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Home My WebLink AboutPermit Building 2010-2-17 Status Issued 225 Fifth Street, Springfield; OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1116 S 41ST ST ASSESSOR'S PARCEL NO.: 1802064113000 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00207 ISSUED: 02/17/2010 APPLIED: 02/16/2010 EXPIRES: 08/17/2010 VALUE: $ 170,951.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence -SAME AS COM2009-01446 Residential Owner: Address: BRUCE WIECHERT CUSTOM HOMES INC 3073 SKYVIEW LN - EUGENE OR 97405 I" CONTRACTOR INFORMATION ~ Contractor Type General Contractor License BRUCE WIECHERT CUSTOM HOMES INC 101717 BUILDING INFORMATION. REQUIRED PARKING Total: '2 2 Handicapped:\() Yes 'i;1\!vc.o_Il!P'a'Ef: '1~'~~~\\\\1 'l'!OO,qnn ."" 0"'90[1 j tn :\ic\'r\lO\~"" .' i.~c\ bY ti\8 I "ale set 101 ~\ )/J lules ad~~ . ihose lules /'.R 952..00\' I PUBLIC IMPROVEMENT511itil~~ 952.-00'-00~ in copieS 01 ~ ~~nol1e "11'0 llI3,Y ob a 'Note' tne e 'l'calIol\ 0090. ~llI/.lvEi'l!lli\\1!lle:\ Utility Notll ca\lil1ii\\\;he..PJ.~9~-2344). I1Ulll~~te':II~"\ ~ . Cen Pel' D. \M~fiit~E~riveway width is not to exceed 24 feet. curb an11&~tPeRMIT SHALL EXPIRE IF THE WORK !.IUI ~OMMENCED OR IS AS t\')Y 180 DAY PERIOD. Type of Construction # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: I R-3 U VB 3 Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 16.50 7.00 7.00 26.00 10.75 Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: I Height of Structure 21.50 Type of Heat: Forced Air Gas Water Type: Gas Range Type: Electric Energy Path: Sprinkled Building: n/a I DEVELOPMENT INFORMA nON ~ Overlay Dist: #'Street Trees Rqd: ,Paved Drive Rqd: % of Lot Coverage: Expiration Date 09/16/2010 Phone 541-606-5050 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,552 548 Driveway measures 26 feet on site plan. Stormwater to Description $ Pel' Sq Ft or multiplier Square Footage or Bid Amount Page I of 4 .f' i~:i" 'I!' "I . Value Date Calculated . "''''; ..,;." ,t- . ," Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Estimate Cara2e/Misc SFlDuplex $1.00 $37.72 $96.83 Estimate U VB Utilitv R-3 VB 1&2 Familv Total Value of Project ~ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00207 ISSUED: 02/17/2010 APPLIED: 02/16/2010 EXPIRES: 08/17/2010 VALUE: $ 170,951.00 100,000.00 548.00 1,552.00 $100,000.00 $20,670.56 $150,280.16 $270,950.72 02/16/2010 02/16/2010 02/16/2010 Fee Descriotion Amount Paid Date Paid Receipt Number Plan Review Same As $250.00 2/16/10 1201000000000000136 + 12% State Surcharge $212.49. .. 2/17/10 1201000000000000147 + 5% Technology Fee $106.39"':':: \ jl 2/17/10 1201000000000000147 1st Appliance $79.00 .' 2/17/10 1201000000000000147 2 Baths One or Two Family $337.00 ,. 2/17/10 1201000000000000147 Addressing Assignment $38.00 2/17/10 1201000000000000147 Appliance Vent $9.00 2/17/10 1201000000000000147 Building Permit $997.72 2/17/10 1201000000000000147 Curbcut Permit $88.00 2/17/10 1201000000000000147 Dryer Vent $9.00 2/17/10 1201000000000000147 Exhaust Hoods $13.00 2/17/10 1201000000000000147 Fire SF Fee - Residential $105.00 2/17/10 1201000000000000147 Fireplace (Listed) $20.00 2/17/10 1201000000000000147 Cas Outlets 1-4 $7.00 2/17/10 1201000000000000147 Plan Review Major - Planning $211.00 2/17/10 1201000000000000147 PW Disc - 2nd Permit $-30.00 . 2/17/10 1201000000000000147 Residence Wiring 1000 Sq Ft $134.00 2/17/10 1201000000000000147 Residence Wiring Ea Addtl 500 $75.00 2/17/10 1201000000000000147 Sanitary Sewer ~ Im'provement $573.20 2/17/10 1201000000000000147 Sanitary Sewer - Reimbursement $753.82 2/17/10 1201000000000000147 SDC MWMC Administration $10.00 2/17/10 1201000000000000147 SDC MWMC Compliance Charge $22.63 2/17/10 1201000000000000147 SDC MWMC Improvement $1,333.57 2/17/10 1201000000000000147 SDC MWMC Reimbursement $101.97 2/17/1 0 1201000000000000147 SDC Sanitary/Storm Admin - $105.97 c. , 2/17/10 1201000000000000147 SDC Transpo Improvement $931.65 2/17/10 1201000000000000147 SDC Transpo Reimbursement $211.21, 2/17/10 1201000000000000147 SDC Transportation Admin $91.11 ' 2/17/10 1201000000000000147 Sidewalk Permit $88.00 2/17/10 1201000000000000147 Temp Power 200 amps or less $63.00 2/17/10 1201000000000000147 Vent Fan $27.00 2/17/10 1201000000000000147 WilIamalane Single Family $2,858.00 2/17/10 1201000000000000147 Total Amount Paid $9,832.73 I Plan Reviews ~ Pa2e 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM201O-00207 ISSUED: 02/17/2010 APPLIED: 02/1612010 EXPIRES: 08/17/2010 VALUE: $ 170,951.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Planning Review 02116/2010 02/1612010 APP DDK Require street trees as shown on street tree plan attached to permit: species as shown. 2" caliper, leave name tag on until approved. Driveway width not to exceed 24 feet per phone conversation with D. Westover. Stormwater will he routed to curb and gutter. No stormwater SDCs. As noted on plans Public Works Review 02/16/2010 02116/2010 APP TSS Structural Review 02/16/2010 02/16/2010 APP CJC 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. l..ReouirecUnsnections I Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction witb footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Slab: To be made after all inslab building service equipment, conduit piping and otber equipment items are in place but prior to concrete. Post and Beam: Prior to 11001' insulation or deckiug. Floor Iusulatiou: Prior to deckiug. Sbear Wall Nailing: Before covering sbeatbing with finish materials. Framiug luspection: Prior to cover aud after. all rough in inspcctions have been approved. Walllnsulatiou: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Masonry: Final Bnildiug: 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 backfill. Underl100r Plumbing: Prior to insulation Of decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewcr Line,: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. 'Page 3 of 4 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00207 ISSUED: 02/17/2010 APPLIED: 02/16/2010 EXPIRES: 08/17/2010 VALUE: $ 170,951.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Final Plumbing: When all plumbing work is complete. Underlloor Mechanical. Prior to insulation or decking and including required testing. (;'j ~: Underlloor Gas: After line is installed and req~ired 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. 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 Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Cnrbside: After forms are erected but prior to placement of concrete. By signature, I state and agree, that I have carefuIlY"~f,amired the completed application and do hereby certify that all information hereon is true and correct, and I further\~.ertify th:tt any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the "'aws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure withont 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 Pl'oject. I further agree to ensure that all required inspections arc 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 ti7}7tr~y-- Owner or Contractors Signature rz-~7 /J 0 . I Date ~.'. :1 . l":,1., Pa~e 4 01'4 s 'f! s..J- c ? -('(1((,. ~ tl tYJ( 1270 4.5 I' ~} " '......~ .",... l "'I ',:".,' 'J.. ..~~.::".\(.. . ~ ;..,.,. . ~i ',:" ~.~ CITY,OF SPRINGFIELD~ OREGON,j"".:: . :;' "..~:..: 1:. _,'. 'd ., .~~' ,::0:.. .- ~ ,.1..1-" ~""",!l.'," ZON INITIALS . DATE SOURCE ~.PA~:O':~~~ .." ., 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-37SJ . FAX: (541)726-3689 ELECTRICAL PERMIT APPUCA110N City Job Number COWl 2,0'" - VO 2 07 o Dale 1. L0CA1"ION OF /NSTALLA'/"iON: 1/1 b ~ Lj(Sr LEGAL DESCRIPTION: /8oZ0bt(1 13600 JOB DESCRlPTlON)l ./. ~1""1(E:' f.!!.""-"-' Y -+ TeMP Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 3. COll'IPLEfE FEE SCHEDULE BELOW. . " -'~ . A. 'New Residential- Single or Multi-Family per dwelling ilDit, ',. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof ~ Each Manufact'd Home or Modular Dwelling Service or Feeder /3'-1 /3'( .$RHlo -- ~, '15fP~.:;o $ 22.00 . "'/-'>_ I .3. $57.00 ~', ~':::,-.~.." ~...":'~-.. -'-'<-:;., ',;.,~~...::,:,.",- "".'. r"......:.."...~_.. _","',,,"",, . " - '; 2.,.cq~(J'ORWSr1!L.ATION ONLf Electrical Contractor L +- I.: B. . S~r~-i~~s(ir,~ ~~~:("e'~s ~-In'stll~iati()ll: ~\;ter~tio~'~:~"/"RelodlHon:::~'::: .' .- > ' -," - "<'. - ~ - -". . ~', -~. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 73.00 $ 86.00 $143.00 $186.00 $426.00 $ 57.00 Address q Z. -g s 3 ACl"eS 30>0<.') City '5 f C \ ~ Phone 5 l J >1-/1 9 d' Supervisor License Number L{ I 7 'i - j- 12/10/11 , Constr. Contr. Number I b S- Y 7 5'- 3)/0 . C. Temporary Sen'fces or Feeders 3fr-o Expiration Date Installation, Alteration or Relocation ( &3- az.I, _l:L (!;t) $>?:OO-- 19 V. $ 79.00 $114.00 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Expiration Date Over 600 Amps or 1000 Volts see "B;' above. D. 8ranch CirrllitS"' , Signature of Supervising Electrician F ~ '~D\}~l ~ .'> .. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Pennit $ 50.00 $5.00 Owners Name ~, liCe LJ i e",ked Address :, b 7 j (uSb!'" ""...., S 5Ilyv;,w lrJ Phone bU,- 9 4)~ E. Miscellaneous (Sen:ice/reeder not included) -Each InstAllation City t: (j J "''''' OWNER INSTALLATION Pump or irrigation $ 57.00 Sign/Outline Lighting $ 57.00 Limited EnergylResidential $ 29.00 Limited Energy/Commercial $ 52.00 Minimum Electric Permit Inspection Fee is $52.00 + SUf,harges 4. SUH'I'Ol'A/,OFABOVR 0172.. C5'b 12% State Surcharge 2>1t . \04- 10% Administrative Fee ~ 5% Technology Fee =:=1______ \..Ql) TOTAL 3/ -Lr Shared Drive(T:)lBuilding Fonns/Electrical Pennit Application 7-08.doc I The installation is being made on property I own which. is not intended for sale, lease or rent. Owners Signature: .~ ,,~\'\ >-~O \}abJ IIJ.'? . ~. " Inspection Request: 726-376rf1r),'T d ':\. ~<:(1 V-~ -;:;tM t A 5 Structural Permit Application._ C"1 - OIl/Vb . . -;'~'i!":' CI;r;y,OFSPRINGEIELD.9RlOGON : - .,'_u_..<.' 'P.,~......~. . ~.A . ?'''''''i-&! ..... <;'.1 ~, '.- 'GI1' . ?; DEPA~fMENT:US.rQN~Yfr\ .",,,,,,,,','_;I,,.,,~~,,,,.ltL.lj.,,.......,, ~,... ..*i,,': COMZOtO-ocZC"7 Pennit no.: Date: 2-16 . 10 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 . FAX(54 1)726-3689 This permit is issued uuder OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. fiJMa.,'Wil0c;ft"GOVERNMEN'frAPP.ROVA~~"'~i;1~'i~~[~\"~ .. " _' ~t;jJ____.JJ!;L....uu_...__..........._.... . ~~.,il<!"....,$. This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Date: Zoning approval verified: DYes DNo Property is within flood plain: DYes DNo i~':'~{\''':~~~''CAiEGORy!,1;'OF.',;CONS'i'RDctION'':[;;/l/!'1<.''.: '.:~ .:.. ~,: ; ~~ _ ,/t/.~ 'f';. It._.<___.___._ ,_ .'_'.' ._..1:~..._... ._.._.......". _ . ,.:__~..._ __ ._ ~ _,__' '.'.',j; [i1 Residential I 0 Government o Commercial ~~~::rll6B~sif'WiNF6RMATlci"~ANDjif6'cAficr':Plfi::;~~~'~i; ~, ..,.....u.._....,Egiu._u... ,.......~ .... . .u.......u~.,",. ..,~ Job site address: illb 5 l-) 151- City:<;"'r,,, ~ C: <-I A State: 0 IL I ZIP: if 707 Subdivision: F;' j h~ {-t ~(<.!-"I.J'~ ., Lot no.: 5"9 Reference: ) 8c:>z OE,qr I Taxlot: /3 000 ~1~~~~t:IG~.~f:t~~~~~.RRQR.~BTI~IQWN~~(~{~. 'i~;~;,: ;\~,? .... ~., Name: e, {,I (<. Iv;" c.h. ,t Cvr,\;:)", 110"'0", :tt\l(;.. Address: ~ 0,'3 S~" view /..N City: t '''Ie"", State", '" I ZIP:'! 7105 Phone: ~ -bU- '1'i'>E Fax: -, tr- ~3b? E-mail: W i<c.-h...,1' \<..o~5 (~CD'~U.S\ Nc.f"' This 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: ~51t'i!?""'!llf:"uu""-,,,'"'' ._" ....."'.,..-....'.. "N"'''''' ." L ii :O:'Ili'!'~41, ,~,<;,O~TMgIQ~l!"!STAlL:ATIQNUi,~.,~f~~:..;{i'.;-)i:: Business name: ~"'vc.c \.1;(,,1.,-,< Cu~b1"-- I>o;,",,~ :t)v<- Address: '3 07 1 S \::~ vie"" L,.-,. City: >: ", e..... State:o<L I ZIP;'17)DS~ Phone: .6J'b 'I"} S ? Fax: ",'1 'I .. 33 b z E-mail: W'; eL-\,..,...t \.-,0 IN'S @ COM Uo.54 ~ v-Jc, t . CeB license no.: 101 ) (7 Print n~e: ~ -e ",t'.,;.l~ W", \"HV Signature: fA,{ W _______ ~ ~"%UE~!iEl~Qf:tIR4({f..OR;jt:lff9RM~ttQN~lt!t'1?[.~L, " Name CCB License Number Phone Number Electrical t....C '><1 YI ~ (, Plumbing5fC.",i "Yl-)'1b'- Meebanieal CF H 72-6.. 0 I 00 ""i'''''''''')1iIIfii't~...<,.", ,". i'^'''''''''~'''''''''''''i.' ~;.;f.,~,:.~lh~"'..' ,":hk ", .' -,::fiE;5~~,~Ii~PU~~,~1't';.~~~~. -':..; ~~~i~.'~ '1;;-vc'1.t'1Jl^"'~"llif~j;\~~-Tff'"el6;rf~~l..,)', L.j. ;~i~;;'?'t.,~,:r~~~~"'J"~;!\i.~-'; .' ;'_).,~.JuL!.o.n!L9.!m~.JQ~.:,,~lr-1.:tr.:,n.-':'~':~'~,~)t;~~~'#l'L., ,.. '~.~,.a~;'" ,,~',~j: (a) Job description: ~Fll. Occupancy -e."l/v.. Construction type: ","l Square reet: Cost per square foot: Other infonnation: Type of Heat: FAj€:-~ S Energy Path: ~ IA ..anew 0 alteration 0 addition (b) Foundation-only permit? D.Yes Brio Total valuation: I $/O~OOC B"' ':''''.'~~'f(-.,;':;;''''J'...._.'~I;;);',>; . .. .. .. ~...."...<- 'f;itItt Co ~ 2. udd~~g~. ~~~)~ :Ii;(f~":-.~i~,~( ~,..:" . ,. ':'~./~:!~~m~i~~!~)' '~, 1"; (a) Permiil(ee (use valuation table): $ (b) Investi~~tive ree (equal to [2a]): $. (c) Reins'p~ction ($ . per hour):' $ (niJinb~r ofho1;1fS x fet;.per hour) '-,; (d) Enter 12% surcharge '(12 x (2a+2b+2c]): $ (e)..Subtotal offees above (2a tbrough 2d): $ ,r3.t-'pianVFeVi~wire~~i~:J~:V(~(l~1t~.p:~~ti;!~~~~{f~i~~.~f;~?L ... ....,........-""'......_._.@. ~.. ri...~....... ,'.0-:, .'.., _. ''Jd.m.,......:... "...", (a) Plan review (65% x permit ree [2a]): ~ $ 250- (b) Fire and tire safety (40% x permit fee [2a]): $ (e) Subtotiil;offee. above (3a and 3b): $ , , ..' ..".--'.'K.,..7,.,!.'........i.."-'..... "_' " }:";l'" ."..-...;.~~>,.'t"~..\,If,..:l'). ,...... . .'. '.'... /. .... ,..,.., 4.Mi~ce.ltaiieoiisrees;:.'\ .. ;"<' .. .."_' ',_:".;'1. >'-;:~:_h. - .:;+.~~~.m.~,,~E,J~ i , (a),$eisrnic fee, 1%(.01 x permit fee [2a]): $ TOTAL fees and surcbarge. (2e+3c+4a): $ .' . ~.~ '< 2~ willamalane t\6 Park and Recreation District . Job. No. {!ltJ~.Z?7 SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 '-NAME:~:.Bi<f;.fC:E" W/eCff8LICGlJ~'~~PHONE:s=rt1 b'86>q-Ifr.ff . ," -,. - ~. . . . ...ADDRESS:'3d7J S,qtlcW LN CITYcW4E"Nt::. S'rATE~ ZIP: '11'10$" LOCATION OF PROPOSED BUILDING SITE: Str~et Address: I f1 ~ S. 4/S1 5f. . Plat Name: ~\~ ~ Tax Lot Number: lo~ ,Mt'II:roocJ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definITions are on the . back.) . A. Sinqle-Familv Detached NO. OF UNITS I X $2,858 per unit = $ ZJ"5Y . B. SinQle~Familv Attached NO. OF UNITS X $3,100 per unit = $ C. Multi-Familv Apartment NO. OF UNITS X $2,641 per unit = $ D. SinQle Room Occupancy . ~_.~"_~~~",~~'_._'_'"_.' NO...QF UNIT~ . X. ~.1~~.?tpe!.!lnlt::_ . ... J. E. Accessory DwellinQ Unit NO. OF UNITS X $1,550 per unit = $ WILLAMALANE.SDC $ 2~Cb .# 2. .SDC CREDIT (If applicable) SDC payer mustfumishproof of . Willamalane Credit approval.) $ . .-. . .-... ..' .... " . . -"--'-""-".".~.==-=,.",~~--=>..-=.=_.='.~""-"""""""",~=,-""""'=-...,.......,,..,..,,.....,.~.....=;.-~-'.."-~-~~ ,...........,-- .~"""'-c.....,,-..._=."'""..""'-c.~~.. 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) .' -"'~,',~'~'="=-,,",,,=- ..,,,",-~,," ~..."'-."'. .' '''''~',n'~ ".. '.. ..._.....~, $ ftSF' 6R Development Services Department City of Springfield ~/.1;(.i ~I cJ Date \1 5 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Wi- City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000136 8:53:05AM Date: 02/16/2010 Job/Journal Number COM20 I 0-00207 Payments: Type of Pllyment CredilCard cRcceinll Description Plan Review Same As Paid By BWCH Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 250.00 $250.00 Amount Paid DJB 05523D In Person Payment Total: $250.00 $250.00 " . ,)!.. /\,1 " :'.: " , Page I of I 2116/20 I 0 if~ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: Date: 02/17/2010 I:J4:3IPM 1201000000000000147 Job/Journal Number COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 1 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 1 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 1 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20] 0-00207 COM20 1 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 1 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 1 0-00207 COM20 1 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 COM20 I 0-00207 Description Addressing Assignment Willamalane Single Family 2 Baths One or Two Family I st Appliance Vent Fan. Appliance Vent Exhaust Hoods Dryer Vent Fireplace (Listed) Gas Outlets 1-4 Residence Wiring 1000 Sq Ft Residence Wiring Ea AddtI 500 Temp Power 200 amps or less Fire SF Fee - Residential Building Permit + 12% State Surcharge Plan Review Major - Planning Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit 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 Compliance Charge SDC Transportation Admin + 5% Technology Fee Amount Due 38.00 2,858.00 337.00 79.00 27.00 9.00 13.00 9.00 20.00 7.00 134.00 75.00 63.00 105.00 997.72 212.49 211.00 88.00 88.00 (30.00) 753.82 573.20 2] 1.21 931.65 101.97 1,333.57 10.00 105.97 22.63 91.11 106.39 $9,582.73 c' Item Total: Payments: Type of Payment Check CreditCard cRece!ntl Paid By BRUCE WIECHERT CUSTOM HOMES BRUCE W]ECHERT CUSTOM HOMES Check Number AuthorizOItion Received By Batch Number Number How Received Amount Paid njm ] 93330 In Person $82.73 njm 015350 In Person $9,500.00 Payment Total: $9,582,73 Page I of2 2/1 7/201 0