HomeMy WebLinkAboutPermit Building 2005-9-6
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01213
ISSUED: 09/06/2005
APPLIED: 09/0612005
EXPIRES: 03/06/2006
VALUE:
.
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2711 Game Farm Rd
ASSESSOR'S PARCEL NO.: 1703224105700
Springfield TYPE OF
Site Work Only
PROJECT DESCRIPTION: Install water line to lot 4 Cline partition
TYPE OF USE: New
Residential
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Owner:
Address:
CLlNE RALPH G JR & BE'ITY A
1150 wmsrLERS LN
ROSEBURG OR 97470 'leS '10U to
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10\IOo.N lules tel. \ u-,.- h o"'~ "''''~ -
Contf3!:to~ion ~~,oo,o thlOu9 01 the luleti:1ense
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009U\.\.~v9~t~e ';Bl'ln:;nING INFOJiMATioNI
ca \" J I . '" f
bel 101 \11" ' . - 0_33"""'" .
nu('(l centel \~\;F~tories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Patb:
Sprinkled
Contractor Type
Plumbing
# of Units:
Primary Occupancy Group:
Secondary Occupancy
P'rlmary Construction Type
Secondary Construction
# of Bedrooms:
nla
I DEVELOPMENT INFORMATION'
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
I 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
.
. CITY UJ' M"KlNGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01213
ISSUED: 09/06/2005
APPLIED: 09/06/2005
EXPIRES: 03/06/2006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
~~ Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - 1st 50 Feet
Water Line - Each Addtll00'
Amount Paid Date Paid Receipt Number
$7.30 9/6/05 1200500000000001306
$5.11 9/6/05 1200500000000001306
$45.00 9/6/05 1200500000000001306
$28.00 9/6/05 1200500000000001306
Total Amount
$85.41
I Plan Reviews I
To Request an illSpection 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.
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 ofthe 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.
1 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
at all times during constructlolL
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Owner or Contractors Signature
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Date
2 of 2
225 Fifth Street
Springneld, Oregon 97477
541-726-3759 Phone
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~ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Job/Journal Number
COM2005-01213
COM2005,Ol213
COM2005-01213
,
COM2005,Ol213
Payments:
TWe of Payment
CreditCard
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9/6/2005
RECEIPT #:
1200500000000001306
Date: 09/06/2005
Description
Water Line, 15t 50 Feet
Water Line - Each AddtllOO'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
RALPH CLINE
Received By
OJB
1 of I
Item Total:
Lheck Number Autbortzatton
Batch Number Number How Received
086681 In Person;
Payment Total:
2:36:05PM
Amount Due
45.00
28.00
5.11
7.30
$85.41
Amount Paid
$85.41
$85.41