HomeMy WebLinkAboutPermit Land Drainage Alteration 2000-8-30
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Job# 00-00522-03
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Page 1 of 3
TRANS#:01-0003068
DATE:AUG 30 2000
AMT RECD:1 $ 120.00
CHANGE:$ 10.00
CASHIER: 061
'j
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00522-03
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 10 Harlow Rd Spr
Assessors Map#: 17032233
Lot: Block: Addition:
Tax Lot #: 00400
Subdivision:
Owner:
McKenzie-Willamette Hospital
1460 G Street
Phone Number: 541-726-4432
City/State/Zip: Springfield, OR 97477
Address:
Scope Of Work: Land Drainage Alter Permit New Value:
Gateway Office Park
In conjunction with Subdivision application 1998-04-0074, Jim Donovan Planner, will be routed
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00522-03
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Tax Lot #: 00500
Addition: " , t"SubclhilSi~'i1f:llawrequiresyouto
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City/Statli)~fP952-gl\~~W1,l\rQ9g~~he rules by
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Scope Of Work: Land Drainage Alter Permit New ca\lingthecer)(a'~ltdott$Jlhetelephone
Gateway Office Park numberfortheOregon UtllltyNotlflcatlon
In conjunction with Subdivision application 1998-04-0074, iJii\i'tlof1o~:n"~l~~~e~~be routed
Location Of Proposed Site: 1 0
Assessors Map#: 17032233
Lot: Block:
Harlow Rd
Spr
Owner:
McKenzie-Willamette Hospital
1460 G Street
Address:
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NOTICE:
THIS PERMIT SHALL EXPIRE IFTHE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
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I Job# 00-00522-03 I
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
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Page 2 of 3
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Job Number: 00-00522-03
225 North Fifth Street
Springfield. OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 10 Harlow Rd Spr
Assessors Map#: 17032233
Lot: Block: Addition:
Tax Lot #: 00600
Subdivision:
Owner:
Address:
McKenzie-Willamette Hospital
1460 G Street
Phone Number: 541-726-4432
City/State/Zip:
Springfield, OR 97477
Value: $0
Scope Of Work: Land Drainage Alter Permit
Gateway Office Park
In conjunction with Subdivision application 1998-04-0074, Jim Donovan Planner, will be routed
New
Contractor Type
Plumbing Contr
Contractor
Centerline Excavation & Constructr*
800 S 18Th St, Springfield, OR 97477
Registration #
98191
Expiration Date
4/27/00
Phone
541-747-9215
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections 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
working day.
Sanitary Sewer Line
Storm Sewer Line
Required Inspections
I Plumbin!l
- Prior to filling trench.
-Prior to filling trench.
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Zoning:
FloodPlain? 0 Wetlands? 0
Journal numbers
1: 2:
Comments:
I Job# 00-00522-03
Overlay District:
# of Street Trees:
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Page 3 of 3
Land Use:
Pave Driveway? 0
3:
Additional Requirements:
Glenwood Area? 0 Required Attachments:
Source Locn:
Material:
Minimum Plumbing Permit Fee
State Surcharge For Plumbing Permit
Storm Sewer Footage
Plumbing Administrative Fee
Total Plumbing
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 futher certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield, applicable City
Standard Specifications and Drawings, and the laws of the State of Oregon pertaining to the work
described herein. I further certify that only contractors and employees who are in compliance with
ORS 701.055 will be used on this project.
Planner:
Urban Growth Boundary?D
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA:
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
,Area (Sq. Feet)
I Main: Accessory:
Fee
Flood Plain FEMA:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Paid On Receipt#
Plumbing
08/30/2000 3068
08/30/2000 3068
08/30/2000 3068
08/30/2000 3068
Value/Quantity
Fee Amount
535
$.00
$7.00
$100.00
$3.00
$110.00
$110.00
The City may inspect the work site described in this permit at any time during a one year period
following the receipt by the City of notice of completion of the described work and specify, at the
City's sole descretion, any additional restoration work required to return the site to a standard
acceptable to the City. The permittee will be notified in writing of any work required and will have
thirty (30) days from the date of the notice to complete the work. Work not completed at the end of
the thirty days will be performed by the City and the costs will be billed to the permittee. I further
agree to ensure that all required inspections are requested at the proper time, that the project
address is readable from the street, and the approved set of plans will remain on the site at all times
during co~syuction. () /J 9/So) 00
.Q!{Lp.e/l-c:...e-'K .~
signaturel ~ Date