HomeMy WebLinkAboutPermit Building 2005-11-30
Status: Issued
- 225 Fiftb Street, Springfield, OR
'541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01654
ISSUED: 11130/2005
APPLIED: 11/29/2005
EXPIRES: 05/30/2006
VALUE: $ 45,000.00
SITE ADDRESS: 6880 GLACIER DR
ASSESSOR'S PARCEL NO.: 1802031101900
Springfield TYPE OF
Single Family Residence
TYPE OF USE: Alteration
Residential
PROJECT DESCRIPTION: Raise foundation wi Helical Piers
Owner:
Address:
.,";--'" .
Ie:, . . '.~.
THIS PERMI i ;". - " ,r _
AUTHORIZED UNDth I I " ,~ \I''''1K
(:nMM/:~11'['2 "n if: _ _ n c' , . ,)]'
~ "U"'~UU'~L,-, rurl
I CONTRACTOR ll'lI'URWm'IlI'''''''O.
PETERSON RALPH M & PAULA M
6880 GLACIER ST
SPRINGFIELD OR 97478
, ,
Contractor Type
General
Contractor
WILLIAM VAN DORN
Phone
510-3366
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
, # of Bedrooms:
: Front yard Setback:
. Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
DescriDtion
License
165804
Expiration Date
07/27/2007
I BUILDING INFORMA nON.
# of Stories: Lot Size:
Height of Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
VB Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Patb: ATTEN Sq Ft Other:
Sprinkled fo/l TION: wa9gon ,PJcuP.!'l)t Load:
ow f1J/f.3C" ......J_ . reUUln::Jc \,.........
I DEVELOPMENT iNFORMA:m)Nti'~Th~~~~e Oregon- Uti/Ii;
00 '~V"-1J1J1-001O th ules 'REQUIRED PARKING
, 90, You ma ,rough OAB 9:<:>. -,."
Overlay Dlst: calling th Y Obtain Copies of tITotal:- 001.
# S T e cen4e" (N H'f'-> f1/I:"lC" I....
treet reesurco' f t ", ote' the t and capped:
, , 'Lr Or the 0 'e'cnhnn_
Paved Dnve Rqd: regon Uti/it N Compact:
% of Lot Coverage.Center is 1.800332 Y OW/cation
. - -2344),
IPUBLlC IMPROVEMENTSI
Sidewalk Type:
DownspoutslDralns
I Valuation Descriotion ,I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Value
Date Calculated
I of 2
.
.
CITY OF SPRINGFIELD
Building/Combination Permit
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2005-01654
ISSUED: 11/30/2005
APPLIED: 11/29/2005
EXPIRES: 05/30/2006
VALUE: $ 45,000.00
Bid Amount
Use Bid Amount
$1.00
45,000.00
$45,000.00
$45,000,00
11129/2005
Total Value of Project
Fp.p.s Paid I
7 Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Amount Paid
Date Paid
$34,14
$23.90
$341.40
11130/05
11130/05
11130/05
Receipt Number
1200500000000001764
1200500000000001764
1200500000000001764
Total Amount
$399,44
I Plan Reviews ,
To Request an inspection caD 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. wiD be made the following
work day.
I RP.n~
Special: See Plan Reviewer or Inspectors Notes for specific requirements,
Final Building: After all required inspections have heen requested and approved and the building Is complete.
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 bt accordance
with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herebt,
and that NO OCaJP ANCY 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 thj all required inspections are requested at the proper time, that each address Is readable from
the street, that the permit e d is located at the front of the property, and the approved set of plans wID remain on the site
at all tim7 during construe on. f) 'J I
IA ~ L- \ <_IL.--- (I 30 oS
Owner or Contractors Signature Date ( I
2 of 2
<
225 )fifth Street
,Springfield, Oregon 97477
Y'41-726-3759 Phone
.
Job/Journal Nl1DIber
COM2005-0 1654
COM2005-01654
COM2005-0 1654
Payments:
Type of Payment
Check
,
~.
ii'
1.'
11/30/2005
RECEIPT #:
....~l!lN..ftmlll,C!___'I,
~~'-."'i
, "
.,' .'
,'. '.. ~'..~ .
.ity of Springfield Official Receipt
'Wf>evelopment Services Department
Public Works Department .'
1200500000000001764
Date: 11/30/2005
Description
Building Permit
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
VAN DORN CONSTRUCTION
Received By
ddk
1 of I
Item Total:
t.:beck Nl1DIber Aulllorlzatlon
Balch Number Number How Received
2002 In Penion
Payment Total:
9:26:IOAM
Amou nt Due
341.40
23,90
34,14
$399.44
Amount Paid
$399.44
$399,44