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Home My WebLink AboutPermit Building 2008-8-5 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01008 ISSUED. 08/0512008 APPLIED 07/0812008 EXPIRES: 02/05/2009 VALUE: $ 202,39000 225 FIfth Sh eet, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LIne SITE ADDRESS 3153 DOUGLAS DR ASSESSOR'S PARCEL NO 1802062109600 SPRINGFlETYPE OF WORK Single FamIly ResIdence TYPE OF USE New ResIdentIal PROJECT DESCRIPTION Single famIly reSIdence Owner DJS INVE!'.TMENTS LLC Address 2860 MARTINIQUE AVE EUGENE OR 97408 -\€f-' .~ 0=' I CONTRACTOR INFORMATION' Contractor Type General Electncal Mechamcal Plumbing Contractor DJS INVESTMENTS LLC BOB FISHER ELECTRIC INC MARS HALLS INC JAMMAL INC License 131714 96275 25790 158262 ExpiratIon Date 10/09/2008 01/25/2010 12/23/2009 01/12/2010 Phone 541-485-2655 541-689.7973 541-747.7445 541-484-7440 # of Umts Pnmary Occupancy Group Seconddry Occupaucy Group Pnmary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms ~ you to follow rules adopted by the Oregon Utility Notiflcat1bIlt@Ml!l'! Those rules are set forth R2 In OAR 9!1!JObq<G~lJ\tfflmgh OAR 9ill.Qll}1. U 0090. YO\)'l!llI'fdfltatn cople9IO*tMIIU~by VB call1ng'thlJ'lrelttm: (Note: the telepl<<me 1I~!ttIiI'~gon Utility Notlfioatlon 3 ~ 1&l0000ll-332-2344).Path 5 Spnnkled BUIlding No Lot SIze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Carport Sq Ft Other Occupant LOdd 1,719 475 I DEVELOPMENT INFORMATION' Frontydrd Setback SIde I Setbdck Side 2 Setback Rearyard Setback Soldr Setbdcks 1550 500 600 11 30 1310 Overlay Dlst # Street Trees Rqd Paved Dnve Rqd 0/0 of Lot Coverage I Yes 2800 REQUIRED PARKING Totdl 2 Hdndlcapped Compact Street Improvements Storm Sewer AvaIlable SpecIal InstructIOn I PUBLIC IMPROVEMENTS I I~U 1I1.t: Sidewalk Type Fully Improved THIS PERMIT SHALL EXl?JR~JF.J:H~.w.QRJ< Yes AUTHORIZED UNDER THrS'~~fmrl'SrFJ6t COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. CurbSIde 5' Curb and Gutter Notes storm water to curb Pa2e I of 4 .-4PRIHqFJIU.,O "', ;',I;i!!J!JI!J!; ,!II Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO. COM2008-01008 ISSUED: 08/05/2008 APPLIED: 07/08/2008 EXPIRES. 02/05/2009 VALUE: $ 202,390.00 225 FIfth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LIne I. Valuation OescrlOtlOn I A C - ReSlden DwellInes Garaee Type of ConstructIOn AC - Resldenhal V Wood Frame Garage $ Per Sq Ft or multlpher $500 $ 105 00 $28 00 Square Footage or BId Amouut 1,71900 1,71900 47500 Value Date Calculated DescriptIOn Total Value of ProJect $8,595 00 $180,495 00 $13,30000 $202,390 00 07/08/2008 07/08/2008 07/08/2008 ~ Fee Description Amount PaId Date PaId ReceIpt Number -Mech Iss 2+ Apphances- $40 00 8/5/08 1200800000000000842 + 100/0 AdmlRlstratIve Fee $16663 8/5/08 1200800000000000842 + 12% State Surcharge $186 79 8/5/08 1200800000000000842 + 5% Technology Fee $97 18 8/5/08 1200800000000000842 2 Bath. One or Two FamIly $280 00 8/5/08 1200800000000000842 AddreSSIng AssIgnment $35 00 8/5/08 1200800000000000842 B0I1er/Comp Up To 100,000 btu $1400 8/5/08 1200800000000000842 BUIldIng PermIt $991 58 8/5/08 1200800000000000842 CUI bcut PermIt $88 00 8/5/08 1200800000000000842 FIre SF Fee - Resldenhal $10970 8/5/08 1200800000000000842 Fireplace (LIsted) $1700 8/5/08 1200800000000000842 Furnace - up to 100,000 btu $1400 8/5/08 1200800000000000842 Gas Outlets 1-4 $500 8/5/08 1200800000000000842 Gas Outlets 4+ $200 8/5/08 1200800000000000842 Plan Review Major - Pldnnmg $211 00 8/5/08 1200800000000000842 Plan RevIew Resldenhal $644 53 8/5/08 1200800000000000842 ResIdence Wmng 1000 Sq Ft $11700 8/5/08 1200800000000000842 ResIdence Wmng Ea Addt1 500 $63 00 8/5/08 1200800000000000842 Samtary Sewer - Improvement $483 84 8/5/08 1200800000000000842 Samtary Sewer - Reimbursement $636 30 8/5/08 1200800000000000842 SDC MWMC AdmInlsh atlOn $10 00 8/5/08 1200800000000000842 SDC MWMC Improvement $1,00917 8/5/08 1200800000000000842 SDC MWMC Relmbunement $97 90 8/5/08 1200800000000000842 SDC Samtary/Storm Admm $14853 8/5/08 1200800000000000842 SDC Transpo Improvement $888 98 8/5/08 1200800000000000842 SDC Transpo ReImbursement $20 I 54 8/5/08 1200800000000000842 SDC TransportatIOn AdmIn $72.92 8/5/08 1200800000000000842 SIdewalk PermIt $88 00 8/5/08 1200800000000000842 Storm DraInage ImpervIOus Area $1,101 28 8/5108 1200800000000000842 Storm Sewer Each Addtll 00' $32 00 8/5/08 1200800000000000842 Vent Fan $21 00 8/5/08 1200800000000000842 Wlllamalane SIngle Fanllly $2,513 00 8/5/08 1200800000000000842 Total Amount PaId $10,38687 Paee 2 of4 CITY OF SPRINGFIELD. Building/Combination Permit Status Issued PERMIT NO' COM2008-01008 ISSUED. 08/0512008 APPLIED' 07/08/2008 EXPIRES: 02/05/2009 VALUE: $ 202,390.00 225 FIfth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon LIne Plan RevIews I PlannlOl! RevIew PublIc Works RevIew 07/08/2008 07/08/2008 07/08/2008 07/08/2008 APP APP TAJ LKW Storm waler to curb & gutlerS To Request an inspectIOn call the 24 hour recordmg at 726-3769 All mspecttons requested betore 7'00 a.m. WIll be made the same workmg day, mspections requested after 7:00 a m. will be made the following work day. I RplllllrPrIJnsnectlons I Ufer ElectrIcal Ground' Install gronnd rod at footlOg and call for lOspectlOn 10 conJunctIOn WIth footIng and/or foundation mspectlOn FootlOg After trenches are excav dted. FounddtlOn Alter forms arc erected but prIOr to concrete placement Post and Beam PrIor to floor msuldtIon or deckmg Floor InsulatIOn PrIor to deckIng Shear Wall NaIlIng Before coverIng sheathlOg WIth fimsh materIals FramlOg InspectIon PrIOr to cover and after all rough 10 lOspectlOns have been approved Wall InsuldtIon PrIOr to cover Celhng InsulatIOn Prior to cover Drywall PrIor to taplOg Fmal BuIldmg After all reqUired IDspectIons have been requested and approved and the buIldmg IS complete UnderfloOl PlumbIng PrIOr to InsulatIOn or decklOg Underfloor Dram PrIor to cover or placement of concrete Rough PlumblOg PrIor to cover and lOcludlOg reqUIred testlOg Water Lme PrIor to fillIng trench and mcludIng reqUIred testmg Samtary Sewer LIne PrIOI to fillIng trench and mcludIng reqUIred testIng Storm Sewer Lme PrIOr to fillIng trench Fmal Plumbmg When all plumbmg work IS complete Underfloor Mechamcal PnOl to msuldtlOn or decklOg and mcludlOg reqUIred testlOg Underfloor Gas Alter lIne IS mstalled and reqUIred testmg and cdpped If not atlached to dn applIance Rough Gas Alter lIne IS mstalled and reqUIred testIng and capped If not dtlaehed to an applIance CdS Service After hne IS mstalled and hne has been connected to d mmlmum of one apphance mcludmg nqmred testlOg Presure test done at thIS pomt Rough Mechamcal Pnor to Cover Pal!e 3 of 4 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO. COM2008-01008 ISSUED: 08/05/2008 APPLIED: 07/08/2008 EXPIRES: 02/05/2009 VALUE. $ 202,39000 225 FIfth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme Fmal Gas When all gdS work IS complete FInal Mechanical When all mechanical work IS complete Rough ElectrIc PrIor to Cover Electric Service Approval reqUired prior to utilIty company energlzmg service Fmal ElectrIc When all electrIcal work IS complete Curbcut - Stdndard Aftcr forms are erected but prIOr to placement of concrete SIdewalk - CurbSIde After forms are erected but prIOr to placement of concrete By sIgnature, I state and agree, that I have carefully exammed the completed applIcatIon and do hereby certIfy that all mformdtlon hereon IS true dnd correct, and I further certIfy that any aud all work performed shall be done In accordance WIth the Ordmances of the CIty of SprIngfield and the Laws of the State of Oregon pertaInIng to the work descrIbed herem, and that NO OCCUPANCY WIll be made of any structure WIthout permISSIOn of the Community ServIces DIVISIOn, BuIldmg Safety I further certIfy that only contractors and employees who arc m complIance WIth ORS 701 005 wIll be used on thIs project I further agree to ensure that all reqUIred mspectlOns arc requested at the proper tIme. that each address IS readable from the street, thdt the permIt card IS located at the front of the property, and the approved set of plans WIll remdm on the sIte at dll times ,"6 10. nstructJon ---- a -- S-(J~ --... Date Paee 4 of 4 I D (2.- I k\ ~ I.D '09> ~~ ZON INITIALS DATE SOURCE 225 FWI II SlllliET . SPRIJ\GFIELD, OR 97477 . PII (541)726-3753 . FAX (541)726-3689 ELECTRICAL PERMIT APPLICATION CIty Job Number C"M~ B - DIC>Of? 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Phone jdi. '7' 7C, 73 Over 1000 AmpsNolts r ~ b ?5 '1 {po L( [.. Reconnect Only SupervIsor LIcense Number '7 Cf?C:;-.5 _ATTENT/Of4. 01!f(JHnofla~ ServIccs or Fceders IUflOW rules adopted b a threqurres you to Notification CeI>>at;llll>>~ ~lfR.IlfIJ,l~)(,catlOn :r, :;hr. 952-001z00!{htJo... are set forth 0090 You may~t I ~.f4m!!JhQAR 952-001. C~'long the cen r~~ r:.:~"ules by number for th# reg, ~ ()jMy ~hone J ()- ) D - D <1 Center Qv~rlillr\l).33l!P2811ff.Illf~\I9see "B~ above D Ilraneh Clrelllts I LOCATION OF INS1ALIATION. 3/5> 'bo,""-,,, fA"- \ a..... LEGAL DESCRJPT10N /'/302- C>b 2-\ o 7600 JOB DESCRIPTION HOV--l> ~ iN ; -ILe Permits are non-transferable and expire .fwork IS not started wIthIn 180 days of Issuance or If work IS Suspended for 180 days 2 CONTRACTOR INSTALLATION ONLY II ElectrIcal Contractor PL)f) n 7ft e-v- n 1.--1y211':.- Address /'f,!J (.(.11/<4 <.., b,}"u'J 7JV-G ,- I CIty t:i fJ'1 -"--:.- EXpiration Date /(')-\ D- (0 Constr Contr Number 9;, 'z 7.., ExpIration Date SIgnature of SupervIsIng ElectrIcIan -.~dr ;p+V'k b"\ <; :::i:...... ~ ~ 1Mb'\. -f S Address Z8 bO W'fAiLtuJ I G.Ue CIty . ~~ Phone ,,7 -")550 Owners Name OWNER INSTALLATION The mstallatlOn IS bemg made on property 1 own whIch IS not mtended for sale, lease or rent Owners SIgnature InspectIOn Request 726-3769 Date 3 COMPLE1E FEE SCHEDULE BELOW A New ResldentIal- SlIIgle or Mulh-Famlly per dwelling umt ServIce Included I 1 000 sq ft or less $11700 /17 Each addItIonal 500 sq ft or 3 bJ portIOn thereof $ 2100 Each Manufact'd Home or Modular DwellIng ServIce or $55 00 Feeder ServIces or Feeders - Installahon, AlteratIOns or RelocatIOn $ 70 00 $ 83 00 $13800 $180 00 $413 00 $ 55 00 $ 55 00 $ 76 00 $110 00 New AlteratIOn or ExtenSIOn Per Panel One CIfCUIt Each AddItIOnal CIrcUIt or wIth Service or F ceder Permit $ 48 00 $ 400 E MIscellaneous (Servlce/reeder not IOcluded) -Each InstallatIOn f lITIgatIOn f To''' 'Mn~'(55 00 ~~t\\ ~\Rt , ~\1 Ie:. t.lQ1' 55 00 rn~~iIi\i\S PE~~D cnlL $ 28 00 Aqt'ht\ t~~~t\~OO '- . - $ 50 00 MIO~ oct5~~spechon Fcc IS $50 00 + Surcharges 4 ~BTOTALOFABOVE /8D 12% State Surcharge C{ b.::> 10% AdrnmlstralIve Fee lIS 5% Technology Fee , ZZ8hO TOTAL Shared Dnve(T )/BuJidmg FormslElcctncal Permit ApphcatlOn 1-08 doc CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAl OR JOB NUMBER COM2008-01008 NAME OR COMPANY DJS Investments LOCATION 3153 Douglas lAX LOT NUMBER 1802062109600 DEVELOPMENT TYPE SInelc FamIly ResIdence NEW DWELLING UNITS I BUILDING SIZE (SF 2194 LOT SILE (SF) I S roRM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM liMPER VIOUS S F x I COST PER S F CHARGE 308700 I $0357 J = I $1,10128 RUNOFF ROUTED TO DR YWELL DESIGNED AND CONSTRUCTED TO CI I Y S r ANDARDS I IMPERVIOUS S F I x I COST PER S F I x I DISCOUNT RATE I I I 000 $0357 I 50% I I ITEM 1 TOTAL - STORM DRAINAGE SDC $1,10128 2 SANITARY SEWER - CITY A REIMBURSEMENT COST I NUMBER OF DFU's I x I 23 I DISCOUNT $000 COST PER DFU $27 67 B IMPROVEMEN r COS I I NUMBER OF DFU's I x I 23 I COST PER DFU $2104 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =1 $1,120 ]4 3 TRANSPORTAl ION A REIMBURSEMENT COST I ADTTRJP RAIL I x I NUMBER OF UNI1 S I x I COST PER TRIP x I NEW TRIP F ACTORI I 957 I 1 2106 I 100 I B IMPROVEMENT COST I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTOR I I 957 I I I I $92 89 I 100 I ITEM 3 TOTAL- TRANSPORTATION SDC = I $],09052 7841 $],10128 $636 30 $483 84 V] w a o u ~ w _, l- V] G ;;j .I t070 11091 I 11092 I ! $20] 54 I t093 I $888 98 I t094 I 4 SANITARY seWER - MWMC A REIMBURSEMENT COST INUMBER OF FEU's I x I I I ICOST PER FEU I $97 90 B IMPROVEMJ:NT COST INUMBER OF FEU's I x ICOST PER FEU I I I $1,00917 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I SUBTOTAL (ADD ITEMS ].2,3, & 4) ~ / $1,11707 = $97 90 I t054 t055 1054 1056 $4,4290] ~ 5 ADMINISTRATIVE FJ:E I SUBTOTAL x I ADM fEE RATE I~ I $4,42901 I 5% I TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE CHARGE $221 45 = $1.009 ]7 $000 $10 00 7/8/2008 TOTAL SDC CHARGES t079 1078 Kaye Wilson PREPARED BY DATE 14853 $72 92 =, $4,650 46 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBFR OF Nr. W FIXTURES x UNIT EQUIY ALENT = DRAINAGF FIXTURE UNITS (NOn. FOR REMODELS CALClJLA TE ONLY THE NET ADDITIONAL FIXTIJRES) NO OF FIXTUR~,S DRAJNAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBAIHTUB 1 0 3 = 3 IDRJNKlNG FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 IINTERCI-.P roRS FOR GREASE 1 OlL 1 SOLIDS 1 ETC 0 0 3 = 0 INTI-.RCEPTORS ~OR SAND 1 AUTO WASH 1 rrc 0 0 6 = 0 !LAUNDRY TUB 0 0 2 = 0 iCLOTHESWASHER 1 MOP SINK 1 0 3 = 3 ICI OTHESWASH[R - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK fRAP (I PER TRAJLER) 0 0 12 = 0 IRFCEPTOR FOR REFRlG 1 WATER STATION IETC 0 0 1 = 0 IRECEPl OR FOR COM SINK 1 DISHW ASH[R 1 ETC 1 0 3 = 3 I SHOWER, SINGLE STALL 1 0 2 = 2 IS\lOWER, GANG (NUMBER OF \lEADS) 0 0 2 = 0 ISINK COMMERCiALlRl-.SlDENTIAL KiTCHFN 1 0 3 = 3 ISINK COMMERCIAL BAR 0 0 2 = 0 ISINK WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 ISINK SINGLE LAVATORY!RbSlD[NTIAL BAR 1 0 1 = 1 IURINAL, STALL 1 WALL 0 0 5 0 ITOll El, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLAIION 2 0 3 = 6 MISCELLANEOUS DFU IYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS L 23 :.EDU (Eqwvalent Dwellmj!; Unit) IS a dIscharge equivalent to a..~~l!I~, [amllY d.welllng unIt (20 DRJ's set at 167 lions ,da MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE [- YEAR CREDITRATE/$I~ ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXA nON CREDIT" 2 I BEFORE 1979 $529 (Enter I for Yes, 2 for No) I 1979 $529 IS IMPROVFMENT ELGIBLE FOR ANNEX CRI DlT" 2 I 1980 $519 (Enter 1 for Yes 2 for No) I 1981 $512 BASE YEAR 1979 I 1982 $498 I 1983 $480 CREDIT FOR LAND (IF APPLICABLE) I 1984 $463 VALUE 11000 CREDIT RATE I 1985 $440 $000 x $529 ~ , $000 1986 $407 I 1987 $367 CREDIT FOR IMPROVEMENT (IF AFTER ANNI-.XA nON) I 1988 $322 VALUE 11000 CREDIT RATE I 1989 $273 $000 x $529 ~ I 0 Ii 1990 $225 1991 $180 1992 $159 TOTAL MWMC CREDIT = $000 I 1993 $145 I 1994 $125 I 1995 $109 I 1996 $092 I 1997 $072 I 1998 $048 I 1999 $028 I 2000 $009 I 2001 $005 ~~ Willamalane (,.'\i Park & Recreation Dlstnct Job No CtJ/#2LXJ~-n/~tJ!J SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2008 NAME 7)cJS INJJc.<1TJ11tNT.{ PHONE [;;7-S55(') ADDRESS 2.2>.60~TY .Gz/tt:dUt! STATE~ZIP 9 7-:mS LOCATION OF PROPOSED BUILDING SITE Street Address "<../53 DZJU.4t.+s TJi;? Plat Name Tax Lot Number /9(JZ/J6/J (') '76t:JV 1. DEVELOPMENT TYPE (Check appropnate dwellIng(s) DwellIng type definitions are on the back ) A Smale-Family Detached NO OF UNITS B Smale-Family Attached NO OF UNITS C Multi-Family Aoartment NO OF UNITS D Smale Room Occuoancy NO OF UNITS E Accessorv Dwelhna Unit NO OF UNITS WILLAMALANE SDC X $2,513 per unit = '$ 25/7 X $2,726 per Unit = $ X $2,323 per Unit = $ X $1.162 per Unit = $ X $1,257 per unit = $ $ 2. SDC CREDIT (If applIcable) SDC payer must furnish proof of Willamalane Credrt approval) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (If SDC reduced for Credit) Q/] Development Services Department City of Spnngfield $ ZJ3IY ~5/CA:r Date 5 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-0 1 008 COM2008-0 1 008 COM2008-0 I 008 COM2008-0 1 008 COM2008-0 I 008 COM2008-0 I 008 COM2008-0 I 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 I 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 I 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 1 008 COM2008-0 I 008 COM2008-0 I 008 COM2008-0 1008 COM2008-0 I 008 COM2008-0 1 008 COM2008-0 1008 COM2008-0] 008 Payments Type of Payment CredltCard Check cRecemtl RECEIPT #: ~~ CIty of Sprmgfield OffiCIal ReceIpt Development ServIces Department PublIc Works Department 1200800000000000842 Date. 08/05/2008 DescriptIOn Plan RevIew Major - Planmng Plan RevJew ResIdentIal BUIldIng Penmt Addressmg Assignment WIllamalane SIngle FamIly 2 Baths One or Two FamIly Storm Sewer Each Addtl 100' Furnace - up to 100,000 btu BOIler/Comp Up To 100,000 btu Vent Fan Gas Outlets 1-4 Gas Outlets 4+ FJreplace (LlSted) -Mech Iss 2+ Apphances- FIre SF Fee - ResIdentIal Curbcut Permit Sidewalk PermIt Storm DraInage ImpervIOus Area Samtary Sewer - ReImbursement Samtary Sewer - Improvement SDC Transpo ReImbursement SDC Transpo IInprovement SDC MWMC Retmbursement SDC MWMC Improvement SDC MWMC AdmInlStratlOn SDC Samtdry/Storm AdmIn SDC Transportation AdmIn ReSIdence WIrIng 1000 Sq Ft ReSIdence WIrIng Ea Addtl 500 + 5% Technology Fee + 12% State Surcharge + 10% AdmInIstrative Fee Paid By DALE KAST DJS INVESTMENTS LLC Item Total Check Number AuthorizatIOn Received By Batch Number Number How Received dJb 09268C In Person dJb 5938 In Person Payment Total Page 1 of2 114426AM Amount Due 21100 644 53 99158 3500 2,51300 28000 3200 1400 1400 2100 500 200 17 00 4000 10970 8800 8800 1,10128 63630 483 84 20154 888 98 9790 1,00917 10 00 14853 72 92 117 00 6300 9718 18679 16663 $1O,3~6 ~7 Amount Paid $9,500 00 $886 87 $ 10,386 87 8/5/2008 RECEIPT # 1200800000000000842 Date 08/05/2008 11 44 26AM Job/Journal Number DeSCriptIOn Amount Due COM2008-0 1 008 Plan ReView Major - PlannIng 21100 COM2008-0 1 008 Plan RevJew ResldentJal 644 53 COM2008-0 1 008 BUlldIng Permit 99158 COM2008-0 I 008 AddresslOg ASSignment 3500 COM2008-0 1 008 WIlIamalane SIngle Family 2,51300 COM2008-0 1 008 2 Baths One or Two FamIly 280 00 COM2008-0 I 008 Storm Sewer Each Addt) 100' 3200 COM2008-0 I 008 Furnace - up to 100,000 btu 1400 COM2008-0 1008 BOller/Comp Up To 100,000 btu 1400 COM2008-0 1 008 Vent Fan 2100 COM2008-0 1 008 Gas Outlets 1-4 500 COM2008-0 1 008 Gas Outlets 4+ 200 COM2008-0 I 008 Fireplace (Listed) 1700 COM2008-0 1 008 -Mech Iss 2+ Apphances- 4000 COM2008-01008 FIre SF Fee - ResIdentIal 10970 COM2008-0 1 008 Curbcut PermIt 8800 COM2008-0 1 008 Sidewalk Permit 8800 COM2008-0 1 008 Storm DraInage ImpervIOus Area 1,10128 COM2008-0 1 008 SanItary Sewer - Reimbursement 636 30 COM2008-0 1 008 SanItary Sewer - Improvement 483 84 COM2008-0 1008 SDC Transpo Reimbursement 20154 COM2008-0 1 008 SDC Transpo Improvement 888 98 COM2008-0 1 008 SDC MWMC Reimbursement 9790 COM2008-0 1 008 SDC MWMC Improvement 1,00917 COM2008-0 1 008 SDC MWMC AdmInistratIOn 1000 COM2008-01008 SDC SanItary/Storm AdmIn 14853 COM2008-0 1 008 SDC TransportatIOn AdmIn 72 92 COM2008-0 1 008 ReSIdence WIrIng 1000 Sq Ft 11700 COM2008-0 I 008 ReSIdence WIrIng Ea Addtl 500 6300 COM2008-0 I 008 + 5% Technology Fee 9718 COM2008-0 I 008 + 12% State Surcharge 18679 COM2008-0 1 008 + 10% AdmInIstrative Fee 16663 Item Total $10,38687 Payments Check Number AuthOrization Type of Pa) ment PaId By Received By Batch Number Number How Received Amount Paid CredltCard DALE KAST dJb 09268C In Person $9,50000 Check DJS INVESTMEN rs LLC dJb 5938 In Person $886 87 Payment Total $10,38687 cRcc..elOtl Page 2 of2 8/5/2008