HomeMy WebLinkAboutPermit Building 2005-9-6
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CITY OF SPRINGFIELD .
Building/Combination Permit
PERMIT NO: COM2005-01211
ISSUED: 09/06/2005
APPLIED: 09/06/2005
EXPIRES: 03/06/2006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
I 541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 2727 Game Farm Rd
ASSESSOR'S PARCEL NO.: 1703224105700
Springfield TYPE OF
Site Work Only
PROJECT DESCRIPTION: Install water line to lot 2 Cline partition
TYPE OF USE: New
Residential
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- Owner: CLINE RALPH G JR & BETrY A
Address: 1150 WIDSTLERS LN \0
ROSEBURG OR 97470 C; '10'\,\'1
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~o(\ \'3' \,\\e C IC@N'IRAeTOR INFORMATION I
- . Ole 0'0'1 (\)\1. ~~ - ~e'" - .
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Contractor TyQll:.~ ~o.!itr~ft6r (0\)<:(, 0\ oiS'e (\,\\of' ,1'0 License
. Plumbing ~ \:>1 \\)\'F;~R't~'S(;)1~!,~:!36\'I~l'Rl{C;;i!'jON INC 312
~o~~~\C'3-\~~'2:Cl<;) ~ ~'O\'3-\" ~o.:) ,inlliomG INFORMA nON,
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# of Units: \(\()\f<l<;)'-{O ~ \,\\0 C;oiS'e O'~.'O()()'~ # of Stories:
Primary Occupancy <{PIiIP..e(\o\ ~e\\C; Height of
Secondary Occupancy(\\)~O Cef' Type of Heat:
P'rimary Construction Type Water Type:
Secondary Construction Range Type:
# of Bedrooms: Energy Path:
Sprinkled nla
I DEVELun,IENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
. Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Street
Storm Sewer Available:
Special Instruction:
Notes:
....
I Valuation Descriotion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
1 of 2
,
Expiration Date
11/24/2007
Phone
503-769-7751
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
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.
CITY OF SPRINGFIELD .
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-01211
ISSUED: 09/06/2005
APPLIED: 09/06/2005
EXPIRES: 03/06/2006
VALUE:
Total Value of Project
Fl'l'stlWU
~. Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - 1st 50 Feet
Water Line - Each AddU 1 00'
Amount Paid
Date Paid
55.90
54.13
545.00
514.00
9/6/05
9/6/05
9/6/05
9/6/05
Receipt Number
1200500000000001308
1200500000000001308
1200500000000001308
1200500000000001308
Total Amount
569.03
I Plan Reviews I
To Request an inspection caD 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. wiD be made the following
work day.
-'
IRl'n~
Water 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 wiD 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 wiD remain on the site
~uring constructiolL
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. ,-
Owner or Contractors Signature Date
2 of 2
225 Fifth Street
SpribgfiehJ, Oregon 97477
! 541-726-3759 Phone
Job/Journal Number
COM2005,01211
COM2005-01211
COM2005-01211
COM2005-01211
Payments:
Type of Payment
CreditCard
...
,
,
,
9/6/2005
.
RECEIPT #:
Description
Water Line - 1st 50 Feet
Water Line - Each Addtl 100'
+ 7% Slate Surcharge
+ 10% Administrative Fee
Paid By
RALPH CLINE
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WiL.
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..ity of Springfield Official Receipt.
.evelopment Services Department
Public Works Department '
1200500000000001308
Date: 09/06/2005
Item Total:
Check Number Aulhorization
Received By Batch N umber Number How Received
DJB 086681 In Person
Payment Total:
I of I
2:37:22PM
Am...nt Due
45.00
14,00
4.13
5.90
$69.03
Amount Paid
$69.03
$69.03