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Home My WebLink AboutPermit Building 2006-8-2 (2) Status Issued . .CITY 01' ~ndNGFIELD ' Building/Combination Permit PERMIT NO: COM2006-00829 ISSUED: 08/0212006 APPLIED: 07/05/2006 EXPIRES: 02/17/2007 VALUE: $ 221,964.00 225 Fifth Street, Springfield. OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeclion Line SITE ADDRESS: 2073 OLYMPIC ST ASSESSOR'S PARCEL NO,: 1703254201100 Springfield TYPE OF WORK: Interior TYPE OF USE: Remodel PROJECT DESCRIPTION: 2nd noor remodel for Seleo Community Credit Union Commercial Phone Number: 541-686-5320 Owner: SELCO COMMUNITY CREDIT UNION Address: PO BOX 7487 EUGENE OR 97401 Contractor Type Geueral Electrical Low V ollage Electrical Mechanical Plumbing I CONTRACTOR INFORMATION' Contractor . ,J ,icense "",--"'''''J':'.'\J. 0,.-",,,,, 'a('!lpn..,res. vou to MCKI'Jl,ZI"""-I:IIVlMI<lR\'.'tI\C thUNTRAC;rOR~~539 SCOlllEJDD BI1'EttFR'YCed by t e uregu ulI;3117p2 NA TION~(lJNEt.'W~RK SERv'1(:~~6~6'Wt(15~300 HARVIDS\F&>FRI~1<.f&1 0 througn Uf\ "')(;-V7~- HARV.Ei\l.&,cp.R~GJt ~E;ain copies of the rules7o/y n' <__ ...__ ..............hnn:.J. Call1TlY Ult;; ''''''''1''-'0- \.....~_. .. . . number lor tll_BUILDJ~(NNFORM;\"'ION I Center is 1_800-332-2344). # of Stories: Heighl of Structure Type of Heat: Waler Type: Range Type: Energy Path: Sprinkled Building: Expiration Date 07/2112007 12/21/2007 02/10/2007 10/31/2006 10/31/2006 Phone 541-343-7143 541-686-8612 541-726-9209 541-746-162l 54l-746-1621 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft Isl Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Speciallnstruclion: Notes: B llA n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Sidewalk Type: Curbside 5' To Storm Sewer Fully Improved NOTICE: Yes DownspoutslDrains: THIS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. ". " Page I of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Estimate Estimate Fee Description Plan Review Comm/lnd/Public + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus -Mechanical Issuance Fee- + 100/0 Administrative Fee + 8% Stale Surcharge Building Permit Fixtu re Heat Pump Minimum/Adjustment Mechanical Minimum/Adjustment Plumhing Plan Review Comm/lnd/Puhlic Plan Review Fire & Life Safety + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus Total Amount Paid . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00829 ISSUED: 08/02/2006 APPLIED: 07/05/2006 EXPIRES: 02/17/2007 VALUE: $ 221,964.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 221,964.00 Total Value of Project F",,<, PIWIJ Amount Paid Date Paid $439.50 $13.00 $10.40 $43.00 $42.00 $45,00 $10,00 $105.22 $84.17 $962.15 $14,00 $36.00 $9.00 $31.00 $185.90 $384.86 $4.50 $2.25 $3.60 $45.00 7/5/06 7/20/06 7/20/06 7/20/06 7/20/06 7/20/06 8/2106 8/2/06 8/2106 8/2106 8/2106 8/2106 8/2106 8/2/06 8/2106 8/2106 8/21/06 8/21106 8/21/06 8/21/06 $2,470.55 I Plan Reviews I Fire Department Review 07/07/2006 07/25/2006 OK GRG Inilial Review 07/06/2006 07/06/2006 APP LLH Plaooine Review 07/07/2006 07/10/2006 APP EMM Public Works Review 07/07/2006 07/1912006 APP SB Structural Review 07/06/2006 07/07/2006 WE JMP Paee 2 of 3 Value Date Calculated $221,964.00 $221,964,00 07/28/2006 Receipt Number 2200600000000000917 2200600000000001015 2200600000000001015 2200600000000001015 2200600000000001015 2200600000000001015 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 1200600000000001310 1200600000000001310 1200600000000001310 1200600000000001310 See attached docuement for Fire Department Plans Review comments. NO SDC's Interior remodel only. Removing total fixtures, See attached documents for 9 structural comments faxed to Loren R. Berry. . . CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2006-00829 ISSUED: 08/02/2006 APPLIED: 07/05/2006 EXPIRES: 02/17/2007 VALUE: $ 221,964.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeclion Line Structural Review 07/26/2006 07/26/2006 10 JMP WE. Received responses from Bill Shaw, Called Nathan to request written confirmation of valuation. SUB Review 07/07/2006 07/14/2006 A'PP JF To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Reouired InsD~ Framing Inspection: Prior to cover and after all rough in inspections have been 'approved. Ceiling Grid: After drywall approval bul prior to cover. Final Fire Department. After all requirements of the Fire Departmenl have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. SUB Final: After all required energy inspections have been requested and approved. SUB Ceiling Grid: Interior Lighting Low V oUage: Prior to cover. By signature, I slate 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 Slate of Oregon pertaining to the work described herein, and thai NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Sarety. I further certify that only contractors and employees who are in compliance wilh ORS 701.005 will be used on this projcct. I further agree to ensure thai all required inspections are requested at the proper time, that each address is readable from Ihe slreet, 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. Owner or Contractors Signature Date Pa2e 3 of 3 225 Fifth Street Springfield; Oregon 97477 541-726~3759 Phone - ~ WiLd ' Gaof Springfield Official Receipt _Iopment Services Department Public Works Department RECEIPT #: 1200600000000001310 Date: 08/2112006 1:41:14PM Job/Journal Number COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Low Voltage - Commercial Indus Amount Due 2,25 3,60 4,50 45.00 $55.35 Payments: Type of Payment CreditCard Item Total: Check Number Authorization Paid By Received By Batch Number Number How Received NATIONAL NETWORK SERV djb 013929 In Person Payment Total: Amount Paid $55,35 $55.35 cReceintl Page I of I 8/21/2006 . . CITY OF SrK1!'i~l'lJ!..LD' Building/Combination Permit PERMIT NO: COM2006-00829 ISSUED: 08/02/2006 APPLIED: 07/05/2006 EXPIRES: 02/02/2007 VALUE: $ 221,964.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2073 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1703254201100 Springfield TYPE OF WORK: Interior TYPE OF USE: Remodel PROJECT DESCRIPTION: 2nd noor remodel for Selco Community Credit Union Owner: Address: SELCO COMMUNITY CREDIT UNION ~ \0 PO BOX 7487 .~e"'-l,O'0oi;;\~-l,0.'f:o. EUGENE OR 97401 o..\)~ 0'" \0 . ..Ii?! ~ .",~ ~e' ~(\\ ,,,: v ""v q;~ ~.... _^ _",eo '" V'" n.~J _ Vl , O~e{rCO.NTRACTOR'INEORMA TION I O~' OO'V'- ,\'f:o.u- ~Q". 0\'." ~"0v, 0'" Cont,\acTh\e"'~ ""e~' \'0'S'~0 f:!,e'" ",e,e'\,\\c,"'"""License Moj(~~~itS6~l\lE~SI.]\'L0 gPN~~;\CL!pR 45539 SCOFI~!?.D\I2.!J~e1fl(:t' ~, ~ 0 '0" './:?-"'~ 38702 HAR;VEY\&' e!}!<;)E;:<e.o"~~eQ,~\)'0'''''J 77 HAR~EY(~,PI!'~E'<;:Q~,~ ,,'0 77 v c,"'"'~'Oe~ i:'BU1'LDING INFORMATION I ",oJ # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Contractor Type General Electrical Mechanical Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Coustruction Type Secondary Construction Type: # of Bedrooms: B IIA I DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Selback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Slreetlmprovements: Storm Sewer Available: Special Instruction: Notes: Paee 1 of 3 Commercial Phone Number: 541-686-5320 Expiration Date 07/2112007 1212112007 10/31/2006 10/31/2006 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: "' REQUIRED P;fRKING ~V\ Total:,y '\~\ f? ~~ H~~Jc~~,ed: ~\j~ '<.<F,omp~ct:~<<..\j ~" ,\'(0\"';) S)\J S\\'?1- x,~ 5O<y-.~, ,.\r:." .No\) ~ ';>: I PUBLIC IMPROVEMENTS I ''''~''~'Y.\.~~'<.<::>;:'' \j~ ~\\j'V' , y,\S \:I~'" rx-\.> ,,\." '\ Side~alk\Type:, ' Fully Improved \}.\) ':-*\I'~", \J' , Yes .. D'V"n~po,utslDrams: . -.." \"" Phone 541-343-7143 541-686-8612 541-746-1621 541-746-1621 Curbside 5' To Storm Sewer Status Issued 225 Fifth Slreet, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Estimate Tvpe of Construction Eslimate Fee Description Plan Review Comm/lnd/Public + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Add. Alter, Extend Circ Ea Add Low Voltage. Commercial Indus -Mechanical Issuance Fe..... + 10% Administrative Fee + 8% State Surcharge Building Permit Fixture Heat Pump Minimum/Adjustment Mechanical Minimum/Adjustment Plumbing Plan Review Commllnd/Public Plan Review Fire & Life Safety Total Amount Paid . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00829 ISSUED: 08/02/2006 APPLIED: 07/05/2006 EXPIRES: 02/02/2007 VALUE: $ 221,964.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount . 221,964.00 Total Value of Project F...... PlilIJ Amount Paid Date Paid $439.50 $13.00 $10.40 $43.00 $42.00 $45.00 $10,00 $105.22 $84.17 $962.15 $14.00 $36.00 $9.00 $31.00 $185.90 $384.86 7/5/06 7/20/06 7/20/06 7/20/06 7/20/06 7/20/06 8/2/06 8/2/06 8/2/06 8/2/06 8/2106 8/2/06 8/2/06 8/2/06 8/2/06 8/2/06 $2,415.20 I Plan Reviews I Fire Department Review 07/07/2006 07/25/2006 OK GRG Initial Review 07/06/2006 07/06/2006 APP LLH Plan nine Review 07/07/2006 07/10/2006 APP EMM Public Works Review 07/07/2006 07/19/2006 APP SB Structural Review 07/06/2006 07/07/2006 WE JMP Structural Review 07/26/2006 07/26/2006 10 JMP SUB Review 07/07/2006 07/14/2006 APP JF Paee 2 of3 Value Dale Calculated $221,964.00 $221,964.00 07/28/2006 Receipt Number 2200600000000000917 2200600000000001015 2200600000000001015 2200600000000001015 2200600000000001015 2200600000000001015 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 2200600000000001088 See attached docuement for Fire Department Plans Review comments, NO SDC's Interior remodel only. Removing total fixtures. See attached documents for 9 structural comments faxed to Loren R. Berry. WE. Received responses from Bill Shaw. Called Nathan to request written confirmation of valuation. . . Lll f OF ~rKll~ld'lJ<.LD Status Issued Building/Combination Permit PERMIT NO: COM2006-00829 ISSUED: 08/02/2006 APPLIED: 07/05/2006 EXPIRES: 02/02/2007 VALUE: $ 221,964.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 Re/llliretl ~ledio/ls I Framing Inspection: Prior to cover and after all rough in inspections have heen approved. Ceiling Grid: After drywall approval hut prior to cover. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have heen requested and approved and the huilding is complete. Rough Mechanical: Prior to Cover Fiual Mechanical: When all mechanical work is complete. Rough Eleclric: Prior 10 Cover Final Eleclric: When all electrical work is complete. SUB Final: After all required energy inspections have heen requested and approved. SUB Ceiling Grid: Interior Lighting Low V ollage: Prior 10 cover. By signature, ) state and agree, that) have carefully examined the completed application and do herehy certify that all information hereon is true and correct, and I furlher certify thai any and all work performed shall he done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon perlaining 10 the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I fnrther 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. , I ~~- :l:::::;+A_-1r'r:u..'L;' G"""'li...l_ OwnerIor ~ntractors Signature -t. ;l-l? {, Date Page 3 of3 ,,' . ' . . ATIACHMENT A CITY OF SPRlNGFIEW SYSTEMS DEVELOPMENT CHARGE WORKSHEET (Effective I Julv, 2006) JOURNAL OR JOB NUMBER C0M2006-D0829 NAME OR COMPANY: Selco Community Cn:dit Union LOCATION: 2073 OIV1!!l?ic - 2nd Floor (collections) MAP & TAX LOT NUMBER: 1703254201100 DEVELOPMENT TYPE: Remodel of 2nd floor "Collections Det>t" - NEW DEVELOPED AREA (S,F,): EXISTING DEVELOPED AREA (S,F,): TOTAL IMPERVIOUS SURFACE (S,F,): I STORM DRAINAGE ITE: lTE: LOT SIZE (S,F,): nla ;>, ~ 8 8 ~ ,i.8 IS u u o:S~Jl u 0 =:u $0.00 $0,00 1178 710 IMPERVIOUS SQ, FT. x $ 0.336 PER SF TOTAL STORM DRAINAGE SDC:, 2 SANITARY SEWER-C\IY A. REIMBURSEMENT COST: NUMBER OF DFU's B, IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) -5 x $ 26.03 PER DFU ($130,13) 1183 -5 x $ 19,79 PER DFU $ 45,82 TOTAL WCAL WASTEWATER SDC:I ($98,95) 1184 $0,00 I ($229,09) 3 TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP F AcrOR NEW A. REIMBURSEMENT COST: 0,00 x 11.01 B, IMPROVEMENT COST: 0,00 x 11.01 EXISTING A. REIMBURSEMENT COST: 0,00 x 0 B. IMPROVEMENT COST: 0,00 x 0 x $ 19,81 PER TRIP x 0,9 NTF $0,00 I 0,9 NTF $0,00 , 0 NTF $0,00 I 0 NTF $0,00 I x $ 87.39 PER TRIP x x $ 19,81 PER TRIP x x $ 87.39 PER TRIP $ 107.20 x TOTAL TRANSPORTATION REIMBURSEMENT SOC:~ $0,00 1173 TOTAL TRANSPORTATION IMPROVEMENT SOC: $0,00 1094 TOTAL TRANSPORTATION SDC:, $ I $0,00 4 SANITARY SEWER - MWMC NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 0,00 x $46,88 PER FEU $0,00 I B. IMPROVEMENT COST: NUMBER OF FEU's 0,00 x $494,46 PER FEU $0,00 I EXISTING: A, REIMBURSEMENT COST: NUMBER OF FEU's 0,00 x $0,00 PER FEU $0,00 I B, IMPROVEMENT COST: NUMBER OF FEU's 0,00 x $0,00 PER FEU $0,00 I MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054 TOTAL MWMC REIMBURSEMENT FEE: $0.00 1186 TOTAL MWMC IMPROVEMENT FEE: $0,00 1.187 MWMC ADMINISTRATIVE FEE: $0,00 1189 TOTAL MWMC SDC:, $ $0.00 SUBTOTAL (ADD ITEMS 1,2,3,&4) - $0,00 I 5 ADMINISTRATIVE FEES' BASE CHARGE (SUBTOTAL ABOVE) $ x 5% , $0,00 . TOTAL TRANSPORTATION ADMINISTRATION FEE: TOTAL SEWER ADMINISTRATION FEE: #DIVIOI #DIVIO! 1175 1190 &..... Ol ~ e...., SOC COORDINATOR 711812006 DATE TOTAL SDC CHARGES 'NONE COM2~0829, Selco CCU, 2073 Olympic.xls 1 JULY 2004 . . DRAINAGE FIX11JRE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUlV ALENT - DRAINAGE FIX11JRE UNITS (NOTE: ~ REMODELS, CALCULATE ONLY Tlffi NET ADDmONAL FIXTIJRES) 'Remodel of 2nd floor "Collections Dept" FIX11JRE TYPE BA TIJTIJB DRINKING FOUNTAIN FLOOR DRAIN, FLOOR SINK INTERCEPTORS FOR GREASElOIlJSOLIDSIETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB CWTlffiS W ASHERlMOP SINK CWTIlES WASHER. 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAlLER) RECEPTOR FOR REFRlGERA TOR/W A TER ST A TIONIETC, RECEPTOR FOR COMMERCIAL SINK! DISHW ASHERlETC, SHOWER, SINGLE STAll SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIDOUBLE LAVATORY SINK: SINGLE LA V A TORYIRESIDENTIAL BAR URINAL, ST ALlJW All TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCEllANEOUS: FIXTURES NEW OLD 3 NUMBER OF EDU'S' UNIT EQUNALENT 3 J 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 TOTAL DRAINAGE FIX11JRE UNITS= -EDU (EQuivalent DwellinJl Unit) is a dischlU"'gc equivalent to a single family dwelling (20 DFU) set at 167 gallODS per day . . " , DRAINAGE FIX11JRE UNITS o o o o o o o o o 1 o o o -6 o o o o o o o o o .5 CREDIT CALCULA TION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y YEAR RATE PER SI,OOO YEAR RATE PER SI,OOO ANNEXED ASSESSED VALUE ANNEXED ASSESSED V ALUP. 1979 or before S5,29 1992 1980 S5,I9 1993 SI.45 1981 S5,12 1994 S1.25 1982 $4,98 1995 S1.09 1983 $4,80 1996 SO.92 1984 $4,63 1997 "",-' SO,72 1985 $4,40 1998 SO.48 1986 $4,07 1999 ~;, i . , SO,28 1987 $3.67 2000 SO,09 1988 S3,22 2001 SO,05 1989 ' $2,73 2002 ,SO,OO 1990 $225 2003 ' SO,OO 1991 S1.80 2004 SO,OO CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE x SO,OO IMPROVEMENT (IF AFTER ANNEXATION DA TEl x SO,OO CREDIT TOTAL SO,OO C0M2006-00829, $e1co CCU, 2073 Olympic.xls 1 JULY 2004 225 Fifth Street SpringflBld, Oregon 97477 541-726-3759 Phone . LP~n;~ IIIL.. .' Cwf Springfield Official Receipt ~opment Services Department Puhlic Works Department Job/Journal Number COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 COM2006-00829 Payments: Type of Payment Check cReceinll RECEIPT #: 2200600000000001088 Date: 08/02/2006 Description Fixture Minimum/Adjustment Plumbing -Mechanical Issuance Fee- Heat Pump Minimum/Adjustment Mechanical Plan Review Comm/lnd/Public Plan Review Fire & Life Safety Building Permit + 8% State Surcharge + 10% Administrative Fee Paid By MCKENZIE COMMERCIAL Item Total: (;heck Number Authorization Received By Batch Number Number How Received djb 66384 In Person Payment Total: Page I of I IO:II:OIAM Amount Due 14.00 31.00 10.00 36.00 9.00 185,90 384.86 962.15 84.17 105.22 $1,822.30 Amount Paid $1,822,30 $\ ,822.30 8/2/2006