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Home My WebLink AboutPermit Building 2010-2-16 _~If.!l,I!lI<!ITI,,!!,:~, ~, ~ CITY OF SPRINGFIELD Building/Cqmbination Permit " 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: C:OM2010-00052 ISSUED: 02/16/2010 APPLIED: 01/1312010 EXPIRES: 08/16/2010 VALUE: $1254,000.00 Status Issued SITE ADDRESS: 545 MOUNTAINGATE DR 4 ASSESSOR'S PARCEL NO.: 1802032104200 SPRINGFIETYPE OF WORK: Singie Family Residence PROJECT DESCRIPTION: New Single Family Dwelling TYPE OF USE: New" Residential Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yes % of Lot Coverage: 33.50 I'-TTFNT!ON: Oregon law requires you to fr'lIJ"'IM rlllr.\~ "',..j,"\.....+.-.., 1.-." ~'-- _ .... _ '. ..... .. .u ,~ -..- -. -.l;1....,' "'UII~1 I PUBLIC IMPROYEiVlE'N'I'S'lflter, Those rules are set forth , ',,' ,~,' ,-~~ %~ -001 Q,throu,Q.h.OAFj952.Q01. Street Improvements: , . ,; 0090.. You may obtan>ilC8'?'iIl's'o'lqRe rules by Storm Sewer Available: . ' calling the center.~I~&bll;te\ejlloone Special InsNtr,nocrti,OCn: . ". t number for the Oregon Utility Notification ~ Center is 1-800-332-2344). i Notes: Sto~mwa~~ I\l..curb and gutter I MI" PtKIVIi I SHALL tXPIRE IF THE WORK ~~!T~!O!1JZED UNDER THIS PERMIT IS NOT 'JIJlillVitNCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Owner: HA YDEN HOMES LLC Address: 2464 SW GLACIER PL STE 110 REDMOND OR 97756 I CON:rRACTOR INFORMATIO~ I Contractor Type General Electrical Mechanical Plumbing Contractor HAYDEN ENTERPRISES TOP NOTCH ELECTRIC INC PACIFIC AIR COMFORT INC, STUTZMAN SERVICES INC License 92208 172366 39237 31747 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: 2 Height of Structure 32.00 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Energy Path: Sprinkled Building: No I R-3 VB 3 , DEVELOPMENT I~FORMATlON I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 41.23 5.00 20.00 15.42 Subdivision Not Accepted Pa2e 1 of 5 Expiration Date 07/29/2011 , 09/29/2010 03/25/2010 05/12120 I 0 Phone 541-228-6935 541-317-1998 541-672-9510 541-928-8942 Lot Size: Sq Ft ht Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: r Occupant Load: 5,602 744 992 400 Hillside , REQUIRED PARKING 2 Total: Handicapped: Compact: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726"3769 Inspection Line Description Tvpe of Construction Bid Amount VseBid Amount Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fee 1st Appliance Addressing Assignment Appliance Vent Building Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fireplace (Listed) Gas Outlets 1-4 Plan Review Major - Planning Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Compliauce Charge SDC MWMC Improvement SDC MWMC Reimbursement SDC SanitarylStorm Admin SDC Transpo Improvement SDC Trans po Reimbursement SDC Transportation Admin Storm Drainage Impervious Area Temp Power 200 amps 01' less Vent Fan Willamalane Single Family Total Amount Paid Initial Review 01/14/2010 CITY OF SPRINGFIELD Building/CQmbination Permit I; PERMIT NO: COM2010-00052 ISSUED: 02/i6/2010 APPLIED: 01/13/2010 EXPIRES: 08/16/2010 VALUE: $ 254,000.00 I Valn.ation Descri?,tion I $ Per Sq Ft or mu1tipli~r $1.00 Square Footage or Bid Amount, 254,000.00 Value Date Calculated $254,000.00 $254,000.00 I 01/14/2010 Total Value of Project Fp:p:~l P<;Jifi.l Amount Paid $868.09 $216.66 $100.83 $79.00 $38.00 $9.00 $1,335.53 $9.00 $13.00" .. $106.80 ' c' $20.00 '," $7.00', " ' $211.00 $134.00 $100.00 $661.39 $869.79 $10.00 $22.63 $1,333,57 $101.97 $160.31 $931.65 $211.2] $81.98 $703.63 $63.00 $36.00 $2,858.00 $] 1,293.04 Date Paid Receipt Number 1/13/] 0 2116/]0 2/16/10 .2/16/10 2116110 2/16/10 2/16/10 2/16/10 2/16/10 2/16/]0 2/]6/]0 2/16/]0 2/161]0 2/16/10 2/16/10 2/16/10 2/16/10 2/]6/]0 2/16110 2/16/10 2/16/10 2/16/10 2/]6/]0 2/]6/10 2/16110 2/16/]0 2/]6/10 2/16/10 2/16/10 ]201000000000000041 1201000000000000135 1201'000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 1201'000000000000135, 1201000000000000135 1201000000000000135 1201000000000000135 , 1201000000000000135 120(000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 ., 1201.000000000000135 1201,000000000000135 1201000000000000135 1201000000000000135 120]000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 1201000000000000135 I Plan Reviews I 0111'4/2010 APP LLH Signed Electrical Permil Application submitted with plans. ' Paee 2 of5 CITY; OF SPRINGFIELD Building/Combination Permit , I. Ii PERMIT NO: COM2010-00052 ISSUED: 02/16/2010 APPLIED: 01/13/2010 EXPIRES: 08/16/2010 VALUE: $ '254,000.00 Status Issued 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 01/15/2010 WE CJC 01/25/2010 .. Public Works Review 01/15/2010 01128/2010 APP TSS Plannin~ Review 01/15/2010 APP DDK 01129/2010 Structural Review 02/0512010 ACC CJC 02/05/2010 Strnctural Review 02/08120 I 0 APP CJC 02108/2010 Engineer. will provide updated engineering packet and plan sheets with: I) Signed, dated engineering stamps, 2) Callouts for new hold-downs (specitied connectors are ohsolete), 3) Girder tied own for truss ETGR te meet 494)# uplift rating, and 4) Excerpts from 2008 ORSC (2005 provided,in original set). Review delayed untilissue with stormwater SDCs for paving was " resolved. Stormwater to curb and gutter. Elevations are site specitic and contain ~~quired design elements. Inspectors will tield verify that actual el~vations will match submitte~ designs as shown on approved, plans. Recieved updated engineering As noted!on plans , To Request an inspection call the 24 hour re'cording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspection's requested after 7:00 a.m. will :be made the following work ~ay. .' I RrrollirprlJnsnections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are ~I1stalled. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction: with footin'g andlor 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 decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with tinish materials. Framing Inspection: Prior to cover and urte," all rough in inspections have been approved. Wall Insulation: Prior to cover. ~;:'Pa~e'3 of 5 " /,.,-' CITY OF SPRINGFIELD ~ " 'i" Building/C~mbination Permit PERMIT NO: C'OM20I0-00052 ISSUED: 02/1612010 APPLIED: 01/13/2010 EXPIRES: 08/16/2010 VALUE: $ ,254,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Ceiling Insulation: Prior to.cover. Drywall: Prior to taping, Masonry: Final Building: After all required inspections have been requested and .pproved and the b~i1ding is complete. Perimeter Foundation Drains: After gravel and Iilter cloth is installed but prior to backtill., Undernoor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. W.ter Line: Prior to filling trench and includ~ng r,equired testing. Sanitary Sewer Line: Prior to filling trench art'd including required testing. Storm Sewer Line: Prior to tilling trench. Final Plumbing: When all plumbing work is complete. Undernoor Mechanical. Prior to insulation or decking and including required testing. Undernoor Gas: After line is installed and required testing and capped if not attached to a~ appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 'I 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 Covel' Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is c~mplete. ,{'hI :~. Erosion/Grading Inspection: Prior to ground disturbance and after'erosion measures are installed. ',1 . I' . Page 4 of5 Status Issued 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541~726-3769Inspection Line _,i, CITY. OF SPRINGFIELD Building/C~mbination Permit PERMIT NO: COM2010-00052 ISSUED: 02/16/2010 APPLIED: 01/13/2010 EXPIRES: 08/16/2010 VALUE: $254,000.00 By signatnre, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all information hereon is true and correct, and 1 further certify that any and all work performed shall':be done in accordance witb tbe Ordinances of the City of Springfield and the Laws of the State of Oregoll pertaining to the wo:rk described herein, and that NO OCCUPANCY will be made of any structure witbout permission of the Community Servi~es Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 wilJ.'be used on this project. I further agree to ensure that all reqnired inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. 0:::1:2:.::/ Pa2e 5 01'5 d~d;:: -/if Date .. , l' 225 Fifth Street+Sprlngfield, OR 97477+PH(541)726-3753+ FAX(541)726:3689 'l""t;{;,':":'':'-''';~:'''~';''-':.r.;..~,'':;'i'~'n-';'';;:I''"h'~A~!(i,\.:,\,...""",~~'k"i ,~j"'.DEP.ARfMENt"lJSE'0N c'~X" SPRINGFIELD ~,;~;;;.;_~t:_}';;>'_';;-~'-""-'~';;'!.;~:~~'ff~:1~;'St~~~~~~ I Permit no,: C!/lJ ,- 5;2.. - I Date: 1/1 'J }IO Electrical Permit Application t This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issnance or if work is suspended for 180 days. ;. 1~1!t~'itrQ:q~~,(;);YJ~B,~M!;~ii;I'~eER9}Z~~~~1 ~~~ I Zoning approval verified? 0 Yes 0 No " Mf}~'~ I~W'~!I'G;ttffiEG'@R-'iii'i'0~Ei@J\jSiJiR\ljlMlf0N),Y~\f~!,""!~'" ""1>~'l'it 1t',.\j;I,-.., ~ ~1lb__,,~__L. _......-J"._~_._.'._~..~~~_<..:_-,.,._- ...----">--.>,-.<~_I_"_'_,._^_.,L:I\''';tLr~..~~,~~~c''''''''1f Residential, per unit, service incl~'de-d: I 0: ResidentiaJ ,. .... 0 Government . 0 Commercial ~Q~~)[$ilf4=~INi1@gM~J!iii'rll,~tr;{@,!I!~@~~ii[c.!i(\j]i!-li\;~ !1,OOO.sq, ft, or less (4) I $134,00 $ f5 L( I Job site address: S'I.s .fj-ql rr.f b>J~ I I ~~~~:ritionaI500 sq ft, or portion 'I $ 25,00 $ /O~ City:r-""f~:<'" jot' State: oR I ZIP: 9n78' 1 I timited energy (2) $ 32,00 $ I ,_i~;~~~.mi~~FAW;J~i;;*i~~-4~~! I ~~~71~~S~~~~r~~ ~~~:r(~)Odut $ 63,00 $ I I lL~ I f.A/kt! /ft/YIE _', r ,I Services or feeders: installation, alteration, relocation I Itir~A~~~~~lJ');WNI;~~~~!f';1S~1 : ~:~ ::~oo:;:~~~ : :::::: i I Name: l-L'IJoV\ fk'Vr-o-C' <;, I I 401 to 600 amps (2) $158.00 $ I I Address: :/LfCI!.( Sw /'(",r;,r I 601 to 1,000 amps (2) $205,00 $ 1 I City: Q",o(;".,cVlvl State:<\Q I ZIP:')77S-G, I, Over 1,000 amps or volts (2) $469,00 $ 1 Phone: SLI/-2!g-'0'))5' I FffJi:S2'(/-7'1/- $7? I 1 Reconnect only (2) i' $ 63,00 $ I E-mail: . I I Temporary serv.ices or feeders~- &:stal/arion. alteration, relocation .) This installation is being made on residential or farm property 1,200 amps or less (2) I $ 63.00 $t...2 I owned by me or a member. of my immediate family, This 1 201 to 400 amps (2) I property is not intended for sale, exchange, lease, or rent. OAR $ 87_00 $ 479.540(1) and 479.560(1),' 1401 to 600 amps (2) ,$126.00 , $ 1 Signature: lOver 600 amps or 1.000 volts, see services or feeders section above J 1~~~€[~J\lrn~(ijii':QRl!INsmi;\il!W~]1(!):1iI~>>~t,1lii.'i'icJ'1 I Branch circnits: new, alteration, e'xtension per panel I I Business name: 0p I\!;h--~ E I pC I a, Fee for branch circuits with purc~ase of a service or feeder fee: I ,I Address: r:)O~ A (DVe'1 CI-, 1 Each branch circuit _I $ 6.00 I $ I 1 City: & "oil 1 State: oR 1 ZIP: 1 ,I b, Feefor branch circuits without p,urchase ofa service or feeder fee: I I Phone:SZI/-30-19Q.q I Fax:, - I I First branch circuit (2) I $ 55,001 $ "I I E-mail: I 1 Each additional branch circuit I $ 6.00 I $ I I CCB license no.: ~/Y 30C I BCD license no,: { ..22(}. I I Miscellaneous fees: service or feeder not included I 1 Signing supervisor's license no_: Lj r:l ~4 S 1 1 Each pump or irrigatiimcircle (2) , $ 63.00 $ I I P t a f V. I .-..1 1 Lt.,.~ I 1 Each sign or,outline lighting (2) $ 63,00 $ 1 rin n 'me 0 signing supervisor: ...t!.1' :::::iT/' Ie K..J -, , I Signature of signing supervisor: ,a 1- ,/J, rtl1,' A -' iI",J., I Signal ci,rcuit or a limited-energy panel, $63,00 $ I \ -"d.J(. ~ v ~'1D'-.. alteration, or extension (2). Each additional inspection: (1)' , I $58.00 I $ I _r-f1W ":::~_~R~il1i:~llif1llr\!l'[!;Iii~J1'll:i_ ',,~~-9M-_ I (A) Enter subtotal of above fees ' loV \Jfi-' 0 (Minimum Permit Fee $58.00) $::J:fr.. , o..to.'~ 1 (B)Enter12%surcharge(,12x[A]) $- I I (C) Technology Fee (5% of [A]) $ , 1 I TOTAL fees and surcharges (A through C): $, '"3Lf71 //7 ~\\) \~~ ~ 440-2584-1 (9/08/COM) R-~ willamalane . t-w Parkand Recreation District Job. No. '~Jlf) , rrtidJ_ . , SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 NAME: t,1QH~~}l ff\~~~ >?b .__PHONE:D4 t.?:l9 ~1cA 05 ADDRESS~4.\.04 ~.") G\naWv ~dMOl1L2STATE~ZIP:~~ LOGATION OFPROPOSED BUILDING SITE: 'StreetAddress:~54CS. ~t. (';ni.o.> 4l. 4 ,,- . Plat Name:0.nth\~Tax Lot Number: ~h(H n ~ OcJb.\9-- 1. DEVELOPMENT TYPE (Check appropriate d';"elling(~), Dwelling type definitions are on the back.) A. Sinole-Familv Detached NO, OF UNITS \ X $2,858 per unit = $, ftf/6f--:>PD B. Sinole-Familv Attached NO, OF UNITS X $3,100 per unit = $, I' C. Multi-Familv Aoartment NO. OF UNITS X $2,641 per unit =: $' D. Sinole Room Occuoancv "-NO:-OF-UNFTS.-'--' ,X $1 ;321-p~r unit=' - '$' E. Accessorv Dwellino Unit NO, OF UNITS X $1,550 per unit = $ $, 'lAITJ,CD WILLAMALANE SDC " .,--__ n ----- 2. SDC CREDIT (If applicable) SDC payer must furnish proof of ..: Will.af!1a!afle gred_it apprpxalJ .... ~ c___~. if , . . $ Q.0 ~S.00 '~ \\.9/:' \0 'Date " $ . .' . ~~----,--_......-' 3. TOTAL WILLAMALANE NET SDC ASSESSED '~. (if SDC redu ced for Credit) , ". &\. ' /J /' \ · .' \..f\HXlt, V . Development Services ~~p~utment ' City of Springfield " . 5 '. ) . Stru( 'Permit Application -- 225 Fifth Street. Springfield, OR 97477 . PH(~41)726-3753 . FAX(541)726-3689 I DEPARTMENT USE ONLY I perinit no, t!/tJ -72. I Date /// C1 jiDI This permit is issued under OAR 918-460-0030, 'Permits expire if work is not started within 180 days of issuance or if work is . suspended for 180 days, ,'..,..:::..:;,Ji!6.CAi.::9'c5:\1E@iVi,E.Nfi~~R~9YAil;;:;J'i;/1~:1&:~i,{\[ I T~is project has finallandMuse approval. I SIgnature: Date: I This RrDJect has DEQ approval.. I Signature: Date: j (a) Job description: I Zoning approval verified: 0 Yes 0 No I I Occupancy . 7 p_ro~ert)'_i~_~_it~inflO~?Plain:[],~~S " ,[]NO,:" '_' "I 1- Construction type: ~:~~~~';~~f=ATE~r~~~;i~~~;~.T~U~"I".~~~~~~:;c~~~::~~'~.~: ~:::;e~ese~uaref:~3~- / Y~~e Ig1d~;~ln:;;tJQEl:;,SEJ:I~!..INF;PRMAT!Pt:l?AI'lQnL:O.cATIQt:l[;j~liN:ii,(1 I Other information: I Job site address: t:;4~:tt 'i fl1+I""",k. I I 'TypeofHeat. h I City: <;Dr...J,A'(. I State.: CR I ZIP "f7'f7'if. I I E P =" ,- .i. 'u- .. "nergy ath: d.A ' 1 SubdIvISion: ;,k.,,,,,,, , I Lot no.: ,.?7 . I I IV< 0 " II,Reference.\~t)1-tr~.h~ _\1 Taxlo! CP<Irr') .11 I (~;::dation_o:ll~~~::it? ," '" '" P,RuPER-r" 0WNER ' '. ' " I I'.' .11....- .- - . "I ~Tota'vaJuation: Name: I-k....,rl.~ fIevvt.__ ~ I Address: ,':;/'(;,0 .'l.Jf.:!ar.'r{ . I 'I City: R..-d""'MrA. I State 0 Q I ZIP:'177n" I I Phone:~I-.22\"t;<1~S- Fax: - I I E-mail: I This installation is being made on residential or farm property owned by me or a member ormy immediate family, and is exempt from licensing requirements under ORS 701.010. IS,i~~ here:. ~a~~~LATI9N:_ . . :.,;.1 I Business name: 14"",/,,^ 1-10,';';. <;. I I Address: ,JJff."I .5 v,',; /.',/"'",.- r . I, I City ~dyY/cJnd- I. State: ~K. I zIP,cr-n"c.1 IPhone:5LiI-.:l.l*--t,<t,<;" Fax.~I-itil-..25';o I I E-mail: I I CCB license no,: <t.JJ ofl I I Print name: I ...,.j.Signature: I r~2t;'i;!1~1;!'(:j~(fi)sQEFGot-!Jj@Gt6Ril. N,,6BM.AtIP.Nrt':;11!}~*1;;fl:1~~~;:;tl I Name CCBLicense Number Phone Number I I Electrical 17.1,", 'rP9 No4cV\ I I Plumbiog 317l{7~,?J.r<\!)..K"' I I Mechanical 3'1;J. 37 \:~f). ,{ , I 1/ :','.::;.~;.py\:~:;;F.EE:ScHEDiJLE'~"'..~ -';." ::i :Ya!uati6h;WorDia.tjo~'j:;:I:.t'~::~,7';i.i>':i;;',::::i:,j: : 'Ii? d - " o acidition DYes ONo I. (a) Permit fee (use valuatio'n table):;' I (b) Investigative fee (equal to [2a]):' I (c) Reinspection ($ . per hour): (number of hours x fee per hour) I (d) Enter 12% surcharge (,12 x [2a:.'2b+2C]): (e) Subtotal of fees above(2a through 2d): $ $ I I I I $ $ 1 (a) Plan review (65% x permit fee [2a]): I (b) Fire and life safety (40% x permit fee [2a]): I (c) Subtotal.of fees above (3. and3b): $ f~30Y I I I $ $ I (a) Seismic fee, 1%(01 x permit fee [2a]): I $ TOTAL fees and surch~rges'(2e+3c+4a): $ ~~ 1-::144 2-:. 't 't 2- 1~4VO 'tIll ~\~ ~~ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 I 0-00052 Payments: Type of Payment CreditCard cReccinll RECEIPT #: Description Plan Review Residential Paid By TIM DREILING " City of Springfield Official Receipt " Development Services Department " Pu\Jlic Works Department 1201000000000000041 Date: OllP/2010 2:42:59PM Item Total: Check Number Authorization Received By Batch Number Number How ,~eceived Amount Due 868,09 $M68.09 Amount Paid cjc $868,09 $86M,09 068782 In ~erson Payme'nt Total: " 'i,~. Page I of I 1/1312010 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 1jr~;~! -= City of Spripgfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM20 I 0-00052 COM2010-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 1 0-00052 COM20 1 0-00052 COM20 1 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 1 0-00052 COM20 1 0-00052 COM20 1 0-00052 COM20 1 0-00052 COM20 I 0-00052 COM2010-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 I 0-00052 COM20 i 0-00052 COM20 I 0-00052 COM2010-00052 COM20 I 0-00052 Payments: Type or Payment Check cReccintl RECEIPT #: Date: 02/16/2010 1201000000000000135 Description Addressing Assignment Willamalane Single Family ,:(, Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee - Residential Building Permit 1 st Appliance Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 Fireplace (Listed) Storm Drainage Imperyious Area, Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin ' .' SDC MWMC Compliancc Charge SDC Transportation Admi~, Plan Review Major - Planning + 12% State Surcharge + 5% Technology Fee , , Paid By HA YDEN HOMES Item Total: Check Number Authorization Received By Batch Number Number How J~eceived njm 21958 In person payme'nt Total: , ..:.-, , . Pa,ge I of I 8:27:47 AM Amount Due 38,00 2,858,00 134,00 100,00 63,00 106,80 1,335,53 79,00 36,00 9,00 13,00 9,00 7,00 20,00 703,63 869,79 ' 661.39 . 211.21 931,65 101.97' 1,333,57 10,00 160.31 22,63 81.98 211.00 216,66 100,83 $10,424,95 Amount Paid $10,424,95 $10,424.95 2/16/20 I 0