HomeMy WebLinkAboutPermit Building 2010-4-30
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00528
ISSUED: 04/30/2010
APPLIED: 04/29/2010
EXPIRES: 10/30/2010
VALUE: $177,813.00
Status
Issued
225 Fifth Street, Springfield, OR
.541-726-3753 Phone
'541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4161 STELLAR WAY
ASSESSOR'S PARCEL NO.: 1802064108600
Springfield TYPE OF WORK: Single Family Residence
PROJECT DESCRIPTION:
TYPE OF USE: New
Single family residen~e:.: SA.M/C 1\S COM2009-01469 1138 s 41st
..f'..r ~ ~', .
Residential
..
1"'.
Owner: BRUCE WIECHERT CUSTOM HOMES INC
Address:, 3073 SKYVIEWLN
EUGENE OR 97405
I CONTRACTOR INFORMATION ~
Contractor Type
General
Electrical
Mechanical
Plnmbing
Contractor License
BRUCE WIECHERT CUSTOM HOMES INC 101717
I. & E ELECTRIC INC "'105475
COMFORTFLOW HEATING
STEVE R JOHNSON 65065
I BUILDING IN~\O
~ON:ore\J"I" \neOre e\t~
tf.u(14lIlU\J ~ aSS rules~: :S2-Q91.I
R-~Ml!1l /ij\\~0"", 1dB'.t9I
VIJno~~:atA9 ':~;~~li~S
oo:n"'9 \llGl1l! l~n \J\\\i\'I N~';~ctric
3 rn\:l8f~,&\1g\~R!8Elo-332-2.34 .,.
1\11 ~~d'Building: n/a
# of Units:
Primary Occupancy Group:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVElcOPMENT INFORMATlO~
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
18.00
6.67
5.00
21.00
0.00
Expiration Date
09/16/20 I 0
03/30/2012
Phone
541-606-5050
541-933-2653
03/12/2012
541-342-3765
Lot Size:
Sq Ft 1st Floor: 1,700
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport 350
Sq Ft Other:
Occnpant Load:
REQUIRED PARKING
Total: 2
3 Handicapped:
Yes Compact:
37.60'__ /J""
- ,_".:,...,iii:~i1f>1'i!:I""~"':-~-
.. :l'~~~~;'tOl.r-.~1J',. \'
~,_d:#?;~~q..':'-F#;":"'-"'" <~
I PUBLIC IMPROVE~ """P\?-'C "~"' it \S ~Q1J\:
~O . S~\.\.,~" ~f.?-"^' ~ ,:j)',,:"
Fully Improved \-lIS 1't.~\oJ\~ ~\1"f~~;l'IQ~t.~ f~ ,', ;;~:~':"Curbside 5'
. Yes' \p..\l\\-IO~I1.t.\)\) ~~Jt&!f!IlIl'rains,:,."/" Curb and Gutter
CG\'J\\'J\t.~Ct:p..'l \'t.~IQ\).
p..~'l ~ \)0 \)
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
",(,',_.',J!,~ I. \ " \,
, ,.:;. '\~" ; ,
~f.i, -!{I~ '~'Paf!e i of 4
,'~\; ~
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvve of Constrnction
Use Bid Amount
U VB Utilitv
R-3 VB 1&2 Familv
Bid Amount
Garaee/Misc
SF/Duvlex
Fee Descrivtion
+ 12% State Snrcharge
+ 5% Technology Fee
Plan Review Same As
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
2 BathsOne or TwoFamily
Addressing Assignment
Appliance Vent
Building Permit
Curhcut Permit
'Dryer Vent
Exhaust Hoods
Fire SF Fee - Residential
Fireplace (Listed)
Gas Outlets 1-4
Plan Review Major - Planning
PW Disc - 2nd Permit
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Compliance Charge
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Sanitary/Storm Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
SDC Transportation Admin
Sidewalk Permit
Vent Fan
WiIlamalane Single Family
: _n. ,'-,
,~5.
ii,'. t/
'l.(.",.,,~.
i- ?~~.. ~Ji
\~ ,> j
I Valuation Description I
$ Per Sq Ft
or multiplier
$1.00
$37.72
$96.83
Square Footage
or Bid Amount
176,743.00
350.00
1,700.00
Total Value of Project
~'
I," ,
,.
Amount Paid' ,
$32.64
$13.60
$250.00
$134.00
$75.00
$63.00
$183.27
$94.21
$79.00
$337.00, .
$38.00
$9.00
$1,026.21
$88.00
$9.00
$13.00
$102.50
$20.00....
$7.001-'1:"
$211.00";;"
$-30.00 '.
$507.07i
$666.84
$10.00
$22.63
$1,333.57
$101.97
$103.99
$931.65
$211.21
$91.50
$88.00.
$21:00 '
$2,858.00
;~~~l;'1<~'::
Date Paid
",.' '
4/29/10
4/29/10
4/29/1 0
4/29/10
4/29/10
4/29/10
'4/30/10
,4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/1 0
4/30/10
4/30/1 0
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
4/30/10
;4/30/10
4/30/1 0
4/30/10
4/30/1 0
4/30/10
4/30/10
Paee 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00528
ISSUED: 04/30/2010
APPLIED: 04/29/2010
EXPIRES: 10/30/2010
VALUE: $ 177,813.00
Value
Date Calculated
$176,743.00
$13,202.00
$164,611.00
$354,556.00
04/29/2010
04/29/2010
04/29/2010
Receipt Number
2201000000000000427
2201000000000000427
2201000000000000427
2201000000000000427
2201000000000000427
2201000000000000427
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
2201000000000000439
Status
Issued
s.~ ,
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00528
ISSUED: 04/30/2010
APPLIED: 04/29/2010
EXPIRES: 10/30/2010
VALUE: $ 177,813.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.."
.1.
Total Amount Paid
$9,708.86
I Plan Reviews ,
Plan nine Review
04/29/2010
04/29/2010
, APP DDK
Public Works Review
04/29/2010
04/29/2010
APP TSS
Required street trees as shown on
street tree plan attached to permit:
species as shown. 2" caliper, leave
name tag on until approved.
Stormwater to curb and gutter
through weep hole.
As noted on plans
Structural Review
04/29/2010
04/29/2010
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(lllirerUnsnections 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.
Curbcut - Standard: After forms are erected but prior to placement of concrete.
Ufer Electrical Ground: Install ground rod at footing and 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.
Slab: To be made after all ins lab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before covering sheathing with finish 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.
Masonry:
Final Bnilding: After all required inspections have been requested and approved and the building is complete.
Undernoor Plumbing: Prior to insulation or decking.
~, ~" '
"'P':
, "':;~1~1 '.
.:'1"
Undernoor Drain: Prior to cover or placement of concrete.
Pace 3 of4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM20IO-00528
ISSUED: 04/30/2010
APPLIED: 04/29/2010
EXPIRES: 10/30/2010
VALUE: $ 177,813.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Rough Plumbing: Prior to cover and including required testing.
Water Line: Prior to tilling trench and including requi~ed testing.
Sanitary Sewer Line: Prior to tilling trench an'd 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 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.
Gas Service: After line is installed and line has been connected .to a minimum of one appliance inclnding required
testing. Presure.test done at this point.
Rough Mechanical: Prior to Cover
1,(
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Temporary Electric: Approval reqnired prior to Utility Company energizing pole.
Rongh Electric: Prior to Cover
Electric Service: Approval required prior to utility company energizing service.
. .
Final Electric: When all electrical work is complete.
.'li" 11.\.ri,'_'\'
By signatnre, I state and agree, that I have carefullf~iamine'd the completed application and do hereby certify that all
information hereon is true and correct, and I fnrther 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, and the approved set of plans will remain on the site at all
timeSdurl~ L-hO)JO
Ow."., C.",,,,.,, "''''"'' ---- Do<' 1; ,
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Page 4 of 4
Electrical Permit Application
I
CITY OF SPRINGFIELD, OREGON
I
225 Fifth Street. Springfield, OR 97477.PH(541)726-3753+FAX(541)726-3689
'" DEP~RTMENtusE ONL. y.' .'
tJ - '-:1 r-
Pennit no.:./I > -
Date:
If)
This permit is issued under OAR 918-309-0000. Permits are nontransferahle. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
. ;c-OCAVC;>OVERNMENt ""P.F'ROVAG;:'~/''J''
Zoning approval verified? D Ves D No
>:':i.,:'}::,,:.cATEGOR~j'c5F ':CONSTRUqION'S, .'.;' '.
o Residential 0 Government 0 Commercial
. \(~~tt~i:~tOB~.SITE; INFORMATI()NrANJj!.i(:O_CA'f,ION:ti;i'~5':E
lob site address: 4/6 S+~/'t;"v
City:
Residential, per unit, service included:
1,000 sq. ft. or less (4) ( $134.00 $rN
Each additional 500 sq. ft. or portion 3 $ 25.00 $'1)
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
40 I to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
ZIP: "1710) Over 1,000 amps or volts (2) $469.00 $
$ 63.00 $
~o't\C~~ ~ S
1\1\S ~'t.~~'t.O ~ .
[:>,1.)1\10 HIC't.O') 12% surcharge (.12 x [A])
. CO~~'O\l 0[:>,'1 'i' echnology Fee (5% of [A])
[:>,~ TOTAL fees and surcharges (A through C):
Signature:
Business name:
Address:
CCB license no.: O~ 47':> BCD license no.: :363
Signing supervisor's license no.: '-II 7 '1- S-
Print name of signing supervisor: ~C Oe "o".l~""
C
Signature of signing supervisor:
0<:...
,.~yo<
~, D~
?513
\.1),~
6A: \\)
~Wfh
~
440-2584-J (9/08/COM)
$ 63.00
$ 87.00
$126.00
$")
$
$
volts, see services or feeders section above
.ranc cirCUits: new, alteration, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
. Each branch circuit
$
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2)
Each additional branch circuit
$ 55.00 $
$ 6.00 $
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2)
Each sign or outline lighting (2)
Signal circuit or a limited-energy panel,
alteration, or extension.p) .;, .
Each addition'-afih~p~di'
$ 63.00
$ 63.00
$
$
$
$ 63.00
$58.00 $
N.tB'i.JSE"i,,\i;fj~~;:",;7W.;.Y.:';
.>'flfLL.-
Structural Permit ApplicatioD_
/151 SifS*'
L '/'- 0146 1
r ~. . ...'! '" l. . . .'.
'.:.:~""li:;o eITY,0F.SPRINGEIELD, OREGON .:'. "1.' _1;,:"'; c ,.
'f """'. 7, -,' . _., 1 _' ~. .'", . . .
225 Fifth Street + Springfield, OR 97477 + PH(541)726-3753 + FAX(541)726.3689
O.A.INOl'1l11LDiij.
~,
,. ,...
}), M" 'GlJf ..
. . . -"-. ;"'".,< '-~ M'...."""'_..".....-,...~;.,,,',"'".>.."'.4
1\' DEPMHMENT;U~E;qNUYAi.
.. "~<". .... ''',' ."~"'~I,*"",,,,,.,. _ ,;...\.1', ,..,. .~~_.,
Penn it no,: (1/ [J "j2 F
Date: t:.j / ;J'1 / I .)
./ ,
This permit is issued uuder OAR 918-460-0030. Permits expire if work is uot started withiu 180 days of Issuauce or If work IS
suspeuded for 180 days.
~~~'tOCA~GOVER...MENl\~APPROVAii!"":;:{il1''"J''"~~'il
~,w.<...__........ ..........lI......,.H............ . ,~f.l1i" ,:!!,!'!r,.",,,,,
This project has final laud-use approval.
Signature: Date:
This project has DEQ approval.
Signature: Date:
Zoning approval verified: 0 Yes ONo
Property is within flood plain: 0 Yes ONo
~~~.,.-......_~._.-.~'..<.._...._.-.... ". . ..:;;:~
,. " .-i;i~llj,~Ji~AJJ~~OR.Y.;~9If.;,.C;9N1HRUC:rION(t"M!!.'i;. ':
[Jj Residential I 0 Government 0 Commercial
J\!1ff_<f~Q~ls1igllINff9BMAJiQN'~~&R1l1!Qc::Af!QNn~.fti;%;.i;~~1
Job site address: '-/1 br/J 5'+~ lI~v
City:<;o.; "" C .<-1) State: 0 tL I ZIP:'i7Y 77
Subdivision: p;' I h", f~ (1'\",.).0"<' '1 Lot no.: IS'
Reference: I Taxlot:
~~ri~i!.ij~r~~,t~~f~WJ;t~~~[RRQ#~R~~.QWtt~~tt::: . ""';';"; ... ..,
Name: (!, {11l<' /,J: < Gh.,t ("r,\-;Jp.. \lQMO.s ::trJC-
Address: 30'73 St.",.cw l-N
City: t.'}'tc,,<- StateO I'- I ZIP:') 710'J
Phone: .b~b - '1'i')g Fax: .,1'1- 2,3 b ?
E-mail:W ) (0h.Nf \--.c""'-S QC)I"<~S\ Ne.t'
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:
~'t!~f~M...-'->.,......."."..,~-~.--,.-1:.''''''.."'.~'~":i~A'~' '.,"'''''.'':/..-.,"4:.:'?''',~~I.''::'. ,".:-,','
ill ~i". ;';';.' i>C;QN;TBA9J.Q~.il.'N~I~r,:~IJl:~J,It,~h>iil;\Sii;\{'...,;:~;;i;:
Business name: ~c"i.< W ,e~~'",~ Lv~br- 1;.""",- ~ ]:),1,--
Address: '3 07 3 ~ I<~ v; <..v ,-""
City: ('"< e.H- State:O-1l.. I ZIP:C, 7)DS-
Phone: -M & cl '1 S ? Fax: ;3'1'f. ~3 b z.
E-mail: w; ,,"'1......\ \--.OI\-t'S @ co~'" (t,,)'4 ~ ,>J",t
CCB license no.: 101 } r 7
Printn~e:~ -e...../,.;..I~ W",I-n"v
Signature: VA IN' _______-
j:Nt~~~,,~r~1!f~~EE!SC.HEbiJ[E~~~~l~~...i~r-'.~~\h:::
"~_.,:.-.: 'C\...-...l~-~t,':",_" .!J:<;"" .~""~'-\~,~, :':>,._. _",', ,_".. _..... .,....."__,,,, ,t;~~... _~;.",~.-l;}!hifh~,":.,
ti'(v'T":i''''i'';':''':J;;''ii't;''i"1i~~'''r~(4~~:''~:;jA''i';(.t~'.:;';~~..;;n~i~'~l~;;;t
, o'_:e ~~, _u~L~9.ntL .Q!m~,.!QI,lJr:t;I~i",l;;;'t':','~'l~':';';;'~~~~;':trL" , "', ;2t~t.:;fi;:i,' _:"~,~
(a) lob description: }JeW 5 I- i)
Occupaucy r:). ItA
Construction type: vi)
Square feet: /'7Co if '3 "0 tJ.
Cost per square foot:
Other information:
Type nfHeat: t; r 11
En~rgy Path: I ,tt
Grnew 0 alteration 0 addition
(b) Foundation-only permit? DYes ONo
Total valuation: 1'7& '1'-13 I s
'C 2. Do ild~~g:f~~~~:~~f:';f,~"~'mrJt:":i~!~.".. ~)~n~~.~~l:?~fjtfu"~t.;.: :
.
(a) Permit ree (use valuation table): S
(b) Investigative fee (equal to [2a]): S
(c) Reinspection ($ per hour):' S
(number of hours x fee per hour)
(d) Enter 12% surcbarge (.12 x [2a+21>+2c]): S
(e) Subtotal of fees above (2a through 2d): S
1'3A'pi'''''i<f~'1''-fi'ti$'~t.lf''til'''i'M';''''i'\'"'il''"'''.Jfi;'E'f''If'i'lfj'''
"::,, _t _ ..a,_~_'.r.~Y.. ~l:Yi:.~, . ,,:i~ '~.' ~,J,"ii4i;~~;i!~': ~!"~i\~i~)'t~'::c~'~~. ..-".:rd,0:~"r~f:):_ ';.:,
(a) Piau review (65% x permit ree [2a]): $
(b) Fire aud life safety (40% x permit ree [2a]): S
(c) Subtotal of fees above (3a and 3b): S
'4. Mi"c~ij~ife~!isfeegt;i.' .... . " .'. .,'/~:V2~~~~~tijJ\j~~~~~;f'r~'.:; ~
(a) Seismic fee, 1%(.01 x permit ree [2a]). S
TOTAL fees and surcharges (20+3c+4a): S
" r' "?'~~~';;SUB:CON:tRACTORNF.(jRMAtrON!l;:,\'!l!i.flt,!....,::,.
,- . ,~.._w...,"..,.,_..."._~....--,,.,;_..~-~..;..,_~...:-<..L_,..-,.,, ..........<",,'.._.". ,'~,.~'1}~'""'P,.._,--, ". "
Name CCB License Number Phone Number
Electrical t-..e 5LI 'II ~.&
Plumbing 51c.vd ., y 2- 3'1 &Z;-
Meehanical CI"H 72.6-0100
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tb \s~<t''0-Q
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.Willamalane
Park & Recreation District
Job. No.c,O -005 z,f
SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2009
,
NAME: 1SlJ crt PHONE: <:;'If;''' bar; '5"0 s- Cl
ADDRESS:.3073. S~Ie:W CITY k.lG-CN~ STATE~ZIP: 77~or'
. LOCATION OF PROPOSED BUILDING SITE:
Street Address: 41 b , s ;- (:;t.. ~
Plat Name: /062 06Cf (
wy
Tax Lot Number:
C> 8"60 ()
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dweiling type definitions are on the
back.)
A. SinGle-Family Detached
NO. OF UNITS !
X $2,858 per unit =
$ 23St r
B. SinGle-Family Attached
NO. OF UNITS
X $3,100' per unit =
$
C. Multi-Family Apartment
NO. OF UNITS
X $2,641 per unit =
$
D. SinGle Room Occupancy
NO. OF UNITS
X $1,321 per unit =
$
E. Accessory DwellinG Unit
NO. OF UNITS
X $1,550 per unit =
'$
$
28S"6 -
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SDC payer must fumish proof of
Willamalane Credit approval.)
$
~
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
$ 2l>~g'-
--- ~e
Development -Services Department
City of Springfield
L( .1 SUI ZorC:>
Date
5
': ~':.' ..i:i \ T.~. .'
~.~
_,_,..___..,~..;. -Ok,.....F ".
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
RECEIPT #:
2201000000000000427
1O:42:18AM
Date: 04/2912010
Job/Journal Number
COM20 I 0-00528
COM20 1 0-00528
COM20 I 0-00528
COM20 1 0-00528
COM20 I 0-00528
COM2010-00528
Payments:
Type of Payment
CreditCard
cRcccintl
Description
Plan Review Same As
Residence Wiring 1000 Sq Ft
Residence Wiring Ea Addtl 500
Temp Power 200 amps or less
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
250.00
134.00
75.00
63.00
32.64
13.60
$568.24
Paid By
BWCH
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb
045140 In person
Payment Total:
$568.24
$568.24
,:,
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1",;
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T". .
Page 1 of 1
4/29/2010
22~ Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
WiM;
-""i'.""""""'~"'-'-,' ,.-,. ",u -
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
. .
2201000000000000439
Date: 04/30/2010
9:01 :04AM
Job/Journal Number
COM20 I 0-00528
COM20 I 0-00528
COM20 10-00528
COM20 I 0-00528
COM20 I 0-00528
COM2010-00528
COM20 I 0-00528
COM2010-00528
COM2010-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM2010-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 1 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
COM20 I 0-00528
Payments:
Type of Payment
CreditCard
cRcceintl
Description
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
Building Permit
Addressing Assignment
Willamalane Single Family
2 Baths One or Two Family ."._...
1 st Appliance
Vent Fan
Appliance Vent
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Fireplace (Listed)
Fire SF Fee. Residential
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
BWCH
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Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 00500d In Person
Payment Total:
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Page I of I
Amount Due
211.00
88.00
88.00
(30.00)
666.84
507.07
211.21
931.65
101.97
1,333.57
10.00
103.99
22.63
91.50
1,026.21
38.00
2,858.00
337.00
79.00
27.00
9.00
13.00
9.00
7.00
20.00
102.50
183.27
94.21
$9,140.62
Amount Paid
$9,140.62
$9,140.62
4/30/20 I 0