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Home My WebLink AboutPermit Building 2009-7-30 _~"'"!_lil~J,"",,P-, --:j'" -, dt CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-0I095 ISSUED: 07/3012009 APPLIED: 07/29/2009 EXPIRES: 01/30/2010 VALUE: $ 179,755.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Li~e SITE ADDRESS: 1216S 41ST ST ASSESSOR'S PARCEL NO.: ]802064112400 Springtield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: New Single Family Dwelling SAME AS 1215 S 40TH PL , I Residential Owner: BRUCE WIECHERT CUSTOM HOMES INC Address: 3073 SKYVIEW LN EUGENE OR,'97405 J CONTRACTORINFO~ATION I Contractor Type General Electrical Mechanical Plumbing Contractor License BRUCE WIECHERT CUSTOM HOMES INC 101717 L & E ELECTRIC INC 105475 COMFORT FLOW HEATING CO. 460 ' STEVE!'it~:J~mN~,o~reqon law requires YOU.~~065 foi:ow rule!. biiiiLDiNG'IN'FORMA:T'j0Nll Notification ,--, " ., , OAR 852-001-0010through OAR 952-001: In 1 b# of Stoc1ies:of the rules by ,I 0090 You may 0 lall.l "-'VI-' ;,"" ,. caTh-3 the centefIe\g~Jtl!1 i;l,ttUM'JJi~ho~e .17.00 nuruJer for the o1fygSI~tl(l~earNotIM,orcell AIr Gas , VB Center is "'1Jte.r-J:y,pll:344). Gas Range Type: Gas Energy Path: Sprinkled Building: Expiration Date 09/16/20 I 0 03/30/2010 06/27/2011 03/12/2010 Phone 541-686.9458 541-933-2653 541-726-0100 541-342-3765 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type ' Secondary Construction Type: # of Bedrooms: 3 Lot Size: Sq Ft 1st Floor: 1,685 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport 440 Sq Ft Other: Occupant Load: No J DEVELOPMENT INFORMATION' Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 5.00 10.00 19.79 0.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: REQUIRED PARKING 2 Street Improvements: Storm Sewer Available: Special Instruction: 3 Yes 37.20 _ ,,. "T~I=' \NO?'\<. I PUBL~ l.IlWifR~f.Mt;~~'1 ty,.I'\l\~E~WlI\ \S NV 1 . 1\.('\;:' r '-' I' \lNUd, 1\-IIS ~nMO~ Fullv Improved h\l1\-\ORIltO OR IS h'O~ p . No }!A\IJ\tNCtO 100. Downspouts/Drains: Driveway approach approv~~ '\~ Wjl.)li:P.k~A conditions Total: Handicapped: Compact: Curbside 7' Curb and Gutter Notes: Storm water to curb via weep hole. Page I of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Constroction Caraee/Misc SFlDuplex U VB Utilitv R-3 VB 1&2 Familv Fee Description + 12% State Surcharge + 5% Technology Fee 1st Appliance 2 Baths One or Two Family Addressing Assignment Appliance Vent Building Permit Credit- SDC Storm Improv Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fireplace (Listed) Cas Outlets 1-4 Plan Review Major - Planning Plan Review Same As PW Disc - 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Tran Reimburs-Residential SDC Trans Improvement-Resident SDC Transportation Admin Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Willamalane Single Family Total Amount Paid I Valuation Descrintion I $ Per Sq Ft or multiplier $37.72 $96.83 Square Footage or Bid Amount 440.00 1,685.00 Total Value of Project FpP~, ~ Amount Paid $216.88 $108.22 $79.00 $337.00 $38.00 $9.00 $1,034.35 $-1,215.08 $88.00 $9.00 $13.00 $106.25 $20.00 $7.00 $211.00 $250.00 $-30.00 $134.00 $75.00 $507.07 $666.84 $10.00 $1,146.50 $101.97 $90.58 $211.21 $931.65 $88.18 $88.00 $1,215.08 $63.00 $27.00 $2,858.00 $9,495.70 Date Paid 7/30/09 7/30/09 7/30109 7/30/09 7/30109 7/30/09 7/30109 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 7/30/09 Paee 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01095 ISSUED: 07/30/2009 APPLIED: 07/29/2009 ' EXPIRES: 01/30/2010 VALUE: $ 179,755.00 Value Date Calculated $16,596.80 $163,158.55 $179,755.35 07/29/2009 07/29/2009 Receipt Number 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 1200900000000000855 Status Issued 225 Fifth Street, Springfield, OR 54]-726-3753 Phone 54]-726-3676 Fax 54]-726-3769 Inspection Line Plaonine: Review I Plan Reviews, I 07/29/2009 APP 07/29/2009 Pnblic Works Review 07/29/2009 07/29/2009 APP Structural Review 07/29/2009 07/2912009 APP CITY OF SPRINGl']~LD Building/Combination Permit PERMIT NO: COM2009-01095 ISSUED: 07/30/2009 APPLIED: 07/29/2009 EXPIRES: 01130/2010 VALUE: $ ]79,755.00 DDK Required street trees as shown on street tree plan attached to permit: Species as shown. 2" caliper, leave name tag on until approved. Structure meets minimum setbacks. l\1inimum setback letter attached. Storm water to cnrb via weep hole/ Driveway approach approved thronght Variance A conditions. As noted on plans / reveiw letter LKW CJC 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. ~irprlln~,np('tiwi.l Erosion/Grading Inspection: Prior to gronnd distnrbance and after erosion measnres are installed. Vfer Electrical Gronnd:, Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. . Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insnlation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Walllnsulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. , Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Perimeter Fonndation Drains: After gravel and filter cloth is installed but prior to backfill. Vnderfloor Plnmbing: Prior to insulation or decking. Vnderfloor Drain: Prior to cover or place~ent of concrete. Rongh Plnmbing: prior to cover and including required testing. Paee 3 of 4 .sP.!AIHQEI~~ ,. Ill'"'' " ~ '''WP'J''''''''''''\0!'''i0''''~'''i''*it"'>!<,;iT':l",:;,', 1\,:. "', .' CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-01095 ISSUED: 07/30/2009 APPLIED: 07/29/2009 EXPIRES: 01/30/2010 VALUE: $ 179,755.00 225 Fifth Street, Springfield, OR 541- 726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Water Line: Prior t~ filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Undertloor Mechanical. Prior to insulation or decking and including required testing. Underslab Mechanical. Prior to insulation or decking and including required testing. Undertloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimom of one appliance including reqnired testing. Presnre test done at this point. Rough Mechanical: Prior to Cover Final Gas: When allgas work is complete. Final Mechanical: When all mechanical work is ,complete. Temporary Electric: Approval required prior to Utility Company energizing pole. Rough Electric: Prior to Cover Electric Service: Approval required prior to ntility company energizing service. Final Electric: When all electrical work is complete. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Cnrbcut - Standard: After forms are erected hut prior to placement of concrete. By signature, I state and agree, that I have carefnlly 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 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 are requested at the proper time, that each address is readable from the street, that the permit card is located at the fr~ property, and the approved set of plans will remain on the site at all timeSduringconC:030~ . - '~()/()l , I Owner or Contractors Signature Date Paee 4 of4 _,RINOP'....D ~," Z ON \ ~ ; A. ____ . INITIALS ~~ _ ~... 'DATE . ~. ~\.. D"'\ ~ ~ SOURCE ~~ 225 FIITH STREET. SPRINGFIELD. OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPUCA TION City Job Number !!9- Ie) 95 . -- - . - . ; - . -. '. "1f',"- _. '", -, .- --....... '.: - ~..- -. " I. ;LQCA1JONOFlN!~TAI,!4nmv::,:' 3. 'Ii> "~ -- Iii b "'s 9/,SF' - ". LEGAL DESCRIPTION: /ffDZ 0 bY ( olZl.{o'O JOB DESCRIPTION: J!Ou-"::>(c {v,/Lv I (~~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~"'''''''-- ,>:' _ .,'r--:;J'.J:;.:"~"'-""""'''''-';;''.''"';;:<-'''.~ ':V".',\>:'";-'..' 2 "Co~cti:JR,[N.:rr-:1i,LA.1joiy~gN!:i'f; . _.~~_ -. - _.>..J< ..'.r-, ".., ..:;........ "_'_ol-~:" ___-'ri .__ . '. Electrical Contractor L +- c Address q Z. -g s '3 Acy-~s --S ,....--e r City S.o (C \ ~ Phone5lJ> '1196 Supervisor License Number '-f17'i-S- /2/;0/11 Expiration Date ::+ro Conslr. Conlr, Number I b S- '--/7 5- 3)10 Expiration Date Signature of Supervising Electrician Fcl)~.OwL Owners Name ~y lice WI "c.ked Address ~IO 73 Sic,", .:(1,-'> , Cusic!'" Ilo >'" s Phone lyJ 1:,"3(,-94)3 City f. liS:'''''' OWNER INSTALLATION The installation is being made on property I own which . is not intended for sale, lease or rent. Owners Signature: . ;( InspeetlOn Request: 726-3769 ~ 'b ~ '-.; ... 7/;'0//67 Date i:X!~~LlfIj>flil!,~~!!.~P.ULE~Eip,lf'- '...... ...... <'., "'>:',,'" ~;:;,'~'.--, ~".-:-;;:-.,,,:.- J, --7. ~ -;".... '-;'-.-'- =;-'~':,-\C;<--.~ A. .!'If,...Res!d~n,liar-:;'~ili.gleor; [\'lti,lli-Familr p~r,dwe~I,in~ "n!~'" '.:1 Service Included 1000 sq. ft, or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder ( j!XOo 13 cf 3 $)'00 7::)' $57.00 l::-='~';;--""'-'~~:-:~~._"'1.-~:--""\'::-'-'-~'-::.?'''''_-_~'"'<,:, ,_ :-:"'"..-- '':;,',''1 B. .~~~<2~ ~:~,F~~e~~__~;I,~~a!~~a~~~~_~~ AIt.er:at_isrs'or Relo~~l.ti~![:...;.~~ 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 73.00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 . c. ; '~fe:I~'p~r~~ry:~~r~fc~~sri{Fe~d~}~. "\~: . ", ~",. ," -, Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 100 $ 79,00 $114.00 1,3 Over 600 Amps or 1000 Volts see "B;' above, D. t'-, 8'r~~~:~ '.~i~~l~!is<~~~lf'" !".~ ": ',- ,,;?-.,~~,~ ~ ~-':,:~ ,~,;::~;; . . '~:":" New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit ~.,~. <~.) - :i . . $ 50.00 $ 5.00 E. t "":::".,.,-'; ':_"'-~' :,'''""".,' ~ ,~,... ~";,- .., ,", " :.,:. ';. '. :~-:.,' I MisS.,ell~.ne~njs (~en'_icel(eed~r,not iriclud.e'dh..:E~~h Ins!all~~to~ . . '. . ,. ..' Pump or irrigation $ 57.00 Sign/Outline Lighting $ 57.00 Limited Energy/Residential $ 29.00 Limited Energy/Commercial <C~ 52.00 Minimum Electric Permit ~nspection Fee is ~oo + Surcharges 4. ' SUB1"oi"A-";oh~oVE ::' -,-' 'i Z 7 2- '? 2-b'{ 12% State Surcharge ] 0% Administrative Fee 5% Technology Fee / ) to-. -:?I% ~- TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application 7-08.doc Willamalane Park & Recreation District Job. No. t:!9-/~1) , SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009 NAME: BWC-H. pHONE: G't!k; -n.5-o STATE~ZIP:"? 7as- ADDRESS::JdI3 S~ IIIIf!!:...J CITY &::uG. LOCATION OF PROPOSED BUILDING SITE: Street Address: I :J. I , S. 4.f IJ r PlatName: Tax Lot Number: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) A. Sinale-Familv Detached NO. OF UNITS ( X $2,858 per unit = $ ;2..8S' 0- B. Sinale-Familv Attached NO. OF UNITS X $3,100 per unit = . I $ C. Multi-Familv Aoartment NO. OF UNITS X $2,641 per unit = $ D. Sin ale Raom Occuoancv NO. OF UNITS X $1,321 per unit = $ , E. p..ccessorv Dwellina Unit NO. OF UNITS ,X $1,550 per unit = "$ $ '2. 6 S8?O J!f $ WILLAMALANE SDC 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willainalane Credit approval.) 3. TOTAL WILLAMALANE, NET SDC ASSESSED (if SDC reduced for Credit) $ _.:2FS;-~ ? I 2'7 I oS Date ~'/~ Development SerVices Department CitY of Springfield 5 225 Fifth Street. Springfield. OR 97477. PH(54 1)726-3753 . FAX(54 1)726-3689 . 2..J) S YOt-t..(J1 , , 1-"" "'--'--'''-c_-,-,~~-"w'--'"'--''-l I~ . .oEP,l\Bl~~!;tI",\,t~~!.9~.SX~~: 8PQINC"'8LD ':::J ~~ Pennit no:cY'1-1 07s IP "A I" . So...~ Co\.) Structura ermlt pp lcatIoD-_ Date: 71..27/0,/ This permit is issued under OAR 918-460~0030. Permits expire if work is not started within 180 days at issu~nce or if work is suspended for 180 days. Ii!WA"";::~""~EoCA['4G0i1ERNMENT,""AeF1ROvAi'cl~~~!.tiir;1 ~.~~___,-_t(.;_.._._^~..,,__._~~.'ii!...___.,.-....,_ ~ _,-,-'\. _ .,.."<.~I>._"r. I This project has final land-use approval. I Signature: ' Date: I This project has DEQ approval, I SIgnature: - Date: (a) Job description: I Zoning approval verified: D Yes D No I I Occupancy I Property is within flood plain: DYes D No I I, Construction type: ",f"';\\j;"'i:li:f.,~;r~rCA'~T"-E~G~O-'R''''~'OF.:'?'C~O-N''S'''-R''UC:\"iONi,'!lJbt\i',; .",:':ct,'1 I !;~<!':::'i~....".~ .~"'?.'..~},._.,_.~___..__<, ~.!tl",""_,l,\h".,,,,.._~..ir,...._,--. ..."'-_ .:-~~:;'~o,_-,'i"",_,;, ,', ':'c_::;, Square feet: l&ii~~~~~t~TJ~~0~~it@]~;O:N[Jt~~4TI;~i~~%~~~ i ~::~:f:::t~::ot: I Job site address:, I 'z.) b ,5 L{ (~+- I I Type oCHeat: I City:<;o'~;"'lL<--I'\ 1 State:OiL I ZIP: 9717l' I I Energy Path: I Subdivision:F; ,hd't, I""",,l-U\J'~ I Lot no.: "J=)' 3 I I D D . I I I new alteratIOn I;;;:;~;~~~~~~"__f~';;'~*~:';;":&""'~""""'c""'"",,.~"'c"'"~~~"1.~.~:..""""."p'<:'. :;(,,-\'!,;,":"'-;fr:'.'~ ',~!,.. . I (b) Foundation-only pennit? D No ~,4,4$"~l';11!.?.if~~T.:~~t:P.B9_e~BtE{(~9.WNg~~";':-~:2,r,::,,~".:~):~i:y,,~I'l;:-.,. I Total valuation: I s tl Name: fl>'2i" l/ C (" tv '-'" C.hii ~.t C v SKlW'- ~ (\o\.a~ :tN c.. 1:',2: BIlndirrg~:~'re-est;;<~i;t~~?q~i~t-.,:'~;';;;' .:: < ; 'f_: !:-';,~{r,~,;;\l,?;",:,~tr,-~,~,>",;_.:_t,~:;,:._,'~,~~,.,'\ ~'''',,-,:t,'~;,:'!:1 Address,~071 s~".\<::w L-N ,,,. ,...-..-,.-." '" -." , lei I '" 7 - I (a) Permit fee (use valuation table), $ City: < "'1e,,-,,- StateO I- ZIP:, Y 0'5 . , " v , b v ,tY 7'7b' I (b) InveStlgatlve fee (equal to [2a]): $ Phone: -.1-1'1So Fax: -J -:;/0<-' I" (c) RemspectlOn ($ per hour):' I E-mail:W;(c,\-,."r \-..O~S QCD;OL"~\" Ne.'" (number of hours x fee per hour) This installatlb' on isfbeing mad de, on ~esidlentialdo: farm proPfrerty'lowned by I (d) Enter 12% surcharge (,12 x [2a+ 2b+ 2c]): me or a mem er 0 my ImIDe I~te LamI y, an IS exempt om lcensmg requirements under ORS 701.0 I O. l:r3(~1'p'~I.~<~~~~=~:~~~fi~~:,~~:r:~~;t~,~;~~;;~:!~;~,:,.j~~~Jl;'7~~;~;@~'~^~;~"\~E~~';: ~)'f\;_ ,~ag:Jr~~!~lY?~ ~.~~~~f~,!l'1f,\;~i!.,t;:t';il~,;~71,;tff..;~f};,f~J~A:W~,:~?;~[i~.;,.,~t Sign here: ~~~-f~~9.Q~IM9IQ1iiiNsJAi:~ffQNl;!~~~1!iW,{J:;,~3{ii~lil I (a) Plan review (65% x permit fee [2a]): I I (b) Fire and life safety (40% x permit fee [2a]): Business name: '\b'(vtC. lJ;e(.,~t'..J''( Cu....bt- ~y\..Q.\ J"owG I I I I (c) Subtotal of f.e, above (3a and 3b): , $ Address,'3073 <;iL1V;e..v 1-",- I':'~. '_Mi~~~.fi:$!r~.~~#,sJ~'~~~~~~t\,t.::;;, ';';,'.:-: ~~{ ~;~': ,:,;_'_;A~'~l~_~~~,~F~J~~~~\~~~_::~), I City: {:"~ e,~ I'State:o'.1: I Z'::'17)"'1 I Phone: -M & cl ~I s y I Fax: :s'tlf" ::, 3 b l (a) Seismicfee, 1% (.01 x permit fee [2a]): $ I E-mail: W; <::61...... \ Jr..o I'>-L S @ (.0'''' u..s4 ~ 1N6' I TOTAL fee, and ."rcharge, (2e+3c+4a): S ICCBlicenseno,: /011(7 I I Printn~e:~eoJ...~,;Ac Wt'.~'ro'J"v" I I Signature: W W __________.' I {~d%S~~~\4_i1!~fr~,[@f~qH~p;lt~~:~:~~~*~~t;r~~~~\1 .{i~;,~~t~;;r@1t)J!f!Q!m~ljQp.l};~]]~~;~;G~~~%~~1~m~_J~)~4 D addition DYes $ $ $ $ 1'~"1\;;"-""'>'J'-~lUB'" 0NTR"A' --:-'TN---RMAti0N""'""""~"""" I ~~.^"..Y.Ji~11f..;?,~~;~~_"._,. _,,7,9..~_-, ..,_,..,....'-gJ":,QR.t<__Jf5~L_____\;~L,:__ .~a~~w~.'t~~,',\~\ I,} I Name CCB License Number Phone Number I IEleclricall-+-C /05'17.< 5/-1'11-;& I I Plombing51L;,<i Plc~l,'.,< b5065" :; ~l-3'(" I I Mechanical(fH "~br) 72.(,--0}0" J ~<y ~l\ 225 Fifth Stroeet Springfi'eld, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0] 095 COM2009-0 I 095 COM2009-01095 COM2009-0] 095 COM2009-01095 COM2009-0 I 095 COM2009-0 1 095 COM2009-0 I 095 COM2009-0] 095 COM2009-0 I 095 COM2009-0 1095 COM2009-0 I 095 COM2009-0 1 095 COM2009-01095 COM2009-0] 095 COM2009-0 I 095 COM2009-0] 095 COM2009-0 I 095 COM2009-0 I 095 COM2009-0 I 095 COM2009-0 1 095 COM2009-0 I 095 COM2009-0] 095 COM2009-0 I 095 COM2009-0 I 095 COM2009-0 I 095 COM2009-0 1 095 COM2009-0 I 095 COM2009-0 I 095 COM2009-0] 095 COM2009-0 I 095 COM2009-0] 095 COM2009-0]095 Payments: Type of Payment CreditCard cReceintl RECEIPT #: ii~' " ,~ City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000000855 Date: 07/30/2009 Description Building Pennit Addressing Assignment Willamalane Single Family 2 Baths One or Two Family 1 st Appliance Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets]-4 Fireplace (Listed) Residence Wiring] 000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee 0 Residential Plan Review Major - Planning PW Disc - 2nd Pennit Curbcut Pemlit Sidewalk Pennit Stonn Drainage Imperv~ous Area Credit- SDC Storm Improv Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Trim Reimburs-Residential SDC Tr~ns Improvement-Resident SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sariitary/Stonn Admin SDC Transportation Admin + 5% Technology Fee + 12% State Surcharge Plan Review Same As Paid By BWCH Item Total: ' Check Number Authorization Received By Batch Number Number How Received djb 00590c In Person Payment Total: Page I of I 2:10:39PM Amount Due 1,034,35 38.00 2,858,00 337,00 79,00 27,00 9,00 13,00 9,00 7.00 20,00 134,00 75,00 63,00 106,25 211.00 (30,00) 88,00 88.00 ] ,2]5,08 (1,215,08) 666,84 507,07 211.21 931.65 101.97 1,146.50 10,00 90.58 88,]8 108.22 2]6.88 250.00 $9,495.70 Amount Paid $9,495,70, $9,495.70 7/30/2009