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Home My WebLink AboutPermit Building 2010-5-11 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00529 ISSUED: 05/11/2010 APPLIED: 04/29/2010 EXPIRES: 11/11/2010 VALUE: $170,951.00 \i.f:~;~' ,fr. ~,t: ~Il;'" ;', 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1134 S 40TH PL ASSESSOR'S PARCEL NO.: 1802064115600 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - SAME ,AS COM2010-00207 Owner: BRUCE WIECHERT CUSTOM HOMES INC Address: 3073 SKYVIEW LN EUGENE OR 97405 I CONTRACTOR INFORMATION I Contractor License BRUCE WIECHERT CUSTOJVi;.IXOMES INC 101717 " .( 'c. L & E ELECTRIC INC ;""~ :~.~"... .. 105475 COMFORT FLOW HEATING-CO. 460 . '"" t .~. STEVEN R JOHNSON 65065 ~FORMATlONI ""OlegonlaW~~ti90 torth # of Units: ~1'tE\IliIO ~dop\edt\>'1 ~ (I11eS ~ !ll~ 1 Primary occupa"tGII~!l9Ceo\eIJ,tnloseU9h 0 !!!Wfructure 21.50 Secondary occu_d~:OO1.o01llJ\hIO pieS ot ~~~~~at: Forced Air Gas Primary constru'\W0~ima'l o\lWJI CO \e: \\1e ~cat~: Gas Secondary Constr~ 'e ceO\el. \"'~ U\WIW ~m.(~e Type: Electric # of Bedrooms: cell10 10t \ne.Olj9~O_332.-2.:t\,~;gy .Path:: ' . t\um\lel ceo\el 18 1-& " Sprinkled Building: nla I DEVELOPMENT INFORMATION . Contractor Type General Electrical Mechanical Plumbing -. Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: 20.00 5.00 11.89 28.00 12.25 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: ':.-L~".. ., ''''''" " Residential Expiration Date 09/16/2010 03/30/2012 06/27/2011 03/12/2012 Phone 541-606-5050 541-933-2653 541-726-0100 541-342-3765 Lot Size: 6,153 Sq Ft 1st Floor: 1,552 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport 548 Sq Ft Other: Occupant Load: REQUIRED PARKING 2 Yes 32.50 Total: Handicapped: Compact: 2 I PUBbi€~'IMi~ROVEMENTS I \ ",; ;i\; -~ \ , , . ", SIdewalk Type: .' ,.".n , . Fully Improved " ~~f;'i!:;l~:m>":' J CurbSide 5' Yes 'Do.wnSP'OntS/Dr~' Q?''f.. Curh and Gutter Site plan not drawn to scale - driveway on site plan me"~~~~~~,* 1 [~" ~ih.no overwidth application included. Maximum w~{\lTVttAProv~~~~N ~~' ~ it:..t\Pplieant must apply for overwidth approval to cllnJtsn~~ ~~el'l\\ lb~ dtli?';- 1\'\\ ?\lttl S t>..~t>..~ .' ,.0 'n" . Stormwater to curb and gutter. 1\\)1\,\0 t~cttl Q~ ~ O~ ' ,-." COWlWl "tll\'/ ?t.?\ . r:-~'/ '\'Ov _ ~, . , 'Pake' 1 of 4 " Status Issued 225 Fifth Street, Springfield, OR . 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Garae:e/Misc SF/Duplex U VB Utility R-3 VB 1&2 Familv Fee Description Plan Review Same As + 12% State Surcharge + 5% Technology Fee 1st Appliance 2 Baths One or Two Family Addressing Assignment Appliance Vent Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fireplace (Listed) Gas Outlets 1-4 Plan Review Major - Planning PW Disc - 2nd Permit 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 Sanitary/Storm Admin SDC Storm - Reimbursement SDC Transpo Improvement SDC Transpo Reimbnrsement SDC Transportation Admin Sidewalk Permit Temp Power 200 amps or less Vent Fan Willamalane Single Family Total Amonnt Paid ", ~r,,~ :.~f.. ~.~~:~'~" . ,r' ......,. ".-'- .t: I V a;J'~;ion ~escriotion I $ Per Sq Ft or multiplier $37.72 $96.83 Square Footage or Bid Amount 548.00 1,552.00 Total Value of Project ~.. Amount Paid $250.00 $213.57 $106.84 $79.00 $337.00 $38.00 $9.~9~~!t, .;~t.'1~. $997.7t,;,~.trr ~~>"'~r"~' $88.o.0~,,"g> " '.~:~.".'. $9.0~"'~ $13.00 $105.00 $20.00 $7.00 $211.00 $-30.00 $134.00 $75.00 $573.20 $753.82 ,)' $10.00. $22:631 , $1,333.57 $101.97 $167.26 $127.74 $931.65 $211.21 $81.12 $88.00\:;;" _ =. :!-:-. $63.0o~0>- ;:'.',1."'" $36,Oli)~ ,~-":: ".; . $2,858.00 - $10,022.30 Date Paid / ,'; .,,: (. 4/29/10 5/11110 5/11110 5/11110 5/11110 5/11110 5/11110 5/11110 5/11110 5/11/10 5/11/10 5/11110 5/11110 5/11110 5/11110 5/11110 5/11110 5/11110 511\/10 5/11110 5/11/10 5/11110 5/11110 5111/10 5/11110 5/11110 5/11110 5/11110 5/11/10 5/11/10 5/11/10 5/11110 5/11/10 Paee 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00529 ISSUED: 05/11/2010 APPLIED: 04/29/2010 EXPIRES: 11/11/2010 VALUE: $ 170,951.00 Value Date Calculated $20,670.56 $150,280.16 $170,950.72 05/05/2010 05/05/2010 Receipt Number 2201000000000000428 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 1201000000000000430 225 Fifth Street, Springfield, OR 541-726~3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line " CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00529 ISSUED: 05/ll/2010 APPLIED: 04/29/2010 EXPIRES: 11/1112010 VALUE: $ 170,951.00 Status Issued .',1 Initial Review 05/04/2010 I Plan Reviews ~. 0510412010 APP DJB Structnral Review 05/04/2010 .05/05/2010." '. ::i;;;~_;"'.~" ~ :r', . APP CJC APP TSS As noted on plans Puhlic Works Review 05/0412010 .,o;5Ho/2010: . , Site plan not to scale - shows driveway greater than 24 feet in width, Driveway width shall not exceed 24 feet withont overwidth approvals. Stormwater to curb and gutter. Plannin1! Review 0511112010 05/11/2010 , A,PP DDK Required street trees as shown on street tree plan attached to permit: species as shown. 2" caliper, leave name tag on until approved. 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. . ~eClllire~nsnect-.l Ufer Electrical Ground: Iustall ground rOd';,fiJfilO'ting.aIid call'for inspection in conjunction with footing andlor foundation inspection.,r,.~'\r", ","'. ~ "'- .. \" ,,;~' t' I,~':'. , '.'}' )'r .;. 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 other equipment items are in place but prior to concrete. Post and Beam: Prior to noor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailiug: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough'in inspections have heen approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Masonry: . Final Building: After all required inspections have heen requested and approved and the building is complete. Undernoor Plumbing: Prior to insulation or decking. -i'ii{1'~": 'k:!i':.i"-..iPaee 3 of4 ,;,? ;~" t't., , j~t;:',:r' ,.:.' I.,: CITY OF SPRINGFIELD .":tLl'~{Jf;':' " Building/Combination Permit 'r~XX;~ ,.',' Status Issued PERMIT NO: COM20IO-00529 . ISSUED: 05/11/2010 APPLIED: .04/29/2010 EXPIRES: 11/11/2010 VALUE: $ 170,951.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Underfloor Drain: Prior to cover or placement of concrete. Rough Plumhing: Prior to cover and including required testing. '1,:; Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and inclnding required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumhing 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 require<!testing and capped if not attached to an appliance. ,,,-to. _. ,,0_, ,t", . , Gas Service: After line is installed and line has.bee';c~~necteiI to a minimum of one appliance including required testing. Presure test done at this point. r~.J . 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. Rongh Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. . ,,; 1 Final Electric: When all electrical work is complete. : I ,. .[: Erosion/Grading Inspection: Prior to ground disturhance 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. 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 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 La,,:s of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structJr~!witholi't'perniissio'n ofthe Commnnity Services Division, Building Safety. 1 further certify that only contractors and employees..\\;ho are,in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspectin~i~i-e 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 om"'[Jl'wV >h/IO Owner or Contractors Signature Date , ~. I ~ ) 0,; I' ',\ Pa!!e 4 of 4 >A yre. o..S Structural Permit AppIicatioD-_ III b 5 '-!/s!- ctO-Z=07 .. . . . ~;}~~;~,;~ (:rw,'oF SPRIN6EIEED,'QRf:GON " -""1 ".,,;ll.~':: ,< .: 8PRlNQfI1l1LD ~ ~.A.-!..~'" ~-.. " ~~_. ; DE~)([{fMENt~u~~'ON~~~ ,; -' '.-'" ..,.,"",_.t"..~,~-",.\".-o",J':"..'.' >,.,"',.~..,.~.... CCM.^ZOCO - DO SZ '1' Penn it no.: 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 . FAX(54 1)726-3689 Date: - 2 '1 - / 0 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. ~116cAi1'fGevErr"'MENiWARPRcjVAB',1;W;~~~~~~?;~ . ....~.m_.'....~....,._. JL........."...... .___.. ....~~. ........,.;;ffiL This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Date: Zoning approval verified: D Yes DNo Property is within flood plain: D Yes DNo W,~jf;l$rlii1j;9ATc~(j.Q~X~:QFJ:GQR~.]ff{(jciIQ~fJ:i:ji*ti~;!;:. .toil. [i1 Residential 10 Government 0 Commercial ~4~.~Q!:1)r~i;'r;-~tllN~.Q~MAT!Qij~A~R[t~Qc:.Af!c:5N;~.~;::}.~:.i~I~ Job site address: 113 Y 5 '101-1.. (J) City:<:o.,-;" ~ C :<-1 J. State: 0 rL I ZIP: q7~ 77 Suhdivision: F;" h", (-\: (fIuJ,u".i'> 1 Lot no.: 'i3s- Reference: IAoZob~ \ I Taxlo!: I 5,,"00 ~lt)t~~~i~~t~~J!~c~~q;l~~':~RQJJ~~RIY;jQWNg,iji:~;~,: ; ~'Ff'":~,, ::JL ,:~..~.:~r-',;; ",. ' :~~, Name: \3 {./(<- Iv: , do,. ,t C~r>\;J", lItJ",o.s :tN{" Address: ~ 0 '71 5 (,... .;.:w I-N City: f'v'IO"-<. State;;''''' I ZIP:<J 7t 05 Phone: .b~- '1'1',Z Fax: -,1,/- ~'-3b? E-mail:W \ ~0h.e..J-\' \-,.o""'-S (-i.CD\"<~S\ Net" This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under OR,S 701.010. Sign here: ~~~~~~I'~~Q.Q,*f~gig~~i~$tA~!!Atip,~~'7?~~J~:.n;S~;~x~;~:::;~;}1\ Business name: '6','v'-<: ~,ed.,f'-.J{ Cu:b.-. 1>0,,-,<<; Pw'-- Address: '3 07 3 S k:~ "' ~'" LV'- City: {: </<; eH- State:O {l I ZIP: '1 7)D\- Phone: "-M & '1'1 S i' Fax: -3'1'1- - 3;3 b Z. E-mail: Wi ~c..k'.T 1r-.o ,\-..,S @ COr""" ("-.,4 ~\j..Jc.-t CCB license no.: /01 7 ( 7 Printn~e:~ ~...r',,:,..jC W to \ovv Signature: W W _______-- ~~;i;t~.1Y~JSUEj'.CON;tRACTOR' Nl1ciRMAtioN~?Mi;i!F'.'. ... .-<.- _.~~ ~""~I~"...,._.,.-._~.___I_"..___..-,.~__....JJ___,_,"._ ._~._"",,____~ ",~,~,;,,__, ",jj~." . ,,:' , Name CCB License Number Phone Number Electrical /..+--c J05'-17,<;, 51-I '11 ~ I; Plumbing .5Jc.v<i P "'......1,., "4.' t .501.~ J, ~ l- 3'1 b~ Mechanical CFH "'-1 b V 72.&-0100 *1~~t;ff~*,~1I~i;iJ~, ::~R~~~~H~p.u~~~*ml5f.~~I~~~~{~~;' 'I' ~V'''''':;';I;';'-'I'''tC~I':''l,}7-':;~'''~''-'9;'t~~e{;'~~'~I,-:::. "~:'p-s":;;r4:~,l.I~~'lS'1!:.;:tlJJ:.l1rt::;~1~'~'I~<o J;'_:;., ~..u.,~" ~9!l.i,IDIQ!:m~t.~O~:Tf{i,~f~;t;}P:":,~j!)~'~~':_~t.;~:~g~~~i;.{~iEJ:"Jb;y-::i (a) lob description: S. Icr, tMce Occupancy 'It'1 LA Construction type: V [S Square feet: 2 100 Cost per square foot: Other infonnation: Type of Heat: ;4 c,. kS Energy Path: (A J2nlew 0 alteration (b) Foundation-only pennit? Total valuation: :' 2. Bufld)~ff~~~~V:t:~t~!~-~tn.:'{..... . (a) Pennit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) D addition DYes .B1lO sIlO?S( ., '~:!~111{rt~iif~:t~?f~~:C ':' , s s s (d) Enter 12% surcharge (.12 x [2a+2b+2c]): S (e) Subtotal offee, above (28 through 2d): S T3""P."J' ."'!r-'" r."'~fi "''!'''-'l!-;$l:1l!'/,'tf!.'''-''','''j ,:,".['e,,"'''il'''''''''''Jil.'+!,\1!1,..'<:'I''''''. 'i-~ .~',' . "a,~.:!~y,~~.wt ~,~ftf$~J?~i!.:&t(~~> ;:jr;~.r;:~A~\4~:,~;V;~~:m:\~&~J~,~::,;t}~;':l;.:. s250 s s (a) Plan review (65% x pennit fee [2a]): (b) Fire and life safety (40% x pennit fee [2a]): (e) Subtotal offees above (38 and 3b): . 4. l'1]sl:~fiJ~e~fiirf~es}ii . (a) Seismic fee, 1% (.01 x pennit fee [2a]): TOTAL fee, and ,urcharges (2e+3c+48): $ s Electrical Permit Application CITY OF SPRINGFIELD, OREGON 225 Fifth Street. Springfield, OR 97477HH(541)726-375HFAX(541)726-3689 .......e...'.... _;.' '. . __' ...... . . ..' DEf'AIHMENT USE ONi.. Y Date: Penn it no.: e. This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not slarted within 180 days of issuance or if work is suspended for 180 days. .', ..trOCAL: ~OVERNMENT: APRROV AC".vt:.":.< Zoning approval verified? 0 Ves 0 No . .CATEGORY~'OFCONSTRUCTION{.;A. . '.' PROPERTY. OWNER Name: e,'I"IIU W, eJ-.e.A CvS,+o", Address: 507 s s)t I fJ City: <:: u u-<-- ZIP: "! 71 0 ') Phone:S~1 -b3b Of 5'8' Fax: ~~/-'3Yf ;;36 'Z- E-mail: t.-J;a.hev1-h.o~5eCo....-C....St.IV..-r This installation is being made on residential or fann property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: Address: City: S Phone:""1 -521 - 41 '1 ~ E-mail: CCB license no.: I OS' 4'7S- Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: BCD license no:: -:;$B3 ~ '-/17 ,{-S' /;;'0 Oe"ov.l~.... ~~~ 'b.y ~ \(\ . \P to ~ V Q--1 ~~ 440-2584-J (9/08/COM) ~\ ~_",':i;;~~?~,;;t~:,:;:r1Fi1;b~}1~~:': FEE'~l~s-cti E_O.UIlEj;;;j~~~~{:-~5!:;~~~,~';:(~~~j{~0i~*;~;:S Nuniber ofinsi;ecti~nsp~riiem:() .,cQiy. .'. fOS! '. ....Total. . ... . .... . h,'...... ... .",..' .., ea... cost Residential, per unit, service included: 1,000 sq. ft. or less (4) Each additional 500 sq. ft. or portion thereof Limited energy (2) Each manufactured home or modular dwelling service or feeder (2) - "'\, $134.00 ~ $ 25.00 $\~~ $ f) ~ .LD $ 32.00 $ $ 63.00 $ Services or feeders: instal/ation, alteration, relocation 200 amps or less (2) 20 J to 400 amps (2) 40 I to 600 amps (2) 60 I to 1,000 amps (2) Over 1,000 amps or volts (2) Reconnect only (2) $ 81.00 $ $ 95.00 $ $158.00 $ $205.00 $ $469.00 $ $ 63.00 $ Temporary services or feeders: instal/ation, alteration, relocation 200 amps or less (2) 201 to 400 amps (2) 401 to 600 amps (2) I .., $105. ^" $ $ $ 63.00 $ 87.00 $126.00 Over 600 amps or 1 ,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) Each additional branch ci_rcuit $ 55.00 $ . $ 6.00 $ . Miscellaneous fees: service or feeder '.lot included Each pump or iiTigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, alteration, or extension (2) . Each additional inspection: (I) $58.00 $ :,t~'~~.!:;,W~~_~Y&~~'~~~#:f;~f'fH;S'~;"A'RPLiCA"N,*;?~U$'Et:~i',~i:t{.:;,:;;;tt~::~;~G:':~~},+::;;';: $ 63.00 $ 63.00 $ $ $ 63.00 $ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (.12 x [A]) (e) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through C): $2.'1~ p. $fJJ'L .fO' $ \'t . \.cO $~lh.2:: I!~ willamalane . t-w Park and Recreation District Job. No. (2/C- 5).( SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 NAME: J3t4fLt: 6v'IEctt€1LICW~ ~~ PHONE:)Cf / b8tD t:t'fr% ADDRESS:'30'71 SI4'V/~W Uv CITY cll.t,IFNe. LOCATION OF PROPOSED BUILDING SITE: Street Address: /(3'1 S. ~M.!Z.. Plat Name: Tax Lot Number: /)0.2. ~~/ IS~ STATE~ ZIP: ,!?"oS . 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) A. Sinqle-Family Detached NO.OFUNITS I X $2,858 per unit = $ ~ ?:"b . B. Sinqle-Family Attached NO. OF UNITS X $3,100 per unit = $ C. Multi-Family Apartment NO. OF UNITS X $2,641 per unit = $ D. Sinqle Room Occupancy NO. OF UNITS X $1,321 per unit = $ E. Accessory Dwellinq Unit NO. OF UNITS X $1,550 per unit =' $ $ 2?C"";; WILLAMALANE.SDC 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval.) $ 0 . . 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) . $ ~st af=- >/~ /0 Date \ \ .~ Development Services Department City of Springfield 5. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~~ City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000428 Date: 04/29/2010 10:48:28AM Job/Journal Number COM20 I 0-00529 Payments: Type of Payment CreditCard cRcceiotl 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 04584d In Person Payment Total: $250.00 $250.00 .." t~ .--'--- ..,... .... -.. - . . U':\ ':;1 . < .. .:.\ . I Page I of 1 4/29/20 I 0 RECEIPT #: 1201000000000000430 Date: 05/11/2010 1:33:45PM Job/Journal Number Description Amount Due COM20] 0-00529 Addressing Assignment 38.00 COM20 I 0-00529 Willamalane Single Family 2,858.00 COM20 I 0-00529 Fire SF Fee - Residential 105.00 COM20 I 0-00529 Building Permit 997.72 COM20 I 0-00529 2 Baths One or Two Family 337.00 COM20 I 0-00529 I st Appliance , 79.00 COM20 I 0-00529 Vent Fan ,~: 36.00 COM20 I 0-00529 Appliance Vent 9.00 COM20 I 0-00529 Exhaust Hoods 13.00 COM20 I 0-00529 Dryer Ven! 9.00 COM20 I 0-00529 Gas Outlets 1-4 7.00 COM20 10-00529 Fireplace (Listed) 20.00 COM20 I 0-00529 Residence Wiring 1000 Sq Ft 134.00 COM20 I 0-00529 Residence Wiring Ea Addtl 500 75.00 COM20 10-00529 Temp Power 200 amps or less 63.00 COM20 1 0-00529 + 12% State Surcharge 213.57 COM20 1 0-00529 Curbcut Permit 88.00 COM20 1 0-00529 Sidewalk Permit 88.00 COM20 1 0-00529 PW Disc - 2nd Permit (30.00) COM20 1 0-00529 Sanitary Sewer - Reimbursement 753.82 COM20 1 0-00529 Sanitary Sewer - Improvement 573.20 COM20 1 0-00529 SDC Transpo Reimbursement 211.21 COM20 1 0-00529 SDC Transpo Improvement 931.65 COM2010-00529 SDC MWMC Reimbursement 101.97 COM20 I 0-00529 SDC MWMC Improvement 1,333.57 COM20 1 0-00529 SDC MWMC Administration 10.00 COM20 1 0-00529 SDC Sanitary/Storm Admin 167.26 COM20 I 0-00529 SDC MWMC Compliance Charge 22.63 COM20 1 0-00529 SDC Transportation Admin 81.12 COM2010-00529 SDC Storm - Reimbursement 127.74 COM20 I 0-00529 Plan Review Major - Planning 211.00 COM20 I 0-00529 + 5% Technology Fee 106.84 Item Total: $9,772.30 Payments: Check Number Authorization Type of Payment Paid By Rec~~ved By Batch Number Number How Received Amount Paid CreditCard BWCH DJB 03518D In Person $9,500.00 Check BWCH DlB 19574 In Person $272.30 Payment Total: $9,772.30 cRccciotl ",i'i' .! ..Ea'gel.of 2... "lJB 5/11/2010