The URL can be used to link to this page

Home My WebLink AboutPermit Building 2004-3-22 Status Issued ,,{.. 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00244 ISSUED: 03/22/2004 APPLIED: 03/03/2004 EXPIRES: 09/22/2004 VALUE: $ 22,000,00 ~ SITE ADDRESS: 1320 MENLO LP ASSESSOR'S PARCEL NO.: 1703273303300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential PROJECT DESCRIPTlON: Garage Conversion Owner: PRUSZ CHAD W & KELLY R Address: 1320 MENLO LOOP SPRINGFIELD OR 97477 'I" Contractor Type General Electrical Mechanical Plumbing I CONTRACTOR INFORMATION I License Contractor OWNER OWNER OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Expiration Date Phone BUILDING INFORMA TlON I R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: VN ATTENTION:Ore~',~E~~Y(NRORMATlON .' SETBACKSfollOW rules adopted by tile wagon VlrlllY I Frontyard Setback: \Iotilication Center, Those WWl;.wS~nt w~. Side 1 Setback: In OAR 952-o01-~~~ throuM~~~Mi\Ri: Side 2 Setback: 0090, You may'obtaln'copill~~:t ih' ter (Note" t~tele.ll~_o..~e Rearyard Setback: calling e cen. "11 N&\~~: Solar Setbacks: number for the Oregon Uti I I ...._~'M:.. 1_Mn.~~2-2344). I PUBLIC IMPROVEMENTS I .,. Street Improvements: Storm Sewer Available: Special Instruction: Notes: REQUIRED PARKING Total: Handicapped: Compact: '0 Sidewalk Type: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD, DownspoutslDrains: Paee 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 'i: Description Tvpe of Construction Estimate Estimate Fee Description Plan Review Residential -Mechanical Issnance Fee- + 10% Administrative Fee + 7% State Snrcharge Add, Alter, Extend Circ Ea Add Building Permit Fixture Minimum! Adjustment Mechanical Minimum/Adjustment Plumbing Perm ServlFdr 200 amps or less Vent Fan . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00244 ISSUED: 03/22/2004 APPLIED: 03/03/2004 EXPIRES: 09/22/2004 VALUE: $ 22,000.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 22,000.00 Value Date Calculated Total Value of Project $22,000.00 $22,000.00 03/03/2004 Fpp<, P"illJ Amount Paid Date Paid Receipt Number $130.65 $10.00 $37,20 $26.04 $18.00 $201.00 $42,00 $39.00 $3.00 $63.00 $6,00 3/3/04 3/22/04 3/22/04 3/22/04 3/22/04 3/22/04 3/22/04 3/22/04 3/22/04 3/22/04 3/22/04 1200400000000000271 1200400000000000360 1200400000000000360 1200400000000000360 1200400000000000360 1200400000000000360 1200400000000000360 1200400000000000360 1200400000000000360 1200400000000000360 1200400000000000360 Total Amount Paid $575.89 I Plan Reviews I Initial Review 03/04/2004 03/04/2004 APP LLH Plannin!! Review 03/04/2004 03/11/2004 APP TAJ no Planning review required; no expansion on the lot. Public Works Review 03/04/2004 03/09/2004 APP VRJ No PW's permits or SDC fees. Structural Review 03/04/2004 03/15/2004 APP RJB To Request an inspection call the 24 hour recording at 726-3769. All inspection 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, ~n~nprtin.ILI 8 Post and Beam: Prior to Door insnlation or decking. 6 Floor Insulation: Prior to decking. 7 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 12 Wall Insulation: Prior to cover. 4 Ceiling Insulation: Prior to cover. 5 Drywall: Prior to taping. 1 Final Building: After all required inspections have been requested and approved and the building is complete. 11 UnderOoor Plumbing: Prior to insulation or decking. Pa!!e 2 of3 . . CITY OF ~r.Kl1'~GFIELD Building/Combination Permit Status Issued PERMIT NO: COM2004-00244 ISSUED: 03/2212004 APPLIED: 03/0312004 EXPIRES: 09/22/2004 VALUE: $ 22,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 10 Sanitary Sewer Line: Prior to filling trench and including required testing. 13 Water Line: Prior to filling trench and including required testing, 3 Final Plumbing: When all plumbing work is complete, 9 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 14 Rough Electric: Prior to Cover ,15 Electric Service: Approval required prior to utility company energizing service. 16 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 tbe Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any 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 permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction, ~~~/~/~_ g-?Z-Q~ Owner or Contractors Signature Date Pal!e 3 00 225 Fifth Street If)' Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 Payments: Type of Payment Cash Change Job/Journal Number COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 COM2004-00244 Payments: Type of Payment Cash Change Paid By CHAD PRUSZ CHAD PRUSZ Paid By CHAD PRUSZ CHAD PRUSZ w;o. Iiiiit.i '-"----..~- "'.'." ','. " " \ ,., l 1 '.-. ' . '.~ , , , i _ ' c_h. .'-,,"".... _.~_._...- . Receipt #: 1200400000000000360 Description Building Permit Fixture Minimum! Adjustment Plumbing Vent Fan Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Received By djb djb Description Building Permit Fixture Minimum!Adjustment Plumbing Vent Fan Minimum! Adjustment Mechanical -Mechanical Issuance F ee- Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Received By djb djb Check Number Batch Number Authorization Number Check Number Batch Number Authorization Number City-tif Springfield Official Receipt. Development Services Department Public Works Department', Date: 03/22/2004 2:I7:53PM Amount Paid Item Total: 201.00 42.00 3.00 6.00 39.00 10.00 63.00 18.00 26.04 37.20 $445.24 . How Received Amount Paid In Person In Person Payment Total: $450.00 ($4.76) $445.24 Amount Paid Item Total: 201.00 42.00 3.00 6.00 39.00 10.00 63.00 18.00 26.04 37.20 $445,24 . How Received In Person In Person Payment Total: Amount Paid $450.00 ($4.76) $445.24 ." 'Or. ,',,'" , CIT:Y; 0F-S- .1UNGEIEDD -&JRFGON- .;,' _',C :,:' r~:...:11,t,~' :~~'''I ~-.~,~":~v~~' ;:~,,".;~,' ,.~.' ',1'#",:.,-, >. ".' .";;"t~~~".~-q:\ -i~~ :;-.;rl;,;;;'~"};r 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ' ' II 'n9 bmitted has Ihe fa OWl ELECTRICAL PERMIT APPLICATION A 0 ThefOIlOWlngdProie~~~~:qUUlre specific land use " lonlng and oes City Job Number COWl 'Z.C) 0 l; - oOZI{'1 Date '7 'Z v 0 L{ 'Appro~al. L.'\;>{2.... L 'fj;bCAiji/N:o,"'RiNsTA'~i':f\lroNkl~:'tJii:}~ 3, ~(fOMPLETE":F,EE'Sc~1'lJuLElmLOi?$:'~=?~Q ~~'b~~ ~."""",~"-',,,""- ., ,. '-'>-=7"~'~: I' , . .."" '-~""""''''''''''''''"''-''Dale'''''''' ",. - ~~:i~"'cR.:a'"''"''''''' I '3 2-0. vYJ t:7VL D ~~:,;,_~?~","~~\J!.~or~~~;.~~~~~~~~;-:~~_.~-~:~r~~;'~~-$;':7r"<~~ LEGAL DESCRIPTION A. ~.~~~~~;;:~.\ngleo.r:t:1l'A\!!~.~~~[!tp.f~' ~'~~~~~fu.~i!;,~~ /705 z7'J3 () 350<::::' Service Included JOB DESCRIPTION ZoOA""~g,V'L j b c...\t2-GA-fs PermitS are non.transf{rable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, P".CONT1i4C, "tiJiiTifstltlJAtiO.,&'l(;NfJ!"1 2. L.:!~~~.-," <....klI>(;V.-"i-f> .....:~-/;<:--~_~...,":"..-.. 1000 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 f~lf'j:' '''ZW'_:::'i~;:''--~~r''''}Z~ ';-:t~~"',~ .~~'7:"~~r~~::"I:'p,,<:.i:~' ,-.;.1~.;;':':"'::::-;1 B. ~~~~c~st<!n&e~.~~~~'~.~~~~!9~I~.t~~,~?,:A;l!,e~~~Hg.~~&\~~~~~~J Electrical Contractor 200 Amps or less J $ 63.00 b"3> /() 201 Amps to 400 Amps $ 75.00 Address 40 I Amps to 600 Amps $125.00 1..../ 60 I Amps to 1000 Amps $163.00 ", City Phone~ Over 1000 AmpsNolls $375.00 ) , Reconnect Only $ 50,00 Supervisor License Number _ \J. f\/ c. !~T.e,iilp'ijfiry~Ser.,i~-~.o'r:F~edef;:~-..-;;../tC;f..z{i~-'~:A;h~~i~~~,t~ ::0~,~?1 t - L.'.I;.t'<!";kK,..;''''' -,..- . '.-,",.,. ,-/..1:;;O~~,~...."a-A~,~u",.~"".c__"''''"'......:}f1l~'I'~,,~~ Expiration Date . J -l\ Installation, Alteration or Relocation '. V 200 Amps or less $ 50.00 Constr. Contr. Number 201 Amps to 400 Amps $ 69.00 , WOlleE: ALL EXPIRE IF THE 'W~i\\t1Ps to 600 Amps $100.00 Expiration Date 1\ lit D~IlMIT SH ?ERMIT le~O Amps or 1000 Volls see "B" above. ml:~\~EO UNOER 1t11~ ",:o~~cl:"'~~'''TI'''T" ,', ............'.,~,:-'--,~r'l..'7 ,,,. "'",.,. ",v" 0, Signature ofSupervisineo~ME'tit'EO OR IS ABANOONEO... .r<'ranch'CI~lts:" ~ ;'" .' ::: . h:" "'i!.' ':1~1;,:; .;"";,;,.."'.,,ff '~"I AN'i 180 OAY PERIOO, New Alteration or Extension Per Panel One Circuit _ 1 . ,. ',.\... .'.'A~~( ...c.-<..'r Each Additional CirCUIt or with tJ --~. Service or Feeder Permit ."", $~3:00 1- -- ., .... L E. K~~~li.ai~~;~t~~Bj~~iJi~etit;~i~i~.~ed1.~~iriihI~;s.t.~llt~~ ' Phone o~I.~~S .~q2.R PU.5~fiW~~\~~ you ~o $ 50.00 AT-tENrlON:Ore{;>lb'IDU1!t ffir~tihty , $ 50.00 OWNER INST ALLA nON f \I W rules adoPtElSlJriYellWfifil5~illetttDrtl $ 25.00 o 0 . Ceoler. ;rhoS~ r ..a.c" "n The installation is being made on propertyJ~a\\~ L6'WrB&.'JffllYlQa'UWCl'lllaf $ 45,00 is not intended for sale, lease or rent. In OAR 952'00~~WP<RJpill5cqfe\li\!ltril!~~c\ion Fee is $45,00 + Surcharges 0090, '(ou may r-.W' gte-t1')e.teleP,hO.. e -"-"~ n-'~' c..ntet.i ~ \ . ..;,c::D~1"r1l ~, ~\: \~, t ' c: I Qers i a e: callin'gthec........~ Rif~~~>rp'. ~'.::-',,::,:-"'.'::"~ p number for the,0re2~;;:~~2.234il)~ ',.' L-_,~.,':-'-l,.... G 7 o?Jllolctl- ~.,.'.-" 7% State Surcharge 5 I . 'it10 10% Administrative Fee v i lj 77 ,'. . ,', Owners Name C \\'i:>-D w ,'\)\<. \)S:c 13'20 'N\~ LO LOOP, Address City 5P~\1'l6~lao Inspection Request: 726-3769 $ 43.00 TOTAL Shared Drive(T:)!Building Fonns/Electrical Permit Application I-03.doc "l I). . . \. .: " " " " . .. . Construction Contractors .Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Weh Address: www.ccb.state.or.us .. , ' ' Pennit#: ('~.7A-"O ZL1~ Address:_/~~ hj&Jt L~, Issued by: 'J) r:r Date::;h V'O '-( Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be.jssued, This statement is requiredfor residential building, electrical, mechanical and ,plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701,01(J(7), need not submit this statement. This statement will be filed with the permit. . ' Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: ~L ~ 2. I own, reside in, or will reside in the completed structure, I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure milst be licensed with the Construction Contractors Board, OR % 3B. I will be my own general contractor, If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board, Ifl change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor, I hereby certify that the above information is correct and that I have read and do nnderstand the Information Notice~Rope, _ ners out Construction Responsibilities on the reverse side of this form. \.. \to b~J{O/04- (Sign ~ermit applicant) , (bate) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 03/11103 FIRST ADDITION TO MENLO PARK ,,,.. :J:I "" A,rF/DAVI7 SECTION 27, TOWNSHIP 17 SOUTH, RANGE 3 WEST, W,M~ LANE COUNTY, OREGON . $T.~. a, ~'-J C__ry II' ~__ '0.' r. J_~.../C.~ '6,.,. ,,...., 4_y 11__ _c:lW".,.. .IJI,.,.,. r_. ..tI_...... ,..".,,_... "'''''4-''. .-y 6&~_n_, A"_ r NA_ .: " . ~ L",_ -- "........r*",..,.,-I_,.,_ ~~..--.~...,n.r7'loW.,,-r_............G'" .I.". '4" "'..tl': r.._ ...,,. ~.. 6111....... "", $-,_, _ ~ ~__. nw, ""'"~g'':-A.-*"..... "~""""..I .s,,.S".~.W4~~....... 6~.tI~'",-wZt'r.~r'1r'i..7~;;,''''''' 1');w M ""___< tI'C.~.sUGCy....AY'~' s.. ., C"''''''"Y S"~..-...y C.-<tNWA' 41-""". S 4""J'a'", /,.,.....,. ~ ___ :Sil~'1 Z. FI.r '''tf." 7'1t'I Kw: ~""4' Q,#' 7W. b6-.rc..,,..,il.4. ~~.C~ 'N r".:J. ~,..... Jov.N.,'''' LAN& ~ O<<~/. ~ ''"- ~.. ~_3CII6I'D...,.. :JllMaCtV 13 NI nw, ~ p"" .~. _"<: "'SY.~ ....."'T....,.........._,..4IC~ @.>t..L.LJt." ""'Y~_.... ~O ...l!A-:- ..",.. ,q/., . . "';!,?t~r~...~._.n ) , ... ' ~ /' .......,,"'..' ~.,...C'Iw.6.~_".", -'-,..' S..SIJ{'w.,.._. ~B ~. ~ ~.'~" I ~~~~~'~~:,;.\..' ; ~y::'~>;:,:~; ,. ( .' ," ",' :!,,,Jlo II "~,f~' $~."...r.._' ,-.... .. "'--c-ou.., E_I-.wr '. . . - .p ~~ < . 1If1..,~y""" N..7fI" -1',-- --..~ __..__ i i '" t ... l 5 ......... .~1._. .'~1<~' :~3 ~ ~ a;l" '\!J' ... ... ...--!!.:...... " , ..' .. ..' c__....... ...... )0..... ,." if, ), ~ i ..... . '-.. - -...'- -,..-- '""Oi:- ... ----;.,-- 1'.". 'i G)i . . _ __l"lt:... s.......y.., ..' . ! 4 ! . i s ._Pl.:..._., _".:..._ __..,. -"'-. ~:!:;)AOV:'!,~~S. ("-..."..,~C ~~. C'-W-'l .. , C."/?IfL~~-:- ;~/~ ;1 ~t6)A ~~~~ 'f/7~6~//A~Y' -r / ,. ,".,..#1/t"~ &.._~ " ~IIIA~.., ~/TJ.~~_ S'C.'TA'9' -....... ...... ," ,.....J/ -"-..._~ " p " I ~- a .. , .. ... I. . . . .." -.!L-...-!!.:- _~_ ..' !l , -''''1 " I __ .1.,. '--<- ". '" ". .. .' " I '1 i " .0;. _1'" . ,,'- '- . i . " i " _1lt.:.... _ r.'. __.....:.. I.~I... . FI LED 1l_0"CUa_.. MAY7-J959 HMIII' L CHASl ~ "';~.-?r JC4. " ~. DE$CR/PT/ON IIlltl""""""". ""r.. A.o",,. _CNI. -#1 ,.~ S(J.I#'~.-rt1' ~_ ""'. N""''''',.r ""___4." ~_r"s....",.... 11<#1_.s,.,. ........-.....r c.._c jfJ".,. I....'......... ~."..,......A...,. "--'.....ntt,. S De"",,..., '''1',. <#,_ 'A_ now ""_'*'....,. ~ .,,,,,. '6"'CT8.~...,_... A~.e.......~ 1tI-'1~.T/r~ ~~"""~AI'''':" ..~:, .'C_S-"6. ~, ,,-~. $I-Q'",..."" a"",",..,. ~.n..73IIow"""'-'7..... "..,"""",,,,,.~ II"", 7<V~ "s/-..'4.6"W u..#<O ......,~~. .,..,..,~C S .....,.....1 /.3'AZ.I'<<.r', 7.lo'.....,c. N/.t1I"I r,,-n'-'.r: "",I1IN. AI.,.....,.~.w ...,.. U '11Y..7lf....... s...."~6.-w ~.,.T," 'lIT. 7W.Mt&. "'U.v~w /"'4 """~.AwMC6 .3Z,..":,,.'W /..... ,.....". 7)l6Mtr. N TI-,,',.-w 46." ,..,.. ""."""'. ~'"" 4'.2""". 7N.~. ."'./4',...w ~6.,.~ ~3~"h-,. ...." """~ T.....ION. $46-.7~Z."w Z........IT. ~SM"'_:.,.,-... 61.,~ "n TN._. $1I-~.'_"t1IIlI'.<I/,...,., ~~"U'. 4~._ ,...;.~ 'AN/II(/ICI $...~...... Z41'. tH,..F1____N........ <I,.. N ,.,, po,. PIIf. T.Ir... ,.,..",.,. ..."..,.,-. ~ e..,,~ M.. M'.', A..~,., L._. c~~ .*.....,. ~ . ~ DID'c~r'DN ... K...""tIh. """~N""""'....... J. r,l~_......_~ _. r_(yD.L"_......~ ..IIML.ItV~ C...""" ""..r __ ..... PJ/III D. ,....11 ..~ ~.. 0$.,..,.. AI'",.. ~ NI.._ ""'M:.'.'.~ ""'IF' _. ~AV,.. "".. $I.,.. n/l. s"iI.,r,.,. ...,. '''''''''''''.. "'.. N....,., ~.,,., .."". 1\IloCor .... N....,. O'#lC"'. ~ ".,.. ,.",~. A..tI'l. ',$,.c.~. .1# ~ 'N 7)1" JIk.,. ) (1ff(l~~. -'--;. A. / "" ,1!1t:"'N"W.t. 4'D'i"MGNT #7'_. .,0......,).... C._ry ., ~~ ~ ~.. """".A h.._..uy ANI';". ".,. A...". """"'. J. e'4.,,.~....,J&....... ......"'".y O. ,,""'C' ~ ",-".",,_ """'-W"". ...,. 7'J4I'Y "'~.",..""c....,.. "". 6.r,. _ ,. 6c nv.,. ...~..."..ltlr.._ llel... -rY -/ ..v.r14';'-*-'~ ae..... . _ . '-Jc. ~...~) .os- <"----- I""M.. 'n '<, IU. ;e.'.~ " ~.~!,t\. ~""I'''I.'''I:~ ":j: , ., . ..-.'I".III,.jj" '.." .ASJ .~ ~." ~;;.o<" 03 2-' 3 L,---, 17 JvlAXJMUM r- .;.' \ :.4 t " < ;;;;;;~."'.'. ,_r,. ~;~. ';: ~ ' .. k: ' ., . ~ ." 'fi ~ ~I &. ~- () t. ~ ....... " ~ t ' ..... ~I . , I.LJ '".17 Lu ,It 3200 't' l.. J...... .to: ." 4 . ~ _, 1.11,;;;), r\.~ n, n.M, ThiS map is made solety for 1he ,"" " ..' of assrtstlnlln locating the premises herein described. Western Pioneer Title of Lane County assumes no lIabHlty for variations. 11 any, In dimensions .00 locations ascer. tainab}e by actual survey. :OUNT Y ... 100' 11."./' See Map 1703 27 3 2 :::.~:-- -r~'~~ ".,.. -- ... ._..~~~ ",...., u., ~. ~ . : ~ a~ 2 Ji 4 ,h ,.,.,.5 "f' " [ I) \ , . \ \ \ . \ )o~ . , ~':: -..:,=:: \~ '''' '\~ '''' ...C' _~.I... .....1 2800 II 2700 . 2900 J . .. "" 1/16 Cor.~_ Lct!J1 . . " ~--: . . . , . . , ~ /po fY1vJLa .......4':P . -. - - ~ 3900 ,~ .... It . , , II" .., ~ . . C'~ . ~ , ~.~~ ~c;.I~'- ~ 'm: n-' ~,. of." -3 7~!"O", .. '1 q i' 7">00 ~' '}J' (, .~ ,. ." .'0 Q , · City of springfi~ Report 10: SPRA103 Voucher 10: 00079140 Handling Code: RE Prusz,Chad 1320 Menlo Loop Springfield, OR 97477 Voucher * DescriDtion Account Fund OrQ SubClass Building Refund 215004 821 425602 100 426102 100 Comments: Express Check Project cancelled by owner/Refund Ok'd by Lisa Hopper 80% Bldg,Plm, Mech, & Electrical/100% State surcharge Com2004-00244/1320 Menlo Loop Accounting Date: June 30, 2004 Vendor Number: 0000011402 Invoice Date: March 22, 2004 Invoice # : COM2004-00244 Approver : Puent,David Operator: WILS5940 Gross Amount: 323,64 BY Proi/Grant Amount 2004 26.04 2004 232.80 2004 64.80