HomeMy WebLinkAboutPermit Building 2001-10-12
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I Job# 01-01126-01 I
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Page 1 of2
TRANS#:01-0006973
DATE:OCT 12 2001
AMT RECD:2 $ 265.75
CHANGE:
CASHIER:003
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-01126-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 4750 Franklin Blvd E-11 Spr
Assessors Map#: 1803031,1
Lot: Block: Addition:
Tax Lot #: 03500
Subdivision:
Owner:
Carlos Rodrigues
4750 Franklin D-2
Phone Number: 541-747-7651
City/State/Zip: Eugene, OR 97403
New Value: $1
Address:
Scope Of Work: Manufactured Home in Park
Replacement mobile home in park
Contractor Type
General Contr
Contractor
Mels Budget Homes
3980 Main St, Springfield, OR
Registration # Expiration Date
Phone
541-747-9585
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. Ail inspections 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
working day.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Plumbing
10/12/2001 6973
10/12/2001 6973
10/12/2001 6973
10/12/2001 6973
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Manufactured Home Connection
Administrative Fee - Plumbing
Total Plumbing
1
$,00
$3.15
$45,00
$3,60
$51.75
Manufactured Home Setup Fee
Manufactured Home
10/12/2001 6973
1
$160,00
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Job# 01-01126-01
Page 2 of2
Fee
Paid On Receipt#
Manufactured Home
10/12/2001 6973
10/12/2001 6973
10/12/2001 6973
Value/Quantity
Manufactured Home State Issuance
State Surcharge For Manufactured Hom,
Manufactured Home Administrative Fee
Total Manufactured Home
Grand Total
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 thl~ 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 conlractors and employees who are in compliance with ORS 701.055 will be used on
this project.
1
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
approv~#~/ at all times during construction.
Signature . /1 Date
Fee Amount
$30,00
$11,20
$12,80
$214.00
$265.75
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Job: 01-01126-01
Address:4750 E-11 Franklin Blvd
Owner: Carlos Rodrigues
I
Received: 10/12/200'
Unit: SLOG:
FEE DETAILS
Fees
Value/Quantity
Manufactured Home
Subtotal';&'Ol ti~"~,,,..,,V'>,;...,: '".".:',1
Manufactured Home Permit Fees
Manufactured Home Setup Fee
SubTotal
~-dministfative':F.e~I-=~\,~~S(~"'L;j'i;:i"'1
Manufactured Home Administrative FeE
Manufactured Home Administrative Fee
SubTotal
Surcharge:!l~~r;~!I~ill"~ llL:tVt;,~"'~~~;-.4~!-;:~;;t:-,,;;,~1
Manufactured Home Issuance Fee
Manufactured Home State Issuance
Manufactured Home Surcharge
State Surcharge For Manufactured Home
SubTotal
Total for Manufactured Home
1,00
1,00
Plumbing
Subtotal "
Plumbing Miscellaneous
Manufactured Home Connection
Minimum Permit Fee
Minimum Plumbing Permit Fee
SubTotal
1,00
~dministrative'Fee '.'~r.F:," -, ..,'
Plumbing Administrative Fee
Administrative Fee - Plumbing
SubTotal
Page 1 of 2
FLR:
Amount Due
160,00
160.00
12,80
12.80
30,00
11,20
41.20
214.00
45,00
45.00
3,60
3.60
Amount Paid
0.00
0.00
0.00
0.00
0.00
0.00
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Job: 01-01126-01
Address:4750 E-11 Franklin Blvd
Owner: Carlos Rodrigues
Received: 101121200'
Unit: BLOG:
FEE DETAILS
Fees
Plumbing
Surcharae
Plumbing Surcharge
State Surcharge - Plumbing
SubTotal
Total for Plumbing
Value/Quantity
Grand Total:
Page 2 of 2
FLR:
Amount Due
Amount Paid
3,15
3.15 0.00
51.75 0.00
265.75 0.00
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