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Home My WebLink AboutPermit Building 2010-1-25 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line '0;- CITY OF ~l'KlJ~GFIELD Building/Combination Permit PERMIT NO:COM2010-00076 ISSUED: 01/25/2010 APPLIED: 01/20/2010 EXPIRES: 07/25/2010 VALUE: $ 195,000,00 ..' ~ " SITE ADDRESS: 5787 MICA ST ASSESSOR'S PARCEL NO,: 1802033304100 SPR[NGFIETYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - SAME AS COM2009-01441 5776 Mineral' HA YDEN HOMES LLC , 0 e on law requires youto 2464 SW GLACIER PL STE lh-liTENTION, d~p~d by the Oregon Utility REDMOND OR 97756 follow rules a t Those rules are set forth ...1...."ifi~~ti~nCen er. ..J '"' /I f"J n~l)-nC\1- In O~-OU1-UU IU ''''~~'~'-'_~'}h,,-,)'I.f'~ by 009 llRlVCPJlO'RIJ'NFl')RjVjAT.ID/ll..le ." I 1,. . I \ r . -1iiIIIIiMiWI calling }lEl...1i ,1." 't --Utility Notification .. Contractor number for the, o~~~g~_332_2Mll'J1Se Expiration'Date HA YDEN ENTERPR[SE~enter IS 92208 07/291201 [ TOP NOTCH ELECTR[C INC 172366 09/2912010 PACIFIC AIR COMFORTjNC ' 39237 03/25/2010 STUTZMAN SERVIcEs [Nt ' '"3[7~r'''-''' 05/12/2010 Owner: Address: , Contractor Type General ElectricaJ Mechanical Plnmbing # of Units: Primary Occnpancy Gronp: Secondary Occnpancy Gronp: Primary Constrncti?n Type Secondary Constrnction Type: # of Bedrooms: frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18,00 5,00 6,00 20,00, 0,00 Subdivision Not Accepted Street Improvements: Storm Sewer Available: Special I nstruction: Residential Phone 541-228-6935 541-317-1998 54[-672-9510 541-928-8942 I BUILDING INFORMATION' I R-3 U VB # of Stories: [ Lot Size: Height of Strnctnre 1~,:i!l,RI<. Sq Ft [st Floor: NOTICftype of fI'i.'1. EXI'~\1N~E(fIt\;l OT Sq Ft 2nd Floor: THIS prn\lM1- &Y\lO';: IS PERMlidS.N Sq Ft Basement: AUTHOjl\b.@i9 \1l~~R THANDONED ~ Sq Ft Garage/Carport M~OO- oouB AB Sq Ft Other: ~~\~ 1 g(ftl'A~~QcDpg: n/a Occnpant Load: , DEVELOPMENT INFOR,MA nON , 400 4,590 1,579 3 li_ REQUIRED PARKING '. Overlay Dist: # Street Trees Rqd: ,Paved Drive Rqd: % of Lot Coverage: ' I Yes 43,00 Total: , Handicapped: Compact: 2 I PU~L1C IMPROVEMENTS I -,1 Sidewalk Type: Downsponts/Drains: For this parcel in Jasper Meadows, it is the recommendation to the Bnilding Division, by the City Engineer: "that no connections shall be made to sanitary or storm H20 systems, nntil the subdivision is accepted by City C;ouncil", Notes: Paee 1 of 4 , Status Issued CITY OF SPRIN\..rf< IJ:<.LD ' Building/Combination Permit PERMIT NO: COM2010-00076 ISSUED: 01/25/2010 APPLIED: 01/20/2010 EXPIRES: 07/25/2010 VALUE: $ 195,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Va,luation Oescl'intion I Description Tvpe of Construction Bid Amount Use Bid Amonnt $ Per Sq Ft or mnltiplier $1.00 Sqnare Footage or Bid Amonnt 195,000,00 Valne Date Calculated Total Valne of Projecf $195,000,00 $195,000,00 01/20/2010 F'flP". P~ir1J Fee Descrialtion Amount Paid Date Paid Receipt Number + 12% State Surcharge $213,65 1/25/10 2201000000000000066 + 5% Technology Fee $106.87 1/25/10 2201000000000000066 1st Appliance $79.00 1/25/10 2201000000000000066 2 Baths One or Two Family $337,00 1/25/10 2201000000000000066 Addressing Assignment $38,00 1/25/10 2201000000000000066 Appliance Vent $9,00 1/25/10 2201000000000000066 Building Permit $1,095.40 1/25/10 2201000000000000066 Cnrbcut Permit $88,00 :", 1/25/1 0 2201000000000000066 Dryer Vent $9,00 , 1/25/10 2201000000000000066 Exhanst Hoods $13,00 1/25/10 2201000000000000066 Fire SF Fee 0 Residential $98.95' 1/25/10 2201000000000000066 Fireplace (Listed) $20,00 1/25/10 2201000000000000066 Gas Ontlets 1-4 $7,00 1/25/10 2201000000000000066 Plan Review Major - Planning $211.00 1/25/10 2201000000000000066 Plan Review Same As $250,00 1/25/1 0 2201000000000000066 PW Disc - 2nd Permit $-30,00 1/25/10 2201000000000000066 Residence Wiring 1000 Sq Ft $134,00 1/25/10 2201000000000000066 Residence Wiring Ea Addtl 500 $50,00 1/25/10 2201000000000000066 Sanitary Sewer - Improvement $529.11 1/25/10 2201000000000000066 Sanitary Sewer - Reimbursement $695,83 1/25/10 2201000000000000066 SDC MWMC Administration $10,00 1/25/10 2201000000000000066 SDC MWMC Compliance Charge $22,63 1/25/10 2201000000000000066 SDC MWMC Improvement $1,333,57 1/25/10 2201000000000000066 SDC MWMC Reimbnrsement $101.97 1/25/10 2201000000000000066 SDC Sanitary/Storm Admin $176,62 1/25/1 0 2201000000000000066 SDC Transpo Reimbursement $211.21 1/25/10 2201000000000000066 SDC Transportation Admin $17,01 1/25/10 2201000000000000066 Sidewalk Permit $88,00 1/25/10 2201000000000000066 Storm Drainage Impervious Area $968,33 1/25/10 2201000000000000066 Vent Fan $27,00 1/25/10 2201000000000000066 Willamalane Single Family $2,858,00 i 1/25/10 2201000000000000066 Total Amonnt Paid $9,769,15 Paee 2 of 4 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2010-00076 ISSUED: 01/25/2010 APPLIED: 01/20/2010 EXPIRES: 07/25/2010 VALUE: $ 195,000.00 ~-~i: iii: ..".. --_.".-.-,.._"," 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Plannine Review 01/20/2010 01/20/20 I 0 Plan Reviews I 01/20/2010 APP 01/20/2010 APP DJB DDK Access restricted to 1 driveway/lot. Follow Street tree plan, Lot coverage is at 430/0 with a maximum of 45%, For this p~lrcel in Jasper Meadows, it is the recommendalion to the Building Division, by the City Engineer: "that no connections shall be made to sanitary or storm H20 systems, until the subdivision is accepted by City Council", Pnblic Works Review 01120/2010 01/2012010 APP TSS Structural Review 01/20/2010 01/21/2010 APP CJC As noted on plans 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, ~fflllirplf ~nsneetions _ Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to gronnd distnrbance and after erosion measures are installed, 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 ;Ife erected but prior to concrete placement. .)ost and Beam: Prior to 1100r 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 Insnlation: Prior to cover. Ceiling Insulation: Prior to cover. Hold Downs Installed: Special Inspecfion 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. UnderOoor Plnmbing: Prior to insnlation or decking, Paee 3 of 4 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2010-00076 ISSUED: 01/25/2010 APPLIED: 01/20/2010 EXPIRES: 07/25/2010 VALUE: $ 195,000,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Underfloor Drain: Prior to cover or placement of concrete. Rougb Plnmbing: Prior to cover and inclnding required testing, Water Line: Prior to filling trench and including required testing, Snniiary Sewer Line: Prior fo filling trench and including reqnired testing, Storm Sewer Line: Prior to filling trench, Final Plumbing: When nil plnmbing work is complete, 'Underlloor Mechanicn!' Prior to insnlation or decking and including reqnired testing, Rough Gas: After line is installed nnd required testing and capped ifnot attncbed to an nppliance, 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 Mechnnical: When all mechanical work is complete, Temporary Electric: Approval reqnired prior to Utility Company energizing pole, Rongh Electric: Prior to Cover Electric Service: Approval reqnired prior to ntility company energizing service, Final Electric:, When nil electrical work is complete, Sidewalk - Cnrbside: After forms are erected bnt prior to placement of concrete. Curbcnt - Stnndard: After forms are erected but prior to placement of concrete, By signntnre, I state nnd agree, that I hnve carefully examined the completed application and do hereby certify that all information bereon is trne and correct, and I fnrther certify that nny and nil 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 strncture without permission of the Commnnity 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 fnrther agree to ensure thnt all required inspections are reqnested at the proper time, that eacb address is readable from the street, thnt the permit cprd is located at the front of the property, and the approved set of plans will remain on the site nt all times during construction. --- ~ /2#u~ 4 Owner or Contract~r~ Si;nature,J /- r:JS- ~o Date Page 4 of 4 225 Fifth StreeUSpdngfield, OR 97477 +PH(S41)726-3753t FAX(541)72603689 SPRINGFIELD ~ ~. {. f:',-.n~ ~~ A!..' ",':,~o'~...~' 1~'..(~';;';:~''';~:\:''::l::'~''-''_':<''~J,r.;';f.!':''f~ri...;;';:~~~-~"~'~1 ~'iX~;DE8ART:MENr~IJSE'0Nlli't "";'~ !T~.;':;"k._;I'~"::'_:""-"'.::,:i:~)',';a'ift'!;,;"l~2?i'Z'!&~';'~i~~ COtM-Z4"O - I Permit no,: D007,b I Date: \-2-0./0 Electrical Permit Application D This permif is issned nnder OAR 918-309-0000, Permits are nonfransferable, Permifs expire if work is nof started within 180 days of issnance or if work is suspended for 180 days, ~~~~Ir(;)]i;~!#:'f~q>~\l,EJ~jlMI;Nit;f~Fip.I{(1)~t;~~~ 11~:~:;;~;~~:~.;pi0F.;rG~N~~R.I!JGmf0i'::\fim;t~ 1 = ;lit~w,;L k,~lii I"~:=;~]-=" T[]~~;;;:~nt-~-~T~~:=::l' "I Residential, per nnit, service included: 1~~:~~;~~E~~;@:~~Tl;7A~~~QIt~llifQ~~~11 ~~;~O;:i:~~:II:S~O(:~ ft, or portion i :1::::: I City:)y.."~.(',,,.IO( I State: oR I ZIP: "INn' I I Limited energy (2) $ 32,00 $ 111;:;~i~>:~'~~~dF.:'fW~;~l~~~~~~11 I ~:~~I~:'S~~~~r~~ ~~~~r (~)odular $ 63,00 $ ,"'"""'... ...~""'''''~~~~"":'~;~'__,'''~''_''__''''"'~.w~'''''.'''''',.:;i'i1i'1 I Services or feeders: installation, aiteration, reiocation ,~~~~~ig~~iThY!.[~w~1i~~~r.~~ki,~~11 ~:~ ~:~oo~:: ;~~ : :::~~ : I Name: l-L'-IJN\ Kc;vy-,,,, 0;. I 1 401 to 600 amps (2) $158,00 $ I Address: :;t.;CL/ <'I-J I'-.fAri'er I 11601 to 1,000 amps (2) $205,00 $ I City: R....oIvvocv>vj I State:/lf< ' I ZIP:'j'775'G. I ,Overl,OOOampsorvolts(2) $469,00 $ I Phone:SL//-.228" ,",')~5' 1 Fax:""//-?,!/- $72, I I Reconnect only (2) $ 63,00 $ 1 E-mail:' I Temporary services or feeders: installation. alteration. relocation This installation is being made on residential or farm property 200 amps or less (2) I I $ 63,00 $ b3 owned by me or a member of my immediate family, This I 201 to 400 amps (2) $ 87,00 $ I property is not intended for sale, exchange, lease, or rent. OAR ' 479.540(1) and 479,560(1), I 401 to 600 amps (2) $126,00 $ : I Signature: . lOver 600 amps or 1,000 volts, see services or feeders section above I 1~,k~_!t:clf~]]t~~TLQ8.Itfj'SJnIK~W~]I@ll~),*l\'i1 I Branch circuits: new, aiteration, extension per panel I I Business name: -';;p \\lJri-l, E I pC I I a, Fee for branch circuits with purchase of a service or feeder fee: I I Address: ~O~ A (ovt?'1 C -1-, I I Each branch circuit I I $ 6,00 I $ I I City: & ,,011 I State: oR. I ZIP: I I b, Fee for branch circuits without purchase ofa service or feeder fee: I I Phone:S/" -3i1-l9q~ I Fax: I I First branch circuit (2) $ 55,00 $ 1 I E-mail: I I Each additional branch circuit $ 6.00 $ I I CCB license no.: }-;J. 30C I BCD license no.: I .22rJ. I 1 Miscellaneous fees: service or feeder not included I I Signing supervisor's license no,: 4. 0 5'4 5 I I Each pump or irrigation circle (2) I 'I $ 63'00-1 $ I I Print name of signing supervisor: V.e ~ I g+", ) ck \.4U I I Each sign or outline lighting (2) $ 63,00 $ I I Signature of signing supervisor:l) . (') t7---L- 0 (), ~J ,Signal,circuitoralimited-energypanel,1 1$ 6300 I $ I . ~ ~~ ~ ~ "(If"- alteratlOn, or extensIOn (2) . . ~-Q \))V'~ ~~~k~~~ I TOTAL fees and surcharges (A throngb C): $ z.. '8gl :If. 440-25840J (9/08/COM) 5N1f l:!5 617& fl1l'~'''' c..i'/liLlI I DEPARTMENT USE ONLY CO~ z.O 10 - PemlitoOC> 7b Stru( , Permit Application ~i~'~lf!~!tll.llli11 ' , ." ,~~ __ II ",",0' ~ 225 Fif\h S"eet. Springfield, OR 97477. PH(54J)726,3753. FAX(541)726-3689 SPRINGFIELD t:';~":\a"'..;, ~i;2;i~6,~t:.~~f~~~~: 'ffi~~~ ,IJJ.k"0..... ~~~~,l,. 'W' .~~ Date 1- 20 r I 0 This permit is issned under OAR 918-460-0030, Permits expire if work is not started within 180 days oC issnance or iC work is snspended for 180 days, " ,t?O': C'AL: "'G"O:"y""'E'R'''N M'''E'N'' ';;':"'p" P"R"'O':'Y"A"U\!i}?.:'r::y":!::;;:,,J,J:r:.1 ~.' "",... .., ' _.'.. '._ .'...'_ .._." _.. .._.,.... _'Iy,~.~ .~._.1~""'_''"'" ..._, .'. _-"-.~,..'l'f'.'_~l":'J'-':;~{'.~' ,':<':i~,' ~~~~;~o;eect has finalland,use approval. Date: I I':"" ':',', " ',.-,'i',fOEE 'S'CHEOULE':'?; :,;,',":';;" ", I I Th,'s proj'ect has DEQ approval" I :..!-L~~Yaifi'ia:fio-h'.'in'fo'rm'~Hb;n~U,~l}~~'S~};i~;~)r,1\-;' :~:i~/':;~!ij:;i;r/;/f;,':'i'i~>;:~~).~h);;:;'.;1 Signature Date I (a;j~~~~;~ripti~n ''i,.;;'~I;:'r:A~;';,,;o''1 I Zoning approval verified: 0 Yes 0 No I I Occopancy (L'l /1.1\. I I I Propenyis within flood plain .0 Yes,.DNo . .. ,... I I Construction type ' V IT. I 1~1~;,(j~~;;j!&t~il{9At~(:;QBY;ii.QE~.tCQ@T,RiJ~fi9~i)[q;:~~!;;~,,,*;;:#i~W,;I I Square feet /J71 J ~O'A G I 11,~R,:~~..:.~..id.e2.t~i.~.~.""c_:, ' . ".. _.lC?,~,?~.v.";~,~~:~....~~.,.".. ,..".,'..,.....:!g'.C....~.__r:!.'~,''''~'.~.~._~~~._L::.,..:~.'i;:~..,".'.;11 I Cost per square foot: I It'/):;';<':i~g>B,;S.I:rEI IN,IT0.R,MA'Q(j,N::'Afljplli0.c:A'f:I.QfIj,'',,,J'''i':n/.'t I Other information: I I job site address:_!i'7~". l~.t....., 57 y, 7 /1111 LA II Type of He a.: A I I City:, <?r"t:/,-,/d I State: OR I ZIP: 97'f7'6- I I Energy Path: ..;1.; ~ I I SubdIVISion: ;'f.,a-r, I Lot no,: .2 ~ I I "" 0 ' 0 I I u....-.J?? "2' , ' , I lAJ new alterallon addition Reference: I ~Z.O..>~':.:> I T.axlol: 0 '-If 00' , I ' , I :, PR0I:>ERTY OWNER ':" " 'I I (b) Foundat,on,only permit? 0 Yes ~o I I ::;r:ss :;;~; 7r: < A/and. II~r;~~u~:iii:;;~Sj)}1:'i;;;0:;i~\f!i!t;~V:%:~jlii;t~;';~i'!"'>i\J!'::Z~!~':!1 I' 11 , ' I . I II (a) Permit Cee (use valuation table): $ City: 1",,<lom()fV') , State: 0 Q ZIP977"c., , , , I (b) Investlgat,ve Cee (equal to [2a]): $ Phone'1'I1 '.22<'1..'<;"5' FaX' ' . , '- ' I (c) Reinspection ($ per hour): j E-mail: I (number of hours x fee per hour) $ This installation is bein? made. on resi~entjal o~ farm property ~wne~ by I (d) Enter 12% surchar e (.12 x [2a+2b+2cJ): $ me or a member of my ImmedIate family, and IS exempt from Iicensmg g requirements under ORS 701.0]0, I (e) Subtotal of fees above (2a through 2d): I $ I Sign here: ~ ~ _ L 1~~YJ'~.i~~l~~~:(~:wYt~:~S1~t~_#t~~~~~ft~~~$iJi~'i~~~~lITf$1f~f\lUf~~~I~~~~~%;1 I " , ,'~ONTRAC:r~:~~ST.6.L~ATI9Ni, __ ',':','1 I (a) Plan revie,w (65% x permit fee [2a]): ... f6 $ z.5Cl' I' 1/ . I I (b) FlTe and Iofe safety (40% x permit fee [2a]): $ I Busmessname: f7t:r..1f'...,J,,^. I-k/l1-'1' ~ I - I I Address: -v/(.?j ,S tv ,c,/a <t-,. r ' I' I"~~ ~~~:,~:;,lc~~,~~:~;~~,~:,2,~,:,~~3~!,~;"", ',.",' ',.." $"".""" -" ,",'.. ..1 I City: ~dmc>n.d. I State: ~R... I ZIP~c;-(" I c,]'? ,.,I.~~~a~,e,o,us;,~~Si':1,,:,I),{,,,fi-,'h",t'-',:{;":ij);:t:'~"'\1'jj'<"i',;'i',:,;', I , I (a) Seismic fee, 1% (.OJ x permit fee [2a]): $ Phone:5l11 -AlK--t,'1"5<r Fax>::J.I1 'iI'Il ,.257:2 I ' I E-mail: I I TOTAL fees and surcharges'(2e+3c+4a): $ I CCB license no,: "!;U0i? I ---- ..,-..- n_ I Print name I CIO -/0 I Signature I 619-1 rvtiCOt 1~~~~~~~1~!:~?~.::iK}':tl;s-_lj,~'~.G,0N:jfR'AP_mqf{rfN:~.9.F{M#Ii(g~~~~~':fJ:;f~~~i\\'ftt~~~1 I Name CCB License Number Phone Number I 1 Electrical 17:f1> (j, 1 1 Plumbing 3/7'17 1 1 Mechanical 3qJ, 37 1 1\<6 Od. o~ ~~ 4-100 ~ ''7 t1r... "S' ,2~ willamalane, ,'~ Park and Recreation District '/1)1/1.- /~/ Job, No.i..-/U /(0 SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 NAME: H-A-'IDE",'*6MES. PH0NE:9i/~"2-8".6'7J".f, ADDRESS:2'/fgl./f;w/!/A(../tiJ2. CI1Y~"-,,,b STATE:~~ ZIP:,.q??r~ LOCATION OF PROPOSED BUILDING SITE: Street Address,' S 1]<1; 'l .(11/ e-rr- Plat Name: Tax Lot Numbe~: fio 2. <tJ:;33 '1f {JO , ' 1, DEVELOPMENT TYPE (Check appropriate dwelling(s)~ Dwelling type 'definition~ are on the ~~- ' A. Sinole-Familv Detached NO, OF UNITS ( X $2,858 per unit = , $ ~g'S-[ ,8, Sinole-Familv Attached NO, OF UNITS X$3,100 per unit =, $ C, MLilti-Familv ADartment NO,OF UNITS . X $2,641 per unit = $ D, Sino Ie Room Occuoancv ,...__..:...~_~_,', ,.!"I5?.::OF UNIT~__.___..__._.~,,$1!32!p'er ull,it!.'.__m___L_~_._..,.____ ___ ._________._ ", E. Accessorv Dwelfino Unit .. NO,OFUNITS X$1 ,550 per unit =" ' $ , 00 $0.~~92 . ' p- WILLAMALANE SDC 2. SDC CREDIT. (If applicable) SDC payer ;"ust furnish pro~f of , Will<lmal~ne Cr~dit approvaL) $ , , 3, TOTAi.\'VllLAMALA'NEN'E1' SDCASSESSEO' (if SDC reduced for Credit) ,', fJt Mh' Development Services Department' City of Springfield $;).-[ si: /'/ ~ /0 Date '~~ 5 225 Fift!) Street Springficld, Oregon 97477 541-726-3759 Phone at4il Job/Journal Number COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 1 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM20 I 0-00076 COM2010-00076 COM20 I 0-00076 Payments: Type of Payment Check cReceintl RECEIPT #: ';;[.' . '" 2201000000000000066 Description Plan Review Same As Building Penn it Addressing Assignment WilJamalane Single Family Fire SF Fee - Residential 2 Baths One or Two Family I st Appliance Appliance Vent Dryer Vent Exhaust Hoods Yent Fan Gas Outlets 1-4 Fireplace (Listed) Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Plan Review Major - Planning Curbcut Permit Sidewalk Permit ,..r PW Disc - 2nd Permit ,':'. " . Storm Drainage Impervious Area ,', Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC MWMC Compliance Charge SDC Transportation Admin + 12% State Surcharge + 5% Technology Fee City of Springfield Official Receipt Development Services Department Public Works Department Date: 01/25/2010 II :40: 14AM Item Total: Amount [Jue 250,00 1,095.40 38,00 2,858,00 98,95 337,00 79,00 9,00 9,00 13,00 27,00 7,00 20,00 134,00 50,00 211.00 88,00 88,00 (30,00) 968,33 695,83 529,11 211.21 101.97 1,333.57 10,00 176,62 22,63 17,01 213,65 106,87 $9,769,15 Paid By HA YDEN HOMES Check Number Authorization Received By Batch Number Number How Received Amount Paid cjc .r: ".'. Page I of I 21382 In Person Payment Total: $9,769,15 $9,769.15 1/25/2010