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Home My WebLink AboutPermit Building 2009-10-14 eIT\'; OF ~rtuNGFIELD Building/Combination Permit PERMIT NO: COM2009-01501 ISSUED: 10/14/2009 APPLIED: 10/1312009 EXPIRES: 04/14/2010 VALUE: $:iI74,139.00 _lii~,IJliI'lI;iii!~:g;; .! ,!,', '!,,,"" t; ,. \. :, '_~~:"": ';+: ';;~}"""'):":';; '. . Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1051 S 41ST St ASSESSOR'S PARCEL NO.: 1802061418900 Springfield TYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: , TYPE OF USE: New!" Residential NEW SINGLE FAMILY DWELLING LOT 8 FILBERT MEADOWS- SAME AS 1019 S 40TH ~. ..." "u,,, uregon law reqUIres you to I PUBLIC IMPROVEMENTS rollow rules adopted b th 0 . Ii , . FJ till .' Y e regon Utility o tWiAAJililI}tv\5e:Those rules are s~~ ' Fully Improved In OAfHis2-o01-001 0 through O~ Q'i _ e 7' Yes 0090.~6'bRJI~l%pies ofth'ltlJ butter Storm water to curh via weep hole calling ,the center. (~ote: the tele;~~~e y number for the Oregon UtiJity Notification Center is 1-800-332-2344). " Owner: BRUCE WIECHERT CUSTOM HOMES INC Address: 3073 SKYVIEW LN EUGENE OR 97405 ,. , , CONTRACTOR INFORMATION I Contractor Type General Contractor OWNER License I, BUILDING INFORMATION' . ,,~ # of Units: I # of Stories: 1 Primary Occupancy Group: R-3 Height of Structure 17.50' Secondary Occupancy Group: U Type of Heat: Forced Air Gas Primary Construction Type VB Water Type: Gas Secondary Construction Type: Range Type: Gas # of Bedrooms: 3 Energy Path: NOTiCE: Sp.r.jnkled Building: --;; ;;: r::-:{'rf:T:~ ~,^_~~ CYDIPi= 1J: T~F \N{~~~ AUTHORIZEO UNDER THIS l"t~II\DE~OOPMENT INFORMATION I COMMENCED OR IS ABANDONf:u ~Vh FrontyarjlJll/ll:i'il')j::DAY PERIOD. 17.00 Overlay Dist: Side I Setback: 10.00 # Street Trees Rqd: Side 2 Setback: 14.00 Paved Drive Rqd: Rearyard Setback: 22.00 % of Lot Coverage: Solar Setbacks: 0.00 No , Street Improvements: Storm Sewer Available: Special Instruction: Notes: Overwidth not approved per Richard Perry on 10-13-2009 I V aluation Descr~p,tio~ ., Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Page I of 4 Expiration Date Phone II " Lot Size: 6,865 Sq Ft I st Floor: 1,627 i Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport 440 Sq Ft Other: Occup~nt Load: 2 Yes 29.00 REQUIRED PARKING , Total: 2 :: Handicapped: :. Compact: II Value ! Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Garage/Misc SFlDuplex U VB Utilitv R-3 VB 1&2 Familv Fee Description Plan Review Same As + 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) Gas Outlets 1-4 Overwidth Application Fee Plan Review Major - Planning 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 WilIamalane Single Family Total Amount Paid Amount Paid $250.00 $211.44 $108.20 $79.00 $337.00 $38.00 $9.00 $1,014.00 $-1,236.D2 $88.00 $9.00 $13.00 $103.35 $20.00 $7.00 $45.00 $211.00 $-30.00 $134.00 $50.00 $507.07 $666.84 $10.00 $1,044.5;t $101.97 $87.99 $211.21 $931.65 $85.67 $88.00 $1,236.02 $63.00 $27.00 $2,858.00 $9,379.93 $37.72 $96.83 :i ,: I~ eITY OF SPRINGFIELD Building/Combination Permit t PERMIT NO: dOM2009-01501 ISSUED: 10/14/2009 APPLIED: 10/13/2009 EXPIRES: 0~/14/2010 VALUE: $'174,139.00 ji 440.00 1,627.00 $16,596.80 $157,542.41 10/13/2009 10/13/2009 Total Value of Project , $174,139.21 'I J/pp" P"W I Plan Reviews , Date Paid Receipt Number 10/13/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14109 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 10/14/09 2200900000000001177 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 220~900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 220q900000000001184 2200900000000001184 2200900000000001184 220~900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 220q900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 2200900000000001184 Page 2 014 Status Issued eITY OF SPRINGFIELD Building/CQmbination Permit PERMIT NO: COM2009-01501 ISSUED: 10/14/2009 APPLIED: 10/13/2009 EXPIRES: 0~/14/2010 VALUE: $' 174,139.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 10/13/2009 10/13/2009 POK LKW Overwidth driveway not approved per Rich'ard Perry as of 10-13-2009. Storm w'ater to weep hole in curb. Approv~d as noted on plans Structural Review 10/13/2009 10/1312009 APP CJC Planning Review 10/13/2009 10/14/2009 APP DDK " Required street trees as shown on street tree plan attached to permit: species a's shown. 2" caliper, leave name tag on until approved. Driveway OK - average exceeds 18'. " To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will/be made the following I work day. ~pnlu.In',nprt~ Ufer Electrical Ground: 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 lloor 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: PriOl" to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the b~ilding is complete. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. 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 Plumbing: When all plumbing work is complete. Underlloor Mechanical. Prior to insulation or decking and including required testing. Page 3 of 4 eITY OF SPRINGFIELD " Status Issued Building/C6mbination Permit PERMIT NO: C'OM2009-01501 ISSUED: 10/1412009 APPLIED: 10/1312009 EXPIRES: 04/14/2010 , VALUE: $,174,139.00 " 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Underlloor Gas: After line is installed and required testing and capped if not attached to an appliance. . j Rough Gas: After line is installed and required testing and capped if not attached to an ap~liance., 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. Ii Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Curbcut - Overwidth: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. By signature, !'state and agree, that I have carefully examined the completed application and do h~reby 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,ofthe City of Springfield and the Laws of the State of Oregon pertaining 10 the wdrk described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Servil'es Division, Building Safety. I further certify that only contractors and,employees who are in compliance with ORS 701.005 wili'be used on this project. I further agree to ensure tbat 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 constrJtion. . __I.. y6'.'. ' ( / /l~.._------_._.__..n__'__-'-ZO'lt/y; ()1 '-"'V/~ ~ I . ).' Owner or Contractors Signature . Date " Page 4 of4 ' ,.,(' I!".' 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PER1UIT APPLICA nON City Job Number a 9- / ')rJ / 1. LDCA l'I6NOFl'NSTALiJA'iioN: 0;-. -,-"''''. ' '. ~ , -. 'p '-" ..'. ..,.~< J 0 5 ) S i-/I st- LEGAL DESCRIPTION: L"l.'n 2. Clf.a/ r..; /5; CJon JOB DESCRIPTION: N5tA/' C;~o Permits are nODMtransferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. .,.~::i:'f~"":.:;..<.. 'e';.4""~;'';:_'~'~'';'''3,';._;,~~,ii)S:~;'~::~~if,~~::;'','~'''''-' ~,,<.:::'-:';~~'\'i'''''h'7 ; CONTRAeTOR'TNSTALlJATION ONlX. 2. \;.'T""""I';"'-"""<~""~~-"""_;i"'i(,,(':""~\':::::"i'" _:' ,,"-, c" .",.j....'.-, ,,-' Electrical Contractor L f- I: Address q Z. -g S :, :J p,,,,,r AcyeS City S,o C \ ~ Phone5lJ> '1/96 Supervisor License Number L{ 17 'i - S- 3-/--r-o I 2 Ii 0 J }J . Constr. Contr. Number I b S- '-f 7 y- 3)10 Expiration Date Expiration Date Signature of Supervising Electrician s: (~'~nlN?l~ OwnersName ~'( IIceWi",cke,+ Cosio!"> 140",,$ Address ~ 0 7 3 SIC... .;'W L-,v . City t UJ':"'" OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Phone bi {,- 'j it S-r, Owners Signature: Inspection Request: 726-3769 /--O~ /7#'"(7 . . /U-J<7/Q'7 ,ry, .oS.,.,~ _ , , ZON INITIALS ' DATE SOURCE Date / all 3 )C:Y7' 3. - ........ ,. .: '. ..." . n.':;"',.,.. 'to. .",_ C",'-. _, . CqillPliETE FEE $Cl;lliDULE B,ELOW!,~. . '., '. . - "-,..."""." '. "_ -'\- ,,,,t_ .~"i~~ ,......, }~, c..;;, " _ '. {'.'" "',,0' " ~". '. ',.-'. ~.. ;' : ~ .< . _ , _',' -"^ ..-: '. _" ',I ..'C f A. New Residenti!".'c Single or M~Jti'F;'miJyper ilwellilig linM{;i~'" Service Included 1000 sq, ft. orless Each additional 500 sq, ft. or portion thereof Each Manufact'd Home or Modular Dwell ing Service or Feeder ( 2- i ]"-/ ~,OO Z;- ~ $57.00 ':-j:.{~:t.~':'r ~~~~::::"':'7rt'~;~'rK :t';"~ <, ,,-,-~,_ .:-'i<'Ht~':- :'::-"~:;;T~'~.::~3~{t~~~~;;:.~:_:,. .; ~~i''::...~~.JAG~~' B. :~'S~[~~~~_e~: ~ ~:;,r ~.~;!J:e~ t; 'n,~!t:~IIIJ!I~n; ,~A IJe.rat,!?~~~,~~.~~J()~~,t~~~~~f~ 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only c. Tenipor~i'ry Services lif Feeders i , Installation, Alteration or Relocation 200 Amps or less J 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 VoIls see "B" above. D. Rra~nch'Cir~~"~'iJr:-;::;1:~:)-:~-;,. ,,-!~"',:,~:,- New Alteration or Extension Per pjnel One Circuit II Each Additional Circuit or with Service or Feeder Permit $ 73.00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 $,s.1,90 $ 79.00 $114,00 & 3..0-0 . . ~- ~ ~ t,,"" $ 50,00 $ 5,00 E. Mis~e'lianeotl~' (Se~-yi~e/feeder rio~' included) ~[:Ich Installatj-ori Pump or itrigation $ 57.00 Sign/Outline Lighting $ 57,00 Limited EnergyIRe5idential $ 29.00 Limited Energy/Commercial $ 52.00 Minimum Electric Permit Inspection Fee is $52.00 + Surcharges .,-Q 4. SUll'l'O'i'ALoF:.41iOVE' ;:)L/7., lC 12% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL Shared Drive(T:YBuilding Fonns/EJectricaJ Pennjt Application 7.08.doc /} 6'/'- 11 ~ ~ Willamala~e . t. Park & Recreation District . Job. No.t!1-ISo/ " SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009 ,. NAME: ~Jfa M~t)c!. T PHONE: . t;Fi"d/V.rF ADDRESS:'O'}3" $l:VI//t:.'"W UlCITY81C6"7t-'r STAJE:J)e.ZIP: "!1'ttJS- : LOCATION OF PROPOSED BUILDING SiTE: j/J r-/, t"'., L/'j.1/ StreetAddress: ; (/ J" .). 7. Plat Name:' ~ . . n . Tax Lot NumberJRl.2. c1t;/'1lrw . .. , ." . :~ . 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwellinglype "definitions are ori,the ~~ - , .':1 A. Sinole-Familv Det::lC;hed NO. OF UNITS \ X $2,858 per unit ,,; $ 2-'&" S"f' B. Sinale-Familv Attached _ NO. OF UNITS X $3,100 per unit = '$ C. Multi-Familv Aoartment NO. OF UNITS - X $2,641 per unit = ;'$ D. Sinale Room Occuoancv NO. OF UNITS 1/, ,j' ,. - X $1,321 per unit = }$ " E. Accessorv Dwellina Unit NO. OF UNITS , ' X $1,550 per unit = :$ WILLAMALANE SDC . ~ I :$ , , ' 2. SDC CREDIT (Ifapplicable) SDC payer must fumish'proof of Willamalane Credit approvaL) - ..~ . '$ I, 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) ~ $ ;2.n""4' /~I /71 c1l Date Development Services Department -,. "-:--"-'~-CitYot-Springfield~':" -" -,--7-'- _.~."-'T' --, 5 ~~I~ t~) lei? 5 'to-i~ f\ Structural Permit Application__ 225 Fifth Stree'. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689 , .....a.......iij ~,~.A,~.""" ".- -- If)' '. ..'~i ".~ I- " "",,,,,,.-,,,..,,,.,~,,,,,,,,.,,.,,.,,,.~-- ^ ,DEPARTMENT,;USE:,ONi:;:'4' ,; _:r . .. ,', .,C> t-_:~".. ". ", -...;~""",\.to~ _~,,-.:--""';,~'.-,>':"'n~-~i:;.: .f.H~~~~_~!:J-ly!OF;SPJ~lNGF. ." >.9RlO<\10'N .,::-,,' :;1' ,i..~';.~;:;o P~nnit no,:tJ9- ;:;-tJ I I D~te: /D//J/()l This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days odssnance or if work is suspended for 180 days. 1~~]f;l$VI:IIC;;:QNitBAG:rg_l;t,IH!(Q~M~itIQ.NI\!I:'Jl1cl!\\'t4E:,'. I Name I CCB License Number I Phone Number IElectrical!-+-t' I 105'17,(, 51-1'I1'i& I Plumbing5Jc.vd pUu,~I,',,< h.5q~!1 I. yZ-3'lI", I Mechunical CPH 1 """hI) 172,6-0100 lif~I';;j\)11l?-;;!IiiIoCA'~G6VEifNMENT?'Ai?PROVA@~~~"X~1''''~j' _~~i'.i!'._"_"Jg,_,_,..,,,,_,_,.,,_.'il,_,._._,,,_,__.,,,_.,>il"_",.~.J This project has final land-use approvaL I J !'l;.;..tf.i,ir1'%.trilM,; i!J*.. k'W"-1C.EE'JSCH"EO'. (jLE~."i'if"'.'i~"'!{(1!ir,""'.;~'\:;"~1 :::~:ct has DEQ approval. ::::: I I ;~~~~~:~~~!1!~f,~t;~1'~iwti~i~i1~~~iii I Zoning approval verified: D Yes D No j I Occupancy (2.... J 'V\ I Property is within floodplain: DYes DNo j I, Constructiontyj,e: \lg l~ft~1!~WS;;g!i$1;~AT~~Clifij'og~g9N~'ff{UCIrPNgiji#f',0'f~'1,I I Square feet: ~ [=il~~1~lT~~~~9~Mi~@~~~NPNJQ~&i~Nni~~;i;jkfl;l: ~::::i:f:::t~::~t: I Job site address: , /0 S I .5 - "ftr!_J- ~ I '11 $'1- I I Type of Heat: C F Jt- I City:<:;?....;" ,/: <-1,11 State: 0 YL I ZIP: q 717 7 1 I Energy Path: / k I Subdivision: F; I h""o\' (l'Iu..!,OIoJ'> I Lot no,: IJ I I ~ D ' I j . ~II~ ili~oo I'~~:~~~~~~P~"''''''P''"-' .......~_."~~.I~t.:(E02,;q,,t::,(~{.!~ io~ I (b) Foundation-only penuit? ~tk~~'~~~1%:-:;~;:!.;:-';'~+_":;:'f,'1nJ?J~QR~B,ty;_~:.QW~~~;J}",,<tf:~'?-' . ~LL,:~'-'~ ~:'"' .,'... -,.':;~;j I Total valuation: I Name:(l,(lll<.lv;, Gh..tC"r,1-;Jr'- lI'l!'>.o..\ :trJC- I 1'2 B 'ld..'.... .-"".,<", ," I - . UI IOg'lees"! t!"~!> }'1"~t >.: Address:30/~ St."UI(W L-N I ' - lei I '" 7 - I (a) Penult fee (use valuation table)' City: , V'lete" State;::' f'- ZIP: I to') , I ~ bol '" --cq?"6 ' I I (b) Investigative fee (equal to [2a]):" I $ Phone: - w- '1'1)0 Fax: -,fl-:::>o v " ., I " -- - I (c) RemspectlOn ($ per hour):' I E-mail:W;~GhN\' ho""'-S 6l/CD"""~-;\. Nc.f' I (number of hours x fee per hour) $ This installation is being made, on residential or farm property owned by I (d) Enter 12% surchar e (,12 x [2a+2. b+2c]): I $ I me or a member of my tnllnedmte farmly, and IS exempt from licensmg g :~::i:::~ts under ORS 701.oJO, !~~~;i~~~~i~~;~;~;~;~i~~~~:~~~~,~w[~~M~~.!~~t"j '!iI\"I'i!!~-'~!<""""'''' -...,,,.. ..-.- W''''''''''T' ,...'...' ,'"'' V''''T"'''''' ",- "j I (a) Plan review (65% x penuit fee [2a]): I $ ].)'cF.9-' ~ . 1'\ _ i1l!/J$'4~~I.l)j'j;,c;;,O~jIBAC;;J.Q~.~!t!.$IA"L::ATIQ/OI~!;-;i'!.,tl0.~i;J:i~"oo';,;:;dc.\ I (b) Fire and life safety (40% x penult fee [2a]): I $ I Business name: ~'("V(l' W,ed/\"..s'( Lv~bt--. ~~W2.~ .!)vL I I (c) Subtotal offee. above (3a and ~b): I $ I Address: '3 07 3 <; iL~", eoN LV' j I City: 'i: v, f,"'- , StateO,L I ZIP: q 7)D)1 14'1\1i~C~Wfil~~usri~es:";,. '''W.' '\-;'~\:;~fi~~rf,I\),~'t"tI':@iY:1 I Phone: v _ 6J.6' cl'1 S ? I Fax: ;S'l If _ 33 b z I I (a) Seismic fee, 1% (.01 x permit fee [2a]): $ . I I E-mail: Wi e6~'>. \ \---0 I;"~<; @ co,'" Ct.S-\ ~ ,~,,\ J I TOTAL fee. and surcha~ges (2e+3c+4a): $ --I I CCB license no,: , (a/lf7 j I Print name: 'S') e"\I"~.;.jC W':,~\u';J',/ I Signature: W W -------. J "<"j I I I D addition DYes G1'IO I $ .':""J."";,'~""'"""'" 'j >','lI"';'"F--;',;:o;.'l.-:o'I'''''P'''''''J'';~''' ' "',n;'\,;,J,_~;r:~: .'~~'~;i:~;-';:'"" '. . I $ ~ ~' \( 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 IS01 COM2009-0 150 I COM2009-0 ISO 1 COM2009-0 ISO I COM2009-0 ISO I COM2009-0 ISO I COM2009-0 ISO I COM2009-0 ISO I COM2009-0 ISO I COM2009-01S01 COM2009-0 ISO I COM2009-01S01 COM2009-01S01 COM2009-01S01 COM2009-0 ISO I COM2009-01S01 COM2009-0 ISO I COM2009-0 ISO I COM2009-0 ISO I COM2009-01S01 COM2009-0 ISO I COM2009-0 ISO I COM2009-01S01 COM2009-01S01 COM2009-01S01 COM2009-0 ISO I COM2009-0 ISO I COM2009-01S01 COM2009-0 ISO I COM2009_0 ISO I COM2009-01S01 COM2009~0 ISO I COM2009-0 ISO I Payments: Type ~f Payment CreditCard cReceintl City of Springfield Official Receipt i: Development Services Department Public Works Department " Date: 10/14/2009 II :38:35AM RECEIPT #: 2200900000000001184 Description Storm Drainage Impervious Area Credit- SDC Storm Improv Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Tran Reimburs-Residential SDC Trans Improvement-Resident SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin , SDC Transportation Admin PW Disc - 2nd Permit Overwidth Application Fee Curbcut Permit Sidewalk Permit Building Permit Addressing Assignment Willamalane Single Family 2 Baths One or Two Family I st Appliance Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 Fireplace (Listed) Temp Power 200 amps or less Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Fire SF Fee - Residential Plan Review Major - Planning + S% Technology Fee + 12% State Surcharge Paid By BWCH DEREK WESTOVER Item Total: Lheck Number Authorization Received By Batch Number Number How:Received . Amount Due 1,236,02 (1,236,02) 666,84 507,07 21 L21 931.65 101.97' 1,044,S4. 10,00 87,99 8S,67 (30.00) 45,00 88,00:. 88,00 1,014,00, 38,00 2,8S8,00 337.00 79,00 2700 9,00 13,00 9,00 7,00 20,00 6300 134,00 SO,OO 103.3S: 211.00 108.20 211,44 $9,129.93 Amount Paid KR 03561D In Person Paym~nt Total: $9,129,93 $9,129.93 Page I of 1 10114/2009