The URL can be used to link to this page

Home My WebLink AboutPermit Building 2007-5-3 Status Issued _ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00512 ISSUED: 05/03/2007 APPLIED: 04/09/2007 EXPIRES: 11/0312007 VALUE: $ 174,944.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line .........1'-o'l'D.q, "res VOU LV SITE ADDRESS: 1264 S 41ST PL SP~INGFIl\o~Xfr~~WCU<<'n:. ~ nfle tJ\m~ Residence ASSESSOR'S PARCEL NO.: 1802064109800 ATlEN tedbytheoreg n to\lOW ".u\eS a~9r.lfhWsTeSll!~eWe set fO~ Residential PROJECT DESCRIPTION: Single family residence- Filber1\ll\:ni~t~~ 1 0010 thrOugh OAR 952-00 t In OAR 952-00 -, ,.' cooies of the rules . 009U lUU 111.1')' .,"'tom . tn~~lt:l!J\IV'\e. Owner: BRUCE WIECHERT '\'ng the center. (No~'Q>>ev'~B\R~ati&H-686-9458 Address: 3073 SKYVIEW LN ca , r the Oregon Utility . EUGENE OR 97405 numberfO ,,'_ A o""_,,,,??344). I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor BRUCE WIECHERT CUSTOM HOMES INC L & E ELECTRIC INC COMFORT FLOW STEVEN R JOHNSON License 101717 105475 460 65065 Expiration Date 09/16/2008 03/30/2008 06/27/2007 03/12/2008 Phone 541-686-9458 541-933-2653 541-726-0100 541-342-3765 BUILDING INFORMATION I 3 # of Stories: 1 Lot Size: Height of Struct~fn:TI r.a::. 22.00 Sq Ft 1st Floor: Type of Heat: N\JFib\-'l.fe"lI.Ai~GJ1;S All S2~1~ "J(r<t~E WORK Water Type: THIS PERMI G~ti "S<!'}<1t>>~e~~Nltt IS 1\\01 Range Type: AU1HORIZE\l;w\\OEl$ql ~l~a~~itf~ftrt Energy Path: MMEN~OR \S$QaftMllW}!~D Sprinkled BUildi~V 1 RO oR~ PERlcftfcupant Load: I DEVELOPMENT INFORMATION I 6,309 1,580 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VB 452 REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 5.00 8.00 29.00 15.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 3 Yes 32.20 Total: Handicapped: Compact: 2 Subdivision Not Accepted Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I Fully Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter Notes: For this parcel in Filbert Meadows, it is the recommendation to the Building Division, by the City Engineer: "that final occupancy should not be given until the subdivision is accepted by City Council". Storm H20 SDC's Pa2e 1 of 5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction V Wood Frame Gara2e Dwellin2s Gara2e CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00512 ISSUED: 05/03/2007 APPLIED: 04/09/2007 EXPIRES: 11/03/2007 VALUE: $ 174,944.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $103.00 $27.00 Square Footage or Bid Amount' 1,580.00 452.00 04/09/2007 04/0912007 Value Date Calculated Total Value of Project $162,740.00 $12,204.00 $174,944.00 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $526.11 4/9/07 1200700000000000374 -Mechanical Issuance Fee- $10.00 5/3/07 1200700000000000493 + 10% Administrative Fee $133.44 5/3/07 1200700000000000493 + 5% Technology Fee $85.12 5/3/07 1200700000000000493 + 8% State Surcharge $106.75 5/3/07 1200700000000000493 2 Baths One or Two Family $254.00 5/3/07 1200700000000000493 Addressing Assignment $31.00 5/3/07 1200700000000000493 Building Permit $809.40 5/3/07 1200700000000000493 Curbcut Permit $40.00 5/3/07 1200700000000000493 Curbcut Permit $80.00 5/3/07 1200700000000000493 Dryer Vent $6.00 5/3/07 1200700000000000493 Exhaust Hoods $9.00 5/3/07 1200700000000000493 Fireplace (Listed) $15.00 5/3/07 1200700000000000493 Furnace - up to 100,000 btu $12.00 5/3/07 1200700000000000493 Gas Outlets 1-4 $4.00 5/3/07 1200700000000000493 Plan Review Major - Planning $198.00 5/3/07 1200700000000000493 PW Disc - 2nd Permit $-30.00 5/3/07 1200700000000000493 Residence Wiring 1000 Sq Ft $106.00 5/3/07 1200700000000000493 Residence Wiring Ea Addtl 500 $57.00 5/3/07 1200700000000000493 Sanitary Sewer - Improvement $554.14 5/3/07 1200700000000000493 Sanitary Sewer - Reimbursement $728.74 5/3/07 1200700000000000493 SDC MWMC Administration $10.00 5/3/07 1200700000000000493 SDC MWMC Improvement $961.52 5/3/07 1200700000000000493 SDC MWMC Reimbursement $91.61 5/3/07 1200700000000000493 SDC Sanitary/Storm Admin $163.42 5/3/07 1200700000000000493 SDC Transpo Admin $66.70 5/3/07 1200700000000000493 SDC Transpo Improvement $836.32 5/3/07 1200700000000000493 SDC Transpo Reimbursement $189.58 5/3/07 1200700000000000493 Sidewalk Permit $80.00 5/3/07 1200700000000000493 Storm Drainage Impervious Area $1,230.54 5/3/07 1200700000000000493 Temp Power 200 amps or less $50.00 5/3/07 1200700000000000493 Vent Fan $12.00 5/3/07 1200700000000000493 WiIlamalane Single Family $2,303.00 5/3/07 1200700000000000493 Total Amount Paid $9,730.39 Pa2e 2 of5 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00512 ISSUED: 05/03/2007 APPLIED: 04/0912007 EXPIRES: 11/03/2007 VALUE: $ 174,944.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Planninl!: Review I Plan Reviews I 04/10/2007 APP 05/02/2007 APP NJM TAJ 04/10/2007 04/10/2007 Public Works Review 04/10/2007 WI JLP 04/10/2007 Public Works Review 04/16/2007 04/16/2007 APP JLP Public Works Review 04/23/2007 10 JLP 04/23/2007 Structural Review 04/26/2007 05/03/2007 APP LLH Structural Review 04/10/2007 04/27/2007 10 LLH Plant street trees as required by street tree plan attached: 3 Autumn Purple Ash or Oct Glory Maple, 2" caliper, leave name tags on until occupancy. Rcvd 4/10/2007---Waiting in order PW rcvd for rvw.JLP WI 4/10/07 For this parcel in Filbert Meadows, it is the recommendation to the Building Division, by the City Engineer: "that final occupancy should not be given until the subdivision is accepted by City Council". Storm to curb & gutter. Storm H20 SDC's added, as no resolution has been met to date between Ken/Les and Weichert Homes on repayment methods for storm system. (Adjustments to be made at later date). JLP APP4/16/07 Rcvd overwidth approval from Traffic Dept. JLP 10 4/23/07 Plans reviewed by Shawn Eaton with the Building Department under contract with the City of Springfield Forwarded to the Building Department for structural review under contract with the City of Springfield. 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. Ul-eouirecUnsnections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Curbcut - Overwidth: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: 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. Pal!:e 3 of5 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-00512 ISSUED: 05/03/2007 APPLIED: 04/09/2007 EXPIRES: 11/03/2007 VALUE: $ 174,944.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough 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 complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Underfloor 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 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. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Pae:e 4 of 5 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00512 ISSUED: 05/0312007 APPLIED: 04/09/2007 EXPIRES: 11/0312007 VALUE: $ 174,944.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 are requested at the proper time, that each address is readable from the street, that the permit card is locate at the front of the property, and the approved set of plans will remain on the site at all times dU'2nst' tion. own~' Con'mcton Si{..tu<e D.f~J 07-- Pa2e 5 of 5 Date ZON l ~~ INITIALS ~ DATE .'h.P..:J ~.JI SOURCE 'W\. ~ ~ C-i L5 J 0, , 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number { O/,fA ePO 7 - c 0 S I Z. Installation, Alteration or Relocation 0-0 200 Amps orlessr~~nH~\i~ I $ 50,00 50. 201 Amps to 400 Aqtpfit' PErr''','. $ 69.00 , t'$. _. ;/Vl/! ~("iA(. ", " . 401 Amps to 600 ~~n.,;on'r:'" , '.'..:- :$160:0(l '. :1: ",lfRV: ti... i1/ZeL;. ~JI'IUI-r,; '-,_< ,. ," .,._I..r,' Over 600 AmpsortWRtiYvf~MJtciBr:~Ij,(~.r: :J ,,"'. ..J~=:1 ~t/:! :, :1!(r D. Branch CircuitsAA1y'...'ari.r'!. ',U,: J~,Ai:lf\'\ljJU;\jFri:I'Wj ." .",. .,nlllluuu.t\\f iJERl.OC .. "....L , New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with () WeLL' Service or Feeder Pennit Owners Name D'fV Le.. \ evh~\- vS~ rj...)~'5 ,r,' Address 3073 .s k.. '1 V ~ c:: W E. l\'lisce~~Iie.ous ~Service/feeder not included) ..:..Each Installa tion . - . '. . . " LOCA.TION OF INSTALLAtiON:' 1"2 b \.,/ 5 '1/ ~y LEGAL DESCRIPTION: 13(;>20 b 4 ( 1. 0'8'00 JOB DESCRIPTION: S~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. . C()NTRACTOR'INSTALLATI()NONLY" Electrical Contractor L +- e Address q 2.g 3 3 City \$p tie!.- 'JOh~5 Phone 5 II ,. '11 , ~ Supervisor License Number li / ') '1- 5 (O/(JlJ 07 I Constr. Contr. Number I D .s 't 7 ~ y/o ~ f Signature of Supervising Electrician ('\ U. "()A'/\~lIlJi _.- c .ct/ _.>VVlt L-)v~/lJl,Vf Expiration Date Expiration Date , 'cr6-1L{)'8' City ~vJ~~e.- OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. Phone Owners Signature: [n'pection Req",,'" 726-3769 ~\!\tl 3. .'COMPUlb FEE SCHEDULE BELOW' A. New Residential- Single or Multi-Family per dwelling unit. . . ..;: ;.. ,_' ~ : ' . ~ h. ,..... . . Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof j{)&.O-O 57, crv I $106,00 s $ 19.00 Each Manufact'd Home or ~':il;~~t~~~~nb~;~~~:~!~1 B. ~~iAQrtIti~Jd,"~n~t\Pa~fM~~~~Js9j!~i~cation: . ., 'in OAR. 952..()01 :.001 0 throu~n~Of\H~':;)-,:..btl, " l 20oJA\9f$ d'ftmj11ay obtain copje,~ o~ t~r Irtf6S t 20 I A~iM14btrAl~nter. (Notl:1.. (: It;; tql~~~6e . t.\-we) 401 ~f6{)tpAJn,~. O~~~~~ ~!~I,~~~~\,gf6~r 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375.00 Reconnect Only $ 50.00 C. ,Temporary,~e~i,ces orreeder~, $ 43.00 $ 3.00 Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50,00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 . Minu,n~m Electric ~ermit Inspection Fee is $45.00 + Surcharges --' '\ 4S'U!JTOTAL OF ABOVJ3 ., .' . c::9 r~ ~ % Stat~ S~rch~ge '. . . 1 '\ ..64 10% Administritive Fee ~ \ . ~ 0 5% Technology Fee ~ b A ( 0. ~ TOTAL , , , .' -Slo' q~ Shared Drive(T:)/BUlldmg Fonns/Electncal Pemut APphcation\-06.doc CITY OF Sl JGFIELD SYSTEMS DEVELOPMEN'i:;#'~~RKSHEET JOURNAL OR JOB NUMBER: C0M2007-00512 NAME OR COMPANY: weichert LOCATION: 1264 S 41St TAX LOT NUMBER: Lot #27 filbert meadows DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 1 BUll,DING SIZE (SF: 2545 LOT SIZE (SF): 1, STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F, x COST PER S.F. CHARGE I 3666.50 $0.336 = I $1,230,54 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F, x 1 COST PER S.F.' x DISCOUNT RATE I I 0,00 '$0,336 50% I ITEM 1 TOTAL - STORM DRAINAGE SDC $1,230.54 I ",----, . -r=- tZl ~ Cl o u ~ ~ H E-< , tZl ...... o 62 --- 6309,7 DISCOUNT $0.00 $1,230.54 1070 2, SANITARY SEWER - CITY A REIMBURSEMENT COST: I NUMBER OF DFU's x COST PER DFU , . 28 $26,03 $728.74 109] B. IMPROVEMENT COST: I NUMBER OF DFU's x I 28 $19.79 = I $554.14 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =1 $1,282.88 3, TRANSPORTATION A REIMBURSEMENT COST: ADT TRIP RATE I x NUMBER OF UNITS x I COST PER TRIP x INEW TRIP FACTOR I . 9.57 I 1 I $19,81 I l.00 I $189.58 1093 B. IMPROVEMENT COST: ADT TRIP RATE I x NUMBER OF UNITS x I COST PER TRIP x !NEW TRIP FACTORl' 9.57 I 1 I $87.39 I 1.00 $836.32 ]094 ITEM 3 TOTAL - TRANSPORTATION SDC =, $1,025,90 4, SANITARY SEWER - MWMC A REIMBURSEMENT COST:' INUMBER OF FEU's x COST PER FEU I 1 $91.61 = $91.61 1054 B. IMPROVEMENT COST: INUMBER OF FEU's x ICOST PER FEU I 1 I $961.52 = $961.52 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054 ) I MWMC ADMlNISTRATIVE FEE $10.00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = 1 $1,063.13 SUBTOTAL (ADD ITEMS 1,2,3,& 4) = 1 $4,602.45 5, ADMlNISTRATIVE FEE: I SUBTOTAL x ADM. FEE RATE 1= CHARGE I $4,602.45 5% I $230.12 , TOTAL SANITARY ADMlNISTRATlON FEE: 163.42 1]079 TOTAL TRANSPORTATION ADMlNISTRATION FEE: $66.70 11078 Jeff Prociw 4/16/2007 TOTALSDC CHARGES =, $4,832.57 PREPARED BY DATE " DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET AuUl1 lONAL FIXTIJRES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBATHTUB 2 0 3 = 6 IDRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETe. 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0 LAUNDRYTUB 1 0 2 = 2 ICLOTIIESW ASHER / MOP SINK 1 0 3 = 3 I CLOTIIESW ASHER - 3 OR MORE (EA)' 0 0 6 = 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRIG / WATER STATION / ETC, 0 0 1 = 0 IRECEPTOR FOR COM, SINK / DISHWASHER / ETe. 1 0 3 = 3 ISHOWER, SINGLE STALL 1 0 2 = 2 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASINfDOUBLE LAVATORY 1 0 2 = 2 SINK: SINGLE LAVATORY /RESIDENTIAL BAR 1 0 1 = 1 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 2 0 3 = 6 MIsrJ;'T T ANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 28 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 19&7 19&8 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $5.29 $5.29 $5,19 $5,12 $4,98 $4,80 $4;63 $4.40 $4,07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1,09 $0,92 $0,72 $0.48 $0.28 $0,09 $0.05 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR 2 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $O,QO x $5.29 = , $0,00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0,00 x $5.29 o = $0,00 TOTAL MWMC CREDIT 225 Fifth Street Sprillgfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00512 COM2007-005l2 COM2007-005l2 COM2007-00512 COM2007-005l2 COM2007-00512 COM2007 -00512 COM2007-00512 COM2007 -00512 COM2007-005l2 COM2007-005l2 COM2007-00512 COM2007-00512 COM2007-00512 COM2007-005l2 COM2007-005l2 COM2007-005l2 COM2007-00512 COM2007-00512 COM2007-00512 COM2007-00512 COM2007 -00512 COM2007-005l2 COM2007-00512 COM2007-00512 COM2007-00512 COM2007-005l2 COM2007-00512 COM2007-00512 COM2007-00512 COM2007-00512 COM2007-005l2 Payments: Type of Payment CreditCard cReceintl Citv of Springfield Official Receipt D .opment Services Department Public Works Department RECEIPT #: 1200700000000000493 9:02:58AM Date: 05/03/2007 Description Addressing Assignment WiIlamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea AddtI 500 Temp Power 200 amps or less Sidewalk Permit Curbcut Permit PW 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 SanitarylStorm Admin SDC Transpo Admin Curbcut Permit Plan Review Major - Planning Building Permit 2 Baths One or Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Fireplace (Listed) ~Mechanicallssuance Fee~ + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Amount Due 31.00 2,303,00 106.00 57.00 50.00 80.00 80.00 (30,00) 1,230.54 728.74 554,14 189.58 836.32 91.61 961.5 2 10.00 163.42 66,70 40.00 198,00 809.40 254,00 12.00 12.00 9.00 6.00 4.00 15.00 10.00 85,12 106,75 133.44 $9,204.28 Paid By BRUCE WEICHERT HOMES Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid ddk 005l0B In Person Payment Total: $9,204.28 $9,204.28 Page 1 of 1 5/3/2007