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Home My WebLink AboutPermit Building 2003-10-10 . " .~~e~JlN9.~J~~J' .",. t ~; ;. .' CITY OF SPRINGFI'ELD . .. Status Issued Building/Combination Permit PERMIT NO: COM2003-00936 ISSUED: 10/10/2003 APfLIED: 09/19/2003 EXPIRES: 04/10/2004 VALUE: $ 203,212.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3349 Ambleside Dr ASSESSOR'S PARCEL NO.: 1702193407400 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: SFR Owner: HOMESTYLES INC Address: 4402 HERMAN ST EUGENE OR 97402 Phone Number: 541-345-8000 Phone Number: 541-'914-6419 I CONTRACTOR INFORMATION I Contractor License Expiration Date HOME STYLES INC 89219 02119/2004 EAST SIDE ELECT~~C 117770 10/04/2005 DEAN M SCHU~~~~ 133733 \lp/~/2005 DON C LEW~s..~ .< {:> 0..' 33076 ~0~~1L~005 ~ ~ "J "".I :J"~-',.. 0 ~ ~ ~'BUlLDING INFORMATION. ~0 ~o~ G;,~9J(j "- ~" ~ <{ ~~ ,0~ ~0 ~0 ~~ ~0~ (0 # of Buildings: 'y<i) ~~ ~ # of Stories: fl>-~ ;> ~0~~i.ebi' 0<:'. O~ Primary Occupancy Group~~ ~ '~ Height of Structure o~~ ~o..v ~@i~~# Secondary Occupan<<;y G~iij)~~ ~~. Type of Heat: Fo~ ~'1t W:so~<$ ~)~l~oor: Primary Constr*~~_ f\:)~ ~tN Water Type: ~9 0~0 ~~~ o~~~fjl't!nt: Secondary Co~~~~~ ~~ Range Type: (.....p ~~ ~0'-C\~.'tt.. c; ~ , ge/Carport # of Bedroom~ # ~ fif <:::)~' 3 Energy Path: ~ ~0~ (J~ ,,\Y~'j' ~ ~ ~her: ~ ~~~., ...~ ~~~ ,.s. o~ ~(:) ..\ 0 ~0" 0(}j~0. ,rious Surface Area: r l~' -... ~ ~(' ...-.: .t'). ~"'\ r-<::' ~4;. ()l ~~ I DEVELOPMEN~~'~,<,0 ~~" SETBACKS ~"'~0 "' Hf'" ~ 0'" ~f Overlay Dist: (:)0 v~ 1:''0 CHillside # Street Trees Rqd: ~..;s 2 Paved Drive Rqd: Contractor Type General Electrical Mechanical Plumbing Phone 541-345-8000 541-741-1499 541-767-0626 541-688-1931 1,388 742 430 Rearyard Setback: Solar Setbacks: 30.00 0.00 % of Lot Coverage: Yes 29.80 REQUIRED PARKING Total: 2 Handicapped: Compact: Frontyard Setback: Side 1 Setback: Side 2 Setback: 19.00 12.00 6.00 I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: FullV Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter Notes: Pa2e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 ~nspection Line Description Tvpe of Construction V Wood Frame Gara2e Dwellines Gara2e CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2003-00936 ISSUED: 10/10/2.003 APPLIED: 09/19/2003 EXPIRES: 04/10/2004 VALUE: $ 203,212.00 I Valuation Description I $ Per Sq Ft or multiplier $90.60 $23.80 Square Footage or Bid Amount 2,130.00 430.00 Value . Date Calculated $192,978.00 $10,234.00 $203,212.00 09/1912003 09/19/2003 Total Value of Project .~ Fee Description Amount Paid Date Paid . Receipt Number Plan Review Residential $587.37 9/19/03 1200200000000002173 -Mechanical Issuance Fee- $10.00 10/10/03 2200200000000001643 + 10% Administrative Fee $150.26 10/10/03 2200200000000001643 + 7% State Surcharge $105.19 10/1 0/03 2200200000000001643 3 Baths One & Two Family $306.00 10/10/03 2200200000000001643 Addressing Assignment $8.00 \ 10/10/03 2200200000000001643 Annexed 1997 $-20.08 10/10/03 2200200000000001643 Appliance Vent $6.00 10/1 0/03 2200200000000001643 Building Permit $903.65 10/10/03 2200200000000001643 Curbcut Permit $75.00 10/10/03 2200200000000001643 Dryer Vent $6.00 10/10/03 2200200000000001643 Exhaust Hoods $9.00 10/1 0/03 2200200000000001643 Furnace - up to 100,000 btu $12.00 10/10/03 2200200000000001643 Gas Outlets 1-4 $4.00 10/1 0/03 2200200000000001643 Plan Review - Planning $59.00 10/10/03 2200200000000001643 Plan ReviewIResidential Hourly $45.00 10/10/03 2200200000000001643 PW Mult Disc - 2nd Permit $-30.00 10/10/03 2200200000000001643 Residence Wiring 1000 Sq Ft $106.00 10/1 0/03 2200200000000001643 Residence Wiring Ea Addtl 500 $76.00 10/10/03 2200200000000001643 Sanitary Sewer - Improvement $447.46 10/10/03 2200200000000001643 Sanitary Sewer - Reimbursement $588.64 10/10/03 2200200000000001643 SDC MWMC Administration $10.00 10/10/03 2200200000000001643 SDC MWMC Improvement $34.83 10/10/03 2200200000000001643 SDC MWMC Reimbursement $332.86 10/10/03 2200200000000001643 SDC SanitarylStorm Admin $99.82 10/10/03 2200200000000001643 SDC Transpo Admin $50.63 10/1 0/03 2200200000000001643 SDC Transpo Improvement $727.42 10/10/03 2200200000000001643 SDC Transpo Reimbursement $164.89 10/10/03 2200200000000001643 Sidewalk Permit $75.00 10/1 0/03 2200200000000001643 Storm Drainage Impervious Area $722.97 10/10/03 2200200000000001643 Temp Power 200 amps or less $50.00 10/10/03 2200200000000001643 Vent Fan $24.00 10/10/03 2200200000000001643 Willamalane Single Family $1,000.00 10/1 0/03 2200200000000001643 Total Amount Paid $6,746.91 Paee 2 of 4 CITY OF SPRINGFIELD' Building/Combination Permit . PERMIT NO: COM2003-00936 ISSUED: 10/10/2003 APPLIED: 09/19/2003 EXPIRES: 04/10/2004 VALUE: $ 203,212.00 .. _~!j,1!Q')!!~~Ii@,iB~ l ~t Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Plannine: Review Public Works Review I Plan Reviews I 09/22/2003 APP 09/30/2003 APP 09/2312003 APP LLH TAJ MS 09/22/2003 09/22/2003 09/22/2003 Structural Review 10/03/2003 WE . DLM 09/22/2003 Structural Review 10/08/2003 10/10/2003 APP DLM 9/23/03 - Storm drainage shall go to curb and gutter. -MS Need revised site plan, OR revised building drawings reflecting placement of house on sloping site. . . Also' need engineering for brace walls, or revise for prescriptive method. Owner was contacted with request for additional information. 10/3/2003 dim Submitted Truss design drawings showing attic trussed to be 3-point trusses. Load on garage pier ftg does not exceed 9000#. Therefore, footing design not required. Owner elected to install retaining wall at E. prop. line to adjust for slopes. OK - dim 10/8/2003. To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. 1 Curbcut - Standard: After forms are erected but prior to placement of concrete. 2 Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 3 Site Inspection: T~ be made after excavation but prior to setting forms. 4 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. 5 Footing: After trenches are excavated. 6 Foundation: After forms are erected but prior to concrete placement. 7 Post and Beam: Prior to floor insulation or decking. 8 Floor Insulation: Prior to decking. 9. Shear Wall Nailing: Before covering sheathing with finish materials. 10 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 11 Wall Insulation: Prior to cover. 12 Ceiling Insulation: Prior to cover. 13 Drywall: Prior to taping. 14 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 15 Final Building: After all required inspections have been requested and approved and the building is complete. 16 Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. 17 Underfloor Plumbing: Prior to insulation or decking. 18 Underfloor Drain: Prior to cover or placement of concrete. Pa2e 3 of 4 _~!!~JJ~~r,;I~P) '""~':''' J , Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2003-00936 ISSUED: 10/10/2003 APPLIED: 09/19/2003 EXPIRES: 04/10/2004 VALUE: $ 203,212.00 . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 19 Rough Plumbing: Prior to coveT and including required testing. 20 Water Line: Prior to filling trench and including required testing. 21 Sanitary Sewer Line: Prior to filling trench and including required testing. . 22 Storm Sewer Line: Prior to filling trench. 23 Final Plumbing: When all plumbing work is complete. 24 Underfloor Mechanical. Prior to insulation or decking and including required testing. 25 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 26 Gas Service: After line is installed and line has been connected to a minimiml of one appliance including required testing. Presure test done at this point. 27 Rough Mechanical: Prior to Cover 28 Final Gas: When all gas work is complete. 29 Final Mechanical: When all mechanical work is complete. . . 30 Temporary Electric:. Approval required prior to Utility Company energizing pole. 31 Rough Electric: Prior to Cover 32 Electric Service: Approval required prior to utility company energizing service. 33 Final Electric: When all electrical work is complete. By signature, I state and agree, that I 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 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 arefequested 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. roO~. ~ Owner or Contractors Signature ft0-((o-O'~ - -- Date ~ Pae:e 4 of 4 I f\ rJ . ....\\o'>tl\~~ w~~,:>e . FAX: (541)726-3689~'Q~\\\e~\\1}2'1f\ a':> ':> '~e . . :L. . roc' eo,~\ , ~~o~ ~o\ ~ . ,rl\(\~ AOe':> '0\\0 0 '-' "..<. , a(\ , .\\~ \ , tl'''' cta. ,~ CO]JIPLETE t:'}!;ll~cl:f]iijLlLE 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAL,f.!fF}!.!I. A!.ef.!~~TION City Job Number ~Y\'lUJD'LIJ.Ol.O Date 1. LOCA110N OF INSl'ALLA110N . ~?M \_~_~e~\& t\r\\~ LEGAL DESCRIPTION \l ()1..\C{~ m-W JOB DESCRIPTI IN .. 'LS(O{) . ~ ~ Qb -t (..oil\{) Permits a non-transferable Q.d expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 3. \.I,)~e (\'0- \,.;:.Ie. '6\g A. New Residential:':' Si~gle"3r~Multi-Family per dwelling unit. r''>'' ' Service Included I 000 sq. ft. or less Each additional 500 sq. ft. or pOliion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder \ ~ $106.00 'lDlo.O' f1~ $ 19.00 $50.00 B. Services or Feeders - Installation, Alterations or Relocation: CONTRACTOR INSTALLATION ONLY 2. Elect1:ical Contractor E A 575/ [) C {;(.e.(.. 'XIJC, $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 200 Amps or less 20 I Amps to 400 Amps 40 l Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 Amps/V o Its Reconnect Only ,,0 . O.::>.~" c. Temporary Services or Tiiii.7........~~'O~\) , .~e~ 'V JoJ " ~ 0<:$ 0 r:o ~q; 0G:J . Installation, Alterati~llb;(jeJ8~~~ ,..s o~~ O~ ~. 0 ~0 O~ ~0l~-. ~ 200 Amps or less ~~ ~>S' ....~ ~ ~cJi)O.OO 201 Amps to 4~ 0,?0 ~CS ro~...0,~ $ 69.00 401 Amps tQ/~O~'nPs'<::' ~O 0~0.~.~~ ~$100.00 ~ ~O :';.. <::> C; ~(b '~-1;;) Over 6~~~ o~'Y~~'qf~ve. D. B,(~~r&Jf!tt>,,~"4;Jq," ~~f$'7:i ~....,_~ . O~ s:s ~ ~ ~(lj Cb,\S N~ ~.e~~'16r~t~~~~~ Panel One~~~.~ 4..0~ ~0 ~.ws:,,?~"'~ EacIi)\'l~~~1 ~~,,<6Ii:>~lth Service o~e~ ~litC' <:-.::5 :.;. , E. Miscellaneous (Service/feeder not included) -Each Installa tion 3~2S3 goSCfl6€ L/V, ~ ~"<::'~ Phone 7 Y I-lj{!l~,... ~~ ~~ '#~\)~ , c 9.~ ~<?f ~~ Supervisor License Number lj....~_.;s ~~~ . ~~~ ~'~y Expiration Date L- .1~~ ~ ,,~ ~~~<v~~~ ~ ~~~\)~- constr.contr'~~~~f\~'r~~~~~ ~ ~'\~:~~-~~ Expiration Date ~ -r:ft'C!....~ I - 03 ~- ~ S. fS" ~ .. Ignature 0 upenrlsmg J!lectnc13n Address sP fLD City 5O.a;> ~)-1 f}J ~ OwnersName l~O~~\.\\e~ T~ Address ~rti.- 0\.~~~ C;ty f~ Pho~, :?A.'S.<6tQ) OWNER INST ALLA TION $ 43.00 $ 3.00 $ 50.00 $ 50.00 $ 25.00 $ 45.00 Pump or ilTigation Sign/OutIine Lighting Limited Energy/Residential Limited EnergylCommercial The instaIlation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Permit Inspection Fee is $45.00 + Surcharges -3.,~? _.00 \ In.M. IL'tJ.W '2}1 \ -41 4. SUBTOTAL OF ABOVE Owners Signature: 7% State Surcharge 10% Administrative Fee ') Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FOllns/Electlical Pellnit Application I-03.doc . ;;~c ...':.. CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: C0M2003-OO936 NAME OR COMPANY: Homestyle INC LOCATION: 3349 Ambleside Drive TAX LOT NUMBER: 17021934 Tax Lot 07400 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 1 BUILDING SIZE (SF) 0 LOT SIZE (SF): 7354 Vl ~ o o u ~ i:.a E-< - Vl S ~ 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x COST PER S.F. I CHARGE 2493.00 $0.290 = $722.97 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. x COST PER S.F. I x DISCOUNT RATE DISCOUNT 0.00 $0.290 50% $0.00 ITEM 1 TOTAL - STORM DRAINAGE SDC $722.97 r 2. SANITARY SEWER - CITY A REIMBURSEMENT COST: NUMBER OF DFU's x 26 COST PER DFU $22.64 B. IMPROVEMENT COST: NUMBER OF DFU's x 26 COST PER DFU .$17.21 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = I 3. TRANSPORTATION A REIMBURSEMENT COST: ADT TRIP RATE . x NUMBER OF UNITS x 9.57 1 B. IMPROVEMENT COST: ADT TRIP RATE. x NUMBER OF UNITS x 9.57 1 ITEM 3 TOTAL - TRANSPORTATION SDC = t 4. SANITARY SEWER - MWMC A REIMBURSEMENT COST: NUMl:lhK OF FEU's x COST PER FEU 1 . $332.86 B. IMPROVEMENT COST: -NUMtsbK OF FEU's - x . COST PER FEU 1 $34.83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE I ITEM 4 TOTAL - MWMC SANITARY SEWER SD< = t I SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) = , 5. ADMINISTRATIVE FEE: SUBTOTAL x ADM. FEE RATE $3,008.99 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Matt Stouder 9/2312003 $722.97 11070 ....-.,.........-~~, ~.._....,..... ,,", . = l $588.64 1091 $447.46 11092 $1,036.10 COST PER TRIP $17.23 x 'NEW TRIP FACTORI 1.00 $i64.89 . 11093 COST PER lKll' $76.01 $892.31 x NEW TRIP FACTOR 1.00 1094 $727.42 = $332.86 , 1054 = $34.83 1055 = ($20.08) r 1054 $10.00 1056 $357.61 $3,008.99 - CHARGE $150.45 99.82 1079 $50.63 11078 TOTAL SDC CHARGES = , $3,159.44 l -;.. DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE - NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR'REMODELS, CALCULATE ONLY TIIE NET AuUIUONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE I FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE I OIL I SOLIDS / ETC. 0 0 3 = 0 INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0 LAUNDRY ruB 0 0 2 = 0 CLOlHESWASHER / MOP SINK 1 0 3 = 3 CLOlHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK 1RAP (1 PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG I WATER STATION I ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK I DISHWASHER / ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 - . 0 SHOWER, GANG {NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIALIRESIDENTIAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASINIDOUBLE LAVATORY 2 0 2 = 4 SINK: SINGLE LA VATORYIRESIDENTIAL BAR 1 0 1 = 1 URINAL, STALL I WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDUS 20 = 0 TOTAL DRAINAGE FIXTURE l.l1"'uS 26 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling IUIit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 i985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 ^ 1998 1999 2000 CREDIT RATE/$1,000 ASSESSED VALUE $4.92 $4.92 $4.83 $4.77 $4.64 $4.47 $4.30 $4.09 $3.78 $3.41 $2.98 $2.52 $2.06 $1.64 $1.45 $1.31 $1.13 $0.97 $0.82 $0.63 $0.41 $0.22 $0.04 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 0 (Enter 1 for Yes, 2 for No) BASE YEAR 1997 CREDIT FOR LAND (IF APPLICABLE) VALUE/lOOO CREDIT RATE $31.87 x $0.63 = r . . $20.08 f CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE ~.OO x ~.~ 0 TOTAL MWMC CREDIT = $20.08 CCB - Find A Licensee - Res' - Find A Licensee. Results LICENSE NUMBER: NAME: 117770 EASTSIDE ELECTRIC INC 38253 BOSCAGE IN SPRINGFIELD OR 97478 ADDRESS: WORK PHONE NUMBER: LICENSE STATUS: EXPIRATION 10/4/2005 DATE: 5417411499 . Active ENTITY TYPE: LICENSE General CATEGORY: Contractor/AII Corporation Non-Exempt (Has DA TEFIRST EMPLOYER Employees- LICENSED: 10/4/1996 STATUS: Must Have Workers' Comp Coverage) DEVELOPERS . BOND ' INSURANCE. INSURANCE CLARENDON COMPANY: ,CO - MERGED COMPANY: NATIONAL INTO #429 INS CO BOND AMOUNT: BOND EFFECTIVE TO: $ 15000 . 10/4/2005 Associated Name Information License Number 117770 117770 Bond Information License Number: 117770 INSURANCE $ 500000 AMOUNT: INSURANCE . EFFECTIVE 10/1/2004 TO: Entity Type Name Description KING, CPO KATHERINE Corporate Officer ANN KING, CPO ROGER Corporate Officer DEAN Company Name: 281 - DEVELOPERS INSURANCE CO - MERGED INTO #429 Bond Number: 426622C Bond Amount: $15,000 Bond Effective Date: 10/4/1999 . http://ccbed.ccb.state.or.us/new_web/asp/new _ searchJesults yrint.asp?regno= 117770 ) Page 1 of3 10/1 0/2003 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 COM2003-00936 Payments: !ype of Payment Check Reccipt#:2200200000000001643 Description Addressing Assignment Willamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Sidewalk Permit Curb cut Permit PW Mult Disc - 2nd Permit Storm Drainage Impervious 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 Transpo Admin Annexed 1997 Plan Review - Planning Building Permit 3 Baths One & Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Appliance Vent Dryer Vent Gas Outlets 1-4 ~Mechanical Issuance Fee~ + 7% State Surcharge + 10% Administrative Fee Plan Review/Residential Hourly Received By Check Number Batch Number Authorization Number Paid By HOMESTYLES, INC. Jmp 4796 City of Springfield Official Receipt Development Services Department Public Works Department Date: 10/10/2003 1:39:33PM Amount Paid Item Total: 8.00 1,000.00 106.00 76.00 50.00 75.00 75.00 (30.00) 722.97 588.64 447.46 164.89 727.42 332.86 34.83 10.00 99.82 50.63 (20.08) 59.00 903.65 306.00 12.00 24.00 9.00 6.00 6.00 4.00 10.00 105.19 150.26 45.00 $6,159.54 How Received In Person Payment Total: Amount Paid $6,159.54 $6,159.54