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Home My WebLink AboutPermit Electrical 2006-9-25 L-'iY2- q - 2.. 5" -0;.0 ~P":NCPI"LD '~S~I~ . l:1..~1id';,..t' ~"'l"~f:l:t'.!;;._-; ;~::~~~=.:~;;::r~~ PH:(54I)726-3753 . FAX: (54I)72q6-3.689,lrJ 5~i.~S~~:~o"~"'1 ; CityJobNumbcr~2,ldU(~ - mC1Io.3 'Date 0\ I LJ,) 'f"' I.' ~",j;00A7fuN'byt:iiistXi)i:.4.TIeN<t':']\'i"::;:l 3. r{CoIliPilEi'EFMS€HEiiUi:EHriLoM,;>;. .~Ai!1~;J?1bl~ ~ ~_,~._,. ";.-..,;r',-' ~.."",~ ,<". ",,,,,__,,_~'~"'~".s,,-<;,,,,"'.._1 ~a..;c:.r~,_,,,,"._____-"""M,,-,~~_,,,,,,_,,,,_,,_'~L';Q,~.:~1.. ..)!f;"~J1ke.il3ijrto..::.Ja:;.3 ~315 <5c..o~ Cs\ OfV\ ~ LEGAL DESCRIPTION Il 0 -> ~1 /30 Lf 5 6 0 , JOB DESCRIPTION. (' ~ o.Vc.u.'LJ' W ~og, Permils are non-transCerable and eIpire IC work Is Dot started within 180 days oCissuance or iCwork Is Suspended Cor 180 days. ~~~~f',' '; CdhfbF'~rRlNGF[ELD OREGON' .-',' ~~...__. '. ~_ . '. ~.~ . '_ ~, I ~~. .. - . - . Supervisor License Number 1.../7 '1,2 .5 c. ~~R~iMY:~~tYi~~I9rtf~1~[t~:S~~'~:~'.'~;~:~i!,~:" ,~~81,~d It) _I -^7 J.lCrFlfulIUI'l;Ule;wr" Ii:1W 1 "4ul1'<;:;' yuU lu u InstaUliliblf. teration Jlr IOaWooOregon Utility ,. ~OIlOW ru es aCO!,I' Uy" '" J'-Iq 0,7' I. 2 loW\"t3{tlmfCenter. ThosA r11IAS al$)SO;ooortl Constr,Contr,Number _-I- ~-,#-o( 20 A~m~0010thrn"ghOAf$'62JlOJ01 4O'doW:~8lf.ftlPF'>btain cC'niA" 01 th'Joo.l103 b\ ::~':r~~:~~ ~~~;.~'"r.~~ ~\ .. L./r 1 One Circuit $43,00 '1.:>' ::\'0 ~~~ .U0 L;';:~~!'",":.~; (;'> ~ 54J...,J -.c j City 0 ) Phone J.o ~ l'--. - ,~?-::3 Pump or irrigation $,50.00 *' 0'2.-- 9740.2.... Sign/Outline Lighting $ 50,00' ' OWNER INST ALLA nON Limited EnergylResidential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit luspection Fee Is $45.00 + Surcharges ~,. .,. ...-- <','.' . ' ., '.' _~~"':r'~,..~,-"...__.::-..,~":,,~,....._.~,,, crV J, ..~'..~~" ,........~- .-:.~, ""'"' ~ ' .~ ,'1 "..,^"", '''-,. ~ _ t . ~"l.i"':....."'.'~, .:: H 4. r~PT4L'O~~p~;~ttt;J!~"-:~""',i":~~:."~'~' ,1:.\ ] I 5 f5.t.7It'."..;. ", r"'....~. :I".."l'.'J. " "..-..: . - ,n ~';'~".J;,_.~. J::,j~A\'~,~ "'1 . , ~.~~ %% State Surcharge 10% Administrative Fee . I\'f;....~~." ,,,,,",,,:,,,,,,,,..,:.,:. i;"J.""'-.-....;;;~.._...-I-""-..;;....~..-:;-~=-.; 'U-1 2 '(,e(JN!M<i;J()'!!'rNST1fIJ:A.,. 'U,,!wOl\jIirl . ~~~~~:':~:.!;1C;;._...C"""_'M" J.~b~t'..~ .."t. Electrical Contractor . 'u G Phone I../M-IJ3Y1 Address CJ!P:l , City~ Expiration Date The installation is being made on property I own which is not intended, for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 A. f~~~lB~ili~i!.~;j$l~g1~:~f-1_ij~lti~!;wlfr~~fti!,)ri~ifn~~ Service Included 1000 sq. ft. or less Each additional 500 sq, ft, or portion thereof $106,00 $19,00 Each Manufact'd Home or ~:'~"6~CI~:g Service or $50.00 B ~~~~:~"..~~Xj~;IJ:)~. I,!tiil\'~a~t?,:'t3ht'" f:n;.~,ff ~~.9!,...~,<:.. "j '1 . "..,.~ryl,. ~Rm,' -' ~~~~Vf!!L~~~~!~J?'~:,:rJ 2oo~~ED OR IS ABANDONE!\'i9.\Jo 201~tQ~ERIOD. $75.00 40 I Amps to 600 Amps $125.00 601 Amps to 1000 Amps $163.00 Over 1000 AmpsIVolts '$375,00 Reconnect Only $ 50,00 - .. TOTAL 11 ~ 'cp-- " :';;:0 /55.3S Shared Drive(T:)lBuilding FormsIElectrical Pennit Applic'ation 1.Q3.doc 225 Fifth Street Springficid, Oregon 97477 . 541-726-3759 Phone . J7~~ ~. _ of Springfield Official Receipt .elopment Services Department Public Works Department Job/Journal Number COM2006-00963 COM2006-00963 COM2006-00963 COM2006-00963 COM2006-00963 Payments: Type of Payment Cred itCard cReccinll RECEIPT #: 2200600000000001347 Date: 09/25/2006 Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By LISA D, GRAY Item Total: Lheck Number Authorization Received By Batch Number . Number How Received njm 025388 In Person Payment Total: Page 1 of I 2:34:35PM Amount Due 43,00 2,00 2,25 3,60 4,50 $55.35 Amount Paid $55.35 $55.35 9/25/2006 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00963 ISSUED: 09/06/2006 APPLIED: 07/3112006 EXPIRES: 03/2512007 VALUE: $ 13,728.00 Status Issued 225 Fifth Street, Springfield. OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 438 SCOTTS GLEN DR ASSESSOR'S PARCEL NO.: 1703271304500 Springfield TYPE OF WORK: Garage TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Garage Owner: LOCHA VEN LLC Address: PO BOX 22623 EUGENE OR 97402 Phone Number: 541-688-7523 I CONTRACTOR INFORMATION' Contractor Type General Electrical Contractor HARRISON JACOBSON INC MAG ELECTRIC INC License 66447 149834 Expiration Date 05/07/2007 12/13/2009 Phone 541-689-7762 541-461-0387 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: u # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 1 Lot Size: 12.00 Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: n/a Occupant Load: 528 VN I DEVELOPMENT INFORMATION , REQUIRED PARKING Total: 2 Handicapped: Compact: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay DiSl: 8.60 # Street Trees Rqd: Paved Drive Rqd: 14.60 % of Lot Coverage: 26.00 0,00 I PUBLIC IMPROVEMENTS I Street Improvements: . F II I ,d , u v mproveffS yUU 10 Storm Sewer AA'til~,q:nON:Oregon law ril4ll{1es Utility SpeciallnstructlR8w' rul~ adopted by the Oregon t fort\" TO Th e rules are se "ication Center. os 52-001 Notes: St<!,,lb1tUJAlW9!:2~r,I>j&ogqtjll.tlroU9h OAR 9 I b In 0 btain copies of the ru es ) 0090. You may 0 'ote' the telephone calling the cenoter. (N n utility Notification number for the rego ) Center Is 1_800-332-2344 . Sidewalk Type: Downspouts/Drains: Cu rbside 5' Curb and Gutter NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Paee 1 of 3 -~~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Garaee Ga raee Fee Description Plan Review Residential + 10% Administrative Fee + 8% State Surcharge Building Permit Fire SF Fee - Residential Plan Review Minor - Planning SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer. 1st 50 Feet + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Paid Initial Review Plannine Review Public Works Review Structural Review . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00963 ISSUED: 09/06/2006 APPLIED: 07/31/2006 EXPIRES: 03/25/2007 VALUE: $ 13,728.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $26.00 Square Footage or Bid Amount 528.00 Value Date Calculated Total Value of Project $13,728.00 $13,728.00 07/31/2006 F..... P1W Amount Paid Date Paid Receipt Number $90.09 $21.00 $14.69 $138.60 $26.40 $112.00 $11.23 $224.53 $45.00 $4.50 $2.25 $3.60 $43.00 $2.00 7/31/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/25/06 9/25/06 9/25/06 9/25/06 9/25/06 1200600000000001165 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 2200600000000001347 2200600000000001347 2200600000000001347 2200600000000001347 2200600000000001347 $738.89 I Plan Reviews I 08/01/2006 08/01/2006 08/01/2006 08/01/2006 08/01/2006 08/18/2006 08/07/2006 09/05/2006 APP LLH APP TAJ APP JLP APP DLM Storm Drainage to curb & gutter. Approved as submitted To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. ~prtinn~ I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Paee 2 of 3 . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2006-00963 ISSUED: 09/06/2006 APPLIED: 07/31/2006 EXPIRES: 03/25/2007 VALUE: $ 13,728.00 Status Issued 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 1 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 orany 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. Owner or Contractors Signature Date Paee 3 of 3 -~.~ fIi ~. . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2006-00963 ISSUED: 09/06/2006 APPLIED: 07/31/2006 EXPIRES: 03/06/2007 VALUE: $ 13,728.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 438 SCOTTS GLEN DR ASSESSOR'S PARCEL NO.: 1703271304500 Springfield TYPE OF WORK: Garage PROJECT DESCRIPTION: Garage AT;"''':I'"'iI'' C:r,Y,P.CE10I\\.USE: ,'lreAddition Residential oJ.., -..' IU:~ ......"1'-" ~ yuu lU k"".' n,':c 2:'C,:;~< b;'the Orcgon Utility " . ~;~, l ~. '+-=-r T:,,",,,,,,,,,,, d,..", .......... ....,..,+ f,..,......... i:~'" ,...:" ~Jl.~::;10throu[]h OP.li'o'iie:Niliitber: 541-688-7523 C~ ,'~, Y':u r71';' ou:~in COpi3S of the rules by C,' ";, the cu,sr. (~!ole: tile telephone Owner: LOCHA VEN LLC Address: PO BOX 22623 EUGENE OR 97402 ..-.,.-.--. '..... "''-' ...........::.:V11 VLllILY l'iv..lI'.....a~lull I CONTRACTOR 1i'IFORMATION<"",-2344). Contractor Type General Contractor HARRISON JACOBSON INC License 66447 Expiration Date 05/07/2007 Phone 541-689-7762 BUILDING INFORMA nON, # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: U # of Stories: p I Lot Size: Height of Structure 12.00 Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type; QTIC~: Sq Ft Basement: Range Type':HIS PE:RMI r SHALL EXFM[F!tGp,r,tg~/.S~~Rort Energy Path: "'R THISq-Ft-Othe'I:' .'OT Sprinkled B~\iJi~~:RIZED UNriif Ofc\;~~\n'Lo'l.d1 rm",nlrl=n nr:ll~ ARAIIIIIlIi\lI-IJ HIK I DEVELOPMENT INF.ORMAifJONc,IOD, 528 VN REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 8.60 Overlay'Dist: · # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total:'" 2 Handicapped: Compact: , . 14.60 0.00 26.00 I PUBLIC IMPROVEMENTS' Street Improvements: Storm Sewer Available: Special Instruction: Fullv Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter Notes: Storm water to curb & gutter. I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of2 . Status Issued 225 Fifth Street, Springfield, OR 541- 726-3 753 Phone 541-726-3676 Fax 541-726-3769 I nspection Line Garaee Garaee Fee Description Plan Review Residential + 10% Administrative Fee + 8% State Surcharge Building Permit Fire SF Fee - Residential Plan Review Minor - Planning SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Total Amount Paid Initial Review Plannine Review Public Works Review Structural Review 08/01/2006 08/01/2006 08/01/2006 08/01/2006 $26.00 Total Value of Project Fees Paid I Amount Paid Date Paid . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2006-00963 ISSUED: 09/06/2006 APPLIED: 07/31/2006 EXPIRES: 03/06/2007 VALUE: $ 13,728.00 528.00 07/31/2006 $90.09 $21.00 $14.69 $\38.60 $26.40 $112.00 $11.23 $224,53 $45,00 7/31/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 9/6/06 $13,728.00 $13,728.00 Receipt Number 1200600000000001165 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 1200600000000001376 Storm Drainage to curb & gutter. Approved as submitted To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. $683.54 I Plan Reviews I 08/01/2006 08/18/2006 08/07/2006 09/05/2006 APP LLH APP TAJ APP JLP APP DLM 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 constructio . /' Owner or Contrac I Reouired Insoections , Paee 2 of2 1-6-0fb Date ~ CITY OF aNGFIELD SYSTEMS DEVELOPMEaORKSHEET JOURNAL OR JOB NUMBER: C0M2006-00963 NAME OR COMPANY: Loehaven LLC LOCATION: 438 Scotts Glen Dr TAX LOT NUMBER: 1703271304500 DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE NEW DWELLING UNITS 0 BUILDING SIZE (SF' 384 LOT SIZE (SF): 1. STORM DRAINAGE o If:- II ~ 10 I~ I~ tIl (3 ~ DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F, x I COST PER S.F, I CHARGE I 669.00 I $0.336 = I $224,53 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F, I x I COST PER S.F, I x I DISCOUNT RATE I I I 0.00 I $0.336 I 50% I = DISCOUNT $0,00 ITEM I TOTAL - STORM DRAINAGE SDC 5224.53 $224.53 1070 2 SANITARY SEWER - r.ITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 0 I COST PER DFU $26,03 $0.00 11091 8. IMPROVEMENT COST: I NUMBER OF DFU's I x o I $19,79 ITEM 2 TOTAL - CITY SANITARY SEWER SDC $0,00 11092 = , $0.00 3, TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRlPRATE I x I NUMBER OF UNITS I x I COST PER TRIP x I NEW TRIP F ACfORI I 9.57 I 0 I I $19,81 I 1.00 $0.00 f093 8. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEWTRIPFACTORI 9.57 I 0 I I $87.39 I 1.00 I $0,00 11094 ITEM 3 TOTAL - TRANSPORTATION SDC =, $0.00 I 4. SANITARY SEWER - >,fWMC A, REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I 0 I I $91.61 = $0.00 1054 8. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I 0 I $961.52 = $0.00 '11055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054 MWMC ADMINISTRATIVE FEE $0,00 11056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $0.00 I SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , $224.53 I 5. ADMINISTRATIVE FEE: I SUBTOTAL x I ADM, FEE RATE 1= CHARGE $224,53 I 5% I $11.23 TOTAL SANITARY ADMINISTRATION FEE: 11.23 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $0,00 11078 Jeff Prociw 8115/2006 TOTAL SDC CHARGES = , $235.76 PREPARED BY DATE -.--.. -.- . . . . , DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIX11JRES x UNIT EQUIVALENT' DRAINAGE FIXTURE UNITS (NOTE, FOR REMODELS. CALCULATE ONL V TIlE NET ADDmONAL FIXTURES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EOUIV ALENT UNITS BATHTUB 0 0 3 = 0 DRINKING FOUNTAlN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC, 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 0 0 3 = 0 CLOTHESWASHER - 3 OR MORE (EAl 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0 I RECEPTOR FOR COM, SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER. SINGLE STALL 0 0 2 = 0 I SHOWER. GANG (NUMBER OF HEADSl 0 0 2 = 0 ISINK: COMMERCIAURESIDENllAL KITCHEN 0 0 3 = 0 I SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0 I SINK: SINGLE LA V A TORY /RESIDENTIAL BAR 0 0 1 = 0 'I I URINAL, STALL / WALL 0 0 5 = 0 I ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 I ITOILET. PRIVATE INSTALLATION 0 0 3 = 0 I MISCELLANEOUS DFU TYPE NUMBER OF EDU'S !I 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 .EDU (EQuivalent DwelJin,e; Unit) is a disc~ eQuivalent to D sincle family dwellin~ unit (20 OFU's) set at 167 ~lons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATfj$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 I 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 ~ , SO.OO CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/IOOO CREDIT RATE $0,00 x $5.29 = I o TOTAL MWMC CREDIT $0.00 = 225 Fjfth Street " Springfield, Oregon 97477 541-726-3759 Phone . "j:~~;~ ~'" ~ llii& of Springfield Official Receipt _elopment Services Department Public Works Department Job/Journal Number COM2006-00963 COM2006-00963 COM2006-00963 COM2006-00963 COM2006-00963 COM2006-00963 COM2006-00963 COM2006-00963 Payments: Type of Payment Check cRcceintl RECEIPT #: 1200600000000001376 Date: 09/06/2006 Description Fire SF Fee - Residential Storm Drainage Impervious Area SDC Sanitary/Storm Admin Plan Review Minor - Planning Building Permit Storm Sewer - 1st 50 Feet + 8% State Surcharge + 10% Administrative Fee Paid By GOODEN-HARRISON Item Total: Check Number Authorization Received By Batch Number Number How Received njm 9765 In Person Payment Total: Page I of I 8:18:24AM Amount Due 26.40 224,53 11.23 112.00 138,60 45,00 14,69 21.00 $593,45 Amount Paid $593.45 $593.45 9/6/2006