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Home My WebLink AboutPermit Building 2006-7-10 (2) Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1055 PRESCOTT LN ASSESSOR'S PARCEL NO,: 1703341106000 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00644 ISSUED: 0711012006 APPLIED: 05130/2006 EXPIRES: 0111012007 VALUE: $ 151,995.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - Previous residence demolished 2/22/06 Overlay Dist: # Street Trees Rqd: 1 Paved Drive RA~: V~t t ~r:f;1J~'€~te'r\ff~on law requlr~r u.o follow ruleR adopled by the Orego tlllty ...........;........+;n" r.entor Thn~p. rules are set forth I PUB/1,[0'~MP.Re~E1MEllWs.uugh OAR 952-001- uu~u. IOU III"Y uU1al"u~pies 9f the rules by Partially Improved calling the center, (Note: t~iJIfJ1'~~~l~r1l!.e: Yesnumber for the Oregon Utili~bWiis!PouaID1rains: Center is 1-800-332-2344). Owner: DONALD CANAVAN Address: 1540 JEFFERSON ST EUGENE OR 97402 Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construclion Type Secondary Construction Type: # of Bedrooms: I R-3 U VN Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 26,00 6,60 10,00 34,00 17,50 Street Improvements: Storm Sewer Available: Special Instruction: Residential Phone Number: 541-344-4864 .' I CON'J:RACTOR INFORMATION. E WORK .. - - RMI1 SHI\LL tl\nnc 11 fH 'c: ~'n1 .. 1HIS ~ERIZED UNDER 'mc.ense''l,MITExpiration Date AU1H CED OR IS ABI\NDONED FOK . COMMEN I\NY 180 Dil-Y PERIOD. Phone '1 BUILDING INFORMATION I 3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Fl 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: 210 2 27.00 Wall Heat Electric Electric Path I nla 1,495 I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: 2 Handicapped: Compact: To Storm Sewer Notes: Storm drainage piped to storm main line;Dedication and Improvement Agreement signed 6/16/06 CAS Paee I of 4 .CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00644 ISSUED: 07110/2006 APPLIED: 05/30/2006 EXPIRES: 01/1012007 VALUE: $ 151,995.00 . Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Description $ Per Sq Ft or multiplier $19,00 $99.00 Square Footage or Bid Amount 210,00 1,495,00 Carport Dwellings Tvpe of Construction Carport V Wood Frame Total Value of Project 1-FIPIP~ P'1iriJ Value Date Calculated $3,990,00 $148,005,00 $151,995.00 05/30/2006 05/30/2006 Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $477.52 5/30/06 1200600000000000723 -Mechanical Issuance Fee- $10.00 7/10/06 1200600000000001042 + 10% Administrative Fee $116.87 7/10/06 1200600000000001042 + 8% Slate Surcharge $93.49 7/10/06 1200600000000001042 2 Baths One or Two Family $254.00 7/10/06 1200600000000001042 Building Permit $734,65 7/10/06 1200600000000001042 Dryer Vent $6.00 7/10/06 1200600000000001042 Encroachment Permit $130,00 7/10/06 1200600000000001042 Exhaust Hoods $9,00 7/10/06 1200600000000001042 MinimumlAdjustment Mechanical $28,00 7/10/06 1200600000000001042 Plan Review Major - Planning $198,00 7/1 0/06 1200600000000001042 Residence Wiring 1000 Sq Ft $106,00 7/10/06 1200600000000001042 Residence Wiring Ea Addtl 500 $19,00 7/10/06 1200600000000001042 Sanitary Sewer - Improvement $133,49 7/10/06 1200600000000001042 Sanitary Sewer - Reimbursement $175,49 7/1 0/06 1200600000000001042 SDC SanitarylStorm Admin $18,82 7/10/06 1200600000000001042 Storm Drainage Impervious Area $67,33 7/10/06 1200600000000001042 Vent Fan $12,00 7/10/06 1200600000000001042 Total Amount Paid $2,589.66 I Plan Reviews I Initial Review 06/01/2006 APP LLH 06/01/2006 Plannine Review 06/01/2006 06/26/2006 APP T AJ Paee 2 of 4 Exempt from Willamalane, Fire Fee, and Addressing fee because previous residence was demolished within 2 years of new construction. First 18' of drive needs to be paved if Prescott is a curb & gutter street, A street tree is required only if there isn't one now. . . CITY OF SPRIr~t.J' IELD Building/Combination Permit PERMIT NO: COM2006-00644 ISSUED: 07110/2006 APPLIED: 05/30/2006 EXPIRES: 0111012007 VALUE: $ 151,995.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Public Works Review 06/0112006 06/0212006 APP CAS Improvement Agreement and Dedication signed 6/16/2006 Encroachment added to building permit form must be completed in building packet; STM into main on Prescott 6/1106 CAS 06101/2006 06/1312006 OK RJB Structural Review 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. I Rp~ In~,npction~ I ErosionlGrading Inspection: Prior to ground disturbance and after erosion measures are installed, Encroachment: After item(s) have been removed to inspect condition of public right of way, Ufer Electrical Ground: Install ground rod at footing and eall for inspection in conjunction with footing andlor foundation inspection. Footing: After trenehes 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 decking, Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved, Wall Insulation: Prior 10 cover, Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. 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, 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, Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Temporary Electric: Approval required prior to Utility Company energizing pole, Page 3 of 4 . .CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00644 ISSUED: 07110/2006 APPLIED: 0513012006 EXPIRES: 0111012007 VALUE: $ 151,995.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work 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 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, tha he permit card is located at the front of the property, and the approved set of plans will remain on lhe site at all times d ing onstr~ _ .. . ((lP;M _(~DoA- 7 -10 -2006 CJ - - Owner or Contractors Signature Oat. Pa~e 4 of 4 SPRIN~.P L ,_Jy.;l:-l^- 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S4I)726-3753 . FAX: (541)726-3689 ! -- j~~-. ( ~~~ ELECTRICAL PERMIT APP,LICATION ' " ~~~- City Job Number (\l..o .\o4c~ Date '1-\0 - ~ ~ I. LLOCA110NOFINS1'ALLATION 3, I COMPLErE FEE SCHEDULE BELOW \D'f;~-~~~ LEGAL DESCRIPTION \."'1Dn ~-\\ \ , CITY OF SPRINGFIELD, OREGON Each Manufact'd Home or Modular Dwelling Service or $50.00 Feeder . es you to "-:-.... 1-:a'fIIJ..EtQ\.J\r _ I CONTRAcrOR INSTALLATION ONLY i 'J~~?J Se-rv!~~':nr. Feedffi~ ~Ii~~'\tion, Alterations or Relocation: / . Those rUle~ a'O ~_t_ "J I ;:r;n%bAm or leSsOI\R 952.001- $ 63.00 . C'l 001-lIu I U ,!,*"u~ I by . " "c~ 201 Aml1s'lo:400rAmp~ ru es $ 75.00 Y may nuta" , v-r'. I hone l,v~v. au 4~ I A NllQJiOQll\mll~P . $125.00 culling the ce;:.o~ 111;. slld..i'iii)()lklRJ~icatlon $163.00 number for t\.~ ~:mM..,_nfrt1)' $375.00 CentE;'!' \'5' I 1U1tpSIYO Reconneet Only $ 50.00 n\rifD JOB Q.ESCRIPTION ~..<u~tiL ~ontlomf Permits Dr ~on-transferable an~xpire if work is not started witbin 180 days of issuance or if work is Suspended for 180 days. City Expiration Date (\ City .~ OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. 0~~a1J~ Inspection Request: 726-3769 A. I New Residential- Single or Multi-Family per dwelling unit. J Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof I Z- $ 19.00 $106.00 lOb 3g- c. I Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps f\ "If)'$luo.oo O~Ampsor 10~c\\llI~~(\i qt~B\-l.~~h,Q!~cuiff-\. n-"II'\~ '....,,1'11'1''', 'W,\~ fl."~ n IINJL\' ~~\\)\)\'''' ~~AHI'r.tlion oG~'\tsl\sibn Per Panel o\'~ VCp\tlC:r.\) I'?<\G\.\. EaQ: ~'dltionaed~cuit or with SerVi'ce "oPFeeder Permit ,.. , $.43.00 $ 3.00 Eo J Miscellaneous (Scr\'ice/feed~~lOt i~,-~h;ded) -Ellch Installation 1 P~mp or irrigation Sign/Outline Lighting Limited EnergylResidential Limited EnergylCommercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Elcctrie Permit Inspection Fee is $45,00 + Surcharges 4.1 SUB'rOTAL OF ABOVE 1'1'1 1/52- /1.{ I(() /(,'111= 8% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FormslElectrical Pennit Application 1-06.doc = SO.OO !11055 SO.OO 1054 SO.OO 11056 SO.OO -' $376.31 I CHARGE I S18.82 I 18.82 J 1079 SO.OO 1078 I TOTAL SDC CHARGES =, $395.13 ~ II CITY OF StlNGFIELD SYSTEMS DEVELOPME.ORKSHEET JOURNAL OR JOB NUMBER: COM2006-00644revised NAME OR COMPANY: Don Osteen LOCATION: 1055 Prescott Lane TAX LOT NUMBER: 1703341106000 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 0 BUILDING SIZE (SF' 1022 LOT SIZE (SF): I. STORM DRAINAGE 5000 DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I I 208.46 I S0.323 I = I $67.33 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 I $0.323 I I 50010 = I ITEM I TOTAL - STORM DRAINAGE SDC $67.33 ~ 2. SANITARY SEWER - DTY DISCOUNT $0.00 $67.33 A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 7 I COST PER DFU $25.07 S175.49 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 7 I S19.07 ITEM 2 TOTAL - CITY SANITARY SEWER SDC S133.49 =, $308,98 J. TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIP RATE I x I 9.57 , x I COST PER TRIP x I NEW TRIP F ACTORI S19.09 I 1.00 I x I COST PER TRIP x INEWTRIPFACTORI $84.19 I 1.00 = , = , SO.OO I NUMBER OF UNITS I I 0 I SO.OO B. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I I 9.57 I 0 I ITEM 3 TOTAL - TRANSPORT AnON SDC SO.OO 4. SANITARY SEWER - MWMG A. REIMBURSEMENT COST: IN UMBER OF FEU's I x I 0 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU o I I $865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) ICOST PER FEU I $82.03 = SO.OO MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , SUBTOTAL (ADD ITEMS t, 2. 3, & 4) ~ , 5. ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE I~ I $376.31 I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Cheryl Slaymaker 6/212006 PREPARED BY DATE r- I'" w I@ I~ w I- '" (3 ~ 1070 11091 I '11092 1093 11094 I 1054 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW RX11JRES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONL V TIlE NET ADDmONAL RX11JRES) NO. CF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS I BATHTUB 1 1 3 = 0 IDRlNKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE I OIL I SOLIDS I Ere. 0 0 3 = 0 IINTERCEPTORS FOR SAND I AUTO WASH I ETe. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER I MOP SINK 1 1 3 = 0 I CLOTHESW ASHER - 3 OR MORE (EAl 0 0 6 = 0 I MOBILE HOME PARK TRAP (l PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRlG I WATER STATION I ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK I DISHWASHER I ETe. 0 0 3 = 0 I SHOWER. SINGLE STALL 1 0 2 = 2 I SHOWER. GANG (NUMBER OF HEADSl. 0 0 2 = 0 I SINK: COMMERCIAlJRESIDENT1AL KJTCHEN 1 1 3 = 0 I SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASINIDOUBLE LAVATORY 1 0 2 = 2 I ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 1 1 = 0 I I URINAL. STALL I WALL 0 0 5 = 0 I ~ro1LET, PUBLIC INSTALLATION 0 0 6 = 0 I TOILET. PRIVATE INST ALLA TION 2 1 3 = 3 I MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 7 .EDU (EQuivalent Dwellin.g Unit) is a dischar~ cauivalent to 8 single familv dwellinJ!: unit (20 DFU's) set at 167 ltllllons oer day - MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/SI,OOO ANNEXED ASSESSED VALUE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 2 I BEFORE 1979 $5.29 (Enter 1 for Yes, 2 for No) I 1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 2 I 1980 $5.19 (Enter 1 for Yes, 2 for No) I 1981 $5.12 BASE YEAR 1979 I 1982 $4.98 I 1983 $4.80 CREDIT FOR LAND (IF APPLICABLE) I 1984 $4.63 VALUE I 1000 CREDIT RATE I 1985 $4.40 SO.OO x $5.29 ~ , $0.00 " I 1986 $4.07 I ]987 $3.67 CREDIT FOR IMPROVEMENT (IF AFfER ANNEXATION) I 1988 $3.22 VALUE I 1000 CREDIT RATE I 1989 $2.73 $0.00 x $5.29 0 I 1990 $2.25 I 1991 $1.80 I 1992 $1.59 TOTAL MWMC CREDIT = $0.00 , 1993 $1.45 I 1994 $1.25 I 1995 $1.09 I 1996 $0.92 I 1997 $0.72 I 1998 $0.48 I 1999 $0.28 I 2000 $0.09 I 2001 $0.05 (1),1 \, / ", .,' " ", . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: c..OyY\ e.oa -00 b t...{ if Address: / 0 S-~ rr E'SC.C tI- ~.<< Date: 7/.lob I I Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the app<upriate blanks and initial boxes I and 2, and either box 3A or 3B: 4"1. ~2. I own, reside in, or will reside in the completed structure, I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion, o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~ 3B. I will be my own general contractor, If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to. Property Owners about Construction Responsibilities on the reverse side of this form. lfL;v- 7- (0 ~O~ (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 Adnrrng fill~ ltll111T' (())wnn CGenneIrfillll C!~Irfill~~([DIr? +oJ . - . , ,- INFORi\IlA TION 'NOTICE TO PROPERTY OWNERS ABpuT CONSTRUCTION RESPONSIBiliTIES NOTE: This. Information Notice to Properly Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701,055(5), passed by the 1989 Oregon Legislature, If you are acting a~ your own contractor to construct a new home lIr make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. lEmjpllloyc!l" lRC!ljplolffi!lnlbiillntnc!l You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "emp]oyees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department lIfRevenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes.....- on the wages of all employees. For more information, call the Oregon Emp]oyment Department at 503-947- ]488. The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and'" Unemployment Insurance Tax. To file for a BIN, call 503-945-809] or www.dor.state.or.us/formsnav.htmll for the appropriate forms, Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' cvu,,,"usation insurance for your employees. If you fail to obtain workers' cvw,,"usation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job, For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815, U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wage~ You will be liabl.e for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call tIJe IRS at ]-800-829-4933 or visit their web site at \Wlw.irs.!!ov. Otllnu Resjpl(msnbnlln1l:nes ~llllnidl Al1'eas olf Conncel1'nns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and ~roperty Damage Insurance: Contact Yllur insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-462]) or write the agency at PO Box 14]40, Salem, OR 97309-5052. Property _ owner.doc 06-01-04 I 225 Fifth Street Springfield~ Oregon 97477 541-126-3759 Phone Job/Journal Number I COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 COM2006-00644 Payments: Type of Payment Cred itCard cReceintl . ~.. ~ <Aof Springfield Official Receipt _lopment Services Department Public Works Department RECEIPT #: 1200600000000001042 Date: 07110/2006 Description Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC SanitarylStorm Admin Building Permit 2 Baths One or Two Family Vent Fan Dryer Vent Exhaust Hoods -Mechanical Issuance Fee- Minimum/Adjustment Mechanical Encroachment Permit Plan Review Major - Planning Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 8% State Surcharge + 10% Administrative Fee Paid By DONALD CARA V AN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 040258 In Person Payment Total: Page I of I 10:22:20AM Amount Due 67.33 175.49 133.49 18.82 734.65 254.00 12.00 6.00 9.00 10.00 28.00 130.00 198.00 106.00 19.00 93.49 116.87 $2,112.14 Amount Paid $2,112.14 $2,112,14 7/10/2006