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Home My WebLink AboutPermit Building 2008-5-22 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2008-00532 ISSUED: OS/22/2008 APPLIED: 04/16/2008 EXPIRES: 11/22/2008 VALUE: $ 217,200.00 Status Iss u ed 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 721 CITY VIEW BLVD ASSESSOR'S PARCEL NO.. 1703341404700 Spnngfield TYPE OF WORK Smgle FamIly ReSidence TYPE OF USE Remodel PROJECT DESCRIPTION Remodel Smgle FamIly ReSidence (mam level) Owner. CHASE SHIRLEY ANNE Address 721 CITY VIEW BLVD SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechalllcal Plumbmg Contractor License PAGE REMODELING & CONSTRUCTION I 68337 JB ELECTRIC 104929 CHITTIM ENTERPRISES IINC 47396 ARPS PLUMBING CO INC 38123 I BUILDING INFORMATION I # of Umts # of Stories. Primary Occupancy Group. A;3 e on 'a,J1~bfr8s~u~re Secondary Occupancy GrB\l)J~NTlO~. O~ ~d by-tn~~~J\lltJtlhtyrced Air Electnc Pnmary ConstructIOn T~IOW rule t ~ ThoseWllwa;~t forth Electnc . 'catlon en e.. IlUl Secondary ConstructIon ~1~ 952_001.0010thro~gyM'962-001. Electnc # of Bedrooms' ~90. You may obtain co~U)tM;J~es bV Path 1 II the center. (Not6~~~ttd8Ig No ca Ing -. U,," t.. .le'RIQat.n" numDef lor U1~ ~.. .~... Center i . ., O:N: ;r INFORMATION I Frontyard Setback- Side 1 Setback Side 2 Setback Rearyard Setback Solar Setbacks Overlay Dlst. # Street Trees Rqd Paved Dnve Rqd' % of Lot Coverage I PUBLIC IMPROVEMENTS I Street Improvements Storm Sewer AvaIlable. SpeCial InstructIOn ReSidentIal Phone Number. 541-688-8787 Expiration Date 02/07/2010 03/14/2010 03/08/2009 01/2412010 Phone 541-688-8787 541-687-5770 541-461-2101 541-484- 7246 Lot Size 12,632 Sq Ft 1st Floor Sq Ft 2nd Floor. Sq Ft Basement Sq Ft GaragelCarport Sq Ft Other Occupant Load REQUIRED PARKING Total Handicapped. Compact Sidewalk Type Downspouts/Drams NOTICE: IRE If THE WORK THIS PERMIT ~~~~~ ~~5 PERMIT 15 NOT ~~~~~~~~D OR 15 ABANDONED FOR ANY 180 DAY PERIOD. Notes. Paee 1 of 3 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2008-00532 ISSUED: 05122/2008 APPLIED: 04/16/2008 EXPIRES: 11/22/2008 VALUE: $ 217,200.00 Status Issued 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon Lme I Valuation Description I DescnptlOn Tvpe of ConstructIOn $ Per Sq Ft or multIplIer $100 Square Footage or Bid Amount 217,200 00 Bid Amount Use Bid Amount Total Value of ProJect ~ Value Date Calculated $217,20000 $217,200 00 04/16/2008 Fee DescnptIon Amount Paid Date PaId Receipt Number Plan ReVIew ReSidentIal $679 43 4/16/08 1200800000000000365 -Mech Iss 2+ ApplIances- $40 00 5/22/08 2200800000000000739 + 10% AdmmlstratIve Fee $14943 5/22108 2200800000000000739 + 12% State Surcharge $17931 5122/08 2200800000000000739 + 5% Technology Fee $74 71 5/22/08 2200800000000000739 Add, Alter, Extend Clrc Ea Add $120 00 5/22/08 2200800000000000739 BUlldmg Permit $1,045 28 5/22/08 2200800000000000739 Dryer Vent $700 5/22/08 2200800000000000739 Fireplace (Listed) $34 00 5/22108 2200800000000000739 FIXture $192 00 5/22/08 2200800000000000739 Gas Outlets 1-4 $500 5/22/08 2200800000000000739 Mmlmuml AdJustment Mechamcal $700 5/22/08 2200800000000000739 Perm Serv/Fdr 200 amps or less $70.00 5/22/08 2200800000000000739 SDC SamtarylStorm Admm $294 5/22/08 2200800000000000739 Storm Dramage ImperviOus Area $58 82 5122/08 2200800000000000739 Vent Fan $14.00 5122/08 2200800000000000739 Total Amount Paid $2,678 92 I Plan Reviews I ImtIal ReVIew 04/17/2008 04/18/2008 APP LLH PublIc Works ReView 04/22/2008 04/22/2008 APP BRC Planmne ReView 04/18/2008 05/01/2008 APP T AJ Structural ReView 04/18/2008 05/06/2008 WE DLM Structural ReView 05/14/2008 OS/21/2008 APP DLM Paee 2 of 3 SDC Worksheet attached No Plannmg Issues Need addItIonal mfo for new and eXlstmg roof frammg at IIvmg/dmdmg Sent letter and talked to deSigner 5/6/08dlm Received engmeermg for revIsed roof system 5/14/08dlm ReceIVed addItIonal reVISIOns 5/18/08dlm. See documents for Plan review comments. Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2008-00532 ISSUED: OS/22/2008 APPLIED: 04/16/2008 EXPIRES: 11/22/2008 VALUE: $ 217,200.00 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme To Request an inspection call the 24 hour recordmg 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. Reouired Insoections I Footmg After trenches are excavated FoundatIon After forms are erected but pnor to concrete placement. Post and Beam Prior to floor msulatIon or deckmg Floor InsulatIon. Pnor to deckmg Frammg InspectIOn. Prior to cover and after all rough m mspectIons have been approved Wall InsulatIon Pnor to cover. CeIlmg InsulatIOn Pnor to cover Fmal BUlldmg. After all reqUired mspectlOns have been requested and approved and the buIldmg IS complete Underfloor Plumbmg Prior to msulatlOn or deckmg Rough Plumbmg. Prior to cover and mcludmg reqUired testmg. Fmal Plumbmg When all plumbmg work IS complete. Rough Gas After hne IS mstalled and reqUired testmg and capped lf not attached to an applIance Rough Mechalllcal Pnor to Cover Fmal Gas. When all gas work IS complete Fmal Mechalllcal' When all mechalllcal work IS complete Rough Electnc Prior to Cover ElectriC Service Approval reqUired prior to utIlIty company energlzmg service Fmal Electnc When all electrical work IS complete By signature, I state and agree, that I have carefully exammed the completed applIcatIon and do hereby certIfy that all mformatIon 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 Sprmgfield and the Laws of the State of Oregon pertammg to the work descnbed herem, and that NO OCCUPANCY Will be made of any structure Without permissIOn of the Commulllty Services DIVISion, BUlldmg Safety I further certIfy that only contractors and employees who are m complIance With ORS 701 005 Will be used on thiS proJect. I further agree to ensure that all reqUired mspectIons 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 remam on the site at all tImes dUring constructIOn ~L~o ,? 1'/ Owner or CoQttactors Signature 5/22-/oq' v t Date Paee 3 of 3 Construction Contractors Board 700 Summer St NE SUite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Address Penmt # c:o h-\ -z:..cO ? - 6 (5:S.3 Z- Cl ~ V'tW f Date 5 / ~ z.../u p- I / IZl ':b.:r Issued by Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) requzres reszdentzal constructlOn permzt applzcants who are not lzcensed wzth the ConstructlOn Contractors Board to szgn the followzng statement before a buzldzng permzt can be zssued Thzs statement zs requzred for reszdentzal buzldzng, electrzcal, mechamcal and plumbzng permzts Lzcensed archztect and engzneer applzcants, exempt from lzcenszng under ORS 701 010(7), need not submzt thzs statement Thzs statement wzll be filed wzth the permzt FIll m the appropnate blanks and InItIal boxes 1 and 2, and eIther box 3A or 3B al J2r2 I own, resIde m, or wIll resIde m the completed structure ~3A I understand that I must become ltcensed as a constructIon contractor If the structure IS sold or offered for sale before or on completIOn My general contractor IS -:p~ ~m6Det_/A/4- (Name) I 6f3J7 (cCB #) I WIll mstruct my general contractor that all subcontractors who work on the structure must be ltcensed wIth the ConstructIOn Contractors Board OR o 3B I WIll be my own general contractor If I lure subcontractors, I wIll hIre only subcontractors ltcensed wIth the ConstructIon Contractors Board If I change my mmd and hIre a general contractor, I wIll contract wIth a contractor who IS ltcensed WIth the cCB and wIllllnmedlately notIfy the office Issumg thIS bUIldmg permIt of the name of the contractor I hereby certify that the above informatIon is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. Jd~ /~d~ ~?-Jt!)R / j(~~hgilature of permIt appltcant) (Da1e)~ (Whzte copy to zssuzng agency permzt file, pznk copy to applzcant) Property_owner doc 06-01-04 Acting as Your Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE This Informat/on Notice to Property Owners Construction ResponSibilities was developed by the Construction Contractors Board In accordance with QRS 701 055(5), passed by the 1989 Oregon Legislature , , If you are as your own contractor to construct a new home or a substantIal Improvement to an eX1stmg , structure, you can prevent many problems by bemg aware of the followmg responslbllitles and concerns Employer You W1Il, m most be ruled to be an ard the contract01s you contract with w1l1 "employees" If you use contractors not heensed wIth the ConstruetlOn Co~tractors Board to do labor m constructmg or to aSsIst m the constructiOn or of a reSidential structure the you must comply foUowmg: Oregou's employees are Law: As an employer, you m~st mcome taxes from wages at the tIme You WIll be hable for the tax payments even If you don't actually Wlthhold the tax from your more mformatiOn, call the Department at 503-378-4988 Tax: As an employer, you are teqmrcd to pay a tax for unemployment msurance purposes For more mformatlOn, call Employment Department at 503-947-1488 on I IdentlficatiOn Number (BIN) 1S it number for both Oregon W1thholdmg and Insurance Tax To file for a BIN, can 50}945-8091 or \-nw. dor state or uS/rormsnav htmll for the appropnate forms \ : ')_ ..-~w~ _ Workers' In~Ulrance: As an employer, yop are subject to the Oregon Workers' CompensatIOn Law, must obtam compensatIOn msurance yout you fall to' obtam workers' compensahon msurance, you could be subject to penaltIes and habJe costs If one of your employees IS Injured on the Job more mformatIOn, can the Workers' Compensah~m DIV1slon at the Department of Consumer and Busmess ServIces at 503-947-7815 I U.S. Internal Revenue Scnice: As an employer, you must federal mcome tax from You W1Il be hable the tax payment even If you actually Withhold tax For a EIN IRS at 1-800-829-4933 or ViSIt thelT web SIte at \\....ww 11S l!O\: -,- I wages call the Compliance: As the permIt holder for thIS project ~ou are reqmrements that may brought to your attentlOn through for rcsohmg any to meet code Damage Insurance: yoUr msurance to "iee If you have msurancc and omISSIons such as fallmg toob, over spray. water damage pIpe punctures, fire or sure you have l:.ufficIent tune to supervIse your sure you have the skIlls to act as your olwn to notIfy bmldmg offiCIals as the contractor, to coordmate the work rough-m tJmes so they can perform mspect!ons Hyou Box 1 que<,tlOns can the ConstructIon 97309-5052 (503-378-4621) or 'WrIte at doc 06-01-04 Date ZON \ o-fU INITIALS ~lI/\ DATE 5-~~5 O~ SOURCE (Y\ (-1,5 p-V sJ:J:2 oc( , , 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 · FAX (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number C'JP-t '2LJ:1.Jf15, -0 0 ~ 32- 200 Amps or less 201 Amps to 400 Amps Adilless Lflo85' -r ~'5~t.Le srR..E.€:-r 401 Amps to 600 Amps )/tt. la regu~eS ~g\l ~s to 1000 Amps City E;U6EJJ f::: tJ--pnohe. ~ ~hi7~<j~~-1'W90~~~~\~\~0 AmpsN olts 1( r \.f ,Ul J~ '-" - Those rules are R~ ~~t Only 1'\;,1 (' {<,(Ill (;C'rL080f ~ 0 through OAR 9~ - ~\I A' ~~- I ~ oH~~~.""'1 '" v' ,>>'"' r '" " SupervIsor LIcense Numb\B- Onn ..%ll+atf\ pies t h orary Services or FeederS',f 9 'J CJlN. - .' . the e '0;; , . v . , 'v v . (' 0 ~ I - the center. \ Ol~ ,lit NotlilcatlOn t \ .r tor the or.e9~~2_i344y.nstallatlOn, Alteration or RelocatIOn center \SI -g 200 Amps or less Constr ContI Number IOy..q;\..'1 201 Amps to 400 Amps 3/~ J 401 Amps to 600 Amps ExprratlOn Date ':) /9-0 \ \ . . Over 600 Amps 01 1000 Volts see "B" above SlgnattfO\S.~lVlsmg Clan D .Bri~ch Circuits, - :',,: ;, v ~ I New Alterahon 01 ExtenSIOn Per Panel ~ . One CrrcUlt I ' Each AdditIonal CrrcUlt or WIth "" . / ~_ /'1~..l ServIce 01 Feeder PermIt Owners Name t.J 1ft ~ ~'( ~" '=' C , Addless 72/ 1'/ m ~C!:t<J E Mlscellaneons (SelVlce/feed~l not mcluded) -Each tnstalllltlOn ~ \ - ,~. { ~ CIty ?jl/ tv d'tre:f- ~~{~ 'f -m\in'tJ~~gatlOn $ 50 00 ~ N \s ?ERW\\' S'"'t' \\1\S PERWt\l~~~uie Llghtmg $ 5000 OWNER INSTALLATIO~1\10R\lEO UNOER A~f:\NOONBDJ~ Enelgy/ResIdenhal $ 25 00 The InstallatIOn IS beIng ma~~~W\~ID~ lretf. Lllmted Enelgy/Commercml $ 45 00 IS not mtended for sale, leas~q~~o O~'l PER . MllUillum Electnc Permit InspectIOn Fee IS $45 00 + Surcharges Owners Signature 4 SUBTOTAL OF ABOVE /; 0 ~ /~ State Surcharge 2? 9~ 10% Admmlstratlve Fee I CJ .-..0 5% Technology Fee ~ ~rtJ , 1 LOCATION OF INSTALLATION: 12/ C/7lf f16A.J LEGAL DESCRIPTION /703 ?J4/~ o4a/;v JOB DESCRIPTION .A? ~I) ~e{ PermIts are non-transferable and expire If work IS not started wlthm 180 days of issuance or 1f work is Suspended for 180 days {l > /' A" ~:! f~ ~ fro >>...J "< ; 2 CONTRACTOR INSTALLATION ONLY "" ........ ~ ~ f "" " ~ S< "'-;- ~ Electrical Conti act01 -::r 13 f6 L.E (.,t2..1 C I J..J C I ExpllatlOn Date Inspectwn Request 726-3769 3 COMPLETE FEE SCHEDULE BELOHl A New ResIdentlal- Smgle or Multl-Fanllh per dwellIng unit SerVIce Included 1000 sq ft 01 less Each addltlOnal 500 sq ft or portIon thereof Each Manufact' d Home 01 Modular Dwellmg Service or Feeder $106 00 $ 19 00 $50 00 B \ ' Sernces or feeders -InstallatIon, AlteratIon.s or Relocation ^ \ ~ $~ $ 75 00 $125 00 $163 00 $375 00 $ 50 00 70~ , , , \( , $ 50 00 $ 69 00 $100 00 '" :\' , 'I. .:?() $ 43 00 f.. DO $~ /20~ TOTAL 2Jf/~3" Shaled Dnve(T )/BUlldmg FonnslElectncal Penwt Application 8-06 doc CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER COM2008-00532 NAME OR COMPANY Shirley Chase LOCATION 721 City View Blvd TAX LOT NUMBER 17-03-34-144700 & 4800 DEVELOPMENT TYPE SFD AdditIOn NEW DWELLING UNITS 0 BUILDING SIZE (SF 170 LOT SIZE (SF) I STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS SF x I COST PER S F CHARGE 170 00 I $0 346 = I $58 82 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S F x I COST PER S F x I DISCOUNT RATE DISCOUNT o 00 I $0 346 I 50% $0 00 ITEM 1 TOTAL - STORM DRAINAGE SDC 1 $58 82 2 SANITARY SEWER - CITY A REIMBURSEMENT COST I NUMBER OF DFU's x I 0 COST PER DFU $26 83 B IMPROVEMENT COST I NUMBER OF DFU's x I 0 COST PER DFU $20 40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $000 3 TRANSPORTATION A REIMBURSEMENT COST I ADT TRIP RATE x I 957 COST PER TRIP 2043 I x INEW TRIP FACTOR' I 100 NUMBER OF UNITS x I o I B IMPROVEMENT COST ADT TRIP RATE I x NUMBER OF UNITS x I COST PER TRIP 9 57 I 0 I $90 10 ITEM 3 TOTAL - TRANSPORTATION SDC = 1 $000 x INEWTRIPFACTOR I 100 12632 $58 82 $000 $000 $000 $000 r- ifJ ~ ,t:l o u p:::: ~ ifJ >-< o ~ 11070 I 1091 1092 1093 1094 4 SANITARY SEWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's x I 0 ICOST PER FEU I $9535 B IMPROVEMENT COST INUMBER OF FEU's I 0 x COST PER FEU $990 39 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = 1 $000 SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I $5882 = $000 1054 1055 I 1054 1056 5 ADMINISTRATIVE FEE SUBTOTAL x ADM FEE RATE 1= $58 82 5% I TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE CHARGE $294 BIlly Curtiss "\ ... 22....08 TOTAL SDC CHARGES PREPARED BY DATE '- ~-_...-- .--....- = , $000 =1 $000 = , $000 294 $000 =, $61.76 il 11079 I 1078 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTIJRE UNITS (NOTE FOR REMODELS CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 0 0 3 = 0 DRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 0 0 3 = 0 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION /ETC 0 0 1 = 0 I RECEPTOR FOR COM SINK / DISHWASHER / ETC 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 SINK COMMERCIAL BAR 0 0 2 = 0 SINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = 0 IURINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 0 0 3 = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 *EDU (EqUIvalent DwellIng Urnt) IS a discharge eqUIvalent to a smgle fa/TIlly dwellIng urnt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $529 $529 $519 $512 $4 98 $480 $463 $440 $407 $367 $322 $273 $225 $180 $1 59 $145 $125 $109 $092 $072 $048 $028 $009 $005 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0 00 x $5 29 =, $000 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0 00 x $5 29 o TOTAL MWMC CREDIT $000 = 225 Fifth Street Sprmgfield, Oregon 97477 541-726-3759 Phone City of Sprmgfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 COM2008-00532 Payments Type of Payment Check cRecemtJ RECEIPT #: 2200800000000000739 Date: OS/22/2008 DeSCriptIOn Storm DraInage ImpervIOUs Area SDC SamtarylStorm AdmIn BUlIdmg PermIt FIxture Vent Fan Dryer Vent Gas Outlets 1-4 FIreplace (LIsted) MInImum/AdJustment MechanIcal ~Mech Iss 2+ AppiIances~ Perm ServlFdr 200 amps or less Add, Alter, Extend Clre Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstratIve Fee PaId By SHIRLEY CHASE Item Total Check Number AuthorizatIOn Received By Batch Number Number How ReceIved DJB 1008 In Person Payment Total Page 1 of 1 3 27 41PM Amount Due 5882 294 1,045 28 192 00 1400 700 500 3400 700 4000 7000 12000 7471 17931 14943 $1,99949 Amount Paid $1,99949 $1,99949 5/22/2008