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Home My WebLink AboutPermit Signage 2009-3-31 , i '!_S"P'.d'N",O,,"', Ili!I,;!!;,'~"""",.,,, .'1.',..., .. ' - ,~ IE'" : . t -,,'" ,'~ ~', " { ,> ~..-' _.,_,., '_';_ '_.,' .,....n. Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00401 ISSUED: 03/3l!2009 APPLIED: 03/26/2009 EXPIRES: 10/27/2009 VALUE: $ 12,000.00 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: '140 S 32nd St ASSESSOR'S PARCEL NO,: 1702310000501 Springlield TYPE OF WORK: Sign TYPE OF USE: New Commercial PROJECT DESCRIPTION: Sign - Pizza Hut Owner: MCGLADE & ALBERTS LLC Address: 4055 SPRING BLVD EUGENE OR 97405 I CONTRACTOR INFORMATION I Contractor Type Electrical Sign Contractor E S & A SIGN CORP E S & A SIGN CORP License 163470 163470 Expiration Date 03/16/2011 03/]6/2011 Phone 54] -485-58 I 3 54 I -485-5546 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: quireS you to nENT\l!~lglilr6(:srrj~'lfE Oregon Utility 1~\lOW rUI'fu\P:e:~II~Js~ rules are s~~:~~~ Notilieatl~~,~~r4r~~:thrOugh 01~~e9rules by in OAR 9~....Dl\ Yp h COpies 0 0090 Yolln1l111'yCplI~\: ~ote' the telephone . t~ . .' on ca\\ingSjlOi~ai\:'B~~j,inglility NO\lhliil}l , __.j:,-,r the Or ttl _.^ r"l~A4\. .JI\'J...._- ,- J ...,'\',-.....:-'- I DEVElIDPMENTINFORMATION I Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: _' # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: MOlICE: PIRE4~iio\UOB\{Jins: THIS PERMIT SHf\.L~~H\S PERMIT IS NOT f\.UTHORIZED UND~S f\.Bf\.NDONED fOR COMMENCED OR , f1NY 180 DAY PERIOD. . Notes: Paee I of 3 Status Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541,726-3769 Inspection Line Description Tvpe of Construction Sien Sien Use Bid Amount Use Bid Amount Fee Description + 12% State Surcharge + 5% Technology Fcc Sign, Outline Lighting Each ***+ 100/u Administrative Fee*** + 5% Technology Fee Sign 61-100 Square Feet Sign I'lan Review ***+ 100/0 Administrative Fee*** + 12% State Surcharge + 5% Technology Fee Sign - Outline Lighting Each Sign 61-100 Square Feet Sign Plan Review Total Amount Paid Sie:n Rcvien' 03/26/2009 Sien Review 04/27/2009 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00401 ISSUED: 03/31/2009 APPLIED:, 03/26/2009 EXPIRES: 10/2712009 VALUE: $ 12,000.00 I Valuation Descriotion , $ Per Sq Ft or multiplier $1.00 $1.00 Sqnare Footage 01' Bid Amount 5,000,00 7,000,00 03/26/2009 03/26/2009 Value Date Calculated Total Value of Project $5,000,00 $7,000,00 $\2,000,00 ~PPIi',~ Amount Paid Date Paid Receipt Number $15,\2 $6,30 $126,00 $28,00 $14.00 $280,00 $84,00 $14,00 $7,56 $10,15 $63.00 $140,00 $42,00 3/26/09 3/26/09 3/26/09 3/31/09 3/3 1/09 3/31/09 3/31/09 4/28/09 4/28/09 4/28/09 4/28/09 4/28/09 4/28/09 2200900000000000297 2200900000000000297 2200900000000000297 2200900000000000314 2200900000000000314 2200900000000000314 2200900000000000314 1200900000000000304 1200900000000000304 1200900000000000304 1200900000000000304 1200900000000000304 1200900000000000304 $830,13 I Plan Reviews I 03/26/2009 API' OJB 04/27/2009 APP DJB Additional wall sign added to permit,North elevation, To Request an 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. I Rpnlli~nsnectinns I Sign Attachment: Method of mounting the sign to a structure or pole, Method of attachment of bolts or welds, Sign Electrical: After connection is made byt prior to energizing, Sign-Final: After all required inspections arc conducted aud approved and the sign installation is completed, Paee 2 of 3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00401 ISSUED: 03/3112009 APPLIED: 03/26/2009 EXPIRES: 10/27/2009 VALUE: $ 12,000,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signatnre, I state and agree, that I have carefully examiued 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 Springlield and the 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 arc 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. . o~r10~:actors ~~rf; d ) '(- ~f -() '7 Date Pa2e 3 of 3 Electrical Permit Application CITY OF SPRINGFIELD, OREGON 225 )<'ifth Strcl.'ttSpringlicld. OR 97477tPH(541)726-3753+ FAX(54 1)726-3689 I' DEPARTMENT USE ONLY ~~lpermitno,Cq- 40f I Date 3/b,/0 7 This permit is issued under OAR 918-309-0000, Permits are nontransferable, Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days, I LOCAL GOVERNMENT APPROVAL I Zoning approval verified? DYes D No I CATEGORY OF CONSTRUCTION 1 D Residential .1 D Government )'g Commercial I JOB SITE INFORMATION AND LOCATION I Job site address: \lfiO :). 'OW s+ 1 CitY:~I\~.\\1,l.J 1 State: Of- 1 zIP:'l7'\77 I Subdivision: I Lot no.: I DESCRIPTION OF" WORK I\(\~d ('2..) illt.w'\1.'()~ IDt{,~( 7l'\C/"I1,5 1 -, I I S I PROPERTY OWNER" lel ~lHuo.eoo amps (2) $ 95,00 S 1 Name: rJwdf VIA., b~""de.. ,~,"',,\, Ole90n\a~~:o; ed(j40iJt'o\llo.'~amps (2) $158,00 S I Address: l-\~ "='fYi ~"'l 'O~J.J:I.;:I\~S adopte~:~~~ rule" alE'6!if~J~;wll amps (2) I 1 $205,00 $ I City, Eu.~tJI.,L 61\St~t~:dQn~~I;\~lii"tm\~~i~;CQ'~~M<lD'JtmpsorvoltS(2) 1 1 $469,00 $ 1 Phone:5lt(- '2112 If?>ttD in I'Fa'il.'c!:l;;VLQ'(l>l~@""t\\"'~-t.le ~fu\tlli\fn\l& ,,?nly (2) I I $ 63,00 $ J"1' , I-' ,J.:lr.l'''''P ,./;t\A 11 ,1I....,,,G,,"vr. E-mail: Ltme ~ . ~i~~ the cen~',.'p~'~f\ Ut\\\~ II"l~'~porary services or feeders: installatIOn, alteratIOn, relocatIOn h I .' 'r- -', ,m, lo\'V - ~NM,:j~",.2..>I-\tdo amps or less (2) $ 6300 I $ T IS msta latlOn IS bemg made on \'t1i\4\\ptlaJ'''~!~'l'J''''t''''"'':1 'I ' owned by me or a member of my ImmedlatOllitl/!j', 'ThIS I 20 I to 400 amps (2) $ 87,00 1 $ property is not intend~d for sale, exchange, lease, or rent. OAR I I 1 1 479,540(1) and 479,560(1), dL .\ _ I 401 to 600 amps (2) $126,00 S Signature: ?e..L.. ~? lOver 600 amps or 1.000 volts, see services or feeders section above I CONTRACTOR INSTALLATION Branch circuits: ne", alleralian, eXlension per panel I Business name: E.~ of' A ~'f'Y\ !; rh.oru.'YUj a. Fee for branch circuits with purchase ofa service or feeder fee: I Address: 5~ 510 f..JE Co\\..vY1-\;ht:.. 6\.J.! Each hranch circuit 1 $ 6,00 I S I City:.tb~d. I State: 0(2.. I ZIPP\.7ZJ~ I b. Fee for branch circuits without purchase ofa service or feeder fee: I Phone:51>?,. -~'1.11, 'Llc):) 1 Fax: -6b3, .91-1., 2.l0:) I First branch CIrCUit (2) I $ 55,00 I $ I E-mail: \'\161'\.0\ ~ ,e?CL '7r1CfY\"), C-(JfV\ 1 1 Each addllional bra:,{ CIfCUlt 1 $ 6,00 S I CCB license no,: ~(,,?J1.{70 1 BCD lil\.<jI\!:f:\1{9E: " u- 8 ~'Il'DfWi.t'llI~'f'ce or feeder nol me/oded 1 Signing supervisor's license no,: '7 \l7iIl1$ PERMII :>~lrEt 1 ~\<l,c"f!\iW\M IIti'{;tlOn CIrcle (2) $ 63,00 1 Print name of signing supervisor: ~M:l..l1~~t~?.J~ p.\o(S:~O~\i,\JObMre hghtmg (2) 2. $ 63,00 I Signature of signing supervisor: I""ll~t ,(f C~~\( O~ ;1'i~;::i~~,c~;Ie'~;:nl;::;~t(~)energy panel, I $ 63,00 $ .. ' , ' ,AI ',. .1 Each'additionat inspection: (I). I I $58,00 1 $ ;(' I"c APPLICANT/USE, ~ ..-C\.. ' ~ . (A) Enter subtOtal ofi'tbove' fees \l . (Minimum Permit Fee $58,00) $ \llo, CO ---..&1' ~~ If~ 1"""'"'~="~'(!hrA" .., 15.1'1 ~ rrj~ "" ~ I (C) Technology Fee (5% of[A]) $ (,,~()I ~ ~ 1 TOTAL fees and surcharges (A through C): $ 141,Ll'2.j , 440.2584.J (9/08/COM) I FEE SCHEDULE Number ofinspections per Item () IQty.! Cost ea. Total cost I Residential, per unit, service included: I 1 1,000 sq, ft. or less (4) Each additional 500 sq. ft. or portion thereof $134,00 I $ I S 1 S I S $ 25,00 Limited energy (2) I Each man~lfaclured home or modular dwelling service or fceder (2) I Services or feeders: installation, alteration. relocation I 200 amps or less (2) $ 81,00 $ 32,00 $ 63,00 $ $ \ 'Z.lt Electrical Permit Application CITY OF SPRINGFIELD, OREGON 225 Fifth Street tSpringfield, OR 97477. PH(541 )726-3753. FAX(541)726-3689 {It. 7 I I I ~(l.. ~I~,y , I DEPARTMENT USE ONLY ~nD ~I CO,""1Z00'-OOl(O{ 1(,. Penmt no.: . I Date: Y-Z7-C? This permit is issued under OAR 918-309-0000, Permits arc nontransferable, Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days, I FEE SCHEDULE I Number of Inspection. per Item ( ) I Qty.1 ~st : I Residential, per unit, service included: I 11,000sq,ft,orless(4) I I I Each additional 500 sq. ft. or portion 1 thereof [ I Limited energy (2) I Each manufactured home or modular dwelling service or feeder (2) I Service~ or feeden;)pstallation, alteration, relocation I 200 am~~,pgM~rt~{~\\~ ,- I $ 81.00 $ I PROPERTY OWNER 1"'~Ol't~~Q:""m1~'fg)\~~~', $ 95,00 $ 1 Name:C1\lrk ~Glc.d~ ~$'\~,O~~~OI~4biJq~00:iw~'(W:~~$~ 1 $158,00 $ Address: l1Ct:'5" ~eviV\ 5\JJ, l>.~~'C.~.~;\Il'" ~~;\e ,Yf9.1~oll\'il.9Q,~mp~(i1~ol\e ~ 1 $205,00 $ City: ~U~ i 11 State: Dtl, ~3Z1faJ1ilc.ss\-q";~R~eil~~O:~fu~.~:;'[l~0Ifsl(2j' I $469,00 $ I Phone:~l~~-l 4~q() 1 Faxl1l-(P~~;~t?:~ \II~'i, ~1.\l3-~~J.iest~:~<?)~)- I I $ 63,00 I $ I E-mail: r' _'" - C\ 1m IX . efJlV\. \" a?JJ' . ,- \X\e v, ,e brtI1!P~JBry services or feeders: installation, alteration, relocation :it'lY\ (~ y """ () \\1'(\0.. _of \: ~, ,~ This installation is being u';ade on residential or farm 'prop:eilY ,- 0 el I'~OO amps or less (2) '$ 63,00 $ owned by me or a member of my immediate family, 'Thi~ Ge I 201 to 400 amp's (2) $ 87,00 $ property is not intended for sale, exchange; lease, or rent. OAR I 479,540(l)'and 479,560(1), 401 to 600 amps (2) $126,00 $ Signature: lOver 600 amps or 1,000 volts, see services or feeders section above I CONTRACTOR INSTALLATION I Branch circuits: new. ai/era/ion, exlension per panel I Business name: E5. {A ~ttn ~ ~k.Avt.j Co. I I a. Fee for branch circuits with purchase ofa service or feeder fee: 1 Address: '5'isSb /0~ CDlUMQie-. 'lhV..l 1 1 Each branch circuit 1 $ 6,00 I $ I City(+f..r~c.n.J 1 Sm'te: D~ IZlP:~'7"L\ ~ 1 I b, Fedor branch circuits without purchase of a service orfeeder fee: I Phone:5D3 54 2. '2.J CO I Fax: 5h3:1f2 ' "2\ oS I hst branch circuit (2) ,I ,J-Q/l..55,OO I $ 1 E.mail: \<.-tt.V.\~~e.blt-.Sl~.Cd.fV\ 1 ~ach additional brancheircuit ~J..~ '\!~~\;,oo $ I CCB hcense no,: \1o?14 7 0 r BCD license no,: I MlScellaneousre.s: ~ervlce 'f.~~ ~~lI.'I(.c'hJ~ Stgmng supervisor's license no,: 111 & 6 I Each pump or Imgat}q,\e~ (.;l?,~: k,Sl ~ $ 63,00 Print name of signing supervisor: 0)1\lf'1' ?~p~('\ \~~t:~or':'lt~\\~~1~).~\)\i11 $ 63,00 I Signature of signing supervisor: t f)'r- (-. --- _~~~t1~~~;~~~~i~t~panel'l 1,$ 6,3,00 I $ , 'I Et"!j'a'aii.\i,~~~I)iS\'Rliti~: (I) I I $58,00 I $ I r,\J\~',", 9,\l v' APPLICANT USE I (A) Iln~is~btotal of above rees (Minimum Permit Fee $58.00) I (B) Enter 12% surcharge (.12 x [All I (C) Technology Fee (5% of[All 1 TOTAL fees and surcharges (A through C): I LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No I CATEGORY OF CONSTRUCTION I 0 Residential I 0 Government I Ji( Commercial I JOB SITE INFORMATION AND LOCATION I Jobsiteaddress:_ \40~, 31.M ~~,:+.. I City: ~~ ne.td I StateC>l2. I ZlpC>t,l\i7 I SubdivisIOn:' '&;Oz. 3/0 0 1 Lot no,: DOSO I I DESCRiPTION OF WORK l~ll r tJ dtWVIIMkJ. 0.J.1 "'i\1tr 440-2584.) (9/08/COM) , -~~ ~~ .. ~ ~':)J . \..'\9' (\\X\) ~/ ~ ''r/'' ~V c.(A'" ~-$ Total cost $134,00 $ $ 25,00 $ $ 32,00 $ $ 63,00 $ $ $ $f.93,DD $ i,~lo I $ 115' I SJ~,I\ I 225 Fitlh Strcet Springfield, Oregon 97477 541-726-3759 Phone ~"PRINQ"ELO~ t AA .~ .....: iii: ., , City of Springficld Official Receipt Devclopmcnt Serviccs Department Public Works Departmenj Job/Journal Number COM2009-0040 I COM2009-0040 I COM2009,0040 I COM2009-0040 I COM2009,0040 I COM2009-0040 I Payments: Type of Payment Cred itCard cRcccintl RECEIPT #: 1200900000000000304 Date: 04/28/2009 Description Sign Plan Review Sign6l,l00 Square Feet Sign - Outl ine Lighting Each -I- 5% Technology Fee + 12% State Surcharge ***+ 10% Administrative Fee*** Paid By ES&A SIGN CORP Item Total: Check Number Authorization Received By Batch Number Number How Received djb 028257 In Person Payment Total: Paee I of I 8:29:45AM Amount Due 42,00 140,00 63,00 10.15 7,56 14,00 $276,71 Amount Paid $276,71 $276,71 4/28/2009 CITY OF ~rJ:<.lj~{JJ<1ELD Building/Combination Permit PERMIT NO: COM2009-00401 ISSUED: 03/3112009 APPLIED: 03/2612009 EXPIRES: 09/30/2009 VALUE: $ 12,000.00 Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS:. 140 S 32nd St ASSESSOR'S PARCEL NO,: 1702310000501 Springfield TYPE OF WORK: Sign PROJECT DESCRIPTION: Sign - Pizza Hut TYPE OF USE: New Commercial , Owner: MCGLADE & ALBERTS LLC Address: 4055 SPRING BLVD EUGENE OR 97405 I CONTRACTOR I~FORMA TION I Contractor Type Electrical Sign Contractor License E S & A SIGN CORP 163470 E S & A SIGN CORP, 163470 ~ ArrENT/~.BlIILDlNG INFORMATION I Ollow rUle -'cyon law Notificat' s adO/i"'rSto' ~eqUires In 0 Ion Cent. () " ,Il~tl 0 ~ You to 009 AR 952-001 oElfielglll[l!f ittru~fur'el Utility o y. - 'UJIQ,.J.. 'H '\"s are call" ou may ob' Y,1""Ojj~ji~\JAR Set forth nu ~ng the centei"!tt~r)jf'xee6f th 952-001_ m er for the Or!!ikge'ifYPl'd tel e rUles by Center is 1 En'ilrgY!IIWh', ,efPhone '1:i(J(1~, f "D ' 'ro"t' :Slpiii1-kled'Buitiling~ IOn -v""t"t). # of Units: I'rimar)' Occupancy Group: Secondllry Occupancy Group: Primary Construction Type Secondllry Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION I F.'onty.ud Setback: Side I Setback: Side 2 Setback: RearYllrd Setback: Solllr Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements, Storm Sewer Available: , Special Instruction: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. " Notes: Pllee 1 of 3 Expiration Date 03/16/2011 03/16/2011 Phone 541-485-5546 541-485-5546 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: , Sq Ft Garllge/Cllrport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drllins: ,__SR':RI,N(iiF.JS:.~, ,.m,.I~ 1111' ~, .\ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-00401 ISSUED: 03/31/2009 APPLIED: 03/2612009 EXPIRES: 09/3012009 VALUE: $ 12,000.00 225 Fifth Street, SJlringlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726,3769 Inspection Line I Valuation Descriotion I Sien Sieu Type of Construction Use Bid Amount Use Bid Amount $ Pel' Sq Fl or multiplier $1.00 $1.00 Square Footage or Bid Amount 5,000,00 7,000,00 Valne Date Calculated Description Total Valne of Project $5,000,00 $7,000,00 $12,000,00 03/26/2009 03/2612009 L-Fpp\ P~W Fee Description + 12% State Surcharge + 5% Technology Fee Sign - Outline Lighting Each ***+ 100/0 Administrative Fee*** + 5% Technology Fee Sign 61-100 Square Feet Sign Plan Review Amount Paid Date Paid Receipt Number $15,12 $6,30 $]26,00 $28,00 $]4,00 $280,00 $84,00 3/26/09 3/26/09 3/26/09 3/31/09 3/31/09 3/31/09 3/31/09 2200900000000000297 2200900000000000297 2200900000000000297 2200900000000000314 2200900000000000314 2200900000000000314 22009000000000003]4 Total Amonnt Paid $553,42 I Plan Reviews I Sie:n Review 03/26/2009 03/26/2009 APP DJB To Request an 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. L...jeollireCUnsnections I Sign Attachment: Method of mounting the sign to a structure or pole, Method of attachment of bolts or welds, Sign Electrical: After connection is made but prior to energizing, Sign Final: After all required iuspections arc conducted and approved and the sign installation is completed, Paee 2, of 3 _'~",F.I,GL,})' ."."'..,i.....", ~", ';, '... ; ," _..' _. ,_ ,......._.., ,.~' '"",,/' I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD" Building/Combination Permit PERMIT NO: COM2009-00401 ISSUED: 03/3112009 APPLIED: 03/26/2009 EXPIRES: 09/30/2009 VALUE: $ 12,000.00 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 Springlield and the 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 Serv,ices Division, Building Safety, I further certify that only contractors and employees who arc in compliance ,vith 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 remaiu on the site at all times during construction. \~ IJJJd0h Owne; or Contractors Signatur# Paee 3 of 3 ~ ,2F- 0'1 Date 225 Fif~h Street Sp;ingfieId, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-0040 I COM2009-0040 I COM2009-0040 I COM2009-0040 I Payments: Type of r"yment Check cReceintl RECEIPT #: 2200900000000000314 Date: 03/3l!2009 Description Sign Plan Review Sign 61-100 Square Feet + 5% Technology Fee ***+ 10% Administrative Fee*** Paid By ES AND A SIGN Item Total: Check Number Authorization Received By Batch Number Number lIow Received djb 7527 In Person, Payment Total: Page I of I 1l:54:37AM Amount Due 84,00 280,00 14,00 28,00 $406,00 Amount Paid $406,00 $406,00 3/3 1/2009