HomeMy WebLinkAboutPermit Building 2010-1-28
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00105
ISSUED: 01128/2010
APPLIED: 01126/2010
EXPIRES: 07/28/2010
VALUE: $ 172,000.00
_6P.RI~!!"F!I!!lI:,E!i
.., ...
~l
Status
Issued
225 Fifth Street, Springfield, OR
54] -726-3753 Phone
54]-726-3676 Fax
541-726-3769:'lnspection Line
SITE ADDRESS: 1887,S 58TH ST
ASSESSOR'S PARCEL NO.: 1802033305300
SPRINGF]ETYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRJPTION: Sin'gle family residence,: SAME AS COM2009-00970 5775 Mineral
; Sidewalk Type: ".,', :' Curbside 7'
. I DownsPQ~~~/!lT~.iils:'ij'~~~;!:~;""i'Curb and Gutter
, .,', --: , ":., " HE WOR\(:
, l'tOi\CE.MrT S\-I,.,LL EXPIRE If ~Ii IS NOi ::
'. ~~\~:~~IED U~~~~ :~~~6~~EO fOR~:<::
'~\jtU V" r:J ' ,
I \,UW\lIJI 0 ", '"
Valuation ~e~cn~tlvn O"'Y PERIO .
$ Per Sq'Ft " Square Footage
or multiplier, or Bid Amount
f
./ .
Owner: HAYDEN HOMES LLC
Address: ,2464 SW GLACIER PL STE 110
REDMOND OR 97756
I CONTRACTOR INFORM~TION I
Contractor Type
General
Contractor
HAYDEN ENTERPRIStS
License
92208
r BUILDING INFORMATION I
# ofUnits:ATTENTIOI\l: Oregon lW'6f~}r~ X~i~~ I
Primary Occupancy,Groupfoll?W ~Ilt~adopted b'iM.t'tIIJ~rl!lfitlfllh 15.50
Secondary Occupancy GrotlPllficatlOn genter. ~~~r~~'h 52_00f.orced Air Gas
Primary Construction Typ\!1 OAR 95~ilO1-00t1. c\iil;i ~Illi:rules by Gas
Secondary Construction Tf\@.O.. You may o~ aU(N ~flU~f\ t'lI1~hone Electric
# of Bedrooms: ; ; Calhbng tfh8.ltChenOerr'egol ~lYifllll\ ~!1licalion
num sr or e . .. ;,,"JIo4M 'Id' . I'
.' Center is 1-80ClIlS:.:v","" ..,1" mg. n a
I DEVELOPMENT INFORMA TION I
Front yard Setback:
Side 1 Setback:
Side 2,Setback:
Rearyard Seiback:
Solar Setbacks:
18:00
5.00
]5.00
55.37
0.00
'"-.......'....;~;,.,':~:Oj,(,.'
, , Overlay Dist: . . ,_
# Street Tr~~1'R~~~;;-'
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Fullv Improved
No
Storm water to curb via weephole
Notes:
Description
Tvpe of Construction
"f)j' ;:':1'
~fi'... I.' '..,'
, Page 1 of 4
Residential
Expiration Date
07/29/2011
Phone
54]-228-6935
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
1,148
400
2
Yes
20.20
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
Value
Date Calculated
, _SP-9,,~q"IE,J\I:!'
r
I
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM201O-00105
ISSUED: 01/28/2010
APPLIED: 01/26/2010
EXPIRES: 07/28/2010
VALUE: $ 172,000.00
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54] -726-3676 Fax
54] -726-3769 Inspection Line
Estimate
Estimate
$1.00
] 72,000.00
$172,000.00
$] 72,000,00
01/26/2010
Total vaitie of Project
l..Fpp< P~ir I
Fee Description Amount Paid Date Paid Receipt Number
+ 12% StateBurcharge $207.57 .. 1/28/10 1201000000000000080
+ 5% Technology Fee $104.34 1/28/10 1201000000000000080
]st Appliance $79.00 1/28/10 1201000000000000080
2 Baths One,or Two Family $337.00 1/28/10 120]000000000000080
Addressing Assignment $38.00 1/28/10 120]000000000000080
Appliance Vent $9.00 1/28/10 ]20]000000000000080
Building Permit $1,001.79 1/28/10 1201000000000000080
Credit - Trans Improv SDC $-931.65 1/28/] 0 1201000000000000080
Curbcut Permit $88.00 1/28/10 1201000000000000080
Dryer Vent $9.00 1/28/10 1201000000000000080
Exhaust Hoods $13.00 1/28/] 0 120]000000000000080
Fire SF Fee' Residential $77.40 1/28/1 0 1201000000000000080
Gas Outlets 1-4 $7.00 1/28/10 1201000000000000080
Plan Review Major - Planning $211.00 1/28/10 1201000000000000080
Plan Review Same As $250.00 1/28/10 1201000000000000080
PW Disc - 2ud Permit $-30.00 1/28/] 0 120]000000000000080
Residence Wiring 1000 Sq..Ft $134.00 1/28/10 120]000000000000080
Residence Wiring Ea Addtl 500 $50.00 1/28/10 120]000000000000080
Sanitary Sewer ~ Improvement $418.88 1/28/10 1201000000000000080
Sanitary Sewer - Reimbursement $550.87 1/28/] 0 1201000000000000080
SDC MWMC Administration $]0.00 1/28/10 1201000000000000080
SDC MWMC Compliance Charge $22.63 1/28/1 0 120]000000000000080
SDC MWMC Improveme~t $] ,333.57 !.'. 1/28/1 0 ]201000000000000080
SDC MWMC Reimbursement $101.97 1/28/10 1201000000000000080
SDC Sanital-y/Storm Admin $]52.70 1/28/1 0 170JOOOOOOOOOOOO080
SDC Tran Reimburs-Residential $211.21 1/28/] 0 1201000000000000080
SDC Trans Improvement-,~esident $931.65 1/28/10 120]000000000000080
SDC Transportation Admin $18.49 1/28/] 0 1201000000000000080
Sidewalk Permit $88.00 1/28/10 1201000000000000080
Storm Drainage rmperviD\~s Area $774.66 1/28/10 120]000000000000080
Temp Power 200 amps or less $63.00 1/28/1 0 120]000000000000080
Vent Fan $27.00 1/28/10 1201000000000000080
Willamalane Single Family $2,858.00 1/28/10 1201000000000000080
Total Amount ~aid $9,217,08
Initial Review
Plan nine: Review
I Plan Reviews I
01/26/2010 01/26/20JO ' OK DJB
01126120'10 01/2612010 APP DDK
01/2612010 01/2612010 APP LKW
Pae.e 2 of 4
Access restricted to I driveway/lot.
Follow street tree plan.
Storm water to curb via weephole
Public Works Review
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
'".
PERMIT NO: COM20]0-00105
ISSUED: 01/28/20]0
APPLIED: 01/2612010
EXPIRES: 07/28/2010
VALUE: $ 172,000.00
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769'lnspection Line
Structural Review
01/26/20 I 0
01/27/2010
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.
~eollirecUns~ec.t;ons I
Erosion/Grading luspection: Prior to.gronnd disturbance and after erosion measnres are installed.
Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Ufer Electrical Gronud: Install ground rod'at'footing '.rid 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 floor insulation or deckiug.
Floor Insnlation: Prior to decking,
Shear Wall Nailing: ,Before covering sheathing with tinish 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: Aft~r all required inspections have been, requested and approved and the building is complete.
Perimeter Foundation Drains: After gravel and tilter cloth is installed bnt prior to backtill.
Underfloor Plumbing: Prior to insulation or decking.
Undertloor Drain: Prior to cover or placement of concl:ete.
Rough Plumbing: Prior to cover and including required testing.
;' ,-." : ' . -~,
Water Line: Prior t,~ tilling trench and including reqnired testing.
Sanitary Sewer Line: Prior to Iilling trench and including required testing.
Storm Sewer Line: Prior to tilling trench.
Final Plumbing: When all plumbing work is complete. '
Underfloor Mech~nical. Prior to insulation or decking and including required testing.
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.
,Paee 3 of 4
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
"
,:' I
PERMIT NO: COM2010-00105
ISSUED: 01/28/2010
APPLIED: 01/26/2010
EXPIRES: 07/28/2010
VALUE: $ 172,000.00
Issued
Gas Service: After line is installed and line has been conuected 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.
By signature, I state aud 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 be 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, lInd the approved set of plans will remain on the site at all
times during construction. . \ - .
- ~/kA/
~ ~-- G-, 'r-
Owner or Contractors Signature
/-.27- h.
Date
.j:"
..... '.'
Paee 4 of4
,
Electrical Permit Application
t
225 Fifth Streett Springfield, OR 97477 tPH(S41)726-375H FAX(541)726-3689
~lf:t:eE,]AR]M]~)lt~1!tf~~Xit,~
. _....- -" ..~.- ~.""',--->-r~'",~,.,,,,,~.~;,,~.t
I COlN\t..OlO - I
Pennitno: Ot) 'O~
I Date: 00D I
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within J80
days of issuance or if work is suspended for J80 days.
1~~I!'Gfe~1-~G:Q~~BJilMI;NJt1A'~gBRQ:W~~~~~ffll
I Zoning approval verified? 0 Yes 0 No 1
1~,j>~1:~~JjJ:.~.tQB.Y:;\lf~~(;f0N$1l1.BID:!3.illIO:~~~1
!2l:Residenti~ I 0 Government I 0 Commercial
\ $134.00 $\,~~~;.1
B'~~~'E:l'![$Jim:jlliii!\5.RM~.ltJ.iGJ\l.i,tl;~!'>~J~QQ~ill[~tii~l ;)
I Job site address: It%'7 S Sflr. 1 t. $ 25.00 $50.f
I City:p,.,~.C'e iot I State: oR I ZIP: '17'178' I $ 32.00 $ 1
l=~~"b1f&~~~~~iw,J~~~~~ $ 63.00 $ I
1 Ih. 1.<1" W/N k.....-1/7\ 1 1
I \reJ:fJ{:~:llfo ~ 1 $ 81.00 $ I
~if~~aRQ~~Ri!1Ytit<:!W!9J;.B!~~~f,~1~\)lilT!1 $ 95.00 $ 1
I Name: l-L'I'JN\ Kevr--e <;. 1 $158.00 $ I
I Address: ;/'iCL( Sw f-,("'r/,r I $205.00 $ I
1 City: I< d V"l<O'" vi I State: i:l Q 1 ZIP: '1775"0. 1 $469.00 $ 1
I Phone: 5'11-228- IS') ~5 ' I Fax:5"/1-7LIi.' d$"7.? ' 1 Reconnect only (2) $ 53,00 $ ,I
I E-mail: - I I Temporary services or feeders: installation, alteration. relocation .[
This installation is being made on residential or farm property 1 200 amps or less (2) $ 63,00 $\..D~ \.""
owned by me or a member of my immediate family. This 1 201 to 400 amps (2) $ 87.00 $ 1
property is not intended for sale, exchange, lease, or rent. OAR
479.540(1) and 479.560(1). 1 401 to 600 amps (2) $126.00 $ 1
Signature: lOver 600 amps or 1,000 :volts, see services or feeders section above I
1~~~~~m~~TlQB1!.~Slrr~~1!'4TI!IQJ~~f~%Ww:.l I Branch circuits: new, alteration, extension per panel I
I Business name: J;;'r \\li(~ F' pC 1 1 a. Fee for branch circuits with purchase ofa service or feeder fee: 1
1 Address: ,.)o~ 7"1 ( OVe'1 C t-. 1 Each branch circuit 1 $ 6.00 1 $ 1
1 City: & ,,01 I State: oR I ZIP: 1 b. Fee for branch circuits without purchase ofa service or feeder fee: I
1 Phone:511/-3i1-1911; 1 Fax: ,I 1 First branch circuit (2) $ 55.00 $ I
I E-mail: I I Each additional branch circuit $ 6.00 $ I
I CCB license no.: '/Y- 3CJC I BCD license no.: I" .12r1_ 1 I Miscellaneous fees: service or feeder not included I
I Signing supervisor's license no,: LJ DS'-IS I I Each pump or irrigation circle (2) $ 63.00 $ 1
I Print name of signing supervisor: \J e-r l ~ \ c 1:::.)"" r~ Each sign or outline lighting (2) $ 63.00 $' I
I Signature of signing supervisor: I, 'I f1 ~. II /J SignaI circuit or a limited.energy panel'l $ 63.00 $ I
' . u, O~ ~- ( tLItrl'l/JL,.... , alteratIOn. or extenSIOn (2)
v
Eaeh additional inspection: (I) I $58.00 I $
-"""~:'_,'i!ll'l!::iill,~"'nn;~'I'''''A-''-N:",~iI'S'E~'''''';'!li.!"."--,,,,,~
~~'.ti\Jg.fii;.~,~U!!:_,_.j!i,;,<.~_____.,.~",,~~;tf,~~~t:e.
(A) Enter subtotal of above fees
(Minimum Permit Fee $58.00)
I (B) Enter li%surcharge (.12x [A])
I (C) Technology Fee (5% of[A])
1 TOTAL fees and surcharges (A through C):
~~~o
V ~1/
~\~
~~
'$
440-2584-J (9/08i.COM)
$2.41.(0
$ ?,.q.trl
$ l'l..~p
r.e5q:{
5AME As
5775 M,~l.
C '7- 17D
StrUt
, Permit Application
-
" >!
t~4~~i:~~'~~~'~
. 225 Fifth Street. Springfield, OR97477 . PH(541)726-3753 . FA.X(54 1)726-3689
DEPARTMENT USE ONLY
CO"",^'Z.O.O -
Permit no.: '_
OU'O~
I Date 1/2 WID
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180'days 6fissu'nce or if work is
suspended for 180 days.
::>PRINGFIEl-D ...~.,
-.-.,,,.,"
I,:, ,i,>-,rLiOCALG9YERN MENT"APpRO:YA~F:,,/;;:;, ,;/;1
1 This project has final land.use approval. 'I I""" ....":;.:'".FE,E, '5(;,' H'i:biJi.E
Signature: _ Date: ....
I This project has DEQ approval. I 1:':i\5~_~~~'~:lL()ffd~.f9'i#f~JI9R~:~,~(;~.~,~,;~t;;.:\,:.;~:~ ..
Signature, Date, I (a) Job description, S'''''1 lor h6-~\Lr
I Zoning approval verified, 0 Yes 0 No I I Occupancy 1R- 3. / U\.
I Property is withinflood plain' 0 Yes ONo,., ". .11 Construction type: \) {J,
ii~:~~:;:;t~~~~~~:::J~:~t~;~::J i ::::=:::' /I", , qgd
I Job site address: n~1 ,S frel" . I I Type of Heat: ;::;
I City:.,.<;:,,~.r,' F'r'of' I State, ClRI ZIP''Y7VlJ': I I' Energy Path: ""'" <.,
I - I:> ,\ I ,J,A '
SubdIVISiOn, ~r;r. - Lot no" di:'u I "" 0 '
I I. lAJ new alteration
I Rererence,{ &> 0 J. 3 '3 Taxlot: C:> 03,0 D I . .
I . .... ,.' '. .'- -'I (b) FoundatIOn-only permit?
',' PROPERTY OWNER, .. ' , .' 1
1 Name: ~\-,.Jl'7'\ ~.. ~ I I,~.~~.~~.I._~~.I.~~~.~~~~-__".,.,_~":,,,_,_.,__..--- U,". , . ,.... ,_.-.-
r I ;.;2';Biiilaing"ife'es;);k'i}:;\;J;r""ti"'c";"~";';;;;,;;,',ii;',:',
I Address; ~"fr,q ,tJ r-;Ia','r(, "..".,...,.." .., ,~C>"..,'"..".,""..,'",',,",...,",",..,. '.
I' () " ,I I (a) Permit fee (use valuation table):
City' t'-l'd"",onr,,( State, 0 Q ZIP~77.,(" I
I ' ' (b) Investigative fee (equal to [2a]),
Phone: ?'II - Xl< " (.;'1~" Fax, 1 ., '
, ,(e) Remspectlon ($ per hour),
E...mail: (number of hours x fee per hour) $
This installation is being mad~ on residential or farm property owned by I (d) Enter 12% surcharge (.12 x (2a+2b+2c]): $
me or a member army immediate family, and is exempt from licensing
requirements under ORS 701.010. I (e) Subtotal of fees above (20 through 2d): $ ~
Sign here: ~ /'2;/L :~~~Pf~~J~:~~~\Y~~~i:~;~~~:~~:;;S~f2Ai,~;r~~e,
I ' "';',C6NTRAC1'9R,i~s~AJ,cLA'n9N'"",
I (b) Fire and life safety (40% x permit fee [2a]), $
I Business name: I-k.'{d t'A /!O,~ <;. I (c) Subtotal of fees above (3a and 3b): $
i t~~:PE=t /..T;:c~~~,~;~ffn<- I i~~:~r~:1~:;:::r~~:,:":'; c'"...
1 CCB license no,' <f;U of!
.1 Print name:
I Signature:
o addition
o Yes
/
I,
I
I
,
I
I
I
I
I
I
I $ f7;l~o~.1
...,..,..1
"'. '.-.,.,.,".
I
$
1""",.,-
u
,erN 0
$
P,'''U'(i[;'7'i?i!i'iS9El-ciD'tt:t:RAc::T:i;5RIN F6Rr;,1'.'fLCiN2}7ft~;;)U~~i;;1\t!tf;:1
I Name CCB License Number Phone Number 1
I Eleetrical !7J)(/n J.01~J) ~...~
I Plumbing 3/747 ......"" n-' '
. I Meehanieal 3'1,'). 31 ~'" . (I..-
/
'-
~~willamalane .,
't'W Park and Recreation District ,.' .
Job. No. '
(!/eJ ~ /(}5
SYSTEM DEVELOPMENT CHARGE WORKSHEET
. January 1-June 30, 2010
NAME:. H-A"IPE:~'. *oMe:S. -.PHONE:9iI..:i2-6'~'7J'..f
ADDRESS:2l{c:W 9,.i/:L/tt.Ia CITY~'-"'b STATE:~LZIP: q'l?rt.
LOCATION OF PROPOSED. BUILDING SITE:
. StreeIAddress:. /YJ'75 . )j~' sr
Plat Name:
Tax Lot Number:
. . . ." ..
. 1.. DEVELOPMENT TYPE. (Check appropriate' dwelli~g(s). Dwelling type, definitions are on the
back.)
'" ",
A. Sinale-Familv Detached
NO. OF UNITS
/ X $2,858 per unit =
$ .2r~~
'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 Occuoanc\(
. "',.'y..--~,-~ ..:.-------.----.
. NO. OF UNITS
~______ _ .,_~_~9~ per ~~it= _~__
$
_.___._~__n'_" _ _~._._ _._____.___
. . - .' -. -
,E. Accessorv Dwellina Unit
. NO,'OFUNrrS "
X$1,550 pe'r unit =
$.
WILLAMALANE SDC $'
. . . .' . .
2. SDC.CREDIT (Ifappli~ble) SDC payer must fu~ish proof of
Willamalane Cred~ approvaL) , $
-. . '.. "-. ..---'-----, -," .- - '- . .'. -.. .-- --..--" - -- ...
" :3. iOTALwh':LAMALANE NET SDC ASSESSED
(if'SDC reduced for Credit)
.~
! I
Date
$ 2Fs-r
MIlO
~Cb,
Development Services Department
. City of Springfield
5
225 Fifth Strc,et
Springfiel!l; Oregon 97477
541-726-3759 Phone
!r-1:~~.!
JIi:. .,' J .,.
City of Spriogficld Official Reccipt
Developmeot Services Departmeot
Pu~lic Works Department
Job/Journal Number
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM2010-00105
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM20 I 0-00 I 05
COM2010-00105
COM20 I 0-00 I 05
COM20 I 0-00 I 05
Payments:
Type of Payment
CredilCard
cReccintl
RECEIPT #:
1201000000000000080
Datc: 01/28/2010
Description
Curbcut Permit
Sidewalk Permit
PW Disc - 2nd Permit
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
Credit ~ Trans Improv SDC
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC MWMC Compliance Charge
SDC SanitarylSlorm Admin
SDC Transportation Admin
Plan Review Major - Planning
Plan Review Same As
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
Temp Power 200 amps or less
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Fire SF Fee - Residential
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
HA YDEN HOMES
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 012274 In Person
Payment Total:
Page I of I
11:31:14AM
Amount Due
88,00
88.00
(30.00)
774.66
550.87
418.88
211.21
931.65
(931,65)
101.97
1,333.57
10,00
22,63
152.70
18.49
211.00
250.00
1,001.79
38,00
2,858,00
337.00
79.00
17.00
9.00
13.00
9.00
7,00
63,00
134.00
50.00
77.40
207.57
104.34
$9,217.U8
Amount Paid
$9,217.08
$9,217.U8
1/28120 I 0