HomeMy WebLinkAboutPermit Building 2008-7-3
CITY OF 8r.Kll~GFIELD.
Building/Combination Permit
PERMIT NO: COM2008,00767
ISSUED 07/03/2008
APPLIED: 06/02/2008
EXPIRES: 01/0312009
VALUE: $ 67,000,00
-iik~
Status
Issued
225 F,fth Street, Sprmgfield, OR
541.726,3753 Phone
541,726-3676 Fax
541-726,3769 InspectIOn Lme
SITE ADDRESS 3197 U ST
ASSESSOR'S PARCEL NO 1702302102900
Sprmgfield TYPE OF WORK Manufdctured Home on
Pnvate Lot
TYPE OF USE New ReSIdential
PROJECT DESCRIPTION Manufactured home replacement
Owner
Address
RICK HAGLER
3197UST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION.
Contractor Type
General
Electncal
Mauul Home Inst
Plumhmg
Contractor
HARRISON JACOBSON INC
ROBS ELECTRIC INC
HARR1S0NJACOBSONINC
HARRISON JACOBSON INC
LIcense
66447
156678
66447
66447
BUILDING INFORMATION I
# of UOItS
Pnmary Occupancy Group
Seconddry Occupancy Group
Pnmary ConstructIOn Type
Secondary Construction Type
# 01 Bedrooms
1
R,3
# of Stones' 1
HeIght of Structure
Type of Heat orced Air Electnc
Water Type Electnc
Range Type Electnc
Energy Path
Sprmkled Buddmg No
VB
3
I. DEVELOPMENT INFORMATION I
Phone N umher
541-741,2942
ExpIration Date
05/07/2010
08/14/2008
05107/2010
05/07/2010
Phone
541,689,7762
541,686,5444
541,689-7762
541,689,7762
Lot S,ze
Sq Ft 1st Floor
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft Garage/Carport
Sq Ft Other
Occupant Load
8,276
1,620
REQUIRED PARKING
2
Overlay Dlst Total. 'ou to
{pn'\ It;;l )
# Street Trees Rqd.:._ , C~ 0,0('02 \3'~ - Ct.'~gglcappeij
Paved Dnve Rqd;X I \ Et TI "a(jOptsd I,y tha I !SOJW'@ct fOlth
% of Lot Coverage".)W · \.o\e~cent~2,90,ose lU he OAR 952.-001-
Not\I'cat\0~_001_001 0 thlOUg s 01 the luleS by
.... nA.R 95 . "''''''>11'"1 r:001e .. _....."-n.oA
:J I ,G';' I PUBLIC II\:lP.ROVEMEN'1'S ,:o~~~a~e~tel lNot~tl~:;; N~t\\lcat\on
Street Improv.emenfs'ifV1\T SHALL EXPIRE .r M"ITn-IS" NOT .. ;~m~~llcg,m\l.~~~t:a32.'2344).
'1Tf.!'1DI7ED UNDER THIS PER centell
Storm Sewer,..~~~'J~ble OR IS ABANDONED FOR DownspoutslDrams
SpeCIal Instrucllon ENCED
ANY 180 DAY PERIOD,
Frontyard Setback
SIde 1 Sethack
SIde 2 Setback
Rearyard Setback
Solar Setbacks
2600
10 00
1800
4600
000
Notes
Paee 1 of3
Status
Issued
225 FIfth Street, Sprmgfield, OR
541,726.3753 Phone
541,726,3676 Fax
541,726,3769 InspectIOn Lme
Description
Tvpe of ConstrnctlOn
FonndatlOn Onlv Use BId Amonnt
Mannf Home Mannfactured Home
Fee DescriptIOn
Plan RevIew ReSIdential
+ 10% AdmmlStratlve Fee
+ 12% State Snrcharge
+ 5% Technology Fee
FIre SF Fee. ReSIdential
FoundatIOn PermIt
Manuf Home State Issuance
Manufactured Home Conn, Plmb
Manufactured Home Feeder
Manufactured Home Placement
Manufactured Home ServIce
Plan ReVIew Mmor ' Planmng
Samtary Sewer. Improvement
Samtary Sewer - ReImbursement
SDC Samtary/Storm Admm
Storm Dramage ImpervIOUs Area
Total Amount PaId
Imtlal ReVIew
06/03/2008
Pubhc Works ReVIew
06103/2008
Structural ReVIeW
06/03/2008
Plannme: ReView
06/0312008
CITY OF SPRINt..1'lJ<..LJJ
Building/Combination Permit
PERMIT NO: COM2008-00767
ISSUED, 07/03/2008
APPLIED, 06/02/2008
EXPIRES: 01/03/2009
VALUE' $ 67,00000
I ValuatIOn Descrinhon I
$ Per Sq Ft
or multlpher
$100
$100
Square Footage
or Bid Amount
7,00000
60,000 00
06/0212008
06/03/2008
Value
Date Calculated
Total Value of Project
$7,000,00
$60,000 00
$67,000 00
FW' P~i'iLI
Amount PaId
Date PaId
ReceIpt Number
$60 39
$43 45
$49 55
$26 45
$2160
$92 90
$30 00
$50 00
$55 00
$16000
$55 00
$11600
$61 21
$80 50
$1456
$14948
6/2/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
7/3/08
2200800000000000802
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
2200800000000001019
$1,06609
I Plan ReViews .1
06/03/2008
APP LLH
06/05/2008
APP LKW
Storm to eXlStmg system
06/18/2008
APP DLM
06/19/2008
APP TAJ
2 street trees are reqUIred unless
they are already 10 ' one tor each
street frontage
To Request an mspectIon call the 24 hour recordmg at 726.3769, All mspectlOns requested before 7'00
a 10, wIll be made the same workmg day, inspections requested after 7 00 a,m. Will be made the followmg
work day
Paee 2 of 3
-~~
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Iss u ed
PERMIT NO' COM2008-00767
ISSUED: 07/03/2008
APPLIED: 06/02/2008
EXPIRES' 0110312009
VALUE: $ 67,000,00
225 FIfth Street, Sprmgfield, OR
541-726,3753 Phone
541,726-3676 Fax
541,726,37691nspectlOn Lme
I Relluired rn.nect,J~n. ,
Uter Electrical Gronnd Install ground rod at footmg and call for inspectIOn In conjunctIOn With footing and/or
foundatIOn inspectIOn
Foundahon After forms are erected but prior to concrete placement
ManufHome Set Up When mstallatlOn of all pIers or stands" complete
Fm.1 Manuf Home Set Up After all reqUired mspectlOns are requested and approved and porches, sklrtmg,
decks, ventmg, street address numbers, trees, drIveway, etc have been lDstalled
Fmal BUIld 109 After all reqUIred inspectIOns have been requested and approved and the bUIlding IS complete
Manuf Home Plumbmg After home has been connected to water and sewer
Storm Sewer Lme Prior to filling trench,
MH ServIce Approval reqUIred prior to uhllty company energlzmg service
MH ElectriC When blockmg, setup and plumbmg mspectlOns have been approved and the home IS connected to
the panel
By sIgnature, I state and agree, that I have carefully exammed the completed appllcahon and do hereby cerhfy that all
mformahon hereon IS true and correct, and 1 further cerhfy that any and all work performed shall be done In accordance WIth
the Ordmances ot the CIty of Springfield and the Laws of the State of Oregon pertalnmg to the work deSCribed herein, and
that NO OCCUPANCY will be made of any structure Without permIssIOn ofthe CommuDlty ServIces DIVISIOn, Bulldlllg Safety
I further cerhfy that only contractors and employees who are III compliance WIth ORS 701 005 will be used on thIS project
I further a e to ensure that JII reqUIred mspectlOns are requested at the proper hme, that each address IS readable from the
street, that t~hl rd IS cated at the front of the property, and the approved set of plans WIll remam on the sIte at all
times dur g c os u tJ n
CC ~ ~ /-. 7J~/IJ 'B
Owner or Contractors SIgnature ~ Date
Paee 3 of3
DEVELOPMENT SERVICES DEPARTMENT
SPRINGFIELD 1:"- ;.,
~. .~~ 1l1J<""ii?ol"Ik"",,"W"''''.'-''' ,",,'~
~- *!'-f::~-~"'1l~.. l'j'..-~~~~ ~~;..j
. ~....H.~,'~.1':::i*~~~~:t&"':4'~~oo;., ~~
....'t~1tJ . .
rp, 1 .~, 225 FIFTH STREET
- . SPRINGFIELD, OR 97477
(541) 726 3753
FAX (541) 726-3689
wwwc, spnngfleld or us
~'iit~"~r!J1~~~.~ijjj'ir'lr~r~=rg!Jj'f'i'{~. @]. r;~_~:
~';;d''t.,~~, ~". ,,-\~. ..1;.., _ ~t(.~ ~ri.t-Vt"l.t:_,+ R.
MANUFACTURED HOME SET-UP AGREEMENT
...
--
As IeqUlred bv the City ofSpnngfield Development Code, [undelstand and agree that wIth the approval o~~
the attached pelIDIts, one of the followmg manufactured homes WIll be placed at '3 I q ~ .'U.... y
, Spnngfield, Oregon, CIty Job Number .1- \lIo1^ -uJ.) q, - 6b '9-G.~
~e IM~nufactured H~
~~tlOnal (double WIde 01 WIder) Ulllt wIth an enclosed floor area of not less than 1,000 squme feet,
that-has a nommallOOfpltch of 3 feet III heIght f01 each 12 feet 111 Width, that has no bare metal sldmg or
roofing and that has been certIfied by the manufacturer to have an extenOI thermal envelope meetll1g
pelformance standards whIch reduce heat loss to levels equIvalent to the performance standards requlled
for smgle family dwellmgs at the tIme of constructIOn ~ mItIals
Type II
A umt ofn t less than 12 feet m WIdth enclosmg a mlmmum floor area of 500 square feet that has a
nom mal roo Itch of 2 feet m heIght for each 12 feet m WIdth, that has no bare metal sIdmg or roofing
and that has b n certIfied by the manufacturer to have an e'<.tenor thennal envelope meetmg performance
standards 'Wl11ch educe heat 10% to level<; eqUIvalent to the pelf01mance standards requIred for <;mgle
famIly dwcllmgs the tunc of constructIOn mlt1als
I further state, by my SIgnature below, that I have been provIded ';lth the followmg mformatlOn
Manufactured Home BlockIng, Water Lme ConnectIon, Sheet Tlee Standards, SanItary Sewel Connection
Electl1cal ConnectIOn and Mmtmum reqUIrements for pemlanent ~tep~
I also understand that the manufactured home shall be placed on an excavated and backfilled foundatIOn
not to exceed 6 percent slope "dthm 10 feet of the penmeter enclosure, enclosed at the penmeter wIth
stone, bItCh. or oth con ~te 0 masonry matenals apploved by the BUlldll1g OffiCIal and wIth no more
than 24 m/\ of he n le;111 atenal exposed ab~ve grade _
.tV- ~ ~
~
SIgnature ~
7/3/0'/
Date
SPRINGFIELD ZON 'vi V
~ INITIALS ....\I'V'
A!. DATE (-,-0;(
225 FIFTH STREET' SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 ." SOURCE ~
ELECTRICAL PERMIT APPliCATION ~./ 'I
City Job Number ~.2/.X2J9, -t2fl7&"7 Dat;'!?/ () K
1 l.f9~Af.rgN OF llVS'I~O~: 3 I.COMJj>1,RtE~E;SCiIEjjfjfE)J~(jliT-J;:f1i~0r~~;:f~'--
q/97 U fiT"
" . ~.:"' .'4~ ,,<.-' ~;j ~':' ,"' ,. ":;" :- L
'~, '-:~QIT~ pF.~sg~GF::W:I;;~~.g1WGO~ : ~"'_ ,,;'
LEGAL DESCRIPTION
170z 3Q2!
JOB DESCRIPTION
>>t;:-~ lJ, fh># D
027&0
Permits are non,transferable and expire If work IS
not started wlthm 180 days of Issuance or If work IS
Suspended for 180 days
2 "goIftilA'qiOR'nyl.ffAtUitOI;l ~~
ElectncalContractor Al9h'S 1---lufY'1 L Ln<
Address f c) fj,,,, )<. 2 'i? 2- I
CIty E"17<.'''t(..
Phone (icll) {" 'i(, nriY
SupervIsor klcense Number '/7'1 tj S
NOTIl;l:.: I ^' l=lPIRF IF THE WOKK
TI'''' nCRMIT '\.l. _
Exprral10n Date .. 'iJlL ~~T ~\C ~~i\i-?s NOT
AUTHORIZtu ,w..iYl, ~ R
consG-ClrAMEillhlJi.~ePR_IS ABANDONED ~~~t. 78
ANY 180 DAY PEhlfi{;
ExprratlOn Date )( -I Y - 2-0 I 1
Signature of SupervIsmg ElectrICIan
O/~ z:.-
Owners Name ~/CK. fIM~
Address ~ rJ q .,0 'S 7.
CIty 5// A . / Phone 21/ - z.1'~ 2-
/
/
OWNER lNSTp.LLA nON
The mstallatlOn IS bemg made on property I own whIch
IS not mtended for sale, lease or rent
Owners SIgnature
InspectIOn Request. 726,3769
A
",~~,,~, '"' ,,,'-~/" ""~~~-"~-,,1~ ""!'Y')""""'" '~" \' M~'" _v_","::~""i 'Y",Ji'f'
!'lew Resid~~ti!thSingle~tMultl~t:ajIiIly p~r dwening UOlt. .
Service Included
1000 sq ft or less
Each addItIOnal 500 sq ft or
portIOn thereof
Each Manufac!' d Home or
Modular Dwellmg ServICe or
Feeder
$1l7 00
$2100
;z..
$55 00 / II) .-
,
'" '"" j'i..~' f d2-'" ;~ :~' ;;;;,1;' n -,;o:,-':l1("'"'0'!:::;:;;''j;Ff;'4'i'fj;;:0.\it'4~,,'Z>';"!i:, I
B l ~~~i~\'S ,o'.:Ji:e,t;d~rs;:- ~ns~ll~pon,:Alt~!:~![(}~~~~~~!~cl\tlOn: '.
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsIVolts
Reconnect Only
$ 70 00
$ 83 00
$13800
$18000
$41300
$ 55 00
c
InstanatIon, AlteratIon or RelocatIOn
200 Amps or less
201 Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above
D
$ 55 00
$ 76 00
$11000
J
New Alterat~mll:iteIiSl<liirPeJ:.Panel -Of" "^ "~ , [,
One C]fCU~fOIlOW rules adopte'l 'J I , _ r) $ 48 00' ,~"
EachAddJ 8&i~&l!fi'iii&~Wrthr 1hosnl''',a:,..o:fOlth
ServIce or Jdm~1-0010thrn", h "$~,tH92-C3-<
90 You may obt~ln ol;~ o! 'hp, ,"~,.
E FM;i~ei",.:p'!!!!,lf}S~W.fc~~3~' D1Jifillclt".r.;Ii)'~El~ll'r~t;li',;ti~~ 1
.... m. ... '~Gr-~@JFegoli'!:1lmry4rql.llm1:11I/()rt-
Pump or lITIgation Center IS 1,aOO'332'23i'!j, 00
Slgn/Oullme LIghtmg $ 55 00
Lmllted EnergylResldentlal $ 28 00
Lmllted Energy/Commerc131 $ 50 00
MlOlmum Electnc Permit Inspection Fee IS $50 00 + Surcharges
~~~ w" ",',,,,~,,"b_ ,"f '''~~~''''''''~--'~~=E:illit%'.[0~cii'$j0;li'i'i1\-..''''Cjja
'1 ' ~ ';:;--::;ii l'lff,' rtt@?-i0h""%' ~"';J
4 ~L~VB,{fJ!Af ~gf:N}OJ{!f+;~~j3;,r::jf;~'f'Ck3~qf/J!!!/j_m~~~~'&JL/),. (}O
t2A"/. State Surcharge I 3 ,:La
10% AdmunstralIve Fee -, ,. ~
5% Technology Fee 'j'": S-o
TOTAL n1 yo
Shared Dnve(T )/BUlldmg FormslElectncal PermIt ApplicatIOn 7-07 doc
v
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER C0M2008,00767
NAME OR COMPANY lUck & Candy H""ler
LOCA TJON 3197 U Street
TAX LOT NUMBER 1702302102900
DEVELOPMENT TYPE Smg}e FamIly ResIdence
NEW DWELLING UNITS 0 BUILDING SIZE (SF 1620 LOT SIZE (SF)
1 STORM DRAINAGE
8276
r--'
1m
t.L1
I~
- I 8
'I ~
1t.L1
1-<
'1 ;
"
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S F x I COST PER S F CHARGE
I 43200 i $0346 1 = I $14948 I
RUNOFF ROlITED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S Fix 1 COST PER S Fix I DISCOUNT RATE I I DISCOUNT
J 0 00 I .1 $0 346 I I 50% I = 1 $0 00
ITEM 1 TOTAL - STORM DRAINAGE SDC
2 SANTTARY SEWER - r:JTY
A REIMBURSEMENT COST
I NUMBER OF DFU's I
I 3 I
B IMPROVEMENT COST
I NUMBER OF DFU's I
I 3
x
COST PER DFU
$26 83
COST PER DFU
$20 40
x
$14948
ITEM 2 TOTAL, CITY SANITARY SEWER SDC = I
1 TRANSPORTATION
A REIMBURSEMENT COST
I ADTTRlPRATE I x
I - 957 I
B IMPROVEMENT COST
I ADTTRlPRATE I
I 957 I
$141 71
I NUMBER OF UNITS I x I
I 0 I I
COST PER TRIP
2043
x INEW [RIP FACTORI
100 - I
I NUMBER OF UNITS I x I
I 0 I I
= ,
x
ITEM 3 TOTAL - TRANSPORTA nON SDC
COST PER TRIP
$9010
$000
x I NEW TRIP FACTORI
100 - I
4 SANTTARY SEWER - MWMf;
A REIMBURSEMENT COST
INUMBER OF FEU's 1 x
I 0 I
ICOST PER FEU
I $95 35
B IMPROVEMENT COST
INUMBER OF FEU's I x
I 0 I
ICOST PER FEU
I $990 39
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
= , $000
~, $29119
I~ CHARGE
I $1456
SUBTOTAL (ADD ITEMS 1,2,3, & 4)
, ADMINlSTRATlVE FEE
'SUBTOTAL x I ADM FEE RATE
I $291 19 I 5%
TOTAL SANITARY ADMINISTRATION FEE
TOTAL TRANSPORTATION ADMINISTRATION FEE
$14948
$80 50
$6121
- $000
$000
=
$000
Kaye Wilson
6/4/2008
PREPARED BY
DATE
TOTAL SDC CHARGES
11070
11091
I
11092
,[
I
1093
. 1094
1054
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUN ALENT = DRAINAGE FIXTURE UNITS
(NOTE FOR REMODELS CALCULATE ONLY TIlE NET ADDmONAL FIXTIJRES)
NO OF FIXTURES
DRAINAGE
FIXTURE
UNITS
o
o
o
o
o
o
o
o
o
o
3
o
o
o
o
- 0
o
o
o
o
UNIT
FIXTURE TYPE NEW OLD EQUIVALENT
IBATHTUB 2 2 3 =
I DRINKING FOUNTAIN 0 0 1 =
IFLOORDRAIN 0 0 3 =
!INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC 0 0 3 =
IINTERCEPTORS FOR SAND I AUTO WASH I ETC 0 0 6 =
[LAUNDRY TUB 0 0 2 =
ICLOTHESWASHERI MOP SINK 1 1 3 =
ICLOTHESWASHER - 3 OR MORE (fA) 0 0 6 =
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 =
I RECEPTOR FOR REFRIG I WATER STATION IETC 0 0 1 =
IRECEPTOR FOR COM SINK I DISHWASHER I ETC 1 0 3 =
I SHOWER. SINGLE STALL 0 0 2 =
ISHOWER. GANG ~ER OF HEADSi. 0 0 2 =
I SINK COMMERCIALIRESIDENTIAL KITCHEN 1 1 3 =
ISINK COMMERCIAL BAR 0 0 2 =
ISINK WASHBASINIDOUBLELAVATORY 0 0 2 =
SINK SINGLE LA V ATORYIRESIDENTIAL BAR 2 2 1 =
URINAL. STALL I WALL 0 0 5 =
TOILET, PUBLIC INSTALLATION 0 0 6 =
ITOILET, PRIVATE INSTALLATION 2 2 3 =
MISCELLANEOUS DFU TYPE NUMBER OF EDD'S
20 =
TOTAL DRAINAGE FIXTURE UNITS
o
3
"EDU (EQwvalent Dwellml!: Urnt) IS a dJ.sc~ eqwvalent to a smgle family d,:ellmg urn! (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
'i YEAR~REDIT RATE/$I,OOO
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2
\ BEFORE t 979 $529 (Enter I for Yes, 2 for No)
1979 $529 IS IMPROVEMENT ELGIBLE FOR ANNEX CREDIT? 2
I 1980 $519 (Enter I for Yes, 2 for No)
I 1981 $512 BASE YEAR 1998
- ,
1982 $498_"
1983 $480 CREDIT FOR LAND (IF APPLICABLE)
1984 $4 63 VALUE I 1000 CREDIT RATE
1985 $440 $000 x $048 ~ , $000
1986 $407 -;
1987 , $367 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
1988 $322 VALUE 11000 CREDIT RATE
1989 $273 $000 x $048 ~ I 0
1990 $225
1991 -$180'
1992 $159 TOTAL MWMC CREDIT = $000
1993 $145'
1994 $125; ,-
1995 $109 ,
, ,,-_ $092 - -
1996 ,
1997 $072-' , ~
,
1998 ' ',,' $048
$028 ,
]999 "
2000 , $009
2001 ' . $005
~
"
I
~
l
I
I
\
I
225 FIfth Street
SprIngfield, Oregon 97477
541-726-3759 Phone
~j~Q~;~
~. -
CIty of Sprmgfield OffiCIal ReceIpt
Development ServIces Department
Public Works DepartmeDt
Job/Journal Number
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008,00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
COM2008-00767
Payments
Type of Payment
Cred1tCard
cRecemtl
RECEIPT #
2200800000000001019
Date' 07/03/2008
DescnptlOn
FoundatIOn Perrmt
Manufactured Home Placement
Manuf Home State Issuance
FIre SF Fee - ReSIdential
Storm Drainage ImpervIous Area
Samtary Sewer - Re,mbursement
SanItary Sewer - Improvement
SDC SanItary/Storm Admin
Manufactured Home Conn - Plmb
Manufactured Home Serv,ce
Manufactured Home Feeder
Plan RevIew Minor - Planning
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% AdministratIve Fee
Pa,d By
WILLIAM B HARRISON
Item Total
Check Number AuthOrization
Received By Batch Number Number How Received
nJm 113063 In Person
Payment Total
Page I of I
9 34 59AM
Amount Due
9290
16000
3000
2160
14948
8050
6121
1456
5000
5500
5500
11600
2645
4955
4345
$1,00570
Amount PaId
$1,00570
$1,00570
7/3/2008