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glglq <br />City of Eugene <br />Permit and Information Center <br />Eugene, OR 97401 (541) 682-5086 <br />Owner: <br />Phone: ( ) - <br />4ek ~ <br />JW INVOICE <br />Log Number 10- 04526- 01 <br />Cashier EFS <br />Site Address : <br />28715 AIRPORT RD <br />Invoice Date 09/01/10 <br />Extension PDD/BPS <br />Alter/Remodel Project Name: <br />f <br />Y•• <br />`~oan <br />"m <br />~:.De`scn 'fion .A <br />G o. <br />a. <br />151-4211-45226-000-000000 Building Plan Check Admin Fee (9%) 3.33 <br />151-4211-45226-000-000000 Building Admin Fee,. State (9%) 5.13 <br />151-4243-42551-000-000000 Building Permit Fee per BLDG DIV Value 57.00 <br />'159-4243-45578-000-000000 Building Plan Check per Applicant Value 37.05 <br />151-9951-45989-000-000000 State Surcharge, Structural (12%) 7.46 <br />Bill City of Eugene: GJN - 511-9131, Dan Durazo,*541-682-5883 aE- <br />~373~1 <br />Amount Due: 109.97 <br />Questions concerning this invoice? MAKE ALL CHECKS PAYABLE TO: <br />Call: Nancy Rich City of Eugene <br />(541) 682-5456 Finance Department <br />PO Box 1967 <br />Eugene, OR 97440 <br />THANK YOU FOR YOUR BUSINESS! <br />Customer Copy ❑ PIC Copy ❑ Finance Copy <br />Page 1 of 1 <br />