HomeMy WebLinkAboutPermit Building 2011-2-23
..
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00201
IVR Number: 811177244157
www.cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
02/23/2011
ISSUED:
APPLIED:
02/23/2011
02/08/2011
225 Fifth SI
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci.springfield.or.us
EXPIRES:
VALUE:
08/22/2011
$70,000.00
SITE ADDRESS: 1408 MAIN ST, Springfield, OR 97477-4921
ASSESOR'S PARCEL NO: 1703363203400
PROJECT DESCRIPTION:
Tenant Infill: 3,386 5.f. Convenience Store
Phone Number:
OWNER:
ADDRESS:
EMMITT PROPERTIES LLC
13593 SE PORTLAND VIEW PL
HAPPY VALLEY OR 97086
SCOPE: Tenant Infill
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Commercial
CONTRACTOR INFORMATION ~
Contractor Type
Plumbing Contractor
General Contractor
Contractor Name
ALPINE PLUMBING & GLASS LLC
DEAN ALAN LOCKE
Lic Type
CCB
CCB
Lie No
186890
80344
Lic Exp
OS/29/2011
04/25/2012
Phone
541-953-4095
541-520-4608
BUILDING INFORMATION ~
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Hazmat:
# of Units:
o
Occupancy Type
Construction Type
M
Type VB
Electrical Specialty Code Edition:
Springfield -::ire Code Edition:
Mechanical Specialty Code Edition:
Municipal' Development Code:
Plumbing, Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
# of Bedrooms:
Spr.inkled Building: No
Fire Alarms: No
Energy Path:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other: 0
Occupancy Load:
2008
2010
2010
2008
2010
Site Information
~
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard ArelIOTlCE:
Retaining Wall: THIS PERMI
Soils Report Req~i0e,df~ORIZE; SHALL EXPIRE IF THE WORK
COMMENCED ~~~~R THIS PERMIT IS NOT
ANY 180 DAY PERlOtBANDONED FOR
Springfield Building Permit
2123/2011 10:01:54AM
ATTENTION: Oregon law requIres you to
foUow rules adopted by the Oregon Utility
~otlffcatfon Center. Those rules are set forth
m OAR 952-001-0010 through OAR 952-001-
0090,. You may obtain copies of the rules by
caUmg the center. (Note: the telephone
number for the, Oregon Utility Notification
Center IS 1-800-332-2344).
Page 1 of 5
SPRIN. GFIE~
..-'-'-
-c ,I!::f;
- -c. \. OREGON
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
. Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.cLspringlield.or.us
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00201
IVR Number: 811177244157
permitcenler@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
02/23/2011
ISSUED:
APPLIED:
02/23/2011
02/08/2011
EXPIRES:
VALUE:
08/22/2011
$70,000.00
SITE ADDRESS: 1408 MAIN ST, Springfield, OR 97477-4921
ASSESOR'S PARCEL NO: 1703363203400
SCOPE: Tenant Infill
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Tenant I"fill: 3,386 s.f. Convenience Store
DEVELOPMENT INFORMATION ~
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
~
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
~
Description
Bid
Tvpe of Construction
NA
Unit Amount Unit Tvoe
70,000,00 Bid
Unit Cost
1.00
Value
70,000.00
70,000,00
Springfield Building Permit
2/23/2011 10:01 :54AM
Page 2 of 5
SP.I.l.IN.GFIE~
J7.~.
..~. ,~
-_:"~ ,'~ OREGON
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00201
IVR Number: 811177244157
, www.cLspringfield.or.us
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci,springfield.or,us
PROJECT STATUS:
STATUS DATE:
Issued
02/23/2011
ISSUED:
APPLIED:
02/23/2011
02/08/2011
EXPIRES:
VALUE:
08/22/2011
$70,000,00
SITE ADDRESS: 1408 MAIN ST, Springfield, OR 97477-4921
ASSESOR'S PARCEL NO: 1703363203400
SCOPE: Tenant Infill
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Tenant I"fill: 3,386 s.f. Convenience Store
FEES PAID
DescriDtion
Structural Plan Review Fee Commercial
Back flow preventer -
Water closet
Mechanical Permit fee (based on value of work)
SDC: Reimbursement Cost - Local Wastewater
Fire, Life, Safety Plan Review
SDC: Improvement Cost - Local Wastewater
SDC: Reimbursement Cost - MWMC Regional WastewatE
SDC: Improvement Cost - MWMC Regional Wastewater ~
SDC: Compl~nce Cost - MWMC 'Segional Wastewater SI
SDC: Administrative Fee - MWMC Regional Wastewater:
SDC: Total Sewer Administration Fee
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
Sink/basin/lavatory
Interceptor/grease trap
Ice maker
Floor drain/floor sink/hub
Building Permit Fee
Total Amount Paid
Springfield Building Permit
I
Amount Paid
$365.72
$19.00
$19.00
$296.89
$1,185.48
$225.06
$578.61
$242.40
$3,170.11
$53.79
$10.00
$262.02
$128.22
$53.43
$76.00
$19.00
$19.00
$57.00
$562.65
$7,343.38
Date Paid
02/08/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
---.-.-.---
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
02/23/2011
ReciDt #
2011000246
----
2011000334
2011000334
-.--
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2011000334
2123f2011 10:01:54AM
Page 3 of 5
SPRING~...FIE.~
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. ^\^\, OREGON
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00201
IVR Number: 811177244157
www.cLspringfield.or.us
225 Fifth 51
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenler@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
02/23/2011
ISSUED:
APPLIED:
02/23/2011
02108/2011
EXPIRES:
VALUE:
08/22/2011
$70,000.00
SITE ADDRESS: 1408 MAIN ST, Springfield, OR 97477-4921
ASSESOR'S PARCEL NO: 1703363203400
SCOPE: Tenanllnfill
WORK INVOLVED: Alleralion
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Tenant I"fill: 3,386 s.f. Convenience Store
Plan Review
~
Deoartment
Application Acceptance
Received Due Date ComDleted
02/08/2011 02/08/2011 02/10/2011
Result
Application Accepted
Reviewer
David Bowlsby
Planning Review 02/10/2011 02110/2011 02/14/2011 Approved Liz Miller
Comments: Must have site requirements completed prior to occupancy. Please Call Steve Hopkins at 541-726-3649.
rp[jbjj2Wfuk,rReVlew'"' ',' -"," ,._': 02ho/20W~792~hO/2b;l1. ~_021141201,1- :::A~iproved."';&"-'~:'~TfJMcEachern -' .- ~.~....
j :'" :"'_" " >--,' ~"' , .;';', .' : . ,-.:;' ' ';, ;~,-,,',J 1'-",;' ", -, ,,~~ " 'C,:,' " , ',' " '~",,-;,;"-i :<: ,:, " . 0 ,~: ' "',no"", ,t~_ ' . -- .' ,',
: Comments: SDC_charg,e_qpernewj(?rdLl}~rce~,,,,,,t_~'.~ ':'j;# . _'" ~''',':" ,~'\'ii:;~i";'"" '~" "..g.A",'" (::;>.'''t
. , . tran.spo~~a,~j?nprtoru"~_~i~e'~i~'fO(;W~~e~, ~to~,'m~Si,~eYf"!iW~Q03: J'~~;;,~I<(, j };, ,. ;,11., J, ;-Yi',
1 ': ... ,.';, :~" ;':_ Q.1w[11c:fJ;tqJI-pepssy{eJ~mgs.terplC!~~~'?Jch4l;i2~.,i~~~071_209~ ~~};;.:~:7,{,';+:.'.,;'{'" 'to..,~ _ ,_c;:, .;.~ :"m~ "
L:.2.-_~ocalt,,~E:!.Yi5l.u;:harg~QJ~er;newjixture<number i-5J~, t '".~.,' ,c, '""7''''<'"''i''; ',.:...w~;fll" ' !x,~_ ".' ~:~
Structural Review 02/10/2011 02/10/2011 02/16/2011 Add'llnfo Required Kip Kaufman
Comments: Mechanical, Electrical (Lighting)
F;~;o~:~~i~~~e~;;ft~.~~:td8~!;e;~;~r!FI;r~~;t~Jr~~;:~~:~;9~i~~t:,~~~:i~(9,;:'.':;...:~~~~;~~I~:~:;~r~~~:4 .:,:;,.:: ~'<';". .'
'-''''l''Cb'--'C'''/''''"''''~----''f'='''''''__'' '''''''''/7,,,,,,- ',,~ ',: '..,;'."":'X!:,:""-','oh"" .'","'"'...':;....'~ 0, ,~M ~"~, .,'... .:<;i'2",.;;t;,~" ',:':',~;'"::;,s~-,,
", ",,~, '-'\;it;" ~ "l".
Structural Review 02/10/2011 02/10/2011 02/23/2011 Approved Kip Kaufman
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SpringfJeld Building Permit
2123/2011 10:01:54AM
Page 4 of 5
www.cl.springfield.or.us
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00201
IVR Number: 811177244157
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
pc rmitcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
02/23/2011
ISSUED:
APPLIED:
02/23/2011
02/08/2011
EXPIRES:
VALUE:
08/22/2011
$70,000.00
SITE ADDRESS: 1408 MAIN ST, Springfield, OR 97477-4921
ASSES OR'S PARCEL NO: 1703363203400
SCOPE: Tenanllnfill
WORK INVOLVED: Alleralion
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Tenant Infill: 3,386 sJ. Convenience Store
INSPECTIONS REQUIRED I
Inspections
1996 Finaflnspection - Planning
1260 Framing
1540 Gypsum BoardlLathlDrywall
Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
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,
Roof Sheathing
1630 Roof Sheathing
1800 Emergency Egress Lighting
2300 Rough Mechanical
2999 Final Mechanical
Rough Mechanical: Prior to Caver
Final Mechanical: When all mechanical work is complete.
Rough Plumbing: Prior to cover and including required testing.
Grease Trap: Prior to Cover.
Backflow Device: Prior to covering and provide a copy of the test report on site at the
time of inspection.
Final Plumbing: When a/l plumbing work is complete.
3500 Rough Plumbing
3610 Grease Trap Interceptor
3620 Backflow Device
3999 Final Plumbing
1070 Parking Lot
1999 Final Building
Final Building: After all required inspections have been requested and approved and
the building 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 shaJJ be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or 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 eac~ 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
conZL-~~
2--P_3/J /
Date I /
Owner or Contractor Signature
Springfield Building Permit
2123/2011 10:01:54AM
Page 5 of 5
tructural Permit Application
-- CITY OF SPRINGFIELD: OREGON - . .' ';: :-'
&P'RINGFlELO ~I$[~
· 6 ~
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~~ 00' ,;
DEPARTMENT USE .ONL Y
~~~~~((-ot:,z.~ l
Date: - f -26
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. .
: ..,:.... .I;OC.A~9QYEBNM~~iUA8BI'i'c;lVAli\~~il/;:',[~:j&h"i:.n
This project has final land-use approval.
Signature: Date:
This project has DEQ approval.
Signature: Date:
Zoning approval verified: DYes D No
Property is within flood plain: DYes D No
Ij~~.J.~~:~~&l(:_AI~:g_Q.~Y1Q.~"'t5::oN_~;i~u.G,ftl9.~r~~;;~~~;t~_i~i;{~~fd~::~
D Residential 0 Government Commercial
!~): ;:;,:: .,.;~t)I3,SrrE: INf,pkMA 'ri9N~AN!'jI~QcATjqN~;1~l{f;~W!~j:l
al
City: State:OC ZIP.
225 Fifih Street. Springfield, OR 97477. PH(541)726-J753. FAX(541)726-3689
D34ca
City: .
Phone: '2 - 210 Fax:
E-mail: a kttJ .v;" 'J CE I'h5:n . C-1!",^-
This insfuJlation 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.
Sign here:
, ,'.
Print name:
Signature:
;~~;;-~~~-~~F~ '1?J".:~~.i~;tf,SVB.;G_0N:mt:tAcmt>rf~NFQ:R~.AItIQN~~iWi~~1~~~~
Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
.:........ ';.';/""FEE'SCHEOuLE:";'.'
.~i.~~;~~_~.~~~:(pn.'ih(&dif~ii9_~t:~~~~i~}f~';~~ri~,:J..~;)1.'.~~";~~,_;i;!/~{:k.,_~:t'J.
,
Ii'
(a) Job description:
Occupancy
Construction type:
Square feet:
Cost per square foot:
Other infonnation:
Type of Heat:
Energy Path:
o new alteration
(b) Foundation-only penmit?
Total valuation:
D add ition
DYes
~~'7_:_'lJ,u.~.i(fin-gJeeK~,;;,.t~f;~ft{f:V{;ll~r~{~i):IX}7~~::;b{:~:>-:~X '.':
'.,.....
(a) Penmit fee (use valualion table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
(e) Subtotal of fees above (2a through 2d):
$
$
$
$
$
1~~O?'~I~'~IE~Vi~~ff~~~~~fj~;~~~~t~11~itlt~~~ll~1l~1&~~t
(a) Plan review (65% x permit fee [2a]):
(b) Fire and life safety (40% x penmit fee [2a]):
(c) Suhtotal of fees above (3a and 3b):
~~4:~jM~~J~ii~~g~~~iTs}f~~}:~~jr~~~.:f~~,(~:~~f,~,~(.r;.'~,':~::'i:, ,.:'.: ,'f::"
(a) Seismic fee. 1 % (.01 x permit fee [2a)):
s
TOTAL fees and sur"harges (2e+3c+4a): S
I
~
~
PLEASE DON'T FORGET ABOUT SYSTEMS DEVELOPMENT CHARGES
The City requires Systems Development Charges (SDCs) on new development and
redevelopment to accumulate funds to construct new streets, wastewater facilities and storm
drainage facilities to accommodate the needs of development. Because SDCs are based on the
intensity ofthe impact on City systems that a use of the property will have, these charges are
sometimes large for commercial developments and can apply even if little or no change is
required to the physical structure of a property.
We are always concerned that someone starting a business in Springfield not be surprised in
needing to pay a significant charge. For that reason, we ask everyone who applies for a
commercial building permit, or inquires about using a vacant or occupied property for
commercial or residential purposes (other than one and two family dwelling units), to give us
some basic information so that we can discuss the potential impact of SDCs. While we can't
provide a precise estimate until we have much more detail, we can point out approximate costs
you may wish to consider.
Please provide the information below, and we can have someone from the City's Public Works
Department contact you to discuss how your development proposal could include the need to pay
SDCs.
Address or location of the proposed business:
) 'fo g-
HCiln Sr!'
Describe the business activities you are proposing at that location and how much area they will
use.
(]-/o cer (J . J C2'/1 LJ "!:A. t.L '3 J-o rc
Will the general public use or come to your location for the proposed business
activity?
Do you anticipate needing additional plumbing fixtures aod/or needing water or
wastewater facilities?
4
I/Jo
I Do you anticipate adding or removing any impervious surfaces or buildings?
What's the best way and time to contact you? S-<-j I - !)?-o- if .cug'
Email: JP] Jo~ tfz ~ 'i 1v4:t.'/.
C"',.. -
Phone Numbers: ..-
<t.. -b Dve...
lbA- ;t: J!~
Name
7/crJ If
Date / (
98
JOHNSON, CLIFTON, LARSON & SCHALLER, P.C.
ATTORNEYS AND COUNSELORS AT LAW
975 OAK STREET. SUITE 1050
.:, EUGE~E. OREGON 97401.~176 .
(541) 464.2434
JACOB K. CLIFTON
E.M~iJ: jcllflonGjclc,com
. . 'GAIL C. CROSS
- LtgaJAuisl;1l1
'E;'MOIII:gcranCJclc.com
ARTHUR C. JOHNSON
JACOB K."CLlFTON, JR. .' .
RICHARO.L;.LARSON.
DOUGLAS G. SCHALLER
OEREK C. JOHNSOW.,
DENNIS M. GERL" .
MARll YN A. HEIKEN, ,_
SCOTT C. LUCAS', . '
JAMES E. BEARD
MICHELE C. SMITH
. . :E.M'AIL'AOORES'S: Jcl~@Jcl~.COm
.: Direct FAX: (54'1) 349-5098
"Mso Memb81C<Wbmia and Washiogtnn Ban.
. Also Membef Callfomla 8a'
March 23, 2005
EI Mexicano
1408 Main St
Springfield, Oregon 97477
Re: Lease Payments
~<&b"6
. ., '-'1"I-~
54 ,..,'1
Dear Tenant.
f~'
Effective January 1, 2095 the property at 14th and Main was transferred
. from the Baldwin Family Trust to the sole ownership of Gary Baldwin and all
future rent payments, including the.rent for March of 2005, should be sent
dIrectly to him at:
Gary Baldwin
PO Box 179
North Lakewood, Wa 98259-0179
If you need to confirm this you can contact Linda Baldwin or the trust's .....
attorney. Randy Bryson at 687-1.333. Of course you are welcome to call me as
well..
Very truly yours,
Jacob K. Clifton Jr.
cc: Randy Bryson
Gary Baldwin
S.PRI.N.G..fIE.L~
.--~
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^^,=\. OREGON
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2011-00201
1408 MAIN ST
CITY OF SPRINGFIELD
225 Fifth 5t
Springfield,OR 97477
541-726-3753
permitcenter@cLspringfield.or,us
RECORD NO: 811-SPR2011-00201 DATE: 02/23/2011
,<~tL~::,c~''f;5{'%d '.(_. '_-;;~-," :",'1;,;:i}:. :,,,\' . ,;aAC_C.O.Uj;~L C.b[)E\,,-4~, ,~5;"::< ~~,":1t"~(. )(1Vi0,U NJ1D_LiE:~ '"
224-00000-425603 19.00
224-00000-425602 562.65
224-00000-425602 225.06
224-00000-425603 57.00
224-00000-425603 19.00
224-00000-425603 19.00
224-00000-425604 296.89
611-00000-426604 10.00
444-00000-426607 53.79
"~'---~"-
443-00000-448025 578.61
.,---,-_._------_.~~.......-
445-00000-448025 3,170.11
442-00000-448024 1 85.48
444-00000-448024 242.40
719-00000-426604 262.02
224-00000-425603 76.00
821-00000-215004 128.22
100-00000-425605 53.43
----
224-00000-425603 19.00
. ---.-..-.--.....-- ---------
TOTAL DUE: 8,977.66
K~,:,R~Y:'MI~j~tyE~'.:0~::e,~iQ8_~~ ~'c~sHI~;N1[~HA6oi;~~~~12.::'C_o.MMi;itIS:-7< ':;,~':. -':-~,'~"'\'i~~ -,.AMO~!fll!L~_~~:;','~:-. ~~'~t~j
Check STH, INC. 14TH & MAIN STREET 6,977.66
1021 MARKET
RECEIPT NO: 2011000334
[DESCRIFiij()N":' ;0':: '-'_::20"";r.;
Backflow preventer
Building Permit Fee
Fire, Life, Safety Plan Review
Floor drain/floor sink/hub
Ice maker
,_ _lnter~~E!or/grease trap "'"______
Mechanical Pe~f!1jt fee (b~~.7_d on value of work)
SDC: Admini~trative Fee - MWMC R."gion.al Wastewater SDC
SDC: Compliance Co~t - MWMC Regional Wastewater SDC
SDC: Improveme~! Cost. Local Wastewater
SDC: Improvement Cost - MWMC Re~ional Wastewater SDC
SDC: Reimbursement Cost - Local Wastewater
SDC: Rei~bursement Cost - MWMC Regional Wastewater SDC
SDC: Total Sewer Administration Fee
Sinkfb~sinflavatory
~~~~te of Oregon Surcharge (12% of applicabl~ fees)
_.-.-:r.e~h.~~gy fee (5% of germ it total)
Water closet
.1
TOTAL PAID:
6,977.66
SPRIN..G~...FI. ELD .
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,~;,~.", OREGON
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth SI
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-00201
1408 MAIN ST
permitcenter@ci.springfield.or.us
L:e.~'y'MJ~~DYPE ;,
Credit Card
01517b
P ~ y()~ . CASHIER' DBOIiJLSBY"
deanlocke
RECORD NO: 811-SPR2011-00201 DATE: 02/08/2011
w :x. 'ACCOUNT:CODE' .,'(. ' p-. AMOLJNT-D.UE---"-:'---.I
224-00000-425602 365.72
TOTAL DUE: 365.72
,.,' 'AMOUNT PAID
365.72
" ",
.
C.()I;:1J"IONIS
.J
RECEIPT NO: 2011000246
[DESCRIPTION' . , . '.': ' '0' .
Structural Plan Review Fee Commercial
TOTAL PAID:
365.72