HomeMy WebLinkAboutPermit Building 2005-2-22
.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
*
.--CITY VI' ~rK11~GN~LD '
Building/Combination Permit
PERMIT NO: COM2005-00195
ISSUED: 02/22/2005
APPLIED: 02/17/2005
EXPIRES: 08/2212005
VALUE:
I
I
Status
Issued
SITE ADDRESS: 1169 Laurel Ave
ASSESSOR'S PARCEL NO,: 1802064200300
Springfield TYPE OF WORK: Site Work Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Site work water line
Owner:
Address:
COREY DEVELOPMENT LLC
3956 MIRROR POND WAY
EUGENE OR 97408 .
Phone Number: 541-344-0250
Contractor Type
Plumbing
Contractor
KlPCO INC
~__~nn '"w reQuires you to
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,1_CONrrRACTOR'mlFORMt'f<leNllet forth
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, 52 001 0010 thrOu911 b
in OAR 9 - - bt in copi~~Qlle ru\eE~'iliration Date
0090, You may 0 ._~ 1~lnt..5MgQe\ephone 02/03/2007
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I 'BUlLDJNGINHfi)RMWJI0N)W)
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"'-" oter is 1-BUu-.3W'-" .
# o/t;~ories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: nla Occupant Load:
Phone
541-689-9265
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION I
NO I ,~~. I\T SHAll EXPIRE \\.,HE W~~~
TH'O?efl~~DlSt:It\lOFR THIS PERMIT IS
AL:#.SGr.~!~Js~qd: M3ANOONEO FOR
C cJl(i,t~i.li))tiv~ R4ljjJ ~ 0
At'Y~ orll\i>(C1?O'vr~ge, '.
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC I,MPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
N~tcs:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!elof2
.
. CITY OF ~rKll'lljt<l~L1J
Building/Combination Permit
PERMIT NO: COM2005-00195
ISSUED: 02/22/2005
APPLIED: 02/17/2005
EXPIRES: 08/22/2005
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
Fp.r~ Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - Ist 50 Feet
Water Line - Each AddtllOO'
Amount Paid
Date Paid
$7,30
$5,11
$45,00
$28,00
2/22/05
2/22/05
2/22/05
2/22/05
Receipt Number
1200500000000000228
1200500000000000228
1200500000000000228
1200500000000000228
Total Amount Paid
$85,41
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, in'spections requested after 7:00 a.m. will be made the following work
day.
~ RP.nllir~d Tn~np."tinn~"
Water Line: Prior to filling trench and including required testing,
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 further certify that any and all work performed shall be done in accordance with
the Ordinan~es 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,
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 will remain on the site at all
times during construction,
\)to r, ), 0 \
Owner or Contractors Signature J
"}\lrlr \{\\
Date
Paee 2 of2
225 Fifth Street
-,
, Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00 195
COM2005-00 195
COM2005-00 195
COM2005-00 195
Payments:
Type of Payment
CreditCard
"
,
,
2/22/2005
RECEIPT #:
Description
Water Line - 1st 50 Feet
Water Line - Each AddtllOO'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
DEBRA COREY
.
lI!!""'"~'_'_'~Q.Q,_ "',._.'"... ".,'.,.
~.'
~,.'.~
~ of Springfield Official Receipt
.elopment Services Department
Public Works Department
1200500000000000228
Date: 02/22/2005
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 041719 In Person
Payment Total:
Page 1 of I
IO:32:32AM
Amount Due
45,00
28.00
5.11
7.30
$85,41
Amount Paid
$85.41
$85,41