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Home My WebLink AboutPermit Encroachment 2005-2-22 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2005-00119 ISSUED: 02/2212005 APPLIED: 01/31/2005 EXPIRES: 08/2212005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4155 CAMELLIA ST ASSESSOR'S PARCEL NO.: 1702323303700 Springfield TYPE OF WORK: Right of Way Permit TYPE OF USE: use initials PROJECT DESCRIPTION: Encroachment permit-sanitary sewer wye installed Residential Owner: RAKOCZYIWELKER ENTERPRISES INC Address: 3496 AMBLES IDE DR SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor RAKOCZY WELKER ENTERPRISES INC License 56636 Expiration Date 05/22/2006 Phone 541-895-8606 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: #of Bedrooms: BUILDING INFORMATION ATTENTIO : Oregon aw req s you to follow libfi3imr~ted by the Oregon Utility Lot Size: NotificatMfl~Mtf~r"'fW!l~ rules are set forthSq Ft 1st Floor: in OAR ~tJB~ ~O through OAR 952-001-8q Ft 2nd Floor: 0090. Yat~~~B~ain copies of the rules bySq Ft Basement: callin Rffleec ~" (Note: the telephone Sq Ft GaragelCarport b iJWrRbe. ~119!l Utility Notification Sq Ft Other: nurn ~J~~f~S f-i!~1832-2344)~/a Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: N(]l~CE: of Lot Coverage: THI~ D~D~AIT C:Wfd I J:)(DI~I= 11= THF WORK PiQ,-!t,.Ll~v-'~~J(~~YBMF)lNTS' KMIT IS NOT COMMENC U K I~ AtH\\ uNED SiQ~alk Type: Fully II}W{'fv-fgo DAY PERIOD. Yes DownspoutslDrains: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: , Special Instruction: Curbside 5' Notes: Encroachment-sanitary sewer wye I Valuation DescriPtion' Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 .~~~I!!,~j~FlJI~~J J. ..:." " F Status Issued , CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00119 ISSUED: 02/22/2005 APPLIED: 01/31/2005 EXPIRES: 08/22/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line, Total Value of Project L Fees Paid I .. Fee Description Encroachment Permit + 10% Administrative Fee + 7% State Surcharge Sanitary Sewer -1st 50 Feet Sanitary Sewer Each Addt1100' Amount Paid Date Paid Receipt Number $120.00 1/31/05 2200500000000000111 $5.90 2/22/05 1200500000000000234 $4.13 2/22/05 1200500000000000234' $45.00 ' 2/22/05 1200500000000000234 $14.00 2/22/05 ' 1200500000000000234 Total Amount Paid $189.03 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. Allinspection 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. L Reouired Insnections I Sanitary Sewer Line: Prior to filling trench and including required testing. 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 d::-rJstru;;on~? J . _ ~:: D ~ l 2-22-0) j Owner or Contractors Signature Date Pa2e 2 of2 225 Fifth Street Springfi"eh1, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department Public Works Department Job/Journal Number COM2005-00 119 COM2005-00119 COM2005-00119 COM2005-00 119 Payments: Type of Payment CreditCard 2/2212005 RECEIPT #: 1200500000000000234 Date: 02/22/2005 Description Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtl 100' + 7% State Surcharge + 10% Administrative Fee Paid By PAUL RAKOCZY Item Total: Check Number Authorization Received By Batch Number Number How Received djb 022118 In Person Payment Total: Page 1 of 1 2:21:30PM Amount Due 45.00 14.00 4.13 5.90 $69.03 Amount Paid $69.03 $69.03