HomeMy WebLinkAboutPermit Building 2003-8-18
It
Status
Issued
II
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2325 GROVED ALE DR
ASSESSOR'S PARCEL NO.: 1703262:!00222
. Ll1 t' VI' ~r.K.ll~ut<'IELD .
Building/Combination Permit
PERMIT NO: COM2003-00788
ISSUED: 08/18/2003
APPLIED: 08/18/2003
EXPIRES: 02/18/2004
VALUE: $ 500.00
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Repair
Residential
PROJECT DESCRIPTION: Install he"der and relocate kitchen sink
Owner: MELLOR KENNETH W & RULENA J
Address: PO BOX 1400 SPRINGFIELD OR 97477
# of Stories:
Height of Structure
Type of Heat:,
Water Type:
Range Type~
Energy~~.~
~~~ ,c, ~f:i
I DEV~"NINNFORMATION 1
. ~~,~~~ REQUIRED PARKING
,~~ ~ '\~ !'l-~Iay Dist: Total:
~. ~ C:" ~<:::)~ ~ ~ Street Trees Rqd: Handicapped:
^,-,\,f\J ~~~ ~)..;;s f:i~ ~ ~~aved Drive Rqd: o\} \~ompact:
o.\.'V c:. ~ ro.~ <.<:::) f/f ",'I ~~,\'l
"...~'" .:>..f:i" ~f;"l" ~ ~ % of Lot Coverage: rooy>,~0 ~ 0 \00
, .~'\'.~"" ~~ (0'" ~O 0\ roo'
'<-'" ,,~"I!o\oS)" _"\'3-'ll_,,,O~e Q,(0:e.(/.J:)'v,
\.)~~ I PUBLIC IMPROVEMEIS,1:S"'~~O ~'l ~~ ~\}';O",Y' ~ ~\}\0~0
-\ ,.! ou; -<;,\\0 roo' \~ roo\ \~ ~,\\o . 0'0
A~~ I<.e'i>?i- ~0~' Sid.~walke;rype:0\0~r.C'3-\~
~' ~\S G0'0 r;:J;)\\J _ coQ' . \,\\0 \.,o\\'~
I<.\o'll ..,0'0 ,,0.... DJlwnspontslD~alns:,
\0 .~\c'l>\ ~'l:v o~\ ~". 0~\'" 't,I>.P'"
~o\~ ~g ~'3-'l ~\e~' ~0'0 ~'l:?:.
. 01" ---l0Y> 0C0 0~0 CO.~
,'0 90. . ~\~ \,\\0. ....'Ci
O\J ~\,~ (\O~ ( ,'i>
C f0~0 G0'0\0
'0\S
Contractor Type
General
Plumbing
Contractor
OWNER
OWNER
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VN
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I CONTRACTOR INFORMATION I.
License
Expiration Date Phone
BUILDING INFORMATION I
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
Pal!e I of3
It
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I Valuation Descrintion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
Total Value of Project
l.J'PPO P"itl I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Fixture
Minimum/Adjustment Plumbing
Amount Paid
Date Paid
$9.00
$6.30
$45.00
$14.00
$31.00
8/18/03
8/18/03
8/18/03
8/18/03
8/18/03
Total Amount Paid
$105.30
I Plan Reviews ,
. CITY OF :St'K11~uJ<1J!,LD
Building/Combination Permit
PERMIT NO: COM2003-00788
ISSUED: 08/1812003
APPLIED: 08/1812003
EXPIRES: 02/18/2004
VALUE: $ 500.00
Value
Date Calculated
Receipt Number
1200200000000001976
1200200000000001976
1200200000000001976
1200200000000001976
1200200000000001976
To Request an inspection call the :!4 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. '
~nonrrtin~
1 Framing Inspection: Prior to cover and after all rough in inspectiops have been approved.
2 Final Building: After all required inspections have been requested and approved and the building is complete.
3 Rough Plumbing: Prior to cover and including required testing.
4 Final Plumbing: When all plumbing work is complete.
Pa!!e 2 of3
r---------
It
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2003-00788
ISSUED: 08/18/2003
APPLIED: 08/18/2003
EXPIRES: 02/18/2004
VALUE: $ 500.00
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
tbe Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to tbe work described herein, and
that NO OCCUPANCY will be made ofllny structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors an,j employees who are in compliance witb 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 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.
~~~~
g--- /r---- C<J
Owner or Contractors Signature
Date
Page 3 00 .
225 Fifth' Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2003-00788
COM2003-00788
COM2003-00788
COM2003-00788
COM2003-00788
Payments:
Type of Payment
CreditCard
9
~'~__J
Receipt #: 1200200000000001976
, Description
Building Permit
Fixture
Minimum/Adjustment Plumbing
+ 7% State Surcharge
+ 10% Administrative Fee
Received By
djb
Check Number
Batch Number Authorization Number
Paid By
BERNHAM MELLOR
000145 283702
City of Springfield Official Receipt
Development Services Department .'
Public Works Department
Date: 08/18/2003
1:40:S4PM
Amount Paid
Item Total:
45.00
14.00
31.00
6.30
9.00
$105.30
How Received
In Person
PSlVnlpnt TntSlI-
_ -.I ---. - -.---
Amount Paid
$105.30
$105.30
. .
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