HomeMy WebLinkAboutPermit Building 2005-7-19 (2)
. CITYOFSPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2005-00918
ISSUED: 07/19/2005
APPLIED: 07/15/2005
EXPIRES: 01/21/2006
VALUE:
.
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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SITE ADDRESS: 1620 KELLOGG RD
ASSESSOR'S PARCEL NO.: 1703342200916
Springfield TYPE OF
Site Work Only
TYPE OF USE: New
PROJECT DESCRIPTION: Sanitary, gas and paving for partition approval parcell
IPUBLIC IMPROVEMENTSI
. -,,'.:. C TUC Sidewalk Type:
Partlall,:~I!!,proved HI\LL \:XPIR\: Ir C1C:' ~'~T
THIS PIl'i'o'l/l\T S \:R IHIS P\:RM\T 1I>0wnspoutslDrahts
I\UI\-\ORII\:O UNOIS I\BI\NOONto FOR
COMM\:NCto OR
I\N1' \ BO 01\1' PtRIOO.
Owner: MEYERS STEWART 0
Address: 33461 BLOOMBERG RD
EUGENE OR 97405
I CONTRACTOR INFORMATION I
Contractor au to License
WALTE~ DM.WmIIDo.uire~~ I lIili\'! 124842
~"f'tC.NT\U'~d~pted '0'1 t"'litiiLDING'INFORMA nONI
_ 1o\l()'ll~\es enter. inoSe. nop.J\':l::>c.-v-
# of Units: NotifiCation C 01-0010 t\'\rou9 lIi'\f\~tories:'o'J
Primary OccupanW! ~Ff$bilP2-O obtain CoP\~S 'V~lg~~ofJne
Secondary OccupWO~O. '(oU rna'l nW, tNote. tr.T.Y,~S'1I1lHeae
Primary Construcho~W19 \he ce Oregon Ut\\\Wf,,~~ .Type:
Secondary Constructi~llrn'Oer lor \he, 1_800-332. Rlinge Type:
# of Bedrooms: center IS Energy Patb:
Sprinkled
Contractor Type
General
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side I 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
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
I of 3
Residential
Expiration Date
0812512005
Phone
541-606-1755
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor,
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Drywell - Provide
Drywell Engineering
Value
Date Calculated
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
, Fee Description
-Mechanical Issuance Fee-
. + 10% Administrative Fee
+ 7% State Surcharge
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Sanitary Sewer - 1st SO Feet
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
Sanitary Sewer Each Addtll 00'
SDC SanitarylStorm Admin
Storm Drainage Impervious Area
+ 10% Administrative Fee
+ 7% State Surcharge
Sanitary or Storm Sewer Cap
Total Amount
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2005-00918
ISSUED: 07/19/2005
APPLIED: 07/15/2005
EXPIRES: 0112112006
VALUE:
Total Value of Project,
~
Amount Paid
Date Paid
Receipt Number
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001033
1200500000000001056
1200500000000001056
1200500000000001056
510.00
$10.40
57.28
$4.00
541.00
$45.00
$247.91
$325.91
$14.00
$74.13
$908.79
$4.50
$3.15
$45.00
7/19/05
7/19/05
7/19/05
7/19/05
7/19/05
7/19/05
7/19/05
7/19/05
7/19/05
7/19/05
7/19/05
7/21105
7/21105
7/21/05
$1,741.07
I Plan Reviews I
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.
IRpn~
Sanitary Sewer Line: Prior to filling trench and including required testing.
Rough Gas: After line is installed and required testing and capped If not attached to an appliance.
Septic Tank Pumped: After septic tank has been pumped and filled. Please provide the Inspector with receipt and
verification from company performing pump and fill.
Sanitary Sewer Cap: Capped within five (5) feet of the property line and capped with an approved material as
required by the code.
2 of 3
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2005-00918
ISSUED: 07/19/2005
APPLIED: 07/15/2005
EXPIRES: 0112112006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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 per it ~~"d at the front of the property, and the approved set of plans wID remain on the site
at all times durin tr:~/~ 1 &~ f-
our'C;;~tractors Signature" Date ' /
3 of 3
~.", :J
225 Fifth Street
: Spl1ingfiel'd, Oregon 97477
541-726-3759 Phone
.
8j:Q~:~'^d_'__"~.~,:
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City of Springfield Official Receipt
.velopment Services Department
Public Works Department
RECEIPT #:
1200500000000001056
Date: 07/2112005
12:19:04PM
Job/Journal Number
, COM2005-00918
: COM2005-00918
; COM2005-00918
"
~
Descrlptlou
+ 7% State Surcharge
+ 10% Administrative Fee
Sanitary or Storm Sewer Cap
Payments:
Type of Payment
CreditCard
Paid By
STEWART MEYERS
Received By
djb
Item Total:
LbeCK Number AutnonzatJon
Batch Nmnber Number How Received
087994 In Person
Payment Total:
Amon ut Due
3.15
4.50
45.00
$52.65
Amount Paid
$52,65
$52.65 .
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712112005
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