HomeMy WebLinkAboutPermit Building 2010-5-19
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1039 S 41ST St
ASSESSOR'S PARCEL NO.: 1802061418700
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00639
ISSUED: 05/19/2010
APPLIED: 05/19/2010
EXPIRES: 11/19/2010
VALUE: $ 171,939,00
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: New
PROJECT DESCRIPTION: Single family residence - SAME AS COM20 I 0-00292
Residential
Owner: BRUCE WIECHERT CUSTOM HOMES INC
Address: 3073 SKYVIEW LN
EUGENE OR 97405
I CON~syouto
f~'li~~gonUtility .
Contractor 't1ficatiorl'Center. Thdsrceri~ll are ~~ tlOn Date
BRUCE WIECHERT C !;I.AOOI(:SJIJ'iTfJ:thrlWkll7 OAR 952- . 6/2010
B F the telephone
er lor the Oregon Utility Notification .
ij'INWtoF.lmter is 1_800-332-2344). Lot SIze:
,Height ol'Siructnre 22,00 Sq Ft 1st Floor:
. Type of Heat: Forced Air Gas Sq Ft 2nd Floor:
Water Type: Gas Sq Ft Basement:
Range Type: '..'-..' Electric Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Bnilding: n/a Occnpant Load:
Contractor Type
General
# of Units:
Primary Occnpancy Gronp:
Secondary Occnpancy Gronp:
Primary Constrnction Type
Secondary Construction Type:
# of Bedrooms:
I
R-3
U
VB
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
22.50
5.00
12.50
25.00
17.50
Phone
541-606-5050
10,405
1,604
451
3
I DEVfM'tENT INFORMATION I ' ,
..~. 'MIT SHi\LL EXPIRE IF THE WORK
l~~~~.RltiJiER THIS PERMIT IS NOT
co'n~nke [he qf!j i\BANDONED FOR ,
Paveil rve : Yes "
ANlk ~f.]j)o'j)ei~~ IJ?D- "18:26
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLI~ IM~R,~VEMENTS ~
Fully Improveij."i 'j" ','
y est'.,,~.,;, ':-1'
"~:F7.
"
Notes: Stormwater to curb and gutter.
Description
Tvpe of Construction
Sidewalk Type:
Curbside 5'
Curb and Gntter
Downspouts/Drains:
I Valuation Description I
$ Per Sq Ft
or multiplier '
Square Footage
or Bid Amount
Value
Date Calculated
,I, :'? "
Page I of 4
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00639
ISSUED: 05/19/2010
APPLIED: 05/19/2010
EXPIRES: 11/19/2010
VALUE: $ 171,939.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
"".{;r.:.1', r ;. 'L",.., .
~~',~.' "
Gara2eIMisc
SF IDuplex
U VB Utilitv
. R-3 VB 1&2 Familv
$37.72
$96.83
451.00
1,600.00
$17,011.72
$154,928.00
$171,939.72
0511912010
0511912010
Total Value of Project
~
Fee Description Amount Paid. Date Paid Receipt Number
+ 12% State Surcharge $215.01 511911 0 2201000000000000537
+ 5% Technology Fee $107.44 5119110 2201000000000000537
1st Appliance $79.00 5119110 2201000000000000537
2 Baths One or Two Family $337.00 5119110 2201000000000000537
Addressing Assignment $38.00 5119110 2201000000000000537
Appliance Vent $9.00 5119110 2201000000000000537
Building Permit $1,001.79 5119110 2201000000000000537
Curbcut Permit $88.00 5119110 2201000000000000537
Dryer Vent $9.00 5119110 2201000000000000537
Exhaust Hoods $13.00 5119110 2201000000000000537
Fire SF Fee - Residential $102.75:;' ,. 5119110 2201000000000000537
Fireplace (Listed) $20.00 " 5119110 2201000000000000537
Gas Outlets 1-4 $7.00': 5119110 2201000000000000537
Heat Pump $17.00'" 5119110 2201000000000000537
Plan Review Major - Planning $211.00 5119110 2201000000000000537
Plan Review Same As $250.00 5119110 2201000000000000537
PW Disc - 2nd Permit $-30.00 5119110 2201000000000000537
Residence Wiring 1000 Sq Ft $134.00 5119110 2201000000000000537
Residence Wiring Ea Addtl 500 $75.00 5119110 2201000000000000537
Sanitary Sewer '- Improvement $740.60 5119110 2201000000000000537
Sanitary Sewer ~ Reimbursement $1,238.32 ;,5119110 2201000000000000537
SDC MWMC Administration $10.00 5119110 2201000000000000537
SDC MWMC Compliance Charge $22.63 5119110 2201000000000000537
SDC MWMC Improvement $1,333.57 5119110 2201000000000000537
SDC MWMC Reimbursement $IOL97 5119110 2201000000000000537
SDC SanitarylStorm Admin $157.71 5119110 2201000000000000537
SDC Storm - Reimbursement $274.67 511911 0 2201000000000000537
SDC Transpo Improvement $1,140.17 5119110 2201000000000000537
SDC Transpo Reimbursement $279.54 5119110 '2201000000000000537
SDC Transportation Admin $99.36 5119110 2201000000000000537
Sidewalk Permit $88.00 5119110 2201000000000000537
Temp Power 200 amps or less $63.00 5119110 2201000000000000537
Vent Fan $27.0Q ;.;' . ',.. .5119110 2201000000000000537
WiIlamalane Single Family $2,858.0Q 5119110 2201000000000000537
1.,';"-:,
Total Amount Paid $1l,1l8.5~.
I Plan Reviews I
Pa2e 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00639
ISSUED: 05/19/2010
APPLIED: 05/19/2010
EXPIRES: 11/19/2010
VALUE: $171,939.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Plannine: Review
05/19/2010
05/19/2010
APP
DDK
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
As noted on plans
':'.1,-'
Public Works Review
Structural Review
05/19/2010
05/19/2010
o5/i 9/201 0'
05it912010
"
APP
APP
TSS
CJC
',"
To Request an inspectiori 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.
~eollirecUnsnections I
Erosion/Grading Inspection: Prior to ground disturban,ce 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. " '"" '
;:,<;U:, :'{?'.,;
Post and Beam: Prior to floor insulation or14e~king~ fj.
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.
Final Building: After all required inspections have been requested and approved and the building is complete.
Undernoor Plumbing: Prior!o insulationor'd'ecking.
Undernoor Drain: Prior to cover or placem"ent of concrete.
Rougb Plumbing: Prior to cover and including 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 filling trench.
"' , ~ !
Final Plumbing: When all plumbing work is ~omplete.
,
"
" Paee 3 of 4
': ~~. i c ..
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00639
ISSUED: 05/19/2010
APPLIED: 05/1912010
EXPIRES: 11/19/2010
VALUE: $ 171,939.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Underlloor Mechanical. Prior to insnlation or decking and inclnding 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 including required
testing. Presure test done at this point.
Rough Mecbanical: Prior to Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
. ~.-<:,,:t" ,,'--~. c' -, ' .
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.
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 pe~niission of the Community Services Division, Building Safety.
I further certify tbat only contractors and employees who are ii. 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
times during construction.
{II !N/~
S))1~ 0
. I
Owner or Contractors Signature
Date
";,,,;.,
'! t,
4.
.....,.
~)1" n.
.1 -t,'
Page 4 of 4
Electrical Permit Application
CITY OF SPRINGFIELD, OREGON
225 Fifth Street. Springfield, OR 97477+PH(541)726-J75JoFAX(541)726-J689
. DEPARTMENT USE ONLy....
60-00 b '3
Pennit no.'
Date: S -( ,- I 0
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
". '[OCAL:C;;OVERNMEIIIT" APcPROVAGi:',,':
Zoning approval verified? 0 Ves 0 No
," '.:};<?,CAtEGbRY~VOF -:_CONSTRUCTlbN~<_:},"
;M\"',<\:.,<.'_
-'wo
D Residential D Government D Commercial
~~ji21~t()BFSITEi'INF()RMATI()NI:ANDVr.OCAtIOIll;;';;(\)';!
.' , , ---- --- -- .- -,-
Job site address: 10 3 '1 4 51-"
City. f.1.!-
BoZOb( Taxlot.: /'l7CJO
.'DESCRIPTION. OFW()RK':'!'
ZIP:" 7 Lf OJ
;;,',-
PROPERTY OWNER
Name: t:>"IIU Wi eJ-.e-A CJ;.+O...
Address: 307 :s '3 ie. I F-J
City: .( u v-<.- ZIP. ,,/7"10)'
Phone:SVf -bab Of ~ ~ Fax: GV/-'3Yf ~3b 'Z..
E-mail: VJ " t'c..h"~~ \-.()~.s f} c.omc,o',S+ . IV "'t-
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).
Address:
City: S
Phone:S'fl -5~1 - 41 'i ~
E-mail:
CCB license no.: O~ 4 7S"
Signing supervisor's license no,:
Print name of signing supervisor:
Signature of signing supervisor:
BCD license no.: ::S.
'-117'1-S"
/;' C Oe "ov,>.:.>-
3L.
^"~~ ~
\)JV 'bqpo\(),.
~
\k~Q/
~
440-2584-J (9108/COM)
~~/,(" ~:~f~:'t~;i\:{~ ;",:,~l}Pt;,\;,!~;!j"":, FoE-E :tSG H Ej),Q l,j Eg;~:.~5~;-fWPi(~~5?i{~}f'j~~t,;j?~~~::~Y~~
. ~ ~nt~er ?fin~pedio?s p~r ,ii~o,.;(i:r Qty. Cost Total
.::'ea;-: :'''0 COSt'.'(
Residential, per unit, service included:
1,000 sq. ft. or less (4) I $134.00 $ /'5Cf
Each additional 500 sq. ft. or portion ~ $ 25.00 $f\~
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 $
Over 1,000 amps or volts (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: instal/ation, alteration. relocation
200 amps or less (2) { $ 63.00 $~'1
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $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 ofa service or feeder fee:
Each branch circuit $ 6.00 $
b. Fee for branch circuits without purchase ofa service or feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder ~ot included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a Iimited-energy,panel. $ 63.00 $
alteration, or extension (2)
Eaeh additional inspeetion: (I) $58.00 $
;j;:;.'Rfi".~~'f!M;',,';;'j!:t;;ti;A~e[[CANfEUSE~j:2i!i;;!i.;"!"1.'.....:";. ..' ;
(A) Enter subtotal of above fees rFIY
(Minimum Permit Fee $58.00) $ ~
(B) Enter 12% surcharge (.12 x [A]) $ :t~
(C) Technology Fee (5% of [A]) $ 1,d ~..
TOTAL fees and surcharges (A through C): $~
4
llg~
2~ willamala'ne
t\it Park and Recreation District
Job. No.
~ ..\b- \Q~
, .
SYSTEM DEVELOPMENT CHARGE WORKSHEET
. January 1-June 30, 2010
NAME: t)~eJ \~)~~
ADDRESS:5Cr\,c._')~l)~ ~STATE:~P:
LOCATION OF PROPOSED BUILDING SITE:
PHONE: \.oDLP SDSO
Q14CJO
Street Address: \ D'6C\ .b
Plat Name: ~\~ ~
,\\'5C
Tax Lot Number:
\ ~ mOto \4 \ 8LOO
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the .
back.)
A. SinQle-Family Detached
NO.,OF UNITS \
X $2,858 per unit =
$ Q,~ ~.o()
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 =
$
3. TOTAL WllLAMALANE.NET SDC ASSESSED
(if SDC reduced for Credit)'
bU
$ 2- ~5<6,cV
;zf
$ ~~Sg.~
b ,11-,tO\D
Date
$
WILLAMALANE SDC
2. SDC CREDIT (If applicable) SDC payer must furnish proof of
Willamalane Credit approvaL)
5
~ tit r'l~ AS 10 (, II
Structural Permit Application-_
s '-II '51"
CIO-Z.<;Z
. . .,....,..,~"O,',."_.7'...,:...,".".,,;_,.,.,...._...';_'n'.. -',-,1.
DEPARTMENT,USE-ONLY;i
. "-," ,'.;-,.:,~-.._".,~ ,,,,,,,,",''>If\.',;.,,.,.'~,,, .",.:"*.'...~.,,?..~
c o vIA ZOIc) - OO63C
Permit no.:
Date: S -I ? 'I D
. . ~. .
,t~?~~;" 'C1!;v"-OF SPRINGFIEkD, gREGON ~'. .-,,:.: :,:~;: : .
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-J689
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.
~J)~V'-EO€A-WG0VERNMEN;ii'APPROVAili~~\lj:;rj:"'~'*"im~~
... '- _ .*11_ _. _,_!J;\__._.'__,_m.._ _._'.)!L.'._.__.______,_"'"o,~..~~
This project has final land-use approvaL
Signature: Date:
This project has DEQ approvaL
Signature: Date:
Zoning approval verified: 0 Yes ONo
Property is within /lood plain: 0 Yes ONo
if~~~~~J;qAf,gc;QRY,:a;oit~iC;9i:l~T[(jG:r'!P/lf'ir21;~f;.:,':(.;f;!
~ Residential 10 Government 0 Commercial
~i~JOBlTsifE;!iNroRMATIO-gIi:Nb1li.OCA'f16N:;'lj~i,~;i!"1i
~'~""" j;! . ,._...~_..,~_...../,...J;L..~.".~..<..>~...__,.._.....,.N_.._._ .....m.. _~_, '_.. ," >...." ""'_"_\." <.:....., ""__
Job site address: 10 3 'i 5 '-I15+-
City:<:or;"" {:: ,,-1,1 State: 0 iL ZIP: q 71 77
Subdivision: F': J h~ y-t ,l'\t&..l.o\o.J"> I Lot no.: (.;)
Reference/80Z OGiI./ I Taxlot: 18700
~~~m:~~i~~~i;ID~~,'K~~9~~,,~RQ:~~RIY.~:QS,yN-~Ri~::;:. :~~:::~?,:_: ;!;r~ ~-;;;F: ' .
, };~
Name: \3 {.It<- tv: , Ii.,f Cv',Ki", ~""o..\ :tI\JL-
Address: 3 0 7'~ 5t:~"iC'w I-N
City: t "',e,,-<- StateO"" ZIP:'171 D<J
Phone: -blb - '1'1'>6 Fax: -1/'1- ?i3b?
E-mail:W )~cJ...e-JT' 1,..0""'-5 QC"'~L"st Ner
This installation is being made on residential or farm property owried by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
Sign here:
~!fJi~~~,~6N:i'BAGiQ'~~!N~f~[;~fi9~~f',\';~if,:f!:.,~idi;;i~;i
Business name: 'b',vu: 1,.J;e~L,..., C::v~b,... 1;",,,,,,-, J:T.J(..
Address: '3 07 3 S il~ ";-:..J LV'
City: 'f: v< e....... State:O .;(.. I ZIP: '1 7~ D 'l
Phone: -6J' b cf '-I S ? Fax: -3'1'1 - 33 6 z.
E-mail: w; e",k.... \ \-.o,....'S @ COI''V\ "",4 ~ ,.j,,\
CCB license no.: (Ol J r 7
Print n~e: ~ -i' ...r',.:../c W";h:HV
Signature: W W ______.-
~~.....'~iiiZ,',lSUB1CONfRACfOR.NF,(jRMAt oNWr :,m
',\!il_ ,,,.it.,..._........_"______.. .L.......__.,.!... ,.i!1i!;l1i'o
Name CCB License Number Phone Number
Eleetrical t-+- e 5 t I 'i I 'i &
Plumbing51c.v<i J, ~l-3'1 &,
Mecbanical cr- H 726- 0 I 00
"y".c'''.-......''';>,_'''''''''... ""...'.'.'....'." i""."".>.""'''ih\~.~ ~1>\iJ.. ~~""'.'''.'
~Q~*.:Y;~'jJ~~~%1.~'~P3$t1>~~-iffl;~~Gtil;~U.!;~:~~t~itl;~1~~}1~~)~~:1~'
~lrYiTIW~jif)~~rglRtm~lrq-~'~~~:~r~':;';fi~Jf~Jif~~~jjf~l~~J~'
(a) Job description: S I... e F.........,
Occupancy :5 vi.
Construction l)Ipe: V~
Square feet:
Cost per square foot:
Other infonnation:
Type of lIeat:
Energy Path: /
.-anew 0 alteration 0 addition
(b) Foundation.only pennit? O.Yes )dNo
Total valuation:
" 2. Build~~'g~"f~,~~,~;.:t.~t~if~i;:~~HtA!,~.;'" .
(a) Pennit fee (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):'
(number of hours x fee per hour) . S
(d) Enter 12% surcharge (.12 x [2a+2b+2c]): $
(e) Subtotal offees above (28 through 2d): $
T=f.~~P,I.~{iiY~~yj~i!rf~~~~r~~il~~~i;{~\m'~1?i~~~~~~t~~~ff~~'?:.
(a) Plan review (65% x pennit fee [2a]): 0
(b) Fire and life safety (40% x permit fee [2a]):
(e) Subtotal offees above (3a and 3b):
4'l\1is~~r!il!!~iJ'ilsfe'es}ii:, . ...
(a) Seismic fee, 1% (.01 x pennit fee [2.]): $
TOTAL fees and ,urcharge, (2e+3c+4a): $
/
RECEIPT #: 2201000000000000537 Date: 05/19/2010 2: 17:52PM
Job/Journal Number Description Amount Due
COM20 1 0-00639 Plan Review Same As 250.00
COM20 1 0-00639 Plan Review Major - Planning 211.00
COM20 1 0-00639 Sidewalk Permit . .lj~';f'" 88.00
COM20 1 0-00639 Curbcut Permit ...~..." 88.00
COM20 1 0-00639 PW Disc - 2nd Permit n (30.00)
COM20 I 0-00639 SDC Storm - Reimbursement 274.67
COM20 1 0-00639 Sanitary Sewer - Reimbursement 1,238.32
COM20 I 0-00639 Sanitary Sewer - Improvement 740.60
COM20 1 0-00639 SDC T~anspo Reimbursement 279.54
COM20 I 0-00639 SDC Transpo Improvement 1,140.17
COM2010-00639 SDC MWMC Reimbursement 101.97
COM2010-00639 SDC MWMC Improvement 1,333.57
COM2010-00639 SDC MWMC Administration 10.00
COM20 I 0-00639 SDC Sanitary/Storm Admin 157.71
COM20 I 0-00639 SDC MWMC Compliance Charge 22.63
COM20 I 0-00639 SDC Transportation Admin 99.36
COM20 1 0-00639 Building Permit 1,001.79
COM20 10-00639 Addressing Assignment 38.00
COM20 I 0-00639 Willama1ane Single Family 2,858.00
COM20 J 0-00639 2 Baths One or Two Family 337.00
COM20 1 0-00639 1 st Appliance 79.00
COM20 1 0-00639 Vent Fan 27.00
COM20 1 0-00639 Appliance Vent 9.00
COM20 1 0-00639 Exhaust Hoods \:., 13.00
COM20 1 0-00639 Dryer Vent 9.00
COM20 10-00639 Gas Outlets 1-4 .,f\k\! )." " 7.00
COM20 1 0-00639 Fireplace (Listed) ..\"" 20.00
"
COM20 1 0-00639 Heat Pump 17.00
COM20 1 0-00639 Residence Wiring 1000 Sq Ft 134.00
COM20 1 0-00639 Residence Wiring Ea Addtl 500 75.00
COM20 I 0-00639 Temp Power 200 amps or less 63.00
COM20 I 0-00639 Fire SP Pee - Residential 102.75
COM2010-00639 + 12% State Surcharge 215.01
COM20 1 0-00639 + 5% Technology Pee 107.44
Item Total: $11,118.53
Payments: Check Number Authorization
Type of Payment Paid By Received By Batch Number Number How Received Amount Paid
CreditCard BRUCE WIECHERT CJC 01563D In Person $9,500.00
Check BRUCE WIECHERT CUST CJC 19592 In Person $1,618.53
HOMES
Payment Total: $11,118.53
j""~\' ',f"
'.., -.
cReceiotl
Page 2 of2 ..
5119/20 I 0