The URL can be used to link to this page

Home My WebLink AboutPermit Building 2010-6-16 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00764 ISSUED: 06/16/2010 APPLIED: 06/15/2010 EXPIRES: 12/16/2010 VALUE: $ 174,139.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,;\ SITE ADDRESS: 1011 S 41ST ST ASSESSOR'S PARCEL NO.: 1802061418300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence -, SAME AS COM2010-00255 1027 S 41st Owner: BRUCE WIECHERT CUSTOM HOMES INC Address: 3073 SKYVIEW LN " EUGENE OR 97405 I CONTRACTOR INFORMATION . Contractor Type Electrical Mechanical Plumbing Contractor License L & E ELECTRIC INC 105475 COMFORT FLOW HEATING CO. 460 STEVEN R JOHNSON 65065 BUlLI:ilNG INFORMATION' # of Units: I # of Stories: Primary Occupancy Group: --,' R-3 ' Height of Structure 17.00 1 Secondary Occupancy Group: U Type of Heat: Forced Air Gas Primary Construction Type VB Water Type: Gas Secondary Construction Type: ~ype: Electric # of Bedrooms: ATTEN110N: Of..,.\8W r ath: foI\OW ftIIe8 adopted by the, Building' n/a :a:..F=~INFORMATlON . ~~. (Note: ttletel8phOM Froutyard Setba...... for the 0reQllIIl UtIlity N~~ist: Side 1 Setback: eentsr 1l1:a:1O aa2-2344),.Street Trees Rqd: Side 2 Setback: 10.00 Paved Drive Rqd: Rearyard Setback: 16.50' % of Lot Coverage: Solar Setbacks: 0.00 ..~..-"...... I PUBLIC IMPROVEMENTS I , Street Improvements: Storm Sewer Available: Special Instruction: Fully Improved No' ", ,'. Storm water to curb! 1p~,\:~~ch va~iaiice A . j..." Residelltial Expiration Date 03/3012012 06/27/2011 03/12/2012 Phone 541-933-2653 541-726-0100 541-342-3765 Lot Size: 5,515 Sq Ftlst Floor: 1,627 Sq Ft 211d Floor: Sq Ft Basemellt: Sq Ft Garage/Carport 440 Sq Ft Other: Occupant Load: 4 Yes 36.30 REQUIRED PARKING Total: 2 Handicapped: Compact: Sidewalk Type: DownspolltslDrains: Curbside 7' Cllrb alld GuileI' .. "'~~ ~<:...~ ':l,';,"q/:!'-" ~:"'i . NOTICE: '"",.--,. ", , THIS PERMIT SHAll EXPIRE IF THE WORK ," AUTHORIZED UNDER THIS PERMIT IS NOT: COMMENCED OR IS ABANDONED FOR;:< ANY 180 DAY PERIOD. " '. ,. Notes: ',' -.j' '" 1,:';" I J, 'i;;,~~it ';~~'c~~~2fL?f 4 ',:'r: -'. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspeetion Line Description Tvpe of Construction Estimate Estimate :.-:;;:;'''7:~:.-;" _~h '\J1 'I , " ," "'ll',;; . . ",' 0;,. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM201O-00764 ISSUED: 06/16/2010 APPLIED: 06/15/2010 EXPIRES: 12/16/2010 VALUE: $ 174,139.00 I Valuation Description I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 174,139.00 Value Date Calculated $174,139.00 $174,139.00 06/15/2010 ,," " . ,.,:.IotatVaI~eof ,Project ~..... "'," ~ .,.' Fee Description Amouut Paid Date Paid Receipt Number, + 12% State Sureharge $216.48 6/16/10 1201000000000000707 + 5% Technology Fee $108.05 6/16/10 1201000000000000707 1st Appliauce $79.00 6/16/10 1201000000000000707 2 Baths Due or Two Family $337.00 6/16/10 1201000000000000707 Addressing Assignment $38.00 ',6/16/10 1201000000000000707 Appliance Vent $9.00 6/16/10 1201000000000000707 Building Permit $1,014.00 6/16/10 1201000000000000707 Credit- SDC Storm Improv $-839.64 ' 6/16/10 1201000000000000707 , Credit- SDC Storm Reimb $-233!4<(:' ',I" 6/16/10 1201000000000000707 Curbcut Permit $88.00 , 6/16/10 1201000000000000707 Dryer Vent $9.00 6/16/10 1201000000000000707 Exhaust Hoods $13.00 6/16/10 ]201000000000000707 Fire SF Fee - Residential $103.35 . 6116/10 ]20]000000000000707 Fireplace (Listed) $20.00 6/16/10 1201000000000000707 Gas Outlets 1-4 $7.00 6116/10 1201000000000000707 Heat Pump $17.00 6/]6/10 1201000000000000707 Plan Review Major - Planning $211.00: .'1:, " ,li~.'i;;'~1:., . ' i, 6/]6/10 ]201000000000000707 Piau Review Same As $250.00::: :, ...~... ,', 6/16/10 1201000000000000707 0',,",-,'-"" ,.........- "., ' PW Disc - 2nd Permit $-30.0,0 i,,';(; , 6/16110 1201000000000000707 Residence Wiring 1000 Sq Ft $134.00',,~ . 6/16/10 1201000000000000707 Residence Wiring Ea Addtl 500 $75.00 6/1611 0 1201000000000000707 Sanitary Sewer - Improvement $740.60 6/]6/10 ]201000000000000707 Sanitary Sewer - Reimbursement $1,238.32 6/16/10 1201000000000000707 SDC MWMC Administration, $10.00 6/16/10 1201000000000000707 SDC MWMC Compliance Charge $22.63 6/16/10 1201000000000000707 SDC MWMC Improvement $],333.57 6/1611 0 1201000000000000707 SDC MWMC Reimbursement $101.97 ,6/]6/10 1201000000000000707 SDC SanitarylStorm Admin $202.7] 6/16/10 120]000000000000707 SDC Storm - Improvement $839.64 6/16/10 ]20]000000000000707 SDC Storm - Reimbursement $233.49 6116/]0 ]20]000000000000707 SDC Tran Reimburs-Residential $279;54"'- 6/16/10 ]201000000000000707 SDC Trans Improvement-Resident " 6/16110 $1,140.17 ]201000000000000707 SDC Transportation Admin $94.29 6/16/10 1201000000000000707 Sidewalk Permit $88.00 6/16/10 ]201000000000000707 Temp Power 200 amps or less $63.00 611 6/1 0 1201000000000000707 Vent Fan $27.00 6/16/10 1201000000000000707 Paee 2 of 4 r, ";11" j't ,;."~.1 t ' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00764 ISSUED: 06/16/2010 APPLIED: 06/15/2010 EXPIRES: 12/16/2010 VALUE: $ 174,139.00 Status Issued ;,."'....;.'.-~. '\", \. ,;". .' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Willamalane Single Family $2,858.00 6/16/10 1201000000000000707 Total Amount Paid $10,898.68 I Plan Reviews r Plannin!! Review 06/15/2010 , 06/15/2010 ' 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. Building placement meets minimum setbacks, All property and structun pins shall remain on the property for verilication by the Building Inspector at the time of footing inspection. storm water to curb via weep holelDriveway.approach Variance A As noted on plans Public Works Review 06/15/2010 ',.. .,-- ''',;.,,",,''~ ';~~'l.'.~~".;~; 961tSl2otO' " .'.1._' . APP LKW .' ~ Structural Review 06/15/2010 06/1512010 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..Reollir~rlJnsnections I f} .' Ufer Electrical Ground: Install ground r~d,"t 'footing "~d-c,tlI 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 inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Post and Beam: Prior to floor insulation or dec~ing. Floor Insulation: Prior to decking.."",,,;:;/;,,,, ~l';'':> :~~';h ,. j~-~1H' ",,' . Shear Wall Nailing: Before covering sheatliingwithfinish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceili.ng Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Perimeter Foundation Drains: After gravel and IiIter cloth is i1istalled but prior to backfill. . , ~ . \\,,,.,<,, , " Paee 3 of 4 ," 1,"\' CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM20]0-00764 ISSUED: 06/]6/20]0 APPLIED: 06/]5/20]0 EXPIRES: 12/]6/2010 VALUE: $ 174,139.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line " Underlloor Plnmbing: Prior to insnlation o~idecki~g.; , i , \,;"';' 'c' ; ~-, ~ l Underfloor Drain: Prior to cover or placem~nt of concrete. Rongh Plnmbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Water Line: Prior to filling trencb and including required testing. Storm Sewer Line: Prior to tilling 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 orie appliance including required testing. Presuretest done at this point. Rongh Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical workis complete. Temporary Electric: Approval required prior to Utility Company energizing pole. >""-1"", ..... Rough Electric: Prior to Cover i"L":'" t.':> . ~~~\ Electric Service: Approval required prior to'utility company energizing service. Final Electric: When all electrical work is complete. Low Voltage: Prior to cover. 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 - Curbside: After forms are erected but prior to 'placement of coocrete. or,1 By signature, I state and agree, that I have carefully examined ih'~ completed application and do hereby certify that all information hereon is true and correctl 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. 1 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 reqnired 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 cOl~struction. IN ~,..,<I.. ,.,.....t-,.".. ':;W i\.,' Owner or Contractors Signature ,... ..jf;:','. 111 Co /r7 t f 0 .....l,_I\ Date Paee 4 of4 So...M~ <AS 102 7 :5 i-lIs -r _ Structural Permit Application__ C/O. Z~r- "1.:i~!~'> C1jj~OF SPRINGFIELD, 9REG9N :'. '; . . :,!1t<::. 8..;::A. l. lfj;. ~.: DEPAR'rMENT~iJSE ONtiYi, h: . ~'_'" . ~,<;...i\"~:> ... .'."..' ,4 CQA..-120fO-o () 7b<{ Penmt no.: Date: /., -IS- -/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. JWl'if,'11i/;'~~i:OO)P1~'G'OYERNMENT~APPROVAi1;' r\':"';:~W;iI*;1 ~1\1',,"',llt.._._.,.Ii!L_,_.__.__._._ ....._....._....... ..!-11\'''m'...."....,'''. This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: 0 Yes 0 No WJit~~~~*,~gA1~~QBX:~6!tJG9~~]~UC,tlqN;::fii;~;il.;.::..:.:;',g: Residential 0 Government 0 Commercial ~ff~~'ilQ[~~it.~lUf~fQBMATjQij~I\.@~il'QCAfjqN::~'f;:r;"~;)i;~l Job site address: 0 IS" 5 r- City:"" ...;" ",,-1 )77 Subdivision: ; f!.. ,,-t Reference: 802 0 1'1 Taxlot: f~~~o~~l~f~:it~.~~~~H.p:RQ'p,:~RfYf~QW~_~~i~; Name:(!,{ c<. t.J:< d,<.t Cv',t::>'" 110"'0';' :tl\lC- Address:3073 51:. .i~w /...N City: tv, e"", StateO"'" ZIP:'17t 0'" Phone: -hU. 9'i)F Fax: -)Ir- ~i3b? E-mail:Wi00h.,,\' 1---0""'-5 C G""L.-;\. 1'Ve-r- 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. 225 Fifth Street + Springfield, OR 97477 + PH(541)726-3753 + FAX(54t)726-3689 Sign here: ~1'!1~11a;~fqQJi;fRA9:r:Q'~ijt:j~t!~~.:tjQNiV~~ijl~ff~iJ~),U1'1: Business name: ~.,v", W;ed",,,, Cu';b,.. 1>0,""-' Ilv<- Address: '3 07 3 S Ii "L >Ai '-'^ City: f.'v e>-<- State:O<l- ZIP:C)7)C\- Phone: -M/' cl'-I S? Fax:;3'/ - 33 b z. E-mail: Wi "0k.... \ \.-.0 ,,,-< s @ COM tt..54 ~ V...l0\ CCB license no.: Print name: Signature: ~~Wr:::fir,~;;$UEI\CON;rB'ActoR;INI10RMAtroNr~\#:"\!(':: :., :;, . ..-... - 1;'",..X1H-""._.."_",>~_.._ __",__.." .'".',....._~.;..l "_'_"".T'''_ :.<'._.--.,~_. ;..\~.!kfj.,Jt..... ".; Name CCB License Number Phone Number Electrical I-'.e 105' .I 7< 5<1 'II 'j & Plumbing )Jr.vr i P v.....~., ,< , .50(,!j :!, yZ-3'1 b~ Mechanical C!"H " " b () 72.b,-oloO ~;; ",'-:f 'r.-'''''''1:i/~J~~'m' ..-.,..",( '"IV.""" ,.' v' ;"",-,':;'~"".;>'!;"w.Jj!1t'~-<:Y:~""f-;:"\(.o.' _' _1~1~N;/<>::'~W} t:~~~iL"~'" -~I7EeSCHEDUtE'~<<f;1'ifi:9j!.E\~~if '~j~1:iAt\01~~/ ..-.':,..., .,.,..,,(L.., f~ , -....,~._"'~.,_.... ,_,,,, -__~...._...,...._~h.___..__:Utl"Wc..l"',..:~)."., "'l;C.V'-"""I;;:~\"'~t<"';~-~~-ll~\~i'i,loi-J:VI)t"':l'tt-;;;.:t:!..~i'~;,."O", ';"$:"l~:;:'~4U'jg.@'~tffi..~"!:;'f~R'''''':: , '.":,;~. ~._~a.., !9,n\:.I'hQ.rm~..~~Q,Il:r:-~~'f~,iJ.';f~:H~Wi:~~<;~~~~~~i--'j~:~;f',tt":; (a) Job description: S ,..... t:...~ ( Occupancy .,L '5 Construction type: Square feet: Cost per square foot: Other infonnation: Type or Heat: FA Euergy Path: I )2t'I1ew 0 alteration (b) Foundation-only permit? Total valuation: . 2. BuildJgg::f~'~~~~::~;;W.t:;:~~M~!t~:.;~\,. ". (a) Permit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) o addition O.Yes $ ;7<{ 13 i '.- : '~:,~jk~~{~rt~~ti!:~\fi:~,. '. : $ $ $ (d) Enter 12% surcharge (.12 x [2a+2b+2c]): $ (e) Subtotal offee. above (2a tbrougb 2d): $ ~~rpj.~~~~lXli'f;r~~.k- ,~~,mtf:~~N~~Jne~~'01'''~*,;I]:'i'~~Y~' ~~~(~;~~~~::~ (a) Plan review (65% x permit fee [2a]): 2. ~ 0 (b) Fire and life safety (40% x permit fee [2a]): (c) Subtotal offee. above (3a and 3b): . 4. Mis~~Wi!ieo'iIsJ~;}\', . '. .'j (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fee. and .urcharges (2e+3c+4a): S SCA"fW- 0...5 /O"ll S l{1,r Electrical Permit Application CITY OF SPRIN,GFIELD, OREGON 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+FAX(541)726-3689 ..;> .....;.:.,..:,.,. " "', . . .' DEPARTMENT USE ONLY . -."' .~ ""- -, ' . ,- -.... , - .. .' C 0 vt-1 ZO/O -00 7fH Penn it no.: Date: -b ~I J - /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. ',. :LOCAL'. COOVERNMENT AP'flROVAC"',':, Zoning approval verified? 0 Yes 0 No ," '. .':.CATEGORY;OF.CONSTRUC'TIOI\I'<' . D Residential D Government D Commercial ~-iiitt)Y}~oB:;:sfrE;.INFQRIlliAJ'IONi'AN[j\111():CA1!IONi.'!{:~t;;y." Job site address: 0 .5 L-Jlsr City: Reference: PROPERTY. OWNER Name, (:,nJu Wi ec.-ho-A CJ;.+o", Address: 5D7:S sit I IV City: <:: u v-<--- ZIP: '1 71 0)' Phone:SVI -bzb Of S'i? Fax: GVJ-'"SYf 31:, 'Z- E-mail: LN;'t:c.-he~l-kO~5 f] Con-CoAst .IV"-\'- This installation is being made on residential or farm 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: . CONTRACTOR INSTALLATION Business name: l- ..r e f ec+....~ G Address: Z g 33 --::50v--es Acr-e5 City: S f \~ State: 0 n. ZIP; q 7 '{ '7 ~ Phone'~'f/ -511 - 4r'i1l .:>,=) - cSq~ E-mail; CCB license no.: OS" 4 '7S" BCD license no.: '0:3<:::.... Signing supervisor's license no.: '-/ / 7 '1- S"" Print name of signing supervisor: J;- () Oe "00.)<:'''' Signature of signing supervisor: ~ ~ '11":fJ ,<I--- ~ t.\~ \\~ 440-2584-J (9108/COM) :~',:\;',::,;,:;):::}~,;~'r~,:,'~'rIi':~1Jff~r:fl:l:%,SC_H EO_O IlE~':~:;;V!':),f.f~~~0~ie~'0~1\~'~?~~~FJil .. CostC-. Total Num~erof.inspecii~ns p~r~te~O:,~ Q~. .' 'ea;.; . . cost ... Residential, per unit, service included: 1,000 sq. ft. or less (4) I $134.00 $ I~l Each additional 500 sq. ft. or portion -:l $ 25.00 05' thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ $ dwelling service or feeder (2) 63.00 Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 20 I to 400 amps (2) $ 95.00 $ 40 I to 600 amps (2) $158.00 $ 60 I 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: installation, alteration, relocation 200 amps or less (2) / $ 63.00 $TI 201 to 400 amps (2) , $ 87.00 $ 40 I 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 of a se'rvice or feeder fee: Each branch circuit I $ 6.00 I $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) I $ 55.00 $ Each additional branch circuit $ 6.00 I $ 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 limited-energy,panel, $ 63.00 $ alteration, or extension (2) Each additional inspection: (I) $58.00 $ ,:~~~g:~1~J~1rt~~~t~tjf;;i:~,~(AR,eLlcANt6j.Js~EKi~lt.:~ ~:'~::;'::;:;;l. .:..,..,~.. '';:,b.-;~',; .:: (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ 27Z (B) Enter 12% surcharge (.12 x [AD $ 3~''f (C) Technology Fee (5% of [AD $ (fb' TOTAL rees and surcharges (A through C): $ J'/8 r. 'R?, willamalane tlJ Park and Recreation District Job. No. (!/(}-7c::; r' . SYSTEM DEVELOPMENT CHARGE WORKSHEET January 1-June 30, 2010 NAME: J3~c...t" f,VIE<::tt€1LIClA$~ ~~ PHONE: .>'// b~{P '?ttr% ADDRESS:'30'7J Sl4'tllE"w t..N CITY btt,E"Ni:. LOCATION OF PROPOSED BUILDING SITE: Street Address: /~/I .):trl!r..~ STATE~ ZIP: q?'IoS Plat Name: Tax Lot Number: 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 = $ ~ ~S- . 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 OccuDancv .._u______.._.___~..~NQ._QE..Ul\J IJ.S ~C$.1,:321 R-er Jmil = ___$ E. Accessory Dwellinq Unit NO. OF UNITS WILLAMALANESDC X $1,550 per uhit = $ $ 2~~ . .. . : -"~-~--'--; ~ ':':_.--;_::;;-~.:-":-':':~--":~~-=::~::"":::"":"'===-==--=--"'=:;;:'::~:";::::"~.~:~-.:"""':::.-_':':::-'::::::':-_=:=":-.=':~-:-:"_::':=:":"=.":.:....~-=.-=-:. - . 2. SDC CREDIT (If applicable) SDC payer mustfumish proof of WiI!am,,"aneC~edit approvaL) . $ o .---,-.--- ----..-. ---~ ,- - ._.__._--_.-.....__.~~-_._--_.,_.. .-. ..... -. .. .~"~-.-._------.- 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) $ ~st ~ Development Services Department City of Springfield Date c; I~ t~ /0 ( 5 225 Fiftlt Street Spri!lgfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000707 Date: 06/16/2010 8:39:46AM Job/Journal Number COM20JO-00764 COM2010-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0'00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 , COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 10-00764 COM2010-00764 COM2010-00764 COM2010-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM2010-00764 COM20 I 0-00764 COM20 I 0-00764 COM2010-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM20 I 0-00764 COM2010-00764 COM2010-00764 COM2010-00764 COM20 I 0-00764 COM20 10-00764 COM201O-00764 COM20 I 0-00764 Payments: Type of Payment CreditCard Check cReceint 1 Description Plan Review Major - Planning Plan Review Same As Building Permit Addressing Assignment Willamalane Single Family 2 Baths One or Two Family I st Appliance Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlets 1-4 Fireplace (Listed) Heat Pump Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Temp Power 200 amps or less Fire SF Fee - Residential + 12% State Surcharge Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit SDC Storm - Improvement SDC Storm - Reimbursement Credit- SDC Storm Improv Credit- SDC Storm Reimb Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Tran Reimburs-Residential SDC Trans Improvement-Resident.'- SDC MWMC Reimbursement . r, SDC MWMC Improvement SDC MWMC Administration SDC MWMC Compliance Charge SDC Sanitary/Storm Admin SDC Transportation Admin + 5% Technology Fee ". ,~~ .';i' ",,{"", " I,: I 'IS. -,' Paid By BWCH BWCH Check Number Batch Number ., Rec,eived By djb djb ,-" '.1:\' .;} ,.,. P.~ge l.of2 Item Total: Authorization Number How Received 19699 03560d In Person In Person Payment Total: Amount Due 211.00 250.00 1,014.00 38.00 2,858.00 337.00 79.00 27.00 9.00 13.00 9.00 7.00 20.00 17.00 134.00 75.00 63.00 103.35 216.48 88.00 88.00 (30.00) 839.64 233.49 (839.64) (233.49) 1,238.32 740.60 279.54 1,140.17 101.97 1,333.57 10.00 22.63 202.71 94.29 108.05 $10,898.68 Amount Paid $9,50000 $1,398.68 $10,898.68 6/16/20 I 0