HomeMy WebLinkAboutPermit Building 2009-8-27
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01243 ,
ISSUED: 08/27/2009
APPLIED: 08/25/2009
EXPIRES: 02/27/2010
VALUE: $ 145,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5795 MINERAL WAY
ASSESSOR'S PARCEL NO.: 1802033302800,
SPRINGFIETYPE OF WORK: Single Family Residence
TYPE OF USE: New Residential
PROJECT DESCRIPTION: NEW SINGLE FAMILY DWELLING LOT 275 JASPER MEADOWS- SAME AS
1852 S. 58TH
, REQUIRED PARKING
2
Owner:
Address:
HAYDEN HOMES LLC
2464 SW GLACIER PL STE 110
REDMOND OR 97756
Contractor Type
General
Electrical
Mechanical
Plumbing
I CONTRACTOR INFORMATION I
ATTENTlO '
Contractor fOf/ow rut N: C1dcense Expiration Date
HAYDEN ENTERPRISES ;NOlificatio:~ ad'~22"'O~' b;~ reqUirEO:7J~J1011
TOP NOTCH ELECTRIC INC1 OAR 952 ooentl'7236~se r e Oreg09/291281O
PACIFIC AIR COMFORT IN890, You ~a I~03i.~?")roug~eSarf~~/i~~~9AO
STUTZMAN SERVICES INCn~~/!ng the C~nt~)7~7;OPies n~~R 05IH/.7PJO
BUlLDINGiNFORMAT-I0N:I')v~t:'lthe tet;p~"nS by
I Ity Not", e
, '0 l-tiUO-332_ Il/calio
# of Stories: ~'44).Lot SizQ:
Height of Structure 14.50 Sq Ft 1st Floor:
Type of Heat: Forced Air Gas Sq Ft 2nd Floor:
Water Type: Gas Sq Ft Basement: \
.
Range Type: Electric Sq Ft GaragelCarport
Energy Path: Sq Ft Other: -,-
Sprinkled Building: No Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I
R-3
VB
2
I DEVELOPMENT INFORMATION 1
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
18.00
5.00
6.00
40.00
0.00
Overlay Dist: Total:
#fsGi[e1CJI!!es Rqd: 2 Handicapped:
P,i\':'~9 PfWfv~d: Yes Compact:
r.o' oflbobCo~b~a~(;!:I\LL EXPIRE ,ll.7.0
'v, ?VnILED UNO r I HE WORK
COMMFM"cn "'~ ,SR THIS PERMIT 1<, ,,"'_
I PUBiic\jMPRO~iti~1t,TiJ[jAIVDONED FOR' ''-'',
Sidewalk Type: ,
Street Improvements:
Storm Sewer Available:
Special Instruction:
Fully Improved
Yes
Storm water to curb via weep hole
DownspoutslDrains:
Notes:
Paee I of4
Phone
541-228-1081
541-317-1998
541-672-9510
541-928-8942
4,676
832
280
Curbside 7'
Curb and Gutter
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Garaee/Misc
SF/Duplex
Tvpe of Construction
U VB Utilitv
R-3 VB 1&2 Family
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
I Bath One & Two Family
1st Appliance
Addressing Assignment
Appliance Vent
Building Permit
Credit - Trans Improv SDC
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Gas 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 SanitarylStorm Admin
SDC Tran Reimhurs-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
280.00
832.00
Total Value of Project
Fpp<, P~iUJ
Amount Paid
$177.35
$91.75
$220.00
$79.00
$38.00
$9.00
$891.90
$-931.65
$88.00
$9.00
$13.00
$55.60
$7.00
$211.00
$250.00
$-30.00
$134.00
$25.00
$352.74
$463.89
$10.00
$1,044.54
$101.97
$ 122.26
$2II.2I
$931.65
$17.97
$88.00
$620.25
$63.00
$27.00
$2,858.00
$8,250.43
Date Paid
8/27/09
8/27109
8/27/09
8/27/09
8/27/09
8/27/09
8/27109
8/27/09
8/27109
8127109
8/27/09
8/27/09
8/27/09
8/27/09
8/27109
8/27/09
8/27/09
8127109
8/27/09
8/27/09
8/27/09
8/27/09
8/27/09
8/27/09
8/27/09
8/27/09
8127/09
8127/09
8/27/09
8/27109
8/27/09
8/27/09
Paee 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01243
ISSUED: 08/27/2009
APPLIED: 08/25/2009
EXPIRES: 02/27/2010
VALUE: $ 145,000.00
Value
Date Calculated
$10,561.60
$80,562.56
$91,124.16
08/25/2009
08/25/2009
Receipt Number
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
1200900000000000998
Status
Iss u ed
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01243
ISSUED: 08/27/2009
APPLIED: 08/2512009
EXPIRES: 02/2712010
VALUE: $ 145,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannin2 Review
08/25/2009
I I. Plan Reviews 1
08/25/2009 APP
DDK
Access restricted to one
driveway/lot. Follow street tree
plan.
Storm water to curb via weep hole
As noted on plans
Public Works Review
Structural Review
08/2512009
08/2512009
08/25/2009 APP
08/25/2009 APP
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.
~e(]lIirerUnsnections I
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to Iloor insulation 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.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Final Building: After all required inspections have been requested and approved and the building is complete.
Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill.
Underlloor Plumbing: Prior to insulation or decking.
Underfloor 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 Plumbing: When all plumbing work is complete.
Underlloor Mechanical. Prior to insulation or decking and including required testing.
Underlloor Gas: After line is installed and required testing and capped if not attached to an appliance.
Pa2e 3 of 4
CITY VI' l'lyt<mtJl'lELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-01243
ISSUED: 08/27/2009
APPLIED: 08/25/2009
EXPIRES: 02/27/2010
VALUE: $ 145,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,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.
ErosionlGrading Inspection: Prior to ground disturbance and after erosion measures are installed.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Sidewalk - Curbside: 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 OCCUPANCY will he 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.
---;?:" Z2 A
'f; -,.:)7-cy/
Owner or Contractors Signature
Date
Paee 4 of 4
Electrical Permit Application
. I ~
r:&~::,;.:.:;_~"il;.."\:::~~:~~;f,,..:;.~r.;.o;-:.,,::"''i''(~~ffl';i;'';.v.\~'~'~:"';~\I
1;",;;-: :DEf>ARTMENT~l:JSE'0NlkY,C''''tl
.,~_'- ',.j., o:.~: ":," '-'-."'-.,', "-;"J' ",.."",',,:....,_~.#~"'-..o/'~""_,.. ~..,~,~,~'".._
',_. < _.. -,". ',' ,_, '....."., _'_'o"_'~="''''''';;:''''.~'''''''''-'-'"~~_'''~~''~'';
I
I
Permitno: m- /2'13
...
225 Fifth Street. Springfield, OR 97477.PH(54t)726-3753+ FAX(541)726-36B9
X/:2-':> /0'
, Date:
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. '
~~1,\'0e~'l:G:(;!Mi;BliIM~~[~gIillR()~~~~~~~
I Zoning approyal verified? ~ 0 Yes 0 No
1[~J!l1~3.1~\!B~Ei.'t<;~1rLI;QJ,jI~;(&t0:'~!;:.:Qr;jS.illRI!!!;:..:1jLQr)t~-m:~~
i=~~~~~f.rLi:J(~k~:~~';;AH~!~~C~~@'~~~~~ I ~:~~::ti;!, :,el::n(:; service included: I $134,00 $
I ' 1 I Each additional 500 sq, ft: or portion
Job site address:t)7'15' M,'Aer", I thereof ' . I $ 25,00 $
I City:p-""0C'" 10\ I State: oR~ 1 ZIP: 97'178' 1 Limited energy (2) $ 32.00 $
~~;;~~~&~~~~F.iW.J~R~~~~~~~ ~~~71~tn~~~~~~r~~ ;e~~;r (~)odular $ 63,00 $
I II - II I. <.- / -r lOflOW rut -.~, u 'ef &~'i"j~~~.or feeders: installation, ~lteratjon, relocation
-\OlJS~QW\( f~I"1D ~I~.", eS"rl~)t ,,',"',.
I . ~ . I" - ''''~''''On C~ E C2QO,amps odefs'(2hu to $ 81 00 $
.. tnOA'R entfr-.JlIJ.:oIfh.,.._'" .
Oc.... ':' - '! I''''',", -~V" Urr
1~~'f~R~~=~~~~~~R~~~~~r~ ~;'1.t;~t~;~;j~7~:~~~ ~ :1::::: :
I Address: ;/'-IC~-f <;t-../ I,(NI,," -',v"~~or.theO;)rf"6dIltO~A,9q~,~f.'s"(2)by $205,00 $
I City: r<:ooIVVlC"'v( I State:(jQ' I ZIP:')7~S<~S li80j~,~!I,I((,~do'amp~m;x~lts(2) $469,00 $
IPhorie:5LIi-.2Ib'''G'l~5' IFax:52'/1'7'/I-,J57.?' I Rec~n'ii~ct~ly(2)~' $63.00 $
'I E:-mail: .IITempOraryservicesorfeeders:installation.alteration.re/ocatio.n
This installation is being made on residential or farm property I 200 amps or less (2) I $ 63.00 $ b.....
owned by me or a memher of my immediate family. This I 201 to 400 amps (2) $ 87.00 $ 1
property is not intended for sale, exchange, lease, or rent. OAR I
479.540(1) and 479,560(1), ,401 to 600 amps (2) $126,00 $ I
Signa~e: lOver 600 amps or 1,000 volts, see services or feeders section above I
1~"il'l!~~:<;!fiJlI1~~jij~B~IN$m:t,li~l!i;Xif;,I,QN..~~~:I1I;'\iJ'iEill I Branch circuits: new, alteration, e:,tension per panel I
1 Business name: --';:;p \\):,tc~ E ll'/oQT1CE: 1 I a,Feeforbranchcircuitswithpurchaseofaserviceorfeederfee: I
I Address: dO~ A (OVi?'1 ci~~S PERMIT !:::/-w J Each branch circuit ,I I $ 6,00 I $ I
I City: &......0'\ I State: (ift/,?~[fIdiifD uNni~ g~F !lIlf~frfJrr-IJf"f){f},cir<;uits without purchase of a service or feeder fee: I
I I ~ ";;"VIC':/V' 'ED ~ 7 -/1, t'~ D. -nl,
Phone:5'Ii-311-1'1'i1;" F"'54NvcigO:: OR IS AE4tJ-"irm"ffnf1lJ~iliepft(2)' '$ 55,00 $ I
IE-mail: uflYPERIOD..1!~€lI-l..rdlll9nal branch circuit $ 6,00 $ I'
I CCB license no.: 17230C 1 BCD license no.: ( 22rJ _ I Miscellaneous fees: service or feeder not included I
I Signing supervisor's license no,: <J,;JO "I()"~ I Each pump or irrigation circle (2) $ 63,00 $ I
I Print name of signing supervisor: Ver I ,('-ITic~ler I Each sign or outline lighting (2) $ 63,00 $ I
I Signature of signing supervisor: (.\ I " S1...J., / / I Signal circuit or a limited-energy panel, $ 63,00 $ I
. -U -'AI'.. ~" alteratIOn, or extenslOn (2)
I Each additional inspection: (I) '$58,00 $ I
9AQvJD ~~~::~!~~~lt~~~]~~~~~1
t,t9:l 'D ~'\9JcI^- (.'",mom '-'''''''"') , ;?~~
C\ ~.~ , to ct;<~ r~~~::~n~~~~:::~~~;~~~A]) : 2// f ~
~ 'N I TOTAL fees and surcharges (A through C): $ ,?C .,17 y'
\.j.J' """""J, -
440-25B4-1 (9/0BICOM)
1~7
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I
I
I
I
I
1
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I
~ SAME
Structural Permit Application
,
225 Fifth Street. Springfield, OR 97477. PH(54 ])726.3753. FA.X(541)726-3689
I'DEPARTMENT USE ONL V ]
Pemit no, M- '( 2Lf]
, I Date F7:2->/tJ)1
This permit is issued nnder OAR 918-460-0030. Permits expire if work is not started within 180 days ofi;suanc/or if work is
suspended for 180 days,
AS __ S~
/r>S:;i
.~PR'NQF"IELD ::..~.,.':'.,;1:
l~it~!E~'g5~~~-
I,,: , ,,;':';~0CAh(:;i5Y~Rt-!M~N:i;;;'AiiifRQYAEj::b~;j;:,;:;::i,9~{::1
I This project has final land~use approval.
Signature: Date:
I This project has DEQ approval.,
Signature: . Date:
I Zoning approval verified: O'Yes 0 No
I Property is within fiood plain: 0 Yes 0 No
l~ijs~~~t;~&i-;~j(j~#/9At~,Q_QfiY:~tQ_F;~.~.q}~~ifRQ:G}i;'i.9r{,~1i~~t:~;~.t:~1I~;i~)fJi :\~~.
11iI Residential I 0 Government I 0 Commercial
Ij:~j:;;j+,.:f,iJ9.B:i:sltI,UNF,0RMAtf(;lN~ANiJ~'~qQAj-;iQ:&K:i;!~;'!J.::n
I Job site address: 57"f5 ,M~f\tVC\.1 _
I City: ..5ot,';",:\(I.lrA I State: oR
I Subdivi;ion: ~"'"P<''' Mr..dPIAJ" I Lot no,:
I Reference: I Taxlot:
I :" PRQPERTVOWNER'.
I Name ~li~~ ~~C; -
Addre~s: " . LI 5"-' 6/!J.r.tlvI
City: ,Ri>cl"1o~J ' I State: ocz I ZIP:'j77.f(,.,
--r'
Phone: -.;Bt- &n3"- I Fax: -Nt- 2S7d
I E-mail:
This installation is being made on residential or farm property owned by
me or a member afmy immediate family, and is exempt from licensing
requirements under ORS 701.010. .
1'~.~'Valtl::ttb~;';~iZ~i~i~~~,:~:i:~~~;~;~,E.'" ,
1 (a) Job descriptior.:
I Occupancy
I
I
...........
1
.".::)
I
j
I
Construction type:
Square feet:
x~ If :2f?o
Cost per square foot:
Other information:
j I
I ZIP '17<(7'1 j I
.)7S- , I
I State:
Fax:
I ZIP:
Type of He. I, (~~
Energy Path: ;). Jlr
o new 0 alteration 0 addition
I (b) Foundation-only permit? 0 Yes '~No
1.~~t.'~.I",ation:H('t.\(~ ,
fi.~2j:~,~: ~,lfJ.ilig'iJ~~~~.f:;;~~M~-~tW;~'~{;:tt~:;H.~jl~~A:::.V,i)!;~-f.~'.i:! :~~,;'.
I (a) Pemit fee (use'valuation 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
I (e) Snbtotal offees above (2a through 2d): ; $
1~~-;iRI~illfgVj~~;f~~sf~W{i~~;:iiiiW~!~f::i:};;~l'l'i;f~}0!;;iE""i$);i};\%,iJ\">;"'ii:j
,: i I (a) Plan review (6S% x per~it f~e[2a]): " " ,:~.." : "'j
I (b) Fire and life safety (40% x permit fee [2a]): $ j
j '1I",:,~;)"".~,~.b:~ta.I.~~.,~~,~:, a~o,~e, :(",3.~",,~~~3b),:. $j
I '4dVflscellaneous.fees,:,li:.:,"'i:,:.' """",::",',i".:..:,,-" "''-,C' . '
.:"'."..,, ...,,','"':',.' ,.,.."..'" '::"'j
1 I (a) Seismic fee. 1% (01 x permil ree [2a]): I $ I
j 'I TOTAL fees and surcharges (2e+3c+4a): $ I
I
j
I
I
I $ 1
,,~r,';,;~,:~:;;/~\:;j')'ji
$
$
Sign here:
I, , ' CONTRAGI()R:i~~:r.A.tLA'tIQN;
I Business name: l-io..'Id.r'''' l~wv...
I Address: <Po.V'\E:
I City:
I Phone:
I E-mail:
CCB license no,:
I Print name:
I Signature:
,"':-'-:--,;,'.'.
IMP;,:$':;'j;?ZJ:;stJ ~~C.ON1:F{;;;~1:(jRJN ~9RM;ti.fLQN~,~i:Jf,:I:~:)R:i)i%$:i:j
I Name I cen License Number Phone Number ~-
I Electrical n '1.-)&& ~n -I'1W;( I
I Plumbing I 31 7'-/7 '1J'?- ~ 4?- I
I Mechanicat 13Q.:10 7 I (0'7) - 1'010' I
~'
Willamalane
Park & Recreation District
Job. No.C1-;::l-LI3
'NAME: Ji &,:U).E H~ ~J4o M.~:.5
SY~TEM, DEVELQPMENT CHARGE WORKSHE~TFO~20,09
ADDRESS:::l'-{~4 Sw &lA-.c/~~ i!.P1V\#JD
PHONE:~~O c;~3~S=
STATE@.zIP:Q?4?4
, ,
, LOCATION OF PROPOSED BUILDING SITE:
Street Address: ')77) /11/NE1<A-L
Plat Name: Tax Lot N~mber: /TCf2.. oS'S? o.2..Ro
1. ,DEVELOPMENT TYPE (Check appropriate dwelllng(s), Dwelling type definitions are ari the
back.) , , ' ,
A. Sinale-Familv Detached.
NO. OF UNITS
'( , X $2,858 per unit =
$ 2-rrd
,B. Sinale~Familv Attached
NO. OF UNITS
X$3,100 per unit =
$
C.' MulticFamilv Aoartment
NO. OF UNITS
X $2,641 per unit =
$
D. Sinale Room Occuoancv
NO. OF UNITS
X $1,321 per unit.=
, ,$
E.Accessorv Dwellina Unit
NO. OF UNITS
X $1,550 per unit =
. $ ,
$
WILLAMALANE SDC
'2. SDC CREDIT (If.appJlcable) SDC payer must furnish proof ~f
Willamalane Credit approval.)
$
3. TOTAL WILLAMALANE NET SDC ASSESSED
(If SDC reduced for Credit)
$ US!)
~
:T I 2)'1 'r::Pt:t
Date
Development Services Department
City of Springfield
5
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-01243
COM2009-0 1243
COM2009-01243
COM2009-0 1243
COM2009-01243
COM2009-0 1243
COM2009-01243
COM2009-01243
COM2009-0 1243
COM2009-0 1243
COM2009-0 1243
COM2009-01243
COM2009-01243
COM2009-0 1243
COM2009-01243
COM2009-01243
COM2009-01243
COM2009-01243
COM2009-0 1243
COM2009-0 1243
COM2009-01243
COM2009-0 1243
COM2009-01243
COM2009-0 1243
COM2009-0 1243
COM2009-01243
COM2009-0 1243
COM2009-01243
COM2009-0 1243
COM2009-0 1243
COM2009-01243
COM2009-0 1243
Payments:
Type of Payment
CreditCard
cReceint I
RECEIPT #:
ap,,~~!"'!,_"'_IllJ),. 'j4", ' '.,'
if" - ,', ,
~ .1.-' :
.-:
~ I)",
d c. .
--,".'---._".. '."
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000998
Date: 08/27/2009
Description
Plan Review Major - Planning
Plan Review,Same As
'Building Permit
Addressing Assignment
Willamalane Single Family
I Bath One & Two Family
1 st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Residence Wiring 1000 Sq Ft
Residence Wiring Ea AddtJ 500
Temp Power 200 amps or less
Fire SF Fee - Residential
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC SanitarylStorm Admin
SDC Transportation Admin
Credit - Trans Improv SDC
Sidewalk Permit
Curbcut Permit
PW Disc ~ 2nd Permit
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
TIM DREILING
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
DlB 077127 In Person
Payment Total:
Pa"e I of I
11:53:3IAM
Amount Due
211.00
250,00
891.90
38,00
2,858,00
220,00
79,00
27,00
9,00
13,00
9,00
7,00
134,00
25,00
63,00
55,60 .
620,25
463,89
352,74
211.21
931.65
101.97
1,044,54
10,00
122,26
17,97
(931.65)
88,00
88,00
(30,00)
91.75
177.35
$8,250.43
Amount Paid
$8,250.43
$8,250.43
8/27/2009