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HomeMy WebLinkAboutPermit Building 2007-4-17 ~CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00443 ISSUED: 04117/2007 APPLIED: 03/26/2007 EXPIRES: 10/17/2007 VALUE: $ 210,727.00 i- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1219 S 40TH PL ASSESSOR'S PARCEL NO.: 1802064114000 SPRINGFIE TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - SAME AS COM2006-01499 1196 Delrose Owner: BRUCE WIECHERT Address: 3073 SKYVIEW LN EUGENE OR 97405 ~CTORINFORMATION I ~\~ \)\\w.i ~ Contractor Type Contract~~ \e6\e<b0f\ 'Oe\ \O~;; License General ~~ ~~\I'&~@\jSci~c.~qMEs INC 101717 Electrical K\~ ~\~~~~\O\lo-~ \\).\e'O e 105475 Mechanical t>--0~~ \\).\ ~~@R t ~~~ s 0\ \"~e~"O\\of\ 460 Plumbing ~('\\\O~ ..,~~~.~Jf~~..."e\e ,,'i\\\c'3-~ 65065 ~o\\\\~~~S'2:~~'i O~~~\. ~~~( \>DTI~\~n~G INFORMA nON I \f\ 0 ~:{O\). ~e cef\ O\e<bO ~.~?j" # of U nits: \J;::'~ ~\\f\9J ~ 0\ \{\e. .1 ,\.f()~ # of Stories: 1 Primary Occupancy G~~&~e\ ~ ef\\~~3 , Height of Structure: 23.00 Secondary Occupancy O'foup: G U Type of Heat: Forced Air Gas Primary Construction Type VB Water Type: Gas Secondary Construction Type: Range Type: Gas # of Bedrooms: 2 Energy Path: Path 1 Sprinkled Buildi~g~~~~ n/a J..'""y "l},,\ n I DEVELOPM~~ lNFW1~TION I \,\. 't.~S ~'t.\\\ ~ ~\)\\, (\\1\~" t-f\\\ S\\*~~u.'y\~~t-j\)~~ ~\J 7 ~\\\';\ \)~!fe"iOPiees Rqd: \\\5% <0\\\1.'t.\) \) <j?l~~d ~~ive Rqd: R~'O x.~CV\C. ~&\\~ot Coverage: 16~~~ ('\ \)~~ \) {....Ijl;\J ~~ I PUBLIC IMPROVEMENTS I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Subdivision Not Accepted Street Improvements: Storm Sewer Available: Special Instruction: Residential Phone Number: 541-686-9458 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 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 6,298 1,817 604 REQUIRED PARKING 2 Yes 38.40 Total: Handicapped: Compact: 2 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". JLP 4/8/07 Pa!!e 1 of 5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descriution Tvue of Construction AC - Residential V Wood Frame Garae:e A.C. - Residen Dwelline:s Garae:e Fee Descriution Plan Review Same As ~Mechanical Issuance Fee~ + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge 2 Baths One or Two Family Addressing Assignment Boiler/Comp Up To 100,000 btu Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fireplace (Listed) Furnace - more than 100,000 Gas Outlets 1-4 Heat Pump 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 Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan I Valuation Description I $ Per Sq Ft or multiplier $4.00 $103.00 $27.00 Square Footage or Bid Amount 1,817.00 1,817.00 604.00 Total Value of Project ~ Amount Paid $200.00 $10.00 $160.54 $90.62 $118.75 $254.00 , $31.00 $12.00 $926.40 $80.00 $6.00 $9.00 $121.05 $15.00 $15.00 $4.00 $12.00 $198.00 $-30.00 $106.00 $57.00 $554.14 $728.74 $10.00 $961.52 $91.61 $154.73 $67.43 $836.32 $189.58 $80.00 $1,071.29 $50.00 $18.00 Date Paid 3/26/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/1 7/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 4/17/07 Pae:e 2 of 5 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00443 ISSUED: 04/17/2007 APPLIED: 03/26/2007 EXPIRES: 10/17/2007 VALUE: $ 210,727.00 Value Date Calculated $7,268.00 $187,151.00 $16,308.00 $210,727.00 03/26/2007 03/26/2007 03/26/2007 Receipt Number 2200700000000000410 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 12007000000000004~4 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 1200700000000000424 Building/Combination Permit PERMIT NO: COM2007-00443 ISSUED: 04/17/2007 APPLIED: 03/26/2007 EXPIRES: 10/17/2007 VALUE: $ 210,727.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line WiIlamalane Single Family $2,303.00 4/17/07 Total Amount Paid $9,512.72 I Plan Reviews I Initial Review Planninl! Review 03/27/2007 03/27/2007 03/27/2007 04/13/2007 APP APP NJM TAJ Public Works Review 03/27/2007 04/08/2007 APP JLP Structural Review 03/27/2007 04/13/2007 APP RWC CITY OF SPRINGFIELD' 1200700000000000424 Plant street trees according the street tree plan attached to the stree1 tree handout: Autumn Purple Ash or Oct Glory Maple, 2" caliper, leave name tags on until occupancy. PW rcvd 3/27.JLP 3/27/07 *** For this parcel in Filbert Meadows, it is the recommendation to the Building Division, by the City Engineer: "thaI final occupancy should not be given until the subdivision is accepted by City Council". Storm H20 SDC's added, as no resolution has been me1 to date between Ken/Les and Weichert Homes on repayment methods for storm system. (Adjustments to be made at later date). JLP APP4/8/07 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. ~eouiredJnsnections I 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 concrete. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. 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. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Pa!!e 3 of 5 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-00443 ISSUED: 04/17/2007 APPLIED: 03/26/2007 EXPIRES: 10/17/2007 VALUE: $ 210,727.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. Roofing: Prior to installing any roof covering. Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. Hold Downs Installed: Special Inspection performed prior to placement of concrete., Provide report to City Building Inspector. Final Building: After all required inspections have been requested and ilPproved and the building is complete. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering 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. Final Plumbing: When all plumbing work is complete. Underfloor Mechanil;al. 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. Pal!e 4 of 5 CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2007-00443 ISSUED: 04/17/2007 APPLIED: 03/26/2007 EXPIRES: 10/17/2007 VALUE: $ 210,727.00 225 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 located at the front of the property, and the approved set of plans will remain on the site at all times during construction. ! J j tf;/7/0:;- I Iv " Owner or CQ.Htractors Signature Date Pal!:e 5 of5 ZON ~ INITIALS ~ DATE 4--\fb-D'"'l SOURCE \t^ ~~ 225 FIFTH STREET _ SPRINGFIELD, OR 97477 - PH:(541)726-3753 - FAX; (54])726-3689 ELECTRICAL PE~Jl' APPLICATION City Job Number C)' 1...44~ C. Temporary Services or. Feeders ATTENTION: Oreoo."nlaw r . Instaf@iHw~,r'M~ation or)j<.elOl;~tl~~LJlreS you to !1)oJ +" . ,~ ClUU/)[t]G oy me Oraban ~~"Ii1V 20otAm~ffilm&;Center. Tho<ce M"-'" "tia $ .ooh .. 201i?;~R91~~oon~01 ~ thl~)~9h -07~"9s~e _ ~(_ 4010Ahi~~.l(pwolA!llp$Jtaln cop!!"':; of the rdfeO~B) Cc';ilno the q6t6W, (1\/ ~ H Y Overr?8~tq:n or D u-vo t~~ @:~ulUibfMphone Signature of Supervising Electrician D. Branch ~iF-C?tlAhe.Oregan IJtlJlty Notification ) _ . venter IS 1800-332 2344). r, C \\ ~~ .\ New Alteration or Extension Per Panel r { -/ \ ~{" L...-Lv '--, '- One Circuit Each Additional Circuit or with Owners Name OO~.Q..J.DtO~ ~service or Feeder pel111it $ 3.00 Address ;'J,\~ ~ Lt .") tQ..Ll ') E. Miscellaneous (Service/feeder not included) -Each Installation City 11~bt.(\O/ Phm~J ~S0 OWNER INST ALLA nON 1. L\~C{OZS~~c LEG/:~Dm~\ 10 DE~RlPTION: \4CXYJ . '~~ Pe'mit, ace on-t'an,fecable and ~ire if w~ not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRA,CTOR INSTALLATION ONLY Electrical Contractor l r. E E \.a-. C~\ C. Address 0 ~ '3 -S:3 jo-w '> kre) \Q<L City SD ~ \ <i Phone 5~ \ -y \ ~8 , Expiration Date Y\l'-\-S \b/\/ol \D54is 3 / ?O/ 08 Supervisor License Number Constr. Contr. Number Expiration Date The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 Date 3. COlllPLETE FEE SCHEDlJLE BEL 0 TV' A.New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 \ fJ\o 19 n!lIl/ \ ~~ $ 19,00 Each Manufact'd Home or Modular Dwelling Service or $50.00 F&e6lICE:. ......<..."....'.'.',., .'...,'.".'......, ,'...". '....,, ," B. T~~~fflWl~~J:{J~~filltlW-off;~I1\tIi':\N6m1&r Relocation: ^bI1HORIZED UNDER THIS P[f1MIT IS NOT 2~,. ()W""iE ,?J(~'~~I DR IS ABANDONED FO~ 63.00 20't AillPtso 4)b' A~R~O-' $ 75.00 4&~Xmp~Qol ~ ~~s II $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsNolts $375,00 Reconnect Only $ 50.00 $ 43.00 Pump or irrigation ' $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimnm Electr" Pe,milln'pection Fee;, $45.00 + SnCCha/je'm 4. Sf JB TO TAL OF AB01lE ' i /)~ 8% State Surcharge 'l'1.CJ4 10% Administrative Fee ~..- i .~'-l 5% Technology Fee -+0. (pC:; TOT AL 1lc2 t .~q Shared Drive(T:)/Building FonTIs/Electrical Pennit Application 8-06.doc CITY OF S~~GFIELD SYSTEMS DEVELOPMEN"P':~RKSHEET JOURNAL OR JOB NUMBER: COM2007-00443 NAME OR COMPANY: Weichert LOCATION: . 1219 S 40th PI TAX LOT NUMBER: Lot #69 Filbert Meadows DEVELOPMENT TYPE: SINGLE F AMlL Y RESIDENCE NEW DWELLING UNITS . 1 BUILDING SIZE (SF: 2604 LOT SIZE (SF): 1, STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F, x I COST PER S,F, CHARGE I 3192.00 r $0.336 I =' I $1,071,29 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S,F, x I COST PER S,F, I x I DISCOUNT RATE I I 0,00 I $0.336 I I 50% = I ITEM 1 TOTAL - STORM DRAINAGE SDC '$1,071.29 2, SANITARY SEWER - CITY I A. REIMBURSEMENT COST: I NUMBER OF DFU's x I 28 B., IMPROVEMENT COST:, I NUMBER OF DFU's x I" 28 . COST PER DFU $26,03 $19,79 6298,8 rFJ P-1 Ci o u ~ P-1 E-< rFJ ..... o ~ DISCOUNT $0,00 $1,071.29 J 1070 $728:74 1091 $554.14 1092 ITEM 2 TOTAL ~ CITY SANITARY SEWER SDC =, $1,282.88 -'." 3, TRANSPORTATION A. REIMBURSEMENT COST:. ADT TRIP RATE x NUMBER OF UNITS I x COST PER TRIP x INEW TRIP FACTORI 9,57 1 I $19,81 I 1.00 I $189.58 i: 1093 B. IMPROVEMENT COST: ! I ADT TRIP RATE x I NUMBER OF UNITS I x I COST PER TRIP I x I NEW TRIP FACTOR I 9,57 1 1 I I $87.39 I I 1.00 $836.32 1094 ITEM 3 TOTAL - TRANSPORTATION SDC = , $1,025.90 I 4, SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's x I 1 ICOST PER FEU I $91.61 B. IMPROVEMENT COST: INUMBER OF FEU's I x I 1 I ICOST PER FEU I $961.52 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATlVE'FEE ITEM 4 TOTAL - MWMC S~IT ARY SEWER SDC = , SUBTOTAL (ADD ITEMS 1,2,3, & 4) =,' 5, ADMINISTRATIVE FEE: SUBTOTAL x ADM, FEE RATE - $4,443,20 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Jeff Prociw 4/8/2007 PREPARED BY DATE = $91.61 1054 = $961.52 1055 $0.00 1054 $10.00 1056 $1,063.13 $4,443.20 CHARGE $222,16 154,73 1079 $67.43 11078 TOTAL SDC CHARGES =, $4,665.36 . , . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET AuUl1 lONAL FIXTURES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS ,. "'._~__L_ BATHTUB 2 0 3 = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC, 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 LAUNDRY TUB 1 0 2 = 2 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 . CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC, 0 0 1 = 0 RECEPTOR FOR COM, SINK / DISHWASHER / ETC. 1 0 3 = 3 ISHOWER, SINGLE STALL 1 0 2 = 2 ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 I SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2 ISINK: SINGLE LA V ATORY/RESIDENTIAL BAR 1 0 1 = 1 IURINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 28 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) s~~L6? gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$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 $0,00 x $5,29 = I $0,00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0,00 x $5,29 o TOTAL MWMC CREDIT = $0,00 225 Fifth. Street .' . Springfield, Oregon 97477 541-726-3759 Phone C;..... of Springfield Official Receipt L lopment Services Department Public Works Department Job/Journal Number COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007 -00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007 -00443 COM2007-00443 COM2007 -00443 COM2007 -00443 COM2007-00443 COM2007 -00443 COM2007 -00443 COM2007-00443 COM2007 -00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007-00443 COM2007 -00443 COM2007 -00443 COM2007-00443 COM2007-00443 COM2007-00443 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200700000000000424 Date: 04/17/2007 Description Fire SF Fee - Residential 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 Sanitary/Storm Admin SDC Transpo Admin 2 Baths One or Two Family Furnace - more than 100,000 Boiler/Comp Up To 100,000 btu Vent Fan Exhaust Hoods Gas Outlets 1-4 Heat Pump -Mechanical Issuance Fee~ Residence Wiring 1000 Sq Ft Temp Power 200 amps or less Plan Review Major - Planning Building Permit Addressing Assignment Willamalane Single Family Fireplace (Listed) Residence Wiring Ea AddtI 500 Dryer Vent + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By BWCH Item Total: Check Number Authorization Received By Batch Number Number How Received djb 03573B In Person Payment Total: Page I of I 11 :38:08AM Amount Due 121.05 80.00 80.00 (30.00) 1,071.29 728.74 554.14 189.58 836.32 91.61 961.52 10.00 154.73 67.43 254.00 15.00 12,00 18.00 9.00 4.00 12.00 10,00 106,00 50,00 198.00 926.40 31,00 2,303.00 15.00 57.00 6.00 90.62 118.75 160.54 $9,312.72 Amount Paid $9,312.72 $9,312.72 4/17/2007