HomeMy WebLinkAboutPermit Building 2009-8-7
Ul i'; OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01141
ISSUED: 08/07/2009
APPLiED: 08/06/2009
EXPIRES: 02/07/2010
VALUE: $186,000.00
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5792 MINERAL WAY
ASSESSOR'S PARCEL NO,: 1802033302100
SPRINGFIETYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: NEW SINGLE FAMILY DWELLING SAME AS 5752 MICA
Owner:
Address:
HAYDEN HOMES LLC
2464 SW GLACIER PL STE 110
REDMOND OR 97756
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor License
HAYDEN ENTERPRISES 92208
TOP NOTCH ELECTRIC INC 172366
PACIFIC AIR COMFORT INC 39237
STUTZMAN SERVICES INC 31747 '
I BUILDING INFORr.'A'f!ON,j~y
ATTEN1\UN, ';'~~~;d bY \\1e ure\,lU'~;\ 10r\\1
< low rules 8# of Sior\ies:, rules are 5~ 00' _ I
"lO" C -tr.>r 1\ vv'" (""\!\'R. 9 c..- I_
R-(3'\j'\ca\iOn EHeight'jo,f,Structure ules ']6,00
NJl ~ lJvl~ '''.......... +...~Af eJ
'nil, ^R 95Z-0vtyue\ofrHeat:',eS 0' ForceiLA, ir Gas
m"Ut"'\ ,,"co i::lL I ...-, te\epllU Iv
Y.OB'O You meWatee TYJ!e:e: \\18 \'j'\Ca\'\O\yas
u", \1 oOD'"'' ," T\ No \
calling \ e Raugli'c.ype:lJ\\ \ Y 44) Electric
'\u~ber lOr E'11,r~ iath:'33Z,Z3 '
'i III to( );f'~l ... ~
CerSpnnkled Building: No
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Coustruction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFOR~1ATlON ,
Fronryard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
18,00
8,00
5,00
28,00
15,00
Resideutial
Expiration Date
07/29/2011
09/29/2010
03/25/2010
05/12/2010
Phone
541-228-1081
541-317-1998
541-672-9510
541"928-8942
Lot Size: 5,300
Sq Ft 1st Floor: 1,235
Sq Ft 2ud Floor:
Sq Ft Basemeut:
Sq Ft Garage/Carport 480
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
I
Yes
23.30
"Total:
Handicapped:
Compact:
2
I PUBLIC IMPROVEMENTS I
Street Improvements: Fully Imnroved 't:. Sidewalk. T,vM:\t."-NOR~ C b 'd 5'
~ ~\01\C". "LL j;.!S~\"t Ir ",'Ico, NO \ ur 51 e
Storm Sewer Available: Yes \~ p\:.RN\\I S\'I"tJ"'(V(sP(I'.(!~ZD~ainS': Curb and Gutter
Special Instruction: 1\'11S OR\I\:.O \.lNO\:.R ~~\DON\:.O rOR
p.,\.lI\'1 0 ORIS p.,'[),
Notes: STORMWATER TO CURB AND GUTTER CON\N\\:.N~\:.p.,'i p\:.RIOO. '
p.,N'i "\80 .
Pa2e I of 4
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,
Status
Issued
CITY: OF SPRINGFIELD
Building/Cqmbination Permit
PERMIT NO: COM2009-01141
ISSUED: 08/07/2009
APPLIED: 08/06/2009
EXPIRES: 02/07/2010
VALUE: $'186,000.00
225 Fiflh Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I V a~u~,~io~ Description I
Description Tvpe of Construction
Bid Amount Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
186,000.00
Value
Date Calculated,
Total Value of Project
$186,000.00
$186,000,00
08/06/2009
~ F~~, ~1ilU
, Fee Description Amount Paid Date Paid Receipt Number
,
+ 12% State Surcharge $214.41 8/7/09 1200900000000000890
+ 5% Technology Fee $106.44 8/7/09 1200900000000000890
1st Al'pliance $79,00 8/7/09 1200900000000000890
2 Baths Oue or Two Family $337,00 8/7/09 1200900000000000890
Addressing Assignment $38,00 8/7/09 1200900000000000890
Appliance Vent $9,00 8/7/09 1200900000000000890
Building Permit $1,058,77 8/7/09 1200900000000000890
Curbcut - 2nd Curbcut $-45,00 8/7/09 1200900000000000890
Curbcut Permit $88,00 8/7/09 1200900000000000890
Dryer Vent $9,00 8/7/09 1200900000000000890
Exhaust Hoods $13,00 8/7/09 1200900000000000890
Fire SF Fee - Residential $85,75 8/7/09 1200900000000000890
Gas Outlets 1-4 $7,00 8/7/09 1200900000000000890
Plan Review Major - Planuing $211,00 8/7/09 1200900000000000890
Plan Review Same As $250,00 8/7/09 1200900000000000890
Residence Wiring 1000 Sq Ft $134,00 8/7/09 1200900000000000890
Residence Wiring Ea Addtl 500 $50,00 8/7/09 1200900000000000890
Sanitary Sewer - Improvement $529,11 8/7/09 1200900000000000890
Sanitary Sewer - Reimbursement $695,83 8/7/09, 1200900000000000890
SDC MWMC Administration $10,00 8/7/09 1200900000000000890
SDC MWMC Improvement $1,146,50 8/7/09 1200900000000000890
SDC MWMC Reimbursement $101.97 8/7/09 1200900000000000890
SDC Sanitary/Storm Admin $165.36 8/7/09 1200900000000000890
SDC Tran Reimburs-Residential $211,21 8/7/09 1200900000000000890
SDC Transportation Admin $16,16 8/7/09 1200900000000000890
Sidewalk Permit $88.00 8/7/09 1200900000000000890
Storm Drainage Impervious Area $935.71 8i7/09 1200900000000000890
Temp Power 200 amps or less $63,00 8/7/09 1200900000000000890
Vent Fan $27,00 8/7/09 1200900000000000890
Willamalane Single Family $2,858.00 8/7/09 1200900000000000890
Total Amount Paid $9,493,22
Paee 2 of 4
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-0] ]4]
ISSUED: 08/07/2009
APPLIED: 08/0612009
EXPIRES: 02/07/20]0
VALUE: $ ]86,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plan nine Review
08/06/2009
I Plan Revie,:s I
08/06/2009 APP
DDK
Public Works Review
08/06/2009
08/06/2009 APP
BJG
Access restricted to one
driveway/lot. Follow street tree
plan,
STORM.wATER TO CURB AND
GUTTER '
AS NOT!m ON PLANS
Structural Review
08/06/2009
08/06/2009 APP
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:jbe made the following
work day.
~PPtion'J
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed,
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction'with footing and/or
f?undation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to lloor insulation or decking,
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sbeathing with finisb materials,
Fr~ming Inspection: Prior to cover and after all rough in inspections have heen approved. .
Wall Insulation: Prior to cover,
~eiling Insulation: Prior to cover.
Drywall: Prior to taping,
Final Building: After all required inspections have been requested and approved and tbe building is complete.
Perimeter Foundation Drains: After gravel and IiIter cloth is installed but prior to backlill.
Underlloor Plumbing: Prior to insulation or decking,
Underlloor Drain: Prior to cover or placement of concrete,
Rough Plumbing: Prior to cover and including required testing,
Water Line: Prior to 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 PI~mbing: When all plumbing work is complete,
Underlloor Mechanical. Prior to insulation or decking and including required testing,
Paee 3 of 4
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Iss u ed
PERMIT NO: COM2009-01I41
ISSUED: 08/0712009
APPLIED: 08/0612009
EXPIRES: 02/0712010
VALUE: $ 186,000.00
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54]-726-3676 Fax
54] -726-3769 Inspection Line
Underfloor 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 minimum of one appliance including required
testing, Presure test done at this point.
Rough Mechanical: Prior to Cover
Final Gas: When all gas 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 utility company energizing service.
Final Electric: When all electrical work is complete,
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete,
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 the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUP 4NCY will be made of any structure without permission of the Community Serviees Division, Building Safety,
I further certify that only c'ontractors 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.
o-wn~~~'
j'-7-0i
Date
Pace 4 of 4
SAMsE 18>, S79-
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DEP.ARTMEl'hU~E9N~Y 'I
Structural Permit Application
-
225 Fifth Street. Springfield, OR 97477. PH(S41)726-375.]. f.A.X(541)726~3689
Permit no, CJ9- // q /
.1 Date ?/t.1
This permit is issued under OAR 918-460-0030, Permits expire, if work is.not started within 180 days orissuance or if work is
suspended for. 180 days,
,;- "...; ~~:;;~q(;A~J~:QYgR..!\rMgNT!(AeRRQ:y~]lX~f;li((~~V1;,.Elt~i;;HI
I T~is project has ~nalland-use app:oval. I
SIgnature:' Date:
I This project has DE.Q approval. I
S!gnature: Date: I (a) Job description:
I Zoning approval verified: D Yes DNa: I \ Occupancy
I Property is within flood plain: 0 Yes 0 No I I Construction type:
Ir:w:\i.~l;~~,,~ji,\!4~i,!!.gAt~99~Y!Jl}jJ~~(ijH~f8.u(;t(ii.iil.li~~~)!!iJi,;";J,t;$~Ii"!1 I Square feet I:) ~S-
I 0 Residential I 0 Government I 0 Commercial 1 1 Cost per square foot: ~
IT%~,~i;~!:;:i;OQ~~siJ~);IN~1'5i'iMe.Tip.~~A~R~:~QqA;,.IQ:~11W~%~~iifH:l I Other information.
I' Job site address: <\PI;). f'lhWta..1 'I I Type of Heat:
I City. ~"'''"~P..lt! 1 State. o[ I ZIP''T7<nf I I Energy Patb: :1A
I SubdiVISion. :tc.s~ r---I,~,..... I Lot no .-:2(Jl'6, 1 I
I .lX:1 new 0 alteration
I Reference: I Taxlot:
:~a~e. H~l'~:" p.~:':::TYQWNER"""'l : ~~t:~~::::i~:~~nlY permit? '
I Address: ,:).L{C,4 .,;..... 6/"':'''''' PI,or" I
I City(m""-O! I State:oR.. I ZIP;1nS'~ I
I Phone: ~,i-1lt -4P~~r Fax: S'1I-71I1" .2~7L ' I
I E-mail I
This installation is being made on residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701,010,
Sign here:
I. "";l::ONTRAl::I()"jIJ:olSi;.A.LLATI9N:.:,.~;;;
I Business name:
I Address;
I City:
I Phone:
I E-mail;
I CCB license no.:
\ Print name:
I Signature:
I State.
I Fax.
I ZIP;
1:;lq;j;;g;;(iii*~~\$QEi,iC0N)113.A.<':;:tQR"@Qi~'I'Il;b;\f:LQi'!1~?ltt~0[J0;i)~'@;\1Rlj
I Name I CCB License Number Phone Number I '
I Electrical '6J3Ub .5C/I-3D~/'1'1f I
I Plumbing ?/7tf? ~/~~7d."1S/0 I
I Mechanical ~~7 ,i5t-II - Cf:)$ -'if14')., I
o addition
o Yes
1
I
I
I
1
I
I
I
I
I
I
ONo
I (a)Permit:fee (use,yaluation-table):,'
I (b) Investigative fee (equal to [2a]);.
I (c) Reinspection ($ , per hour).
(number of hours x fee per hour)
I (d) Enter 12% surcharge (.12 x [2a+2b+2c]):
I (ei Subtotal of fees ahove (2. througb 2d):
$
$
$
$
'(a) Plan review (65% x permit fee [2a]);
I I (b) Fire and life safety (40% x permit fee [2a]):
I ,I (c)'Subtotal of fees above (3a and 3b):
I
I
I
I
I
I
$
$
$
I (a) Seismic fee, 1% (.01 x permit fee' [2a}):
I
$
TOTAL fees and surcharges (2e+3c+4a): $
.,
Willamalane
Park & Recreation District
Job, No, L?9- //7'1
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
NAME: tYnt~PHONE:';.2J"df?r
.' -"ADDRESS:~~ fr,,/'cL~/iciTY~l:r 'sTATEdiip;-~1S?'-
LOCATION OF PROPOSED BUILDING SITE:
Street Address: ;"1'1)
~/Nt'aAL
Plat Name:
Tax Lot Number:
1, DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type definitions are on the'
back,) ,
A. Sinale-Family Detached nc'\,i''''S '1out~
, - I.' 1""1 fe'"" ,n\)t!\lcY
NO, OF UNIT~ ".,:::::~" n;8;Y)" ~\~?1858'J?~~\w;\1~'\=
r.\ \ \.:;.,4 , _""fl8r...llJ), l\esa,\t;;;:J; 00'\-
t\ I v' Y:.11;-;0 v.U:r:--. 1t\Ose \'~ (' \p.952.-
B, Sinale-Famny\;A:ttai:hed~\\"'~'" fJ \\110\.1<;)\' U!"\18 \ \.lIes bY
N(\I\,\\ .. 1'::') ,...,G1J)IJ \ ~i)\('S 01" ~ of,e
NO, OF UN\;rSf,n go';;,v c,bta\r:x'~3. ~i)()Jle'?ilJ~)t",
. ,r,[ \~,,_' ~I'\\ \ ;e.... ., \-\/ \':!OUI Ct..
00::;\..1. ,r(.'\ll'.... , \Jt\\\lj I
-"\",,q In8 v' 0\800\\ 2344),
C, Multi-Family A~ai:tment\ Ire, 1.GUO.33Z'
[kll' ,- ceflte\ \S
NO, OF UNITS X $2,641 per unit =
$.;).tfFd
$'
$'.
D, Sinale Room Occuoancy
NO, OF UNITS
X $1 ,321 per unit =
$
E,Accessorv Dwellina Unit
X $1,550 per unit = ' '$
. ?j
WILLAMALANE SDC t. II' ,\\\: \"J~(!f':
, ~...\rt:. , \..\.. \:~?\~ (:.\l,\'J\\1 \S ,
2. SDC CREDIT (If applicable) gp\j pa~t~at~5fiJc\f~FO\'\t.D \,()I" ,:
Willamalane Credit approval.l\f\\S ~\7);,'0 \)\\ \" 1\\)1\\;0\'0 $
\.\\\~()\" - XI Q\l, u
3. TOTAL WILLAMALANE NEt~f!)'et,\l)~\~$SEBD'
~C'''''' . ,",\" '
Development Services Department
City of Springfield
NO"OF UNITS
$:' 2d-ra-
171 ~ ,.' /
Date
5
, I
I ,I" , ) 1
225 FfFTll STllliET . SPRINGFIELD, OR 97477 . Pll:(541)72G,3753 . FAX: (541)726-3689
It. ,
ELEC1RrCAL PERMIT APPLICATION
City Job Nl;ll1ber ~q- /1'1/ I
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02.,( C 0 se";'i,e Included " ' /3C(. 1/
JOB DESCRIPTION: I 1000 sg, f[, or less ! $YJJ>O IS.,
I .J' Each rldditional 500 sq, f[, or [)' 0
flu LA. <;, (__~ i ~J 1.fLE .p; / ~i41. t portior tbereof Z. $ 21'00 S-
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Permits are non-trans era can cXj}lre I wor (IS 'ac anUiact ( - ome or
I I I .
not st3rtcd within 180 days of issu31lce or if worl< is MoClular Dwelling 'Service or '
., _.,.... ,Suspended,fod80,dayL___,__ ___..., ,.. __L_____..__,Eeetdel:_,_,__,_'__'__,_,~..__,..,__,__ $55,00
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Electrical Contractor y;"jJ);!;if0;,',;;!ecJ,rp~~ ' 200 Amps or less $ 70,00'
I' -"'le"t' -v"Cld -." IElVv t I
, In OAr/' IOn ('0 ':tIed b requ20I Amps to 400 Amps $ 83 00
;2081'1; 1(%%l.p2'[iJ~n!1 /hnrethe Or~Ujr A'lnps:!o 600 Amps $ I 3800
c' (~U rn ~u I u th rUles '"un Utili' ,
nl ~ny II>,: _~ Ob/am ...:OUgh OA "~J',s)fo~ OOOA.illPs n, $ J 8000
}Dolle r~~,r:~"t!!',7;g> Of thi./;:~!1-{jjfl:/\1iipSIVOlts, -- $4lJ~00---'
Center' UregOn if Ihe tel RCCQIf5~ Only $ 55,00
IS 1'800, 1Jllly N ephon'e ' ,
Ljo.~~ L( s I 33<-23440ct'f/~mr~ i~>>, ;m'u:i'L\ljttl'l~~~WY~It\I:~~JfJ~~~11,1;!I~~rliU'1;~~&;dlo;~l~'5'''1 'i1li':1:,()\~1';')II~;:il:'i~{~~h~'W:f11;~il.7~r~j1~<;:~f'Yij~n''\~;''-!,''
SupervIsor License Numbel J . lIil',:'i;:~ OliaI~p~erl;yjlC~ Ol:Jw:ecl crs~, '11 \~!;i~l:,~I"'kl\~~ llll' 'M~r~'""\;'11'j1L \r.!1~~'
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Expiration Dale ; (2n 7, I Installation, Allcrationor Relocation
I I /
I 200 AJnps or less
, I
20 l1mps to '100 Amps
I. 4011JUPS to 600 Amps
Over ,600 Amps or 1000 Volis, see "B" above,
, ,.!, , I) 1~'Bmf(ijJtr.!Wrlt\~\'a:;JK:~'JflNtl;;I'!~I:p~;ir~;p~; J:,tl~):tYr~~~jjJi~~f:;;11~~'~;*~11fj~.I~~1:~j~f:"I\~~rN:1J!JJ::~ml.!t1iXo/i~~:!~~m::~
S,gna,L TC 0 f S upc.rYA'S1fI -< eclncmn ,. . !~~;I,J~gjJ~~1l~i'&11k~;!;i~II{~ij:I'I&1\~.I~f.1?:\I~W:;;~f'::~'1')'i1k!t;~',~1!M~~i:I~,':1!,r1~~'f~~!Jt~r:;,' ),:~~~X;.':Mi\1j'f,'.\h;~:Z(i
CZ\'~ ~ ~,tJ Ii~::-. "\ /l () A -t,~ __ N~\v ~ItCrati:~ or "~:;:::i:'~';~;-;:'I;'~";""'-"'-'''''~iJ~''~''''."~',"'
- r ~){?5;'~E :.. On,e 8trCllIl ,., $ 48,00
Owners Na;ne J~tJ.~ENA~U Ul~~~~~:'~:~i~d~'~~~~~;;~:~ti~r w,t~' $ 4.00
- '~-~l{ L ~~Z-ll/l.bl- '6fL ~ FOR E ~T;l;~1:~tj%W'J:i!I!j~'i;~W~J:%j~r.\P.?;j~~~Ji!::i:11~~);,;:~r:i'W[lml'~1';i~.m:t~m~f'1i.j~~1;;i;:r;~i;~{ilP:1-f'~;M;11le;'~rm:'Fl"'"11U:lf:y,;~I'.~;:-~(~ft!'.1~
Ad I' ~ 0 r L::> / "CA: I. lii;f'Yf,jse~ 11'~QlIr.:~r~~Cr.NNe/;rc'c,( ClJl,ij~Qt~;mc'liHlCtli\"+\M'3clil 'ifsl!ll :'h)-bh'i
, (less _,' ,'_. _. ,___"""0 ",-- ,-- ,- "., , ~U;~~~n~fl;~1~W:lli~il,~:~rl.wiJY.l-J.~~~~ffiU~:]iil~"btli'.'11:lI:'miJ;fu1'ti.!Wj:f~'!!~m'Jl':;~61ili{1li\I~~'i.'f.l\},\%:I::i;,;r!)::~,~t\\j~!m:
City ?t::DwtOtJ0 Pbon~-t?e:--b7.-?,)PUIl19 or irrigation ' $ 55,00
, , Si~n/eutline Lighting $ 55,00
OWNlm INST ALLAT;lON LiinifedEnergylRcsidential $ 28:00
Ylic"lnstalIalion is beinglll1ade on propertY ro;;';;;~wl;),Ci;-' ,., .,,' I:imilcin,nergyfConulliO'iciar- '-'$-501)0'" ,,---,
, I ' I,
is not intended for sale) lease or rent. " Minimu,m %lectric Permit Inspection Fce is $50.00 + Surcharges
Ow'OC""..mo ~~ .~~. ;-~7
l\\A. Iqolo,Adminislrative Fee /2 J}
~: It 5% Technology Fee
I
TO'FAL
I
Address
L.i\y---R fm..{7(
ConSlr, Conll'. Number
: n 2 '3 &G:.
I
I ;20"'8 '1
$5.x60
-176,00
$1 10.00
b"),
Expiration Date
-
'I
[nspettion Request: 726-3769
zgt n
Shared Drive(T:)/DuiIJing Forms/Electrical Pcnllit Application] -O&,doc
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fifth Street
Springfield,Oregon,97477
541-726-3759 Phone
Job/Journal Number
COM2009-01141
COM2009-0] ]41
COM2009-0] ]41
COM2009-0] 141
COM2009-01141
COM2009-01141
COM2009-0] ]4]
COM2009-0] 14]
COM2009-0] ]4]
COM2009-0] 141
COM2009-01 ]4]
COM2009-0114]
COM2009-0] 14]
COM2009-0] ] 4]
COM2009-0] 141
COM2009-0]]4 ]
COM2009-01141
COM2009-0114]
COM2009-01 ]4]
COM2009-01 ]4]
COM2009-0] ]4]
COM2009-0114]
COM2009-0] 141
COM2009-01141
COM2009-0] 141
COM2009-0 II 41
COM2009-01141
COM2009-0 1141
COM2009-01141
COM2009-01141
Payments:
Type of Payment
CreditCard
(,:Receintl
RECEIPT #:
1200900000000000890
Date: 08/Q.7/2009
1:35:23PM
Description
Plan Revie,\, Same As
Bui]ding Permit
Adqressing Assigrunent
Willamalane Single Family
2 Baths One or Two Family
]st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets]-4
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Fire SF Fee - Residential
Plan Review M~jor - Planning
Sidewalk Permit
Curbcut Permit
Curbcut - 2nd Curb cut
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Tran Reimburs-Residential
SDC MWMC Reimbursement
, SDC MWMClmprovement
SDC MWMC Administration
SDC Sanitary/Storm Admin
SDC Transportation Admin
+ 5% Technology Fee
+ ] 2% State Surcharge
Amount Due
250,00
1,058,77
38,00
2,858,00
337,00
79,00
27.00
9,00
13,00
9,00
7,00
134,00
50,00
63,00
85,75
2] 1.00
88,00
88,00
(45,00)
935,71
695,83
529,11
211.21
101.97
1,]46,50
]0,00
165,36
16,16
1 06.44
214.41
$9,493.22
Paid By
BRETT WILSON
Item Total:
<':heck Number Authorization
Received By Batch Number Number How ~eceived
Amount Paid
djb 03138c In Person
Payment Total:
$9,493.22
$9,493,22
/
Page I of I
8/7/2009