HomeMy WebLinkAboutPermit Building 2009-3-11
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008"00976
ISSUED: 03/11/2009
APPLIED: 07/02/2008
EXPIRES: 09/11/2009
VALUE: $ 134,288.00
I """
-i!.J'!~~Im;1)
," f-". ,
Status
Issued
225 Fifth Street, Springfield, OR
541'726-3753 Pbone
541-726.3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1360 S 2ND ST
ASSESSOR'S PARCEL NO.: 1803022401600
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single family residence - DO NOT ISSUE WITHOUT SEPTIC APPROVAL
Owner: YOGI CHARLENE
Address: 1360 S 2ND ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Architect
Contractor License
NAGAO PACIFIC ARCHITECTURAL p,c.
BUILDt,~G ~~FORMA!~?~ I
# of Units:
Primary Occnpancy Group:
Secoudary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure 20:00
Type of Heat: orced Air Electric
Water Type: Electric
Range Type: Electric
Energy Patb: Patb 1
Sprinkled Building: nla
I
R-3
U
VB
2
I DEVELOPMENT INFORMATION I
Froutyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 ,of Lot Coverage:
Urban Fringe'
,54.00
5.00
43.00
33.00
17:50
I PUBLIC IMPROVEMENTS I
Residential
Pbone Number: 541-556-5558
Expiration Date Phone
541-687-9600
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Otber:
Occupant Load: ,
12,632
1,200
296
REQUIRED PARKING
Yes
11.40
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Storm water drainage to Rain garden witb overflow to creek on soutbside of property
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Paee I of 3
Value
Date Calculated
)<%~~9glE;!,~t
,
T
Status
Issued
225 Fiftb Street, Springfield, OR
54] -726-3753 Pbone
541-726-3676 Fax
541-726.3769 Inspection Line
Dwellin2s
Gara2e
V Wood Frame
Gara2e
Fee Description
Plan Review Residential
Total Amonnt Paid
Initial Review
Public Works Review
Public Works Review
Structural Review
Planninl! Review
Public Works Review
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-00976
ISSUED: 03/11/2009
APPLIED: '07/0212008
EXPIRES: 09/11/2009
VALUE: $ 134,288.00
$105,00
$28,00
1,200.00
296.00
Total Value of Project
F'PP~. ~
Amount Paid
$126,000.00
. $8,288.00
$134,288,00
07/02/2008'
07/02/2008
07/03/2008
07/07/2008
, 07/10/2008
07/07/2008
07/07/2008
03/11/2009
Date Paid
$486.29
7/2/08
$486.29
I Plan Reviews I
07/03/2008
APP LLH
Receipt Number
1200800000000000728
Credit given for square footage of
existing residence and garage. I] II
square feet per RUD. 385
additional sqnare feet cbarged for
fire fee. Willamalane fee and
addressing fee do not apply. Tbis
owner will remain at this location, so
tbey may keep tbeir same address.
Applicant needs to submit new way
for storm water drainage to street.
No splash blocks will be allowed for
tbis site. Will do review and
forward on to other reviewers but I
am requesting not issued until new
site plan or plans sbowbow water is
being diverted to storm sewer.
Waiting for approval of Septic from
Lane County and new plans sbowing
either rain garden or drain gage of
storm water to swale
As noted on plans
Option of raingarden was cbosen for
storm water drainage.
To Requestan inspection call the 24 hour recording 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,
.
07/09/2008
10 LKW
07/10/2008
WE LKW
07/16/2008
APP CJC
09/02/2008
APP DDK
03/t ] /2009
APP LKW
Pa2e2 of 3
\
~P.~Gr:.Irr."-r>
I
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2008-00976
ISSUED: 03/11/2009
APPLIED: 07/02/2008
EXPIRES: 09/11/2009
VALUE: $ 134,288.00
225 Fiftb Street, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
541-726-3769 Inspection Line
I Reauirerll nsnections I
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction witb footing andlor
foundation inspection.
Footing: After trenches are excavated.
Fonndation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Framing Inspection: Prior to cover and after all rough in inspections have'been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover;
Dry~all: Prior to taping.
Final Building: After all reqnired inspections bavebeen requested and approved and the building is complete.
Underfloor Plnmbing: Prior to insulation or decking.
Underfloor Drain:' Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: Wben all plumbing work is complete.
Rough Mechanical: ,Prior to Cover
Final Mecbanical: Wben all mecbanical work is complete.
Rough Elcctric: Prior to Cover
Elcctric Service: Approval required prior to utility company energizing service.
Final Electric: Wben all electrical work is complete.,
By signature, I state and agree, tbat I have carefully examined tbe 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 the Laws of the State of Oregon pertaining to the work described berein, and
that NO OCCUP ANCY will be made of any structure witbout permission of the Community Services Division, Building Safety,
I further certify that only contractors and employees who are in compliance with ORS701.005 will be,used on this project.
I furtber agree to ensure tbat all required inspections are requested at tbeproper time, tbat eacb address is readable from tbe
street, thaUbe permit card is located at the front oftbe property, and the approved set of plans will remain on tbe site at all
times during construction.
o(2~;,""jJU'
3/,/0 1
Date
Page 3 01'3
CITY, OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: COM2008.00976
NAME OR COMPANY: Aimee Yog}
LOCATION: 1360 S, 2nd Street
TAX LOT NUMBER: ] 80302240 1600
DEVELOPMENT TYPE: Single Familv Residence
NEW DWELLING UNITS 0 BUILDING SIZE (SF: 1496 LOT SIZE (SF):
I. STORM I1RAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S,F, x 1 COST PER S,F, CHARGE 1 '
0,00 I $0.357 I = I $0,00 I
RUNOFF ROUTED TO DRY WELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
, 1 IMPERVIOUS S,F, I x 1 COST PER S,F, 1 x 1 DISCOUNT RATE 1 1
I 1697,00 1 I $0.357 I I 50% 1 ~ I
ITEM I TOTAL - STORM DRAINAGE SDC '$302.70
2 SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
1 NUMBER OF DFU's I x
1 221
B. IMPROVEMENT COST:
, 1 NUMBER OF DFU's 1 x
1 22 1
COST PER DFU
$27.67
I COST PER DFU
$21.04
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
DISCOUNT
$302,70
= I
S1,071.44
3, TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRIP RATE I x
9,57 I
B. IMPROVEMENT COST:
1 ADTTRIP RATE I
1 9,57 I
1 NUMBER OF UNITS I x 1
1 0 1 1
COST PER TRIP
21.06
x I NEW TRIP F ACTORI
I LOO
x I NUMBER OF UNITS I x 1
1 '0 1
=1
COST PER TRIP
$92,89
$0.00
x INEW TRJP FACTORI
I 1.00 1
ITEM 3 TOTAL - TRANSPORTATION SDC
(,
4 SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
o 1
ICOST PER FEU
I $97,90
B. IMPROVEMENT COST:
INUMBER OF FEU's I
I 0 1
x
ICOST PER FEU
I $],009,17
MWMC CRED]T IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
= , SO.OO
= , SI,374.14
I~ CHARGE
1 $68,71
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4)
5 AI1MINISTRA TlVE FEE:
/SUBTOTAL x I ADM, FEE RATE
'I $].374,14 I 5%
TOTAL SANITARY ADMINISTRAT]ON FEE:
TOTAL TRANSPORTATION ADMINISTRAT]ON FEE:
7/1112008
Kaye Wilson
PREPARED BY
DATE
I
TOTAL SDc CHARGES
I
12632
S302.70
$608.63
$462.80
SO.OO
SO.OO
=
SO.OO
'I
I~
10
10
I~
1t.Ll
" E-
(/)
6
~
11070
11091
I
1 1092
I
1093
1094
I
"'-1
1054
= SO.OO 1055
SO.OO :11054
SO.OO ! 1056
,
'I
I'
68,7] 1079
SO.OO 111078
=, $1,442.85 I
I
----
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULA TE ONLY TIlE NET ADDITIONAL FlXTIJRES)
NO, OF FIXTURES
UNIT
FIXTURE TYPE NEW OLD EQUIVALENT
!BATHTUB . ------,,-~"-
1 0 31 =
IDRINKING FOUNTAIN 0 0 1 =
I FLOOR DRAIN 0 0 3 =
IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETe. 0 0 3 =
INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 =
I LAUNDRY TUB 0 0 2 =
ICLOTHESW ASHER / MOP SINK 1 0 3 =
ICLOTHESWASHER - 3 OR MORE rEA) 0 0 6 =
IMOBILE HOME PARK TRAP (l PER TRAILER) 0 0 12 =
IRECEPTOR FOR REFRlG / WATER STATION i ETC, 0 0 1 =
IRECEPTOR FOR COM, SINK / DISHWASHER / ETC, 1 0 3 =
ISHOWER, SINGLE STALL 1 0 2 =
ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 =
SINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 =
SINK: COMMERCIAL BAR 0 0 2 =
SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 =
SINK: SINGLE LAVATORY/RESIDENTIAL BAR 2 0 1 =
IURlNAL. STALL / WALL 0 0 5 =
ITOILET. PUBLIC INSTALLATION 0 0 6 =
jTOILET. PRIVATE INSTALLATION 2 '0 3 =
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 =
TOTAL DRAINAGE FIXTURE UNITS
:EDU (Eoui~ent Dwelling. Unit) is a discharg..: equivalent to a single family dwelling ~i~~~~O ?FtYs) seut~~t 167 ~~~ns per day
DRAINAGE
FIXTURE
UNITS
3
o
o
o
o
o
3
o
o
o
3
2
o
3
0'
o
2
o
o
6
o
22
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 RATElSl,OOO III
ASSESSED V AL~
> $5,29'
$5,29""",
~;:'II;;~;:;~ 0'11"
~'i,: 't~:E:i~~~.;"";
~., <~;~~c~'"
,,- =-$3,67 -=~:
i~~J}f"':,~,,~3.,~r'.~~,
~ - '-'$2,73"00
c" ,;.:$2,25,ci~
f:~:-~ii'it ;.,~ '$' . "BO^"'t'i'1
:f~'Ii"'r' ""." 1. "-,-
,,~$1,59 ,-
~::: \~~~~ :~; f,
! , $1,09 __.
r;:" i~~:j~ ~;"'
;~, ,,' ,,;~$0.48
'J,::':f::ig'~~,,~Lc ,I
2
IS LAND ELGIBLE FOR ANNEXATION CREDIT?
(Enler I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
CREDIT FOR LAND (IF APPLICABLE)
VALUE /1000 CREDIT RATE
$0,00 x $5,29
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE /1000 CREDIT RATE
$0,00 x $5.29
TOTAL MWMC CREDIT
=
2
1979
~ ,
$0,00
\,
o
SO,OO
I
APPLICANT'S COPjY
, ,
,
Parcels
R
SEPTIC INSTALLATION PERMIT
SP097026
18-03-02-24-01600 Site: S ON PIONEER PKW A Y/TURNS INTO S 2ND/ON
1360 S 2ND ST SPR '
Applicant:
YOGI CHARLENE
Owner:
YOGI CHARLENE
1360 S 2ND ST
SPRINGFIELD OR
97477
1360 S 2ND ST
SPRINGFIELD OR '
97477 I
I
Site Inspection'Number:
Work Description: NEW SEPTIC SYSTEM
System Type: ALT_MJR , ALTT
Issued Date: ;? ~ il- f
Expiration Date: p -1/..../0
INST ALLA TION REOUIREMENTS:
Projected Daily Flow: 300 gallons
Drainfield Size: 150 feet '
Special Conditions: Drainfield construction cannot occur
until (July-Oct). Soil must be dry.
Septic/dosing tank may be used as a
holding tank.
8" trench w/ 20" soil cap.
Submit As-built and Materials list for
Inspection. Fax # 682-3947
Call 682-3751 to discuss permit.
Septic Tank Size: 1502 gallons
Trench Depth: 8 in.
OTHER REouiREMENTS:
1. Installation of an effluent pump requires and Electrical Permit.
2. Install disposal trenches on contour, The trench bottom shall be level within a tolerance of plus, or minus one (I)
inch over the entire trench length.
3. Minimum of eight (8) inch fall from top of septic tank outlet to top of rust head~r pipe leaving D-box.
4. New systems must meet setback requirements in Table 1.
(/j/: < -.
Jay ~son, Environmental Health Specialist
03/11/2009
Date'
LANE COUNTY ON-SITE-SEW AGE OFFICE
125 E 8TH Avenue, Eugene OR 97401. PH: (541) 682-3754. Fax: (541) 682-3947
SEPTIC TANK DECOMMISSION
(ABANDONMENT)
Township Iff
Range t/3
Section/1/4 Section &2..2'i- Tax Lot /Jt::l7
If you are connecting to an area-wide sewage collection system or you are ~eplacing your septic tank,
please don't forget to properly decommission your septic system. An unattihded and forgotten s~ptic
tank can become a serious danger for everyone's safety. Present Oregon regulations require you to
properly decommission the septic tank as described below. Please have I this form signed by the
appropriate people and return the completed form to:
LANE COUNTY SUBSURFACE SANITATION PROGR'AM
Public Service Building 125 East 8TH Ave Eugene, Oregon 97401
Name of Property Owner '
Septic tank located at
Pumped of sludge on
by
(Date)
(Signature of Licensed Operator)
License # "
The septic tank located at
backfilled with sand or clean bank run gravel after being pumped of sludge on
was
(Date)
Signature of Operator (may be owner) ,
Oregon Administrative Rules (OAR) 340-71-185 Decommissioning of Systems,
1. The owner shall decommission a system when:
a. A sewerage system becomes available and the building sewer has been connected
thereto, or '
b. The source of sewage has been permanently eliminated,
2. Procedures for Decommissioning: ,
a. The tank(s); cesspool. or seepage pit shall be pumped by a licensed, sewage disposal service
to removal septage '
b, The tank(s), cesspool or seepage pit shall be filled with reject sand, bar run gravel, or
, other material approved by the Agent, or the container shall be removed and properly
disposed.
H:\LMD\SANITATION\FORMS\septic Tonk Decommission form,doc
Lane Caunty SubSurface Sanitation Program
125 East 8th Ave, Eugene OR 97401 (541)682-3754 Fax (541) 682.3947
- . . .
TO:
SEW AGE DISPOSAL ~Y~TEMS PERMIT APPliCANTS
FROM:
LANE COUNTY ON-SITE SEWAGE SECTION
You are required by law (OAR 340-71-160) to be in possession of a permit authorizing installation of a
sewage disposal system before construction of your septic system can begin.' .In addition, the law'
,,) specifies that all work oil said system must be performed by a person licensed with.the State of ,
Oregon Department of Environmental Quality (DEQ). The work can also be completed by the owner,
contract purchaser or their'regular employees. Before starting any digging, carefully read all the
specifications on the installation permit, plot plan & plans. If-you have any questions regarding i
installation procedures or specifications of the approved area, call your sanitarian at (541) 682-37~ .
& they will be glad to assist you.
If you intend to hire 'someone to do the work for you, you should make sure that the person is licensed
with the DEQ'to perform such work. This protects you as the consumer, as each licensed installer has
to post a bond & is liable for the work performed. To check the licensing of an individual, you can call
the Lane County On-Site Sewage Section at (541) 682-3754 & we will check for you to see if the,
individual or contractor, you have chosen is licensed. ORS 454.705(3) requires that every licensed
installer must provide to each permittee (owner) a written notice of the name & address of the
bonding agent & of the permittee's rights. This must be provided before the work is completed. We
urqe you to request this from the installer or contractor you have chosen prior to hiring them.
, When the construction of your septic system is complete & before yo'u backfill, it is necessary to have
the system inspected. To obtain an inspection, make a drawi'ng of the system as installed on the
detailed system plot plan (As-Built) form provided.' Submit the completed As-Built & Materials List
forms to this office & the inspection will be scheduled. Final insDection for sewaae systems can
not be reauested bv teleDhone.
Do not hesitate to conta'ct Lane County On-Site'Sewage Section if. you have any questions.
Lane County Land Management Division
On:..Site Sewage Program
125 East 8th Avenue
Eugene OR 97401
H:\LMD\SANITATION\FORMS\Permit Cover letter,doc
(TItle as shown on DEQ Iice.nse)
MUST BE IN INK
Permit #Sfo'l- l{lZ L Twnshp I (f Range {73 Se~t!9!'" CZ-, z.'/. _ Tax Lot
Standard System Alternative System ~ TYJle? AX7t/"d/.v1 t',fI7-ld/b A:'/LL
Site Location (Street Address) I '3kt7 'S 7x'1 5FI7/ar/E2b b7X
, DETAIL SYSTEM SITE PLAN (AS-BUILT*)
/fiP'C
D.F
Instoller
Telephone
Li cense #
scale
=
N
Bonding Com pony
(Signature of Licensee)'
(Date)
If Installed by Owner-
(Signature of Owner)
(Date)
Name & Address of person(s) to receive form:
VICINITY MAP
"'ATTACH MATERIALS LIST
N
FOR OFFICE USE ONLY , Approved, "Not Approved Needs Corrected
COMMENTS RF /5C?v?/.4B/ ;= KE J::%/~
...!.../Tv w./,77='( Sq:/O ~/$. /It/fUr (;f:tI71UfT 1/ rJrrEt1f;;7-t/Jt,/pf.\..
System orrected Date
System Capacity..-Z/P gal/day Signature Date
INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION when signed by the County's Environmental Health Specialist
This certificate is evidence as per ORS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location.
To request inspection, return this form and the Materials List to: Lane County Land Management Division, located in the basement of the Public
Service Building, 125 East 8th Avenue; Eugene OR 97401
I\FO~MS\AS Built Form.com
MATERIALS LIST
(Required) OAR 340-71 170(3)(b)
LANE COUNTY ON-SITE SEWAGE DISPOSAL PROGRAM
Office: (541) 682-3754 Fax: (541),682-3947
SP#J?C; "7&Z~
T 115
R Cl~
S tl2;
v. S .2: If
TL / ~d:J
Owner
Installer
A PRE,COVER INSPECTION WILL NOT BE SCHEDULED UNTIL THIS MATERIALS LIST & AS-BUlL T
DRAWING ARE SUBMITTED TO THE LANE COUNTY ON-SITE SEW AGE DISPOSAL PROGRAM
SEPTIC TANK
Mfg.
Type/Material
Gallons
D Water tightness tested after placement. Results w/in allowed limits (Required)
D Riser (water tight) inches to ground surface (Required)
D Effluent filter - Mfg.
D Anti-buoyancy provided as per mfg. specs.
DISPOSAL SYSTEM {D Std./Sapiolite 0 Cap fill' 0 Pressurized Dist.' 0 Sand Filter' 0 Other
'Alternative systems require additional information/inspections ,
D Curtin Drain - Depth of trench
D Effluent sewer pipe - Length
D Distribution material - Perforated pipe Dia.
D Drop/Distribution box installed - Mfg,
D Disposal Trench - Total Length
D Drain media - Total depth
Depth of gravel/media
Diameter
ASTM
Outlet location
ASTM
'lnfiltrator/EeeZzz drain/other
, Materia.l
Depth
Depth below pipe
'Supplier
PUMP INSTALLATION RECORD (IF APPpCABLE~
Mfg. & Model
HP
Pump Installer ,
D Pump & float switches installed -Gallons/dose
D Audible-visual alarm installed & tested - Location
D Pressure pipe - Diameter ASTM
D Hydrosplitter Mfg./Supplier
PSI
Comments
I understand that I am responsible for the satisfactory completion of all required testing, corrections & final cover of the system within
30 days of completion. I certifY that construction described above complies with the requirements of Oregon Administrative Rules
Chapter 340 & the permit issued by the LANE COUNTY ON-SITE SEWAGE DISPOSAL PROGRAM.
INSTALLER'S SIGNATIJRE '
DATE
ATTACH TO AS-BUILT
H:\LMDISANlT A T10N\FORMSIMaterials List.doc
, SITE PLAN SUBMITTAL FORM
OWNER NAME:
~ 1tHIu", '/tX,l'
PHONE #
ADDRESS: 1%03 u...( ~DN/I<,~'eJ"
I>R
Map and Taxlot #:
I~~ -JSbo
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22::Al'ifth_,Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S-00976
COM200S.00976
COM200S-00976
COM200S-00976
COM200S.00976
COM200S-00976
COM200S~00976
, Payments:
Type of Payment
Check
cReceintl
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2200900000000000251
Date: 03/11/2009
12:03:13PM
Description
Fire SF Fee - Residential
Stonn Drainage Impervious Area
SDCSanitarylStorm Admin
Plan Review Minor - Planning
Building Permit
2 Baths One or Two Family
-Mech Iss 2+ Appliances-
Furnace - up to 100,000 btu
Vent Fan
-Exhaust Hoods
Dryer Vent
Heat Pump
Residence Wiring 1000 Sq'Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
+ 5%Technology Fee
+ 12% State Surcharge
. ***+ 10% Administrative Fee***
Amount Due
19,25
302,70,
6S,71
119,00
74S,I4
2S0,OO
40,00
14,00
14,00
1000
7,00
'14,00
117,00
21.00
55,00
69,96
153,62
129,94
$2,183.32
Paid By
CHARLENE YOGI,
Item Total:
Check Number Authorization
Rece,ived By Batch Number Number How Received
Amount Paid
]03
In Person
Payment Total:
$2, I S3,32
$2,183,32
KLK
Page I of I
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