HomeMy WebLinkAboutPermit Building 2001-9-11
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I Job# 01-00980-01 I
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Page 1 of 2
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TRANS#:01-0006662
DATE:SEP 11 2001
AMT RECD:2 $ 51.75
CHANGE:
CASHIER:061
CITY OF SPRINGFIELD, OREGON
225 North Fifth Street
Springfield. OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00980-01
Office: 726,3759
Inspection Line: 726,3769
Location Of Proposed Site: 3764 Gem Ave Spr
Assessors Map#: 17023142
Lot: Block: Addition:
Owner:
Ancil Leister
1511 Ranchwood Dr
Address:
Scope Of Work: Miscellaneous
Tax Lot #: 06900
Subdivision:
Phone Number: 541-431-4920
City/State/Zip: Eugene. OR 97401
Alteration Value: $500
Enlarge interior stairway to current stds
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
_.,~o
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To request an inspection call the 24 hour recording at 726-3769, All inspectiQ.,n_~,r.~que's!ejJ]!'lJgre~7~qQot\n
a,m. will be made the same working day, inspections requested after.7:~OO~a,m:will,be.made.the fOllowing;,-
working day. J".\ r',;;1 u\(.s Q.ci:J?'~';''(IOS() (U~O~t\ 95.t;"$ b'i
. 'lr,;.\OW :"'" cel'\~(:<" \i~(Ollg . ~I \ne (U 6,n
ReqUIred Inspec;:tlons',. "r\) \'V' . cOuw' \6\6""-
\,,,,.' -, ~~...'" b\a1r. r .\n6 r. l'oo
Building ;" ;:;:;:,,:rou ({Ia'i c tel. ~i,\o\(l. '\i\'! \,\o\i\\Ca: I
,Prior to cover. .;)::>9\)'I\.'nCl ~ile C3(\ O(69c'~ \.l~~_2'34A)'
- When all required inspections have bee'ii~PRrove-d'a~d the1builiJing is complete,
~un'\:.'''''-ce(\"''O{\'' .
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Framing
Final Building
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
Fee
Building Permit
State Surcharge For Building Permit
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
~O<(..'f..
X ,\Y-~ ~O'\
# Of Stories: Height (feet)\<(..~ '\ <(..~'V-- \'0
Current Units: ,.G' Propose,ni'nits:'?'(;l ...<'\ y.O'?-
,..\, ,v' '0'0"'- '\'(\'V ~.:~
Census Code: Does~Cll apt~",~'V-- \:;,~\)~'?o ~~~()\j,...
.\I~f::J . ~t.~\) ~ \'0 ~
Total: .\(>.y-O":.~,r90 ,.o'f)() ,
Paid On Rr~'BrRt#J\)r' Value/Quantity
Building ?--"
09(11/2001 6662 500
09/11/2001 6662
Fee Amount
$45,00
$3.15
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Job# 01-00980-01
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Page 2 of2
Value/Quantity Fee Amount
Fee
Paid On Receipt#
Building
09(11/2001 6662
$3,60
$51.75
Building Administrative Fee
Total Building
Grand Total
By signature. I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time, that the project address is readable from the street. that the permit card
~;n7;~;r~d <h" pro~d 00' 01 pi,", "" .~'" '" '". "." ," "~~ T //. CJ (
Signature I/'- ----" Date
$51.75