HomeMy WebLinkAboutPermit Building 2005-2-22
.
._ CITY VI< ~rKlr\juI<IELD'
Building/Combination Permit
PERMIT NO: COM2005-00196
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
541-7'26-37691nspection Line
SITE ADDRESS: 1175 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: COREY DEVELOPMENT LLC
Address: 3956 MIRROR POND WAY
EUGENE OR 97408
Phone Number: 541-344-0250
Contractor Type
Plumbing
Contractor
KIPCO INC
I CONTRACTOR INFORMATION'
ATTENTION: Oregon laW ''''i"''''.- J u,~o
f Ilow rules adopted by theJQ~'e Utlfh~XPiration Date
o J,,<~"re set onn
,,_.:"~~Hnn Center, Those rL~~I~ __^ ^^" 02/03/2007
in D.BlIJL'DlN(>;;IiiF~~ Y~ie; by
009U, \ou IfIJJJ~..!! . , , hetelephone
callirigdtSt/iillet!3r. (NO~~lty Notification Lot Size:
numtJjel\llrt~<l."?-2344). Sq Ft 1st Floor:
TJl>>ePIWl!ilI\--- Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
Phone
541-689-9265
# of Units:
Primary Occupancy Group:
Sccondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
NO#"~tre~t Trees Rqd: ORK
,tar.e..~,Rv~,ve~M~L EXPIRE IF THE W
TH% orLot~overalte: THIS PERMIT IS NOT
AUTHUKILt nlJO"R"'IS"ABANOONEO FOR
^"".^~Mr.~
-- --~".,..
II'UUMC: IMPROVEMENTS I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
.
. LIl l' OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005~00196
ISSUED: 02/22/2005
APPLIED: 02/17/2005
EXPIRES: 08/22/2005
VALUE:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
L.F""~ Pili" I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Une - 1st 50 Feet
Water Une - Each Addtl 100'
Amount Paid
Date Paid
Receipt Number
$7,30
$5,11
$45,00
$28,00
2/22/05
2122105
2122/05
2122105
1200500000000000229
1200500000000000229
1200500000000000229
1200500000000000229
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, 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 sball 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 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,
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from thc
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,
Owou.,~~".;~"rn C'-' ~
}\'1->r\ (),
Date
Paee 2 of2
225 Fifth Street
~ ~
Sj5Tingfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00 196
COM2005-00 196
COM2005-00 196
COM2005-00 196
Payments:
Type of Payment
CreditCard
2/22/2005
.
RECEIPT #:
Description
Water Line - 1st 50 Feet
Water Line - Each AddtllOO'
+ 7% State Surcharge
+ 10% Administrati ve Fee
Paid By
DEBRA COREY
1Ifi""".'...Il!!I!,..,.,!+'> '..,,-- '."."'"
'i .... 'u.":
; j
_.-~
t'w'
~ ,',~ . _', ,',.. ,.... n
1200500000000000229
Received By
djb
Check Number
Bateh Number
Page I of I
Cih' of Springfield Official Receipt
eelopment Services Department
Public Works Department
Date: 02/22/2005
Item Total:
Authorization
Number How Received
041719 In Person
Payment Total:
IO:32:52AM
Amount Due
45,00
28,00
5.11
7.30
$85,41
Amount Paid
$85.41
$85,41