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Home My WebLink AboutPermit Building 2010-2-16 CITY! OF SPRINGFIELD Building/C~mbination Permit " 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2010-00095 ISSUED: 02/16/2010 APPLIED: 01/22/2010 EXPIRES: 08/16/2010 VALUE: $"130,000.00 Status Issued SITE ADDRESS: 1487 5TH ST ASSESSOR'S PARCEL NO.: 1703264201302 I SPRINGFIETYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: Single family residence TYPE OF USE: New Residential Overlay Dist: : Total: # Street Trees Rqd: . on la~ futrJlj~lIjipe(f:to Paved Drive Rqd: ATTENTION. qr~~ed by irfiiO'll1P:y:.1l1 Utility % of Lot Coverage: folloW rules ~~~ Those rules are set fOllh Notification Cen oe 010 through OAR 952-001- ._ nAAgC;2-001- , '._ _<tho rl'Ies bv , I PUBLIC IMPROVEMENi)q.. you may o~~;" (N~r~: the tel~~hone MOTI,.,:. " " .,Nllng the cen . njUtili\Y Notification Street ImproHvem~W~~ numbel't<le~$h\R0_3, 32-2344). I IS PE~'T SHAll EXPIR r.enler IS 1'..ao , Storm Sewerlj' A'vailab 'D ElF TNisWORK IYownspoutslOrains: Curb and Gutter " I nuKI 1J~1/')r:Dlul<". " Special Instruction:, ~tb't'fRIW rU.;l<PfiRMIT IS NOT ";:r~I/Vlt_ ~CED OR IS ABANDONED FOR ; ,i : "I" --v DCRIOD .' "."'; J.. Owner: MA TT OLSON Address: 87417 HALDERSON ROAD EUGENE OR 97402 , I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plnmbing Contractor MOlR CONSTRUCTION EASTSIDE ELECTRIC INC MARSHALLS INC DAVID EDWARD RICHARDSON License 41570 117770 25790 157134 BUILDING I~FORM": T10N I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I R-3 # of Stories: I Height of Structnre 17.00 Type of Heat: aseboard Electric ,W~ter'Type: ' Electric Range Type: Electric Energy Path: 'Sprinkled Building: No VB 3 I DEVELOPMENT INFOR~ATlON I Front yard Setback: Side I Setback: Side 2 Setback: R~aryard Setback: Solar Setbacks: 29,00 20,00 6.00 28.25 10.00 Notes: . ;'" }. '~- .':" Page I of 4 Phone Number: 541-517-4507 , Expiration Date 02/14(2011 10/041,2011 12/23/2011 , 11/30(2011 Phone 541-343-4396 541-915-9828 541-747-7445 54 J -606-1588 I L S' I[ ot lze: JI. . Sq Ft 1st Floor: " Sq Ft 2nd Floor: ' " Sq Ft ~~sement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: i! 6,020 1,232 " 'i REQUIRED PARKING 2 Status Issued 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descriotion Tvoe of Construction Estimate Estimate Fee Descriotion Plan Review Residential + 12% State Surcharge + 5% Technology Fee 1st Appliance 2 Baths One or Two Family Addressing Assignment Building Permit Exhaust Hoods Fire SF Fee - Residential 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 Compliance Charge SDC MWMC Improvement SDC MWMC Reimbursement SDC SanitllrylSto.m Admin SDC Tran Reimburs-Residential SDC Trans Improvement-Resident SDC Transportation Admin Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan WiIlamalane Single Family Total Amount Paid Structural Review 01/26/2010 Initial Review 01/25/2010 I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 130,000.00 .Total Value of Project l.Fpp, P~itIJ Amount Paid Date Paid $540.05 $179.98 $85.54 $79.00 $337.00 $38.00 $830.85 $13.00 $61.60 $211.00 $134.00 $25.00 $507.07 $666.84 $10.00 $22.63 $1,333.57 '" $101.97 ',,\.!. $129.32 ',-'; $211.il $931.65 $86.58 $533. I 4 $63.00 $18.00 $2,858.00 f "I,", 1/22/10 2/16/10 2/16/10 2/16/10 2/16110 2/16/10 2/16/10 2/16/10 2/16/10 2/16/10 2/16/10 2/16110 2/16/10 2/16/10 2/16/10 2/16/10 2/16110 2/16/10 2/16/10 2/16110 2/16/10 2/16/10 2/16110 2/16/10 2/16/10 2/16/10 'f ..... $ I 0,008.00 I Plan Reviews I 01/26/2010 APP LLH Pace 2 of 4 -;.' '" CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00095 ISSUED: 02/16/2010 APPLIED: 01/22/2010 EXPIRES: 08/16/2010 VALUE: $130,000.00 Value Date Calculated $ I 30,000.00 $130,000.00 01/2212010 Receipt Number 2201000000000000060 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 12oi'oooooOOOOOOO 137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 1201000000000000137 120!000000000000137 , CITY<' OF SPRINGFIELD Building/Cqmbination Permit " 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2010-00095 ISSUED: 02/16/2010 APPLIED: 01/22/2010 EXPIRES: 08/16/2010 VALUE: $'130,000.00 Status Issued Structural Review 02/0112010 02/0112010 WE KLK Plan nine Review 01/26/2010 WE DDK 02/03/20 10 Plannin2 Review Structural Review 02/04/20 I 0 02/04/2010 DDK KLK 02/04/2010 02/04/2010 APP 10 Initial Review 02/05/2010 APP ,LLH 0210512010 ~":'.", J" Structural Review 02105120 I 0 02/05120 I 0 WI KLK Public Works Review 02/08/20 I 0 APP LKW 02104120 I 0 Structural Review 02/1012010 APP KLK 02/10/2010 Please provide: I) Manufactured Truss Engineering, 2) Signed Electrical Permit Application. Steve Moil' to provide an addendum to the plot plan showing 2 off-stree parking areas. Received:manufactured truss documents. Received a phone call from Roger King, Ea!t Side Electrical approving the nse of one of his signed permits for this 16cation. I have completed the formj'and placed it in the plan file bein~! reviewed at this time. Pnblic \\,orks " Ii Storm wAter to curb r To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before 7:'00 j! a.m. will be made the same working day, inspections requested after 7:00 a.m. willibe made the following " work day.' I, R~i'I'I,irrrllnlO'.nec.tions I Site Inspection: To be made after excavation but prior to setting forms~ Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are i~stalled. Ufer Electrical Gronnd: Install ground rod at footing and call for inspection in conjunction'with footing andlor foundation inspection. ' Footing: After trenches are excavated~ ,.,'" , Fonndation: After forms are erected bnt prior to concrete placement. Post and Beam: Prior to floor insnlation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rongh in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Roof SheathinglNailing: Before covering sheathing with finish material. Page 3 of 4 CITY OF SPRINGFIELD Building/Combination Permit , ' Status Issued .' PERMIT NO: COM2010-00095 ISSUED: 02/1612010 APPLIED: Oi/2212010 EXPIRES: 08/16/2010 VALUE: $ ;;130,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Final Building: After all required inspections have b'een requested and approved and the building is complete. Underground Plnmb~ng: Prior to filling the trench and including required testing. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. U ndernoor Plumbing: Prior to insnlation or decking. Undernoor Drain: Prior to cover or placement of concrete. Rongh Plnmbing: Prior to cover and inclnding required testing, Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing: Storm Sewer Line: Prior to tilling trench. Final Plumbing: When all plumbing workis 'complete. Temporary Electric: Approval required prior to Utility Company energizing pole. , I' Ufor Electrical Ground: Install ground rod at footing and call for inspection in conjuction with footing andlor foundation inspection. I! Rough Electric: Prior to Cover , Final Electric: When all electrical work is complete. .....,;. Rough Mechanical: Prior to Cover ,i,. Final Mechanical: When all mechanical work is complete. Electric Service: Approval reqnired prior to utility company energizing service. Erosion/Grading Inspection: Prior to gronnd disturbance and after erosion measnres are i~stalled. Bysignatnre, I state and agree, that I have carefnlly examined the completed application and do b~'reby certi(y 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 wo'rk described herein,and that NO OCCUPANCY will be made of any structure without permission of the Community Servi~es Division, Bnilding 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 inspection . re requested at the proper time, that each address is readable from the street, that the permit card is located at the fr of the property, and the approved set of plans will remain on the site at all times during constru,:tio ~;; GIlD I u Date ,i, Page 4 of 4 ~ . r '~.'" '" ~. e tt D'e' , . ~ . - .. -." - -.'- -- . . -- -,-- - 225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689 1:"'PE.P,~RTMENTc.USr~~~y'l CO~2:DtO -000 f( ~ PenTIit no,: I Date: I~ 27.. -to 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. I I " l(i;:.{:~?~,j~~~0i\\~i?;::J~;~~~?~flF,-~'E l$C9H~JfjU'~'~,!it;:t?'::t:r\~":1~~ft:it'~";,~:~::~":;-N;p:..: I 1,~-]\:j_vWiu1:HO'~~~int6rffi'IJ"ti()W~JJf;N~~~W%;~~;W:4~~(:ij&i;~,fAB;::FM~;r\t'l\~;;jiI/1 ". ". .,\. ,.,_ .._.. "" ,_ ,...._., ,,_. ',_, ~__"_. ,..0'_ _"__..._.f.....,.i!.!t~..;<:.,.,e.-,~"y,,.-'-.. ~....,~",."'~,w.:_-"'.~....,M'O_<!;;;(,......,.,' I (a) Job description: 51'" ~/e-! ;::tt"",,;l.. I 0 .::> ., ',I, I . ccupancy I'-- ~ I Construction type: \J T.S I Square feet I i 3 Z}, I Cost per square foot: "ji I I Type of Heat: ae::c.. tJL., fr'-L I zIP'i'7Yn I Energy Path: . / 1-\ I I IE new 0 alteration 0 add,ition "'[I (b) Foundation-only permit? DYes ~ I Total v"luation: 'i I $/30_ c;\?OI I li~77i:~~JJ4~iiglfe.~s.}\~~~\^;~!f;fR~~~3J~~?l!%;0\b!-;~~~~~;:I:h,:~,&~;~:~1~1::~:Jg~;1,~~::;:~;,;,\1 I zIP:~'1Y:7? I I (a) Pem1it fee (use valuation table): : $ J I I (b) Investigative fee (equal to [2a]): " $ I I I (e) Reinspection ($ per hour):' I (number of hours x fee per hour) :' $ I (d) Enter 12% surcharge (,12 x [2a+21:>+2c]): $ I 1';t3~~~P.'~'I~~:~:;~':;~~~~;'~':~' :;i~~'::~~~,'. ~:~4\i~'t'k>W<'1'l\~;::~t'M-f;;'V";lFif.j'&<:1li-t.1 \i; ;'; " an.revleW)leesk~::i;:>~,t~>,~i:<:"'t,!'t,"\;~f~~'ttJ.;1il'>'O:e;.)\~;\~",,'Ii;~~"j!fi~f~r'zt,l~'.~ ......- '(~)-~';~~~~;:~-:-(<~-5~';'~;;;~~:~;;:~i;~~;:r., P<=',t~~"~~~~~;~'<3"~(()" -- 1 I (b) Fire and life safety (40% x permi{ree [2a]): $ I I (c) Subtotal of fees above (3" and 31,): $ I 1~'4:;Mj~~~I'lfii'g8uslf(;'e~}1~~~~~~~:i:1~'t!ii~~7i:\~,~i~iiik!~S!~1~f;;31;;1 (a) Seismic fee, 1% (:01 x permit fee~[2a]): $ I J TOTAL fees and surchar:ges (2e+3c+4a): $ I 1~~,:~:';:t':i~~.~~,~r~~~jiGcC:A~.?~:QY~B'ffr~fgNifi;r~FIRt~1;)y~~j~~~~;';~~~~~%~~ I This project has final land-use approval. Signature: Date: I This project has DEQ approval. Signature: Date: I Zoning approval verified: DYes D No I Property is within flood plain: 0 Yes 0 No 1~,;,~~t;tt~;~~1';CAfrEGORV:~O'flC.ONSTRUC:;rI0"N~qf;)jJ1~~~~~~~j~'''~~~,\ ~~%J1;..ltre~,.v.I.,.._._,,,, ,"'" """"'"'''' "~~,~__._.,:sg,, _,'" ',_ ,,,.., ,'...>......,'"" ...,,,',., __.._..I::!:iY'l:,_,,_'''),j~~.~''t~,<s., I.~~._;..:.i,~'~'~~~'~,.~""'t".""'.' "'-~ ._.1...',.9, ~~~~':~~~~..~'~-"'.' --, .~. 'f!1...J.,c,J""y~.., ~~. .~~.-':"'.::~.!~~.' ~~-"'1''l~ !\#;m,,(li\:!'j9B,~SllfEj~1 N I;.0RM.I>.'T19~.~.I>.NR,~~O"c.l>.TI Of)l~;h~Ii!j;.mi!'il I Job site address:\;1 Y 7>,- _5tk \ Sr- I Citys?'o/...--ci/f'!~ ISta~ef.h- I Subdi,.{sion: I _ I Lot no,: I Reference: I 7 01 "Z-bC{ 1.1 Taxlol: or 302 I,;;.., ';~" :" P,RQRER'iv:9VJNEi{',",>,' I Name ffl.A..7f O/Sn ~ / I Address: /tf~ c;-t4 Sf, I City ~ /)/tVyf ~ ~!I'.J I State:;;l/,1_____ I Phon - c>,- , .,~.;.::z Fax, - I E-mail:' Ihis installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010. Sign here: I .. , ". "'., .' ""'I I'Business nam~G%:/~Qzt~;~lLg,'9;:~'~",\ <"",'" I Address /3Qo O/J/L JJI'L- I I City: CIA/fIll./€.. I State:O~ l zlpf7?177 I I Phoneo/J'l/3-f/dt?l Fax~/-1Y'l-ltr3 I I E-mail:_<;...fl10fe?_Ubdt1mC:I.i1;.0A/er I CCB license no: 4/ :)"70 I Print name: SfG..UE. /Y)O/10- I Signature: ~ Other information: 1:!!(~~iil~t'1i,j!il:tj,i~Sl.lB'C;0t{tBl'c:f:9B!Jf.l~OJ{MAi[IQ~~~~1li,~;',*}'1k~I I Name CCB License Number Phone Number I t:A~+?k '. . Ii,. ,J. "- I Electrical tf!J-7V/-/iI'?O ~. r-A ..1 0' l\r\l1Ilr(;\1sOl ~ I Plumbing ~L(I- (,O{;-/.),f f( I ~V\O. UJlkXV<~ "'\? \W'll I Mechanical ;q,-71.f7-7W~ I ~M~5 :' s n--;~ ~dl L ~, {f _S('{I.~--'r{.l-.-S2lb ________-- 11 (' 1 (tJ05('Cl.k) ~l . ,..() pJ ~- 5bf- 225 Hfth Street + Springfidd, OR 97477+PH(541)726-3753+FAX(541)726-3689 I~.*$'----'#~~~I e'!.";>*~~&~,:L!':'l,~;r~~~.;,,~~1i I Permitno,: (\ \0 . q ~ I I Date: :~.~.\D I Electrical Permit Application ,. This permit is issued under OAR 918-309,0000. Pe~mits are nontransferable. Permits expire ifwiork is not started within 180 . days of issuance or if work is suspended for 180 days. , ' , 1'-."":""~1!10CAiJi'l'GO'ilERNI\IIENtJiwr'A' 'ReRO'ilA~'\il!l\'li>f':t:1i:!l\'li'W ....E..E"'S. .C.u-E..D..U..'Y"!iit'ih:----- -'!1ll'''1 ?&iiliIm%:ill8~lL" _ ~a~~_._ ,'_ _"if$',4J1- _ ~ _ ,lidlli~,,,'Ut,,"qjl r; _ ~_'Ij1,'LtEid&Jt~"",~>>1r=]2t1i.dbf 1;;=~~~~~~~~~;'1o~'1Cg~tRUC.tIO~~s~,'!',,_1 mlll(?i.l.l~~\~ ~~.~ti~:~~~l~j i ~~~~~:~~(:::~::.~ ~ ;'::: :~~ $ 32.00 $ $ 63.00 $ $ 81.00 $ i~RE'~~~ i:::::~.::~) ::::: i I City: c(i.;('If' IfU-", 1 StateO~ I ZIP: <..t14.C1I-1 Over 1,000 amps or volts (2)' $469,00 $ I I Phone:~ \ \-J;:\1 \ 45011 Fax: _ 1 Reconnect only (2) . $ 63,00 $ I E-mail: I Temp'orary services or feeders: (nstal/ation, alteration, relocah"on . j This installation is being made on residential or farm property I 200 amps or less (2) ii I \ $ 63,00 I $1 rJ:-, ~ .. owned by me or a member of my immediate family, This 1 201 to 400 amps (2) I', 1 $ 87.00 $ property is not intended for sale, exchange, lease, or rent OAR 479.540(1) and 479,560(1),1 401 to 600 amps (2) I $126,00 $ Signature: I Over 600 amps or 1,000 volts, see_:~services or feeders section above 11_":rDl[coJllillMCj:ORlllrNs:rAl!iEA'tIONIilJI_1rr~1 Branch circuits: new, alteration, ,~tensian per panel I Business name: E" ST5;{) E El.fc-rf?.) ( f a. Fecforbranch circuits with puichase ofa service or feeder fee: I Address: '3 -g ). S' J B 05 C A (; f LA Nt 1 I Each branch circuit 1 $ 6.00 I $ I City: 5Prr'lD 1 State: 0(( 1 ZIP:Q7 Y7YI 1 b. Fecforbranchcircuits without 'purchase ofaservice or feeder fee: I Phone: 5 V 1- 7 I' / -I Y'191 Fax: - i'Jb - V'j(, 0 1 1 First branch circuit (2) $ 55,00 $ IE-mail: rU:./C(;fST5l0(6.YfI;!PO.comll Each additional branch circuit $ 6,00 $ 1 CCB license no,: J 1'77 "2 () 1 BCD license no,:.;l. 0 -t.;O.f (I 1 Miscellaneous fees: service or feeder not included I Signing supervisor's license no.: lJ 7 :2 7 5 1 1 Each pump,or irrigatioo circle (2) $ 63,00 $ 1 Print name of signing supervisor: f( 0 (j- Gf( I( I N G 1 1 Each sign or outline lighting (2) $ 63,00 $ I Signature of signing supervisor: ~ ) . -.\ A I ,J. ' _. I I Signal, circuit or a lip1ited"energy panel, $ 63,00 $ J"C.....O""LI ,I ~ alteratIOn, or extensIOn (2) ,v / Each additinnal inspection: (1) $58.00 1 $ ~ ~\D d)~~ ~~ . (A) Enter subtotal of above fees Ii (Minimum Permit Fee $58.00);' I (B) Enter 12% surcharge (,12 x [A]) 1 (C) Technology Fee (5% of [A]) :[ 1 TOTAL fees and surcharges (A through C): $t1.r1.~c) $ ~.to.lcIt $ \\ .\0 A.. ?l.15C\: '\~ 440-2584-J (9108/COM) 2~ willamalane t~ Park and Recreation District JO~. No. (\ 1 IJ-\ft:As SYSTEM DEVELOPMENT CHARGE WORKSHEET JanuarY 1-June 30, 2010 NAME: .. ~0.~d, f)00- - ",PHONE: .:94V5 \ 1', ~.-W1 ApbREss:BlA\l-th\~' fJJC(eM..sTATE: '"Q~P:, ct"1A~': LOCATION OF PROPOSED BUILDING SITE: Stre~tAddress: \~\ ,b+'<'\ 'l~~ed- T~XLO~ Number: \*1 D3 ZLcA:2 0 \3&2... Plat Name: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s), Dwelling type definitions are on the backJ ' A. 'Sinale-Familv Detached NO.OF,UNITS \ X $2,858 per unit = $' ~B~~ 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'. Sino Ie Room Occuoancv NO. OF UNITS \ X $1,321 per unit =_ _'-,.~~~' ~ .-.".. -- --.. -- -~--- E. Accessorv Dwellinc Unit NO. OF UNITS X $1,550 per unit = $' $''2-656.00 $>> ," "," ," ,,_s'.c._ "- cx.)" $ ,1.<?JSB. ~ Iht \0 Date .. WILLAMALANE SDC 2. ~DC CREDIT (If applicable) SDC payer must furnish proof of Willam~lane CreditapprcivaL) , , , "--3:"TOTACWIi.:-'::AMALANEjifET SbC~ASSESSED (if SDC reduced for Credit) llMj (c)\-~V)D~ / , De:veiopme:nt Services Depart~n\ ~ ' , City of ,Springfield, ' , 5 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 I 0-00095 Payments: Type of Payment Check cRcceintl RECEIPT #: Description Plan Review Residential Paid By MOIR CONSTRUCTION COMPANY INC .....r-~...~~I~OCj4..'...,....'. ~, bIT' --. Citu of Springfield Official Receipt D, ., clopment Services Department Public Works Department 2201000000000000060 Date: 01122/2010 II :42:23AM Item Total: Check Number Authorization Received By Batch Number Number How Received djb 4919 In Person Amount Due 540,05 $540.05 Amount Paid $540,05 Payment Total: $54U.U5 ". "',~;':~~:"t;)t ;~':., "'. Page I of I 1/22120 I 0 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 1 0-00095 COM20 I 0-00095 COM20 1 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM2010-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 1 0-00095 COM20 1 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 1 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 COM20 I 0-00095 Payments: Type of Payment Check cReceintl RECEIPT #: TZQ~~;_,' ..:: " , 1201000000000000137 Description Addressing Assignment Willamalane Single Family Fire SF Fee - Residential Building Permit Plan Review Major - Planning 2 Baths One or Two Family I st Appliance Exhaust Hoods Vent Fan Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Tran Reimburs-Residential SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC SanitarylStorm Admin SDC MWMC Compliance Charge SDC Transponation Admin SDC Trans Improvement-Resident, + 12% State Surcharge + 5% Technology Fee Paid By MOIR CONSTRUCTION City of Springfield Official Receipt Development Services Department , Public Works Department Date: 02/16/2010 9:IS:IIAM Amount Due 38,00 2,858,00 61.60 830,85 211.00 337,00 79,00 13,00 18,00 134,00 25,00 63,00 533,14 666,84 507,07 211.21 101.97 1,333,57 10,00 129,32 22,63 86,58 931.65 179,98 85,54 $9,467,95 Item Total: Check Number Authorization Received By Batch Number Number How Received NJM Page I of I 4922' Amount Paid In Person Payment Total: $9,467,95 $9,467,95 2/16/20 I 0