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Home My WebLink AboutPermit Building 2008-7-8 Status Issued CITY OF 1')rKll...GFIELD' Building/Combination Permit PERMIT NO: COM2008-00543 ISSUED: 07/08/2008 APPLIED' 04/18/2008 EXPIRES 01/08/2009 VALUE: $ 190,617.00 225 Fifth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 778 W M ST ASSESSOR'S PARCEL NO 1703274301902 SPRINGFIETVPE OF WORK Smgle Famtly ReSidence TVPE OF USE New Resldenltal PROJECT DESCRIPTION Smgle Famtly ReSidence Owner MARK SEBRING Address 2890 FEDERAL PLACE EUGENE OR 97404 Phone Number 541-521-9240 I CONTRACTOR,INFORMATlON I Contractor Type General Mechamcal Contractor Hlcense MARK SEBRING ~~J ,rpq')n law requires YO~lfl~5 OWNER ~ '101 ~:::l by the/?~e_~~~~ ;~rth "..r ~" I ~B'iIILri~(;;liNll;U"RMJt'FI('JN'~ In ,fI ~~,2-" I j'f '''Ill'' W,! I obtain copies 0 " .~ . oUd0. You may \iIlpf (!tQ.Jtlt~the telephone I calling the tChen .u~,""<rn\:Jsl~li~\!flcallon 2400 nuE.l.er for e~..,.. u "44) "0' Center ulJ',tOOlI-MtlIt2" 'Forced AIr Cas VB Water Type Gas Range Type Gas Energy Path Path I SprInkled BUlldmg No ExpIratIOn Date 07/2712008 Phone 541-998-261 I # of Umts PrImary Occupancy Group Secondary Occupancy Group PrImary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms 3 Lot SIZe 6,200 Sq Ft 1st Floor 873 Sq Ft 2nd Floor 832 Sq Ft Basement Sq Ft GaragelCarport 4 I 4 Sq Ft Other Occupant Load I DEVELOPl\-,,,,,,, 1l,'J'vKMATION I Frontyard Setback Side I Setback Side 2 Setback Rearyard Setback Soldr Setback. 9500 500 540 800 000 REQUIRED PARKING Overlay Dlst Total 2 # Street Trees Rqd 0 Hdndlcapped Paved DrIve Rqd Ves O?~ompact % of "'elf-overage ?\?E \f8WlE'N 01 t>!O!\t:~lII\\i S,",fl,\.\. ~u,~ PE?WlIi_IS N I PUBLI~',~~Ii6~~Wt~K1{~ ~B;>'NDONr.\J I ~- IIrN~ IL' ~r"1 Fullv Improved CONI I ~o;>.~ PERIOD. Sidewalk Type Ves ;>.N'i 18 DownspoutslDrams Curbside 5' To Storm Sewer Street Improvements Storm Sewer Avallahle Spec131 Instruclton Notes Stormwdter routed to eXlstmg area dram on property The area dram IS served by a 10" pipe that drams to the 12" publIc storm maIO Owner proposmg pervIOus pavers for drIveway Page I of 5 _....,...~ 1aIL, Status Issued 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme DeScflotlOn Tvpe of ConstructIOn Dwelhngs Garage V Wood Frame Garage Fee DescrIPtIOn Plan ReView Resldent131 -Mech Iss 2+ Apphances- + 10% AdmlUlstraltve Fee + 12% State Surcharge + 5% Technology Fee 2 Baths One or Two FamIly Addressmg ASSignment BoIler/Comp Up To 100,000 btu Bmldmg Permit Dryer Vent Fire SF Fee - Resldent..1 Furnace - up to 100,000 btu Gas Outlets 1-4 Plan ReView Major - Plannmg SaUltary Sewer - 1st 50 Feet Samtary Sewer - Improvement Samtary Sewer - Reimbursement Samtary Sewer Each AddU 100' SDC MWMC AdmmlstratlOn SDC MWMC Improvement SDC MWMC Reimbursement SDC SaUltarylStorm Admm SDC Transpo Improvement SDC Transpo Reimbursement SDC Transportalton Admm Storm Dralfiage ImpervIOUS Area Storm Sewer - 1st 50 Feet Storm Sewer Each AddtllOO' Temp Power 200 amps or less Vent Fdn W dter Lme - 1st 50 Feet Water Lme - Each Addtl 100' Wlllamalane Smgle FamIly Totdl Amount Paid I Valuatron Descrmtwn I $ Per Sq Ft or multlpher $10500 $28 00 Amount PaId $61660 $40 00 $16486 $185 II $87 38 $280 00 $35 00 $1400 $948 62 $700 $10595 $1400 $500 $205 00 $50 00 $469 29 $617 17 $1600 $10 00 $990 39 $95 35 $138 10 $862 25 $19548 $71 59 $953 81 $50 00 $1600 $55 00 $2100 $50 00 $1600 $2,513 00 $9,898 95 Square Footage or Bid Amount 1,70500 41400 Total Value of Project F'pp< p~ Date Paid 4/18/08 7/8108 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8108 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 7/8/08 Page 2 of5 CITY OF SPRINul'lJ!.LlJ. Building/Combination Permit PERMIT NO ISSUED' APPLIED: EXPIRES: VALUE: CO M2008-00543 07/08/2008 04/18/2008 01/08/2009 $ 190,617.00 Value Date Calculated $179,02500 $11,592 00 $190,61700 04/18/2008 04/18/2008 Receipt Number 2200800000000000481 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 2200800000000001035 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO. COM2008-00543 ISSUED: 07/08/2008 APPLIED. 04/18/2008 EXPIRES: 0110812009 VALUE $ 190,617.00 Status Iss u ed 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LIOe Plannmg RevlCw Plan Reviews I WE 04/18/2008 ImtIal Review 04/18/2008 0411812008 APP LLH Pubhc Works Review 04/18/2008 04/22/2008 APP TSS Structural Review 04/1812008 06/1312008 APP EAM Planmng Review 06124/2008 APP TAJ 06/2412008 On hold for setback Issue Left message for Mark SebrlOg on 6/5/08 Stormwater routed to eXlstmg area drdlO on property The area dram I' served by a 10" pipe that drams to the 12" pubhc storm maIO Owner propos 109 pervIOus pavers for drIveway A rear setback of 8' was approved under a ModificatIOn of PrOVISIOns SUB2004-0001I Mark Sebrmg has agreed to shlflthe bUlldmg forward I' to meet that setback The solar setback IS preempted by this ModificatIOn of PrOVISIOns A survey IS reqUired because of mlDlmum Side and rear setbacks No street tree IS reqUired because of the eXlstlOg 48" SequOta IS to be preserved Place orange constructIOn fencmg to the drIphne of the tree and keep all construclton actIvltIy out of this area First 18' ot the drIveway IS be paved If W M IS a curb and gutter street To Request an inspectIOn call the 24 hour recordmg at 726-3769. All mspectIons requested before 7.00 a.m. Will be made the same workmg day, mspectlOns requested after 7'00 a m. wIll be made the followmg work day. , R'polllrpl'f ~nsnectlo~ EroslOn/Gradmg InspectIOn PrIor to ground disturbance and after erosIOn measures are mstalled Ufer ElectrIcal Ground Install ground rod at footmg and call tor mspeclton 10 conJunclton With footmg andlor foundatIOn InSpectIOn Fmal Gas When all gas work IS complete FIOal MechaUlcal When all mechaUlcdl work IS complete Page 3 of5 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2008-00543 ISSUED 07/0812008 APPLIED: 04/18/2008 EXPIRES 0110812009 VALUE: $ 190,617.00 225 Fifth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Temporary ElectrIc Approval requIred prIor to Ulthty Company energIZIng pole Ufor ElectrIcal Ground Install ground rod at footmg and call for mspectlOn m conJuclton with footmg andlor foundatIOn mspechon Rough ElectrIc PrIor to Cover ElectrIc Service Approval reqUired prIor to ulthty company energlzmg service Fmal ElectrIc When all electrIcal work IS complete Footmg After trenches are excavated Foundalton After forms are erected but prIor to concrete placement Slab To be made aftel all mslab bUlldmg service eqUipment, condUit plpmg and other eqUipment Items are m place but prIOr to concrete Post and Beam PrIor to l100r msulatlOn or deckmg Floor InsulatIOn PrIOI to deckmg Shear Wall Nadmg Before coverIng sheathmg With fimsh materIals Frammg InspectIOn PrIor to cover and after all rough 10 mspectlOns have been approved Wall In;ulalton PrIOr to cover Cedmg Insuldlton PrIor to cover LathlPlaster To be made after alllathmg and gypsum board, mterIor and exterIor are m pldce, but prIor to plasterIng Fmal BUlldmg After all reqUired mspectlOns hdve heen requested and approved and the buddmg IS complete Underground Plumbmg PrIor to filhng the trench and mcludmg reqUired testmg PerImeter Foundalton Drams After gravel and filter cloth IS lI!Stalled but prIor to backfill Undertloor Plumbmg Prior to msulatlOn 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 filhng trench and mcludmg reqUired testmg Storm Sewer Lme PrIor to filhng trench Fmal Plumbmg When all plumbmg work IS complete Underl100r Gas After hne IS mstalled and reqUired testmg and capped Ifnot attached to an apphance Underl100r Mechamcal PrIOr to msulatlOn or deckmg and mcludmg reqUired testmg Underl100r 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 aud capped If not attached to an apphance Rough Mechamcal PrIor to Cover Page 4 of 5 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00543 ISSUED: 07/08/2008 APPLIED: 04/18/2008 EXPIRES 01/08/2009 VALUE $190,61700 225 Fifth SlI eet, 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 cerllfy that all mformatlOn hereon IS true and correct, and I further certJfy that any and all work performed shall be done 10 accordance with the OrdlOdnces of the City of SprIngfield and the Laws of the State of Oregon pertalOmg to the work descrIbed herem, and that NO OCCUPANCV wtll be made of any structure without permissIOn of the CommuDlty Services DIvIsIOn, BUlldmg Safety I further cerllfy 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 IOspectlOns 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 remdm on the site at all times dUring constructIOn '\i~~\\ (\ \\ <Sl ~5..r-,..~~ -,/7/Q~ Owner or Contrdctors Signature --- -""'"\ ~"'-- \ \ \ ---===. Date Page 5 of 5 2~ Willamalane t-w Park & Recreation Dlstnct Job. No. ~M~ SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME \JJ\tl ~\)riM PHONE rnl-C\f2..~ ADDRESS %C\D 'tErienlcITY~lotf\P ,STATE~ZIP Lf14-D4 LOCATION OF P~Pl.O~D BUll~~:G~E \ \ ('t\ ~_ _ A-' Street Address \ U ~ \ J"'\' <.S'\\ tx:A Plat Name '{\ \ ~ Tax Lot Number \ 'I 03~~4o Ol qCJJ... 1. DEVELOPMENT TYPE (Check appropnate dwelhng(s) Dwellmg type definitions are on the back ) A Slnale-FamllY Detached NO OF UNITS \ B Slnale-Famllv Attached NO OF UNITS C Multl-Famllv ADartment NO OF UNITS D Slnale Room OccuDancv NO OF UNITS E Accessorv Dwelllna Unit NO OF UNITS WILLAMALANE SDC X $2,513 per Unit = X $2,726 per unit = X $2,323 per unit = X $1,162 per unit = X $1,257 per Unit = $r051~.o J $ $ $ $ $ ~o(3.W $f7 $~5(3 ptJ L ~I Zc::o? Date 2. SDC CREDIT (If apphcable) SDC payer must fumlsh proof of Willamalane Credrt approval) 3. TOTAL WILLAMALANE NET SDC ASSESSED 1Yi SJ~ ~- "Cred') Development "S'ervl City of Springfield 5 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 ELECTRICAL PE~J.T APPLICATION City Job Number ~-~ Date I LOCATION OF INSTALLATION: -r15 ~f~~- ~ LEGAL DESCRIPTION 11oC:flJ4~ (){qDQ" ~rTI?rnili% ~ Permits are non-transferable and expue If lvork IS Dot started wlthm 180 days of Issuance or J 'work IS Suspe ded for 180 days 3 COMPLETEFEESCHEDULEBEWW A New Resldent..l- Single or Multi-Fall!t1y l'er dwelbng urut Service Included ] 000 sq ft or less Each additIOnal 500 sq ft or portIOn thereof Each Manufact'd Home or Modular Dwelhng Service or Feeder $11700 $ 2100 $55 00 2 ~; ~~ B ServICes or Feeders - TnstaUatl~!l' AlteratlOnr~r RelocatJon , , ExplratIon1Date I / Signature of SupervIsmg ElectriCian / / New AlteratIOn or ExtenSIOn Per Panel One CirCUit t-- NOTICE' Each AddItional CIrCUIt or WIth OwnelSName \MJI\L <;t hr\C\qTHIS PERMrf'~IfAEtF~fRE1Y!_!H(WO~K , $ ~o~, Address Q.. ~C\() @em.o...V\.1U I HORI~Q Wll!Q.66H(g~wtJSdlQ.i mc1uded)-EachInstaIlatlOn ~()~J'l to\nl ;;~~ENCEQ1)R IS ABANDUNED FOR City nit' -' Phone U~, ~80 DA\'iftRIOO,/latlOn $ 55 00 Slgn/Outhne Llghtmg $ 55 00 Limited EnergylResldentlal $ 28 00 Limited Energy/Commerc13l $ 50 00 Mlmmum ElectrIC PerImt Inspecnon Fee IS $50 00 + Surcharges 4 SUBT?TA!:OFABOVE __,,, r\S.dJ 12% State Surcharge - ~.lJ:() 10% Admmlstratlve Fee ,S .:x;J 5% Technology Fee ()) ')~ l oct hS Address _ _ T 200 Amps or less , '-' I 10N f'J,<; l. TOllow rules ad2lr~J<fi1I"'\Ii)~'You 10 N(\tlf'~o'lon Cenil!lt ~ tlJllillllrAglm Utility In OAR 952-001-t9IJl ~~~Et6~~~t forth 0090 You may oeHffi118B~,oo~1l!,52-00t. calling the cen~o(llJfiffi15mll the rules by nUmbe~enOrtth~ Or~flon UtilIty ~::C~~~ ! er"" 1~~ces'1fl:"ll'tederS CIty Supervisor License Numbe / ExpiratIOn Date ~ Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps , j Constr Contr Number Over 600 Amps or 1000 Volts see,~B" above D 1 Branch Clrc~lIts ~ OWNER INSTALLATION The mslallatlOn IS bemg made on property 1 own which IS not mtended for sale, lease or rent ,%wn:: ~n'r L~~ l~ Inspecnon Request 726-3769 TOTAL Shared Dnve(T )fBUlldmg Forms/Electncal Permit ApplicatIOn 1-08 doc $ 70 00 $ 83 00 $13800 $180 00 $413 00 $ 55 00 \ 5t:J.(j) $ 55 00 $ 76 00 $11000 $ 48 00 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBeR COM2008-00543 NAME OR COMPANY Mark Sebnng LOCArJON 778 West M Street TAX LOT NUMBER 1703274301902 DEVELOPMENT TYPE SINGLE FAMILY RESIDENCE NEW DWeLLING UNITS I BUILDING SIZE (SF 0 LOT SIZE (Sf) I STORM DRAINAGE o I 'r/] " W '0 I' ~ I~ 'r/] 16 gJ DIRECT RUNOFf TO CI I Y STORM SYSTeM I IMPERVIOUS S F x I cos r PER S F CHARm, I 1 193800 1 $0146 I = ! $67059 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPeRVIOUS S Fix I COST PER S F I x I DISCOUNT RATE I r 1 1637 00 I 1 $0 346 1.1 50% ~ I ITEM 1 TOTAL - STORM DRAINAGE SDC $95381 , 2 SANITARY SEWER - CITY A REIMBURSEMENT COST 1 NUMBCR Of DFU's I x I 23 I DISCOUNT $283 22 $953 81 1070 COST PER DFU $26 83 $617 17 11091 B IMPROVEMENT COST I NUMBER Of DFU's I I 23 I x COST PER DFU $20 40 $469 29 11092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC ~ I $1,08646 3 TRANSPORTATION A REIMBURSEMENT COST I ADT TRIP RATE I x I 957 I B IMPROVEMENT COST I ADT TRIP RATE I x 1 957 1 I NUMBER OF UNlTS I x I I I \ I COST PER 1 RJP 2043 x INEWTRJP FACTORI I 100 I $19548 I I 1093 I NUMBER OF UNITS 1_ x I I I COST PER TRJP $90 10 $1,057 73 x INew TRIP FACTORI I 100 I $862 25 1094 ITEM 3 TOTAL - TRANSPORTATION SDC = , _I 4 SANITARY SEWER - MWMf: A REIMBURSEMEN I COST INUMBeR OF FEU's I x ICOST PER FEU 11054 I I I I $95 35 = $95 35 B IMPROVEMENT COST I INUMBER OF FEU's I x ICOST PFR FCU I I I ! $990 39 $990 39 I 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $000 11054 MWMC ADMINISTRATIVE FEE $1000 1 1056 I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~ I $1,09574 - SUBTOTAL (ADD ITEMS 1,2,3. & 4) ~ , $4.19374 ) ADMINISTRA TIVF FEE I SUBTOTAL x ADM FEE RATE I~ CHARGE I $419374 5% I $209 69 TOTAL SANITARY ADMINISTRATION FEE 13810 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE $71 S9 J 1078 Todd Singleton 4/22/2008 TOTAL SDC CHARGES =1 $4,403 43 PREPARLD BY DATE DRAINAGEFlXTURE UNIT (DFU) CALCULATION TABLE __ ____. - ______.u,_ NUMBER OF NEW FIXTURE~ x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO OF FIXTURES DRAINAGE FIXTURE UNITS 6 o o o o o 3 o o o 3 o o 3 o o 2 o o 6 UNIT FIXTURE TYPE NEW OLD EQUIVALENT rBATHTUB 2 0 I 3 : [DRJNKING FOUN rAIN 0 0 1 : IFLOOR DRAIN 0 0 3 : IINTERCEPTORS FOR GREASE 1 OIL 1 SOLIDS 1 ETC 0 0 3 : I INTERCEPTORS FOR SAND 1 AUTO W ASH 1 ETC 0 0 6 : [LAUNDRY TUB 0 0 2 : ICLOTHESW ASHER 1 MOP SINK 1 0 3 : ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 : IMOBlLE HOME PARK TRAP (I PER TRAILER) 0 0 12 : /RECEPTOR FOR REFRlG 1 WATER STATION 1 ETC 0 0 1 : I RECEPTOR FOR COM SINK 1 DISHWASHER 1 ETC 1 0 3 : ISHOWER, SINGLE STALL 0 0 2 : I SHOWER, GANG ~ER OF HEADS) 0 0 2 : ISINK COMMERCIAURESlDENTIAL KITCHEN 1 0 3 : SINK COMMERCIAL BAR 0 0 2 : [SINK WASH BASIN/DOUBLe LAVATORY 0 0 2 : SINK SINGLE LA V A TORY IRESlDENTIAL BAR 2 0 1 : URINAL, STALL I WALL 0 0 5 : TOILET PUBLIC INSTALLAflON 0 0 6 : ITOLLE1. PRIVATE INSTALLATION 2 0 3 : MISCeLLANEOUS DFU TYPE NUMBER or EDU'S 20 : TOTAL DRAlNAGE FIXTURE UNITS o 23 ~u (Equivalent Dwelhng Umt) IS a discharge equIvalent to a smgle farrulv dwellmg urut (20 Dms) set at 167 Jiallons per day MWMC CREDIT CALCULATION TABLE BASED ON COUNTV ASSESSED VALUE YEAR CREDIT RATE/$I,OOO ANNEXED ASSESSED VALUE IS LAND ELGffiLE FOR ANNEXATION CREDIT? 2 BEFORE 1979 $529 (Enter I for Yes, 2 for No) 1979 $529 IS IMPROVEMENT EI GIBLE FOR ANNeX CREDIT? 2 1980 $519 (Enter I for Yes 2 for No) \981 $512 BASE YEAR 1979 1982 $4 98 1983 $4 80 CREDIT FOR LAND (IF APPLICABLE) 1984 $463 VALUE 11000 CREDIT RATE 1985 $440 $000 x $529 ~ I $000 1986 $4 07 1987 $367 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA nON) 1988 $322 VALUE 11000 CREDIT RATE 1989 $273 $000 x $529 ~ , 0 1990 $225 1991 $180 1992 $159 TOTAL MWMC CREDIT : $000 1993 $145 1994 $125 1995 $109 1996 $092 1997 $072 1998 $048 I 1999 $028 II 2000 $009 2001 $005 I -II I I I J II I I 225 FIfth Street Spnngfield, Oregon 97477 541-726-3759 Phone ~~: ~~-' , CIty of Sprmgfield OffiCIal ReceIpt Development ServIces Department PublIc Works Department Job/Journal Number COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 COM2008-00543 Payments Type of Payment Check cRece:mtl RECEIPT #: Date. 07/08/2008 2200800000000001035 DescriptIOn Addressing AssIgnment Wdlamalane Single FamIly Temp Power 200 amps or less Fire SF Fce - Resldenllal Storm Dramage ImpervIous Area Samtary Sewer - ReImbursement Samtary Sewer - Improvement SDC Transpo ReImbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC AdministratIOn SDC Samtary/Storm Admin SDC TransportatIOn Admlfi Plan RevIew Major - Planning Budding Permit 2 Baths One or Two Family Samtary Sewer - 1st 50 Feet SanItary Sewer Each Addtl 100' Water Line - 1st 50 Feet Water Line - Each Addtl 100' Storm Sewer - 1st 50 Feet Storm Sewer Each Addt! 100' Furnace - up to 100,000 btu BOller/Comp Up To 100,000 btu Vent Fan Dryer Vent Gas Outlets 1-4 -Mech lss 2+ Apphances- + 5% Technology Fee + 12% State Surcharge + 10% AdministratIve Fee PaId By SEBRING CONSTRUCTION Item Total Check Number AuthOrization Received By Batch Number Number How Received dJb 3266 In Person Payment Total Page 1 of I 1028 15AM Amount Due 3500 2,51300 5500 10595 95381 61717 469 29 19548 862 25 9535 99039 10 00 13810 7159 205 00 948 62 280 00 5000 1600 5000 1600 5000 1600 1400 1400 2100 700 500 4000 8738 185 II 16486 $9,282 35 Amount Paid $9,28235 $9,282 35 7/812008