HomeMy WebLinkAboutPermit Building 2003-11-6
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2003-01111
ISSUED: 11/06/2003
APPLIED: 11/03/2003
EXPIRES: 05/0612004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 1083 A ST
ASSESSOR'S PARCEL NO.: 1703354103000
Springfield TYPE OF WORK: Fire Damage
TYPE OF USE:
Repair
Residential
PROJECT DESCRIPTION: Fire Damage to Single Family Residence
. Owner: JACK DRESSER
Address: 38131 MCKENZIE HWY SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Electrical
Contractor License Expiration Date
EUGENE ELECTRIC SERVICE INC 90200 03/P/2007
BUILDING INFORMATION' X ,\\'t. ~G~;
j..'r\'i'-'t. ~ ~\\ \'0 ~
# !f.\S~ies: ~~\.\. t: \'0 'r't.'r\ ~ Size:
~iiei~H:\~~~au~et.'i'- \~ ~'iI<\:l$\.t.'O Sq Ft 1st Floor:
,l\ype ?r';:~~li) \)\ \'0 ~'O" Sq Ft 2nd Floor:
~eff,l.~t~~t.\) G~'i'-\()G. Sq Ft Basement:
~~~I~~:G(l..i \' Sq Ft Garage/Carport
EnH~f I!llttl: Sq Ft Other:
l"1 Impervious Surface Area:
Phone
541-344-3561
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VN
SETBACKS
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist: \0 Total:
# Street Trees Rqd: Ites'lOU. .\!landicapped:
Paved Drive Rqd: 1'3-\N teo.u nO{\ \,\\111 Compact:
nO{\ Ote", e\ \01'
% of Lot Coveragere", A 'o'l \\le les '3-te s"" 00
N\ IV" \eU tU .., gJ<--
p..'\I€ ",IeS '3-0~~, \\lOs~,.n\lOp..,=~ {uleS I
I PUBLICThi:iiROVEMi~:rs., ~~. ~~?\es ~ \~\e?~OI~~{\
,- f\ "',,- ov.o.\. ~'e'. \\1 . In\\\IC'3-
{\ Op.. _I \l {l\'3-'l \et. \.~Siilew~,\lffFYP~:
\ gO ,0 ce{\ n{\ VI ?'3AA].
00 '\~\{\9 \\le .'{\e OteQ])myyspoutslDrains:
c'3- t ,ot' ,,, '\ .I'II)\J .
..{l\'oe ",'f" .
{\v ('-"
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation DescriDtion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paeelof2
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CITY OF I)nul~t.l'lELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2003-01111
ISSUED: 11/06/2003
APPLIED: 11/03/2003
EXPIRES: 05/06/2004
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fees Paid I
Fee Description
+ 10% Administrative Fee
.+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Perm Serv/Fdr 200 amps or less
Amount Paid
Date Paid
Receipt Number
$9.90
$6.93
$36.00
$63.00
II16/03
II16/03
II16103
II16/03
1200200000000002428
1200200000000002428
1200200000000002428
1200200000000002428
Total Amount Paid
$]]5.83
I Plan Reviews ,
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 Renuired Tnsneelinns'
I Rough Electric: Prior to Cover
2 Electric Service: Approval required prior to utility company energizing service.
3 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, 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 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
I '
Job/Journal Number
COM2003-01111
COM2003-0 1I11
COM2003-01111
COM2003-0 1I11
Payments:
Type of Payment
CreditCard
~
Receipt #: 1200200000000002428
Description
Perm ServlFdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
djb
Check Number
Batch Number Authorization Number
Paid By
EUGENE ELECTRIC
000214 006266
City of Springfield Official Receipt
Development Services Department
Public Works Department'
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Date: 11/06/2003
8:42:05AM
Amount Paid
Item Total:
63.00
36.00
6.93
9.90
$115.83
How Received
In Person
Payment Tota.:
Amount Paid
$115.83
$115.83
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