007 APP 04/08/2007 APP 04/26/2007 APP .CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00457 ISSUED: 04/26/2007 APPLIED: 03/28/2007 EXPIRES: 10/26/2007 VALUE: $ 291,758.00 LLH TAJ Place orange construction fencing along the Vegetation easement and along the treed areas on the Nand S sides of the lot. Keep all construction activity out of these areas. Follow the Tree Preservation Guidelines attached to the building permit. PW rcvd 3/29. JLP 3/29/07 ... FOI this parcel in Mt. Gate West, it is the recommendation to the Building Division, by the City Engineer: "thaI final occupancy should not be given uotil the subdivision is accepted by City Council". Storm H20 to designated lateral.JLP APP4/8/07 Received add'l beam calc. from bldr. Called engineer requesting correction in calculation (wrong loads entered). Received revised calc this P.M. 4/24/07dlm Noted that retaining wall design not consistent w/ geotech. requirements. Called builder and geotech engineer requesting clarification. Received 19 pgs. of revised engineeering from builder. Engineer called stating that the retaining walls are still not compliant and will e-mail corrected drawigs. Received corrected dwgs from engr.4/24/07 Met w/ contractor to resolve remaining structural issues.4/25/07dlm Contractor returned next morning with revised truss and foundation details - looks like issues resolved.4/26/07dlm JLP DLM 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. I Rpn..irprl Tnsnections , Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Paee30f5 . .CITY OF SPRINl.l'lJ'.,LU Building/Combination Permit Status Issued PERMIT NO: COM2007-00457 ISSUED: 04/26/2007 APPLIED: 03/28/2007 EXPIRES: 10/26/2007 VALUE: $ 291,758.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line. 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 floor insulation 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. Ceiting Insulation: Prior to cover. Drywall: Prior to taping. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Bnilding: After all required inspections have been requested and approved and the building is complete. Special Inspection: Reinforcing Steel Mill Certificate Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Sp'ringfield. Copies of inspection results shall be provided to the City of Springfield. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Underfloor Plumbing: Prior to insulation or decking. Undertloor Drain: Prior to cover or placement of concrete. 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. Line to Septic Tank: Prior to filliug trencli and required testiug. Storm Sewer Line: Prior to filliug trench. Fiual Plumbing: When all plumbing work is complete. Underfloor Mechauical. Prior to insulatiou or decking and including required testing. Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test doue at this point. Rough Mechauical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Paee 4 of5 _~~~~9~1~' , , ,. .. ......' ..- . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00457 ISSUED: 04/26/2007 APPLIED: 03/28/2007 EXPIRES: 10/26/2007 VALUE: $ 291,758.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work descrihed herein, and that NO OCCUPANCY will he made ofany 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 p'ermit card i a ed at the front of the property, and the approved set of plans will remain on the site at all times durr'.ni: c nstructio ~ . /[7, ,((7, r . -.cj - 2~ -c7)Y Owner or Contractors Signature Date Paee 5 of5 225 FIFTH STREET . SPRL'IGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION en _4 ~r'J E.I,cal.contractor . . Addre' . \. City '--', Phone " / " / . . \// Supervisor License Number , . C. Expiration Date ')(' Installation, Alteration or Relocation ;; < . ( 200 Amps or less I $ 50.00 Constr. Contr. Nutl19"; \. 20 lAmps to 400 Amps $ 69.00 / '\. 401 Amps to 600 Amps . $100.00 Expiration Da~ ... '\.. "! 0n~E: Over 600 Amps or 1000 Volts see "B" above. . . ."-I"-"~"-" ~HsEr~rg~ ANY 180 DAY ~~OO,ditional Circuit or with ~ / /'- f Service or Feeder Permit Owners N~ ~~r. ~ r- /c..' ...., . ~ ,;, ~;;:i,~~\/'Wi55i"'W~10'~d'itA~7~'-i=Je:."~~~~~~Jr~~~!ttA:q Address r, C/, 0/ 9"'3;2 E. ,"~c,~!1.~!\!:~I}~~(~.~!1~f~Lf.'f$JJE~g.t)!'.~!g~~~~~l~.,u~tb"},\i:l ci~.Iu:f /j&M<J'hone:PI/-76~-7'i?r Pump or irrigation . $50.00 Sign/Outline Lighting yOU to $ 50.00 OWNER INSTALLA nON nENiI\si~Ol@g;pR~t~gv:~n Iltilitv $ 25.00 The installation is being made on property I own WhiChf~O\lOW r1MroialllEil~R)l,M':a{e~lare set fort $ 45.00 . . . r.!lr~'1'hose r ,., =".f\ , IS not mtended for sale, lease or rent. 'ljotifMiltl/il'i\IlI'~lec ij~6\~pe.ltiO'lFM!e IS 45.00 + Surcharges ~ 2L lnOAf\~~~'.-,~~:tO Owners S re: /.../ 0090~~~.l\l!i '" ". i~ij <:;;0 /' 7'\ ca\\Ing.t~~ Utility 0 I U , t.. /' I numbQ'J(~~!l-jr .,,,?_?Q44'- ~ I 10% Administrative Fee 5 S'ro it!'t.tt ~ I I __fO Z~O TOTAL or City Job Number 1. \'riOCATioNOEriNSTAJJlfATION'$l#i:'/Jfj~ . 6J;i-2;;:;;'"~Z;'~~~ LE\f)VW31:WlliO JOB DESCRIPTION \ftN) \J~\\ ~"-\ Permits ar:non-transferable and expire if work\ .> not started within 180 days of issuance or if work is Suspended for 180 days. ~2f~croR~iNsTATdtTIONibmr},;~ 2.. f~4.'.-$:;j;j'::-~!<<.':?'11JJ~t.>;'iil::'\'iJ0V4.));~dt~~J1l.c;"~~ir::1tJ~ / Inspection Request: 726-3769 ~/ :~t')/ 7 nol Date ~'7~';~C~"1.:,:~r"A~'l'.;,,;-,,";.':~~,x';,r'::!"o'~'#~!:Fl"r:(1i>~'11'_,!.';1~B?~nr~~~0%:.~' , 3.,COMPLETEFEE'SCHEDULEBELOW,~~~j;~,~m:,~\! ,', ~""~ijj'~;;:g~~;;lU:i~"~';~'W~'ii~iN.~~!.G,~qa'f~~~~{XJ'Si.t-:r1?- A. ~'~l~~~~.'iii~~~~.:'~j~I~t1ifuiij1~Jl'~~~[~~1ii~?(T,,:t~~fe~ ~~~,;i1;U~&' ,- ,---~,';(;~.4;n~'''~~;~~-k>W,J,',;:'S')~~"",~"",~ll Service Included I 000 sq. ft. or less Each additional 500 sq. ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 ~i0'''U,,;,~~~~1>:j'iI\'ll'''''lf,,1);~!il;~~ B. ~~~~!:J!.:J~?J}il~Jt~~~~~~r;!s}R~~~~t 200. Amps or less . 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 Amps/V olts Reconnect Only $ 63.00 $ 75.00 . $125.00 $163.00 $375.00 $ 50.00 so $. 3.00 Shared Drive(T:)/Building FonnslElectrical Permit Application 1-03.doc CITY OF SAGFIELD SYSTEMS DEVELOPMEN&RKSHEET JOURNAL OR JOB NUMBER: COM2007-00457 NAME OR COMPANY: River Vallev Bldrs LOCATION: 6251 Gravstone Lp TAX LOT NUMBER: Lot #28 Mt Gate West DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF: 3407 LOT SIZE (SF): I. STORM DMINAGE DIRECT RUNOFF TO CITY STORM SYSTEM ( IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE '5090.00 I $0.336 I = $1,708.29 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I x I COST PER S.F. I x! DISCOUNT RATE ( ! 0.00 I $0.336 I I 50% I ~ I ITEM I TOTAL- STORM DRAINAGESDC $1,708.29 2. SANtTARY SEWER - nTY A. REIMBURSEMENT COST: r NUMBE~30F DFU's I x. B. IMPROVEMENT COST: I NUMBER330F DFU's I x $19.79 ITEM 2 TOTAL - CITY SANITARY SEWER SDC COST PER DFU I. $26.03 ( = I $1,511.96 J TRANSPORTATION DISCOUNT $0.00 A. REIMBURSEMENT COST: I ADT TRIP RATE I x ( NUMBER OF UNITS ( x ( COST PER TRIP x (NEWTRIPFACTOR( 9.57 ( I ( ( $19.81 ( 1.00 I B. IMPROVEMENT COST: ( ADTTRIPRATE I x I NUMBER OF UNITS ( x I COST PER TRIP x !NEWTRIPFACTORI ( 9.57 I I ( I $87.39. ( 1.00 ITEM 3 TOTAL - TRANSPORT A nON SDC = , $1,025.90 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: (NUMBER OF FEU's I x ( 1 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I ($961.52 MWMC CREDIT IF APPLICABLE (SEE REVERSE) ICOST PER FEU ( $91.61 MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , 5 ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE I $5,309.28 I 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: r I Jeff Proeiw 4/8/2007 PREPARED BY DATE 23035 tIl ~ CI o u ~ ~ ,I- tIl 6 ~ $1,708.29 11070 $858.88 1091 $653.09 '1092 $189.58 . 1093 I $836.32 11094 I . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT ""- DRAINAGE FIX11JRE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY mE NET ADDmONAL FIXTURES) NO. OF FIXTIJRES DRAINAGE UNIT FIXTURE FIXTIJRE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB - 6 2 0 3 = IDRINKlNG FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0 ILAUNDRY TUB 1 0 2 = 2 ICLOTHESW ASHER I MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRIG I WATER STATION I ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK I DISHWASHER I ETC. 1 0 3 = 3 ISHOWER. SINGLE STALL 1 0 2 = 2 ISHOWER. GANG (NYMBER OF HEADSl. 0 0 2 = 0 ISINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 = 3 ISINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASINIDOUBLE LAVATORY 2 0 2 = 4 I SINK: SINGLE LA V A TORY /RESIDENTIAL BAR 1 0 1 = 1 URINAL, STALL I WALL 0 0 5 = 0 TOILET, PUBLIC INST ALLA TION 0 0 6 = 0 TOILET. PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 33 -EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 OFU's) set at 167 gallons per day - -- i I I I I I I I I I ~ I I .I MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/S I ,000 ASSESSED VALUE $5.29 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE I 1000 CREDIT RATE SO.OO x S5.29 - , $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE 11000 CREDIT RATE $0.00 x $5.29 o I I I I TOTAL MWMC CREDIT SO.OO = I . 225 Fifth Street Springfield; Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007.00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 COM2007-00457 Payments: Type of Payment CreditCard Check cReceintl . -..ini<-._....~... Wit!.. . -...... _ i >) .,.., ~ '. .. ""',, t. " <;Ill of Springfield Official Receipt .Iopment Services Department Public Works Department RECEIPT #: 1200700000000000466 Date: 04/26/2007 Description Addressing Assignment Willamalane Single Family Temp Power 200 amps or less Fire SF Fee - Residential 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 Building Permit 3 Baths One & Two Family Storm Sewer Each AddU 100' Furnace - up to 100,000 btu Boiler/Comp Up To 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By RIVER VALLEY BLDRS RIVER V ALLEY BLDRS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 011231 In Person djb 13067 In Person Payment Total: Page I of2 2:02:27PM Amount Due 31.00 2,303.00 50.00 163.70 1,708.29 858.88 653.09 189.58 836.32 91.61 961.52 10.00 201.32 64.14 1,189.65 306.00 28.00 12.00 12.00 18.00 6.00 9.00 6.00 4.00 10.00 82.03 131.25 180.44 $IO,1I6.H2 Amount Paid $6,500.00 $3,616.82 $IO,1I6.H2 4/26/2007