HomeMy WebLinkAboutPermit Building 2010-2-1
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00106
ISSUED: 02/01/2010
APPLIED: 01/26/2010
I;:XPIRES: 08/01/2010
VALUE: $ 200,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726.3769 Inspection Line
SITE ADDRESS: 5798 MICA ST
ASSESSOR'S PARCEL NO.: 1802033303600
SPRINGFIETYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single family residence- SAME AS COM2009-00691 5770 Mineral
I PUBLIC'IMPROVEMENTS I iles',!O\l,to
, '" V''ll leC\U . on \.\t\\\\'I
Fullv Improved '<IOI'\'. OSidewda k ~)(pE'lle9, set 10ltn C b 'd 7'
p-llcl'l \ d"ple o~ l<\.esa1e 00)." ur Sl e
Yes' II 'II Iules a R8'WI1'Slfo'ifi'!\W~","95'2.' bfrb and Gutter
Storm water to curb via weephole 10 0, a\\onceil ~'\O thlO\l9 \the lules
l'lotlllC 95'2.'OO~-0 'n copies 0 telepnol\e
, GE: E WORK in ~6: ,/ou f(\a'!e~~~~\ ~I'lot\~~~ I'lotilica\lon
'D~RMll ~HALL EXI'IRE ~~}.~T Ie ~"'\T 00 ,.."I\ing t~e, ?".. Oleg~ ~~?-2'3~~)'
-lORIZED UNDER I HI" r,i'.... ~nR {lU'~"\c~ntel is I'U
~I;MENCED OR IS ABAND\lIl~llat'ibn Descriotion I
,'N 180 DfAc:V PEtRIOt~' $ Per Sq Ft Square Footage
Type 0 ODS rue IOn . . .
or multIplIer or B,d Amount
Owner: HA YDEN HOMES LLC
Address: 2464 SW GLACIER PL STE 110
REDMOND OR 97756
, I CON~RACTOR IN~ORMAnON I
Contractor Type
General
License
92208
Contractor
HAYDEN ENTERPRISES
BUILDING INFORMA nON I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Gronp:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure 19.50
Type'of Heat: Forced Air Gas
Water Type: Gas
Range Type: Gas
Energy Path:
Sprinkled Building: n/a
1
R-3
U
VB
3
I DEVELOPMENT INFORMATION'
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
11.79
10.00
13.60
20.00
18.50
.-'
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Page 1 of 4
Residential
Expiration Date
07/29/2011
Phone
541-228-6935
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant' Load:
1,579
400
3
.Yes
34.50
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
Value
Date Calculated
t~''''
...j.....
Status
Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
54 I - 726-3 769 I nspection Line
Estimate
Estimate
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
2 Baths One or Two Family
Addressing Assignment
Appliance Vent
Building Permit
Credit - Trans Improv SDC
Curbcut Permit
Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Fireplace (Listed)
Gas Outlets 1-4
Plan Review Major - Planning
Plan Review Same As
PW Dise - 2nd Permit
Residence Wiring 1000 Sq Ft
Residence Wiring Ea AddU 500
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Compliance Charge
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
SIJC Transportation Admin
Sidewalk Permit
Storm Drainage Impervious Area
Temp Power 200 amps or less
Vent Fan
Willamalane Single Family
. Total Amount Paid
Initial Review
01/26/2010
$1.00
Total Value of Project
200,000.00
Fpp<, PlW
Amount Paid
$223.65
$1l1.04
$79.00
$337.00
$38.00
$9.00
$1,1l5.75
$-931.65.
!~ ;'.'~
$88.00 :
$9.00 "
, $13,00
$98.95
$20.00
$7.00
$211.00
$250.00
$-30.00
$134,00
$50.00
$529.11
$695.83
$10.00
$22.63
$1,333.57
$101.97
$175.98
$211.21
$931.65
'$17.04
$88.00
$955.99"""
$63,00
$27.00
$2,858.00
',,'
,'~ '
$9,853.72
I Plan Reviews I
01/26/2010
Date Paid
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1 /1 0
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/1 0
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
2/1/10
OK
Page 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00106
ISSUED: 02/01/2010
APPLIED: 01126/2010
EXPIRES: 08/01/2010
VALUE: $ 200,000.00
$200,000.00
$200,000.00
01/26/2010
ReceiptNumber
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
1201000000000000092
DJB
Status
Issued
CITY.OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00106
ISSUED: 02/01/2010
APPLIED: 01/26/2010
EXPIRES: 08/01/2010
VALUE: $ 200,000.00
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Planninl! Review
01/26/2010
01/26/2010 '
APP DDK
Access restricted to I driveway/lot.
3 street trees required - 2 along S.
58th and I 'along Mica St. as shown
on tree plan.
Storm water to curb via weephole
Public Works Review
01/26/2010
01/26/2010
APP LKW
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.
I, RtnlJir~rlli1"mections I
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Sidewalk. Curbside: After forms are erected but prior to placement of concrete.
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: Wheu all gas work is complete. "'",',
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval required prior to Utility Company energizing pole.
Rough Eleetric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: lustall grouud rod at footing and call for inspection in coujunction 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 deeking.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover aud after all rough in inspections have beeu approved.
Wall Insulation: Prior to cover.
It,;:
Ceiling Insulation: Prior to cover. .
'Drywall: Prior to taping,
Masonry:
, "
Paee 3 of 4
_S~l'illl\lQ""Il:L,D,
~'
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00106
ISSUED: 02/01/2010
APPLIED: 01/26/2010
EXPIRES: 08/01/2010
VALUE: $ 200,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone '
541-726-3676 Fax
541-726-3769 Inspection Line
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 backtill.
Underfloor Plumbing: Prior to illsuhltion or decking.
Underfloor Drain: Prior to cover 0,1' 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 treneh 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 instulled and required testing and capped if not attaehed to an ~pplianee.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correet, and 1 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 worJ{ 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 eaeh 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.
,~ ~/h~~
Owner or Contraetors Signature 0'
c;?-/-~
,
L~
'.
l"
Date
Paee 4 of4
:SAMI3- As' '5710 (tIit'lwd
, c'7-69(
Stru( , Permit Application ()EPARTMENT USE,ONL Y
_ pe]~~n~ZOIO,.-
225 F;fth 51"e] . Spe;ngr.e1d. OR 974 J7 . PH(54 I )726-3753. FAX(54 1)726-3689 001 0 b
This permit is issue~ under OAR 918.460-0030, Permits expire if work is not started within 118~:t:yS )~~u~t~ifwork is
suspended for 180 days. ,
I. ". ,.LOCAi.GO\jERNIJi~NT:AP.~ROY;;'L> 2.;;,;~"i+?,;ill
I TShiS project has ftnal land-use approvaL I Date', I sCH'i:buLE' .
19nature_: - .
I :~~~~~;:ct has DEQ appeova! I Date I 1..~~~~:~fi;::~rp:~~oj1ffi~i:~';;i;;';~v\^ 11."" ' '
I Zoning'approval verified 0 Yes 0 No I I. Occupancy i- '3> I \A" ,
I Property is within flood plain: 0 Yes 0 No 1 I Constrliction type: ' ~.1
1*Ji.k\tf~~i;"0;ji1!\GAirE:c.;(;)R:iZ(.QFi;'.c:;,qNs;fR!-lc:II(;jHi;,i,;(.;, '".. " "I I Square feet /571 1- qoo ("""f~.
:{,~((~e:l,dtf;~~i'SltE!!NKO~MX1~~t':ANP"Jo~~~iN(;;~;~:~',:,,:,11 '~:~:;~~f::::t~::ol' 0
I Job site addresS! 57'!( M,',,'i. ,I I Type of Heat: h
II City. ~?r+:I'~lol, I Stalel.LOR ?~ Z31P "t7'17ff. ell' I Energy Path: ri,-; ~
, Subdivision. ~,=r, at no,,;-, I "" 0 ' 0
- / I. lAJ new alteration addition
II Refecence/80?O 'S3,3 I,TaX,lOI ,'. () Sc::>CO 1'1 (b) Foundation-only peemit?
PROPERTY'OWNER'-'" 0 Yes ~o
I -II " I I Total valuation:
Name: /./rJL.\.rllo/\ fk1vtt\.. 't
I AddresS! ,.:;)~a;q ,<;IJ f-,/ar,'d - I
I City R.i>d ""Mol Stat.. 0' Q I ZIP!"1)7.,e" I
I Phone. ~ I - J2\ ~ /-:'1 '>5' ' Fax. I
I E-maiJ I
.This installation is being made on residential or farm property owned by
me or a member army immediate family, and is exempt from licensing
requirements under ORS 701.010.
Sig-n here: ~ /'A,/L
I "'CONTRAG:rOR I NS'rA/:LATfOt<!;,
I
~/c'J((:<'!'"r. I.
_ State C!K. I ZIP.'1'77S-<;' I
Fax' ~/-;t:jl -.2.s'D
I
I
I
I
I Business name: !It:..1r''/'''A
I AddeosS! ,:}.H(,L! .5 tV
I City. R.:dyY/cJnc-l-
I-Phone>5L1I -~-t,,,~,,
I E-mail.
I CCB license no" 1,,;J;), oli
I Print name:
I Signature:
J-b1'J.-IF" ,
r" :,;,i,'\' j' ;j'"S(jB-CQNtRActOR,INF~RMATLciNi"i';j;'r?:;'i:,jC?i;:(
Name
I Electrical
I Plumbing
. \ Mechanical
CCB License Number
17.J,)u'
317'17
3'1;;' 37
Phone Number
I (a) Permit 'fee (us~ valuation table):
, I (b) Investigative fee (equal to [2a]).
I (c) Reinspection ($ 'per hour):
(number ofhDUTS x fee per hour)
I (d) Enter 12% surcharge (.12 x [2a+2b-t2c]).
I (e) Subtotal of fees above (2a through 2d):
Ilf~'~l.U~~~t:~.%f~wrt~~s]~~:~ijh~:~~f~i;3Jt~m,~gf;{~t~e;~~
I (a) Plan review (6?% x permit fee [2a]). . K>
I (b) Fire and life safety (40% x permit fee [2aJ).
I (c) Subtotal of fees above (3a and 3b):
I
I
I
I
$ b>/"~ I
/-',\:,:>1
..-,....,'
I
I
I
$
$
$
$
$
\';~;:~~GA~\jl:?1tj~~W~J
$ i~"tf-'\
I
i
$
$
I (a) Seismicfee, 1 % (,01 x permit fee [2a]).
I
$
TOTAL fees and surcharges (2e+3c+4l:l): $
-tfz~rq~f~~:r.i1~~i!P&_i.l
COW\UIC' CTOI O'=.; I
PenTIlt no,:
Date: I!ZbiD 'I
I
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.
Electrical Permit Application'
D
225 Fifth Street. Springfield, OR 97477+PH(541)726-3?53' FAX(541)726-3689
SPR;NGFOELDA~
1i, """" . -~.~
~+~~~"",~., ..,,~
,~"~,,.
1~~l!IEG]I~J,;'I.({Qg~BNMJ;Niflbi&2]:rGl:.~~B\'i~
~:F:~~~~L~~l,~~~~~~~~iK{~'~~;;:7~1 I Residential, per unit, service included: I
i~:~~::~ii)o~;;BM::~~~~[Ei~~tri!GN~;i~1~ll ~~;~O~d:i:~::II;~o(:~ftOrportion. ~ :1::::: :'~
I City:'5:v-,.,,<'l'C:" jot I State: 6R I ZIP: '17'fn' I I Limited energy (2) $ 32,00 $ 1
1~:~:~~,;",l~,c;~~4iii~,IJf;;l1\.,wt~, ~li'~~~~1i!~,11 I ~~~~I~~S~~~~~r~~ fe~~~r'(~)odular $ 63,00 $ I
1'_i<jj~I~:oi?k~~;i~~'--"-'" -I ~~~v:;so::::s:e;;; installation. alteration, relo~a::~oo $ I
1~~~~~llIRRQI~l~BjliW~~&i\I~~~JtJjf~~~~'t~~~ 201 to 400 amps (2) $ 95,00 $ I
I Name: l--L'I'JeV\ KG""'''' <;., I 401 to 600 amps (2) $158,00 $ I
I Address: ;;'t;CL/ c,C-o.J (',("f,,_r I 1 601 to 1,000 amps (2) , $205.00 $- I
City: R ",0( VVlCO'" c..{ I State: oQ 1 ZIP: ')775'0. lOver 1,000 amps or volts,(2) $469.00 $ I
Phone: SL//- 2!~- ~')) 5" ' I Fax.:5?'-//- 7'llc .;157? ' I Reconnect only (2) $ 63,00 $ I
I E-mail:' I Temporary services or feeders: installation, alteration, relocation . J
This installation is being made on residential or farm property 200 amps or less (2) \ $ 63,00 $lo~l~
owned by me or a member of my immediate family, This 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), 401 to 600 amps (2) $126,00 $ I
I
1
I
I
I
I
1
I
I
I
I
Signature: Over 600ainps or 1,000 volts, see serVices or feeders section above
a~is.~G:Q'i\ljj'H3.-e;~jrl([Bl[tls1tr7N~\r~i1tQN~~iii'ij~~'1j] Branch circuits: new, alteration. extension per panel
I Business name: "To'p \\.}i(~ E I <,C I a, Feefor branch circuits with purchase ofa service or feeder fee:
I Address: ,,)0<;:; A (OVe<f C -\-, I Each branch circuit I $ 6,001 $
1 City: & ,,0-1 1 State:,OR. 1 ZIP: 1 b, Fee for branch circuits without purchase of a service or feeder fee:
I Phone: 51 ,,-311- /91-? I Fax.: I' First branch circuit (2) I I $ 55,00 I $
I E-mail: I Each additional branch circuit \ $, 6.00 $
1 CCB license no.: -r7~L 3c;c: I BCD licens~ no.: (..22r1. I I Miscellaneous fees: service or feeder1not included
I Signingsupervisor'slicetiseno,: .L(OS',</-.s I I Each pump or irrigation circle (2) $ 63,00 $
I Print name of signing supe~sor: 1) e'r J _<+r~UL l><!/ I I Each sign or outline lighting (2) I: $ 63,00 $
I Signature of signing supervisor: U n.!"''( _ . /J ....J I Signal. circuit or a li~ited.ef.lergy pan~l, $ 63.00 $
. I ~ _~ ~ \ 'alteratlOn, or extensIOn (2)
Each additional inspectinn: (1)$58,00 1 $
'''''~~''''~''i'K,~,~l'_''''~''''''.''~'''''''',''r'-, "~~~..-'''' '\\a~~
~~J<:~lg,_JltiI?Jt~l.!ir~Nif1ii!l'!~E:i'~.t!o/g~~~~
(A) Enter subtotal of ahovefees
,(Minimum Permit Fee $58,00)
1 (B) Enter 12% surcharge (,12 x [AD
1 (C) Technology Fee (5% of [AD
1 TOTAL fees and surcharges (A through C):
~v~
~ r-q-~'V
V-~,
..~~
~ (l:;f\i:;
440-2584-J (9108/COM)
~l ~()
I' $~q ,Cc<\
$,1,9..5.:'
~.ef2.PA
I}?;, willamalane
, t~ Park and Recreation Distric;t
Job. No.
~\\). CO\Db
'SYSTEM DEVELOP~ENT CHARGE WORKSHEET '.
January 1-June 30, 2010
-NAME~(\ \~~(){'(\OJ:') . PHONE:-~\.f}.'J/6 . (oQ-3fO-
.. \" '
ADDRESS:2.l\~ ~G.\ati-eICITY RedMtmd STATE:Qt.ZIP:C\ \"1~.
LOCATION OF PROPOSED BUILDING SITE:
Street Address:nt\t . N~
,Plat Name:~~X"' ~ , Tax Lot Number: \ <( o'i(Yo~~ b'5k1Y)
1. DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type definitions are on the
back,)
A. Sinale-Familv Detached
NO, OF UNITS \
,
B. Sinale-Familv Attached
NO. OF UNITS,
X ~2,858 per unit =
$'Q..~~.ou '
"
X $3,100 per unit::: , $
, C, Multi-Familv Aoartment
NO, PF UNITS
X $2,641 per unit =
$
D, Sinale RoomOccuoancv,
, NO. OF UNITS
, X $1,321 per unit =
$
E, Accessorv Dwellina Unit
, NO, OF UNITS
WILLAMALANESDC
X $1,550 per unit =
$'
$ 2.6e;e,.lXJ
$ ,.'~.
-' 2.SDC CREDIT(lfapplicable) SDC payer must furnish proof of,
Willamalane Credit approval.) , ,
3. TOTAL WILLAMALANE NET SDC ASSESSED
, (if SDC reducea for Credit)
, \:fuJ\(\', m\ ")\~!. I, Li
DeveloprT)entServices D~partmen\) I u,"
City a/Springfield ,",:' ,
$ fJiJf8~
~/ \ /' n..o\D
Date
5
City of Springfield Official Receipt
Development Services Department
,
Public Works Departme'nt
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM20 I 0-00 I 06
COM2010-00106
COM2010-00106
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM2010-00106
COM2010-00106
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-001 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM2010-00106
COM2010-00106
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 I 06
COM20 I 0-00 1 06
COM20 I 0-00 I 06
Payments:
Type of Payment
Check
cReccintl
RECEIPT #:
Date: 02/01/2010
2:27:30PM
1201000000000000092
Description
Sidewalk Permit
Curb cut Permit
PW Disc - 2nd Permit
SDC Tran Reimburs-Residential
SDC Trans Improvement-Resident
Credit - Trans Improv SDC
SDC MWMCReimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC MWMC Compliance Charge
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDCSanitary/Storm 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
] st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Fireplace (Listed)
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
Fire SF Fee - Residentia!.
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
88,00
88,00
(30,00)
211.21
931.65
(931.65)
101.97
1,333,57
10,00
22.63
955,99
695,83
529, II
175,98
17,04
211.00
250,00
1,115,75
38,00
2,858,00
337,00
79,00
27,00
9,00
13,00
9,00
7,00
20,00
134,00
50,00
63.00
98,95
223,65
111.04
$9,853,72
Paid By
HA YDEN HOMES
Item Total:,
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
21505
In Person
Payment,Total:
$9,853,72
$9,853.72
nJm
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2/1/2010