HomeMy WebLinkAboutPermit Building 2002-8-12
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I Job# 02-00973-01 I
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TRANSlt:01-0010269
DATE:AUG 12 2002
AMT RECD:2 $ 51.75
CHANGE:
CASHIER: 003
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CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00973-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 2085 Inland Way Spr
Assessors Map#: 18031122
Lot: Block: Addition:
Tax Lot #: 01100
Subdivision:
Owner: Gerald Bruley
Address: 2085 Inland Way
Scope Of Work: . Manufactured Home on Private Lot
Phone Number: 541-747-1369
City/StatelZip: Springfield, OR 97477
Alteration Value: $1,900
Replacing skirting on existing M,H, with masonry block
Contractor Type
General Contr
Contractor Registration # Expiration Date
Gerald Bruley
2085 Inland Way, Springfield, OR 97477
Phone
541-747-1369
Office Use
# Of Buildings:
Occupancy Group:
Heat Source:
.A1Sq;iF.oi:ltage:regon law reqUlreb you,
IUIIUVV I UICi:J ClUVlJlCU uy LIlt:: ull:':yurl VIIII!\
To request an inspection call the 24 hour recording at 726-3769, All inspections:re'quested.tlefore?7:0010Se rules are set fo,
a,m, will be made the same working day, inspections requested after 7:00 a,m, ;wiU:becllla,d.e\!lle fQI!oVLir:!9'ough OAR 952-00
working day, 0090, You may obtain copies of the rules to j
~~lIinn tho. l"cntcr 11\1"....., th.... +....1 ""'...h.............
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Land Use:
Zoning Code:
Bedrooms:
Range:
Footing
Final Building
Required Inspections
I Building
-After trenches are excavated,
- When all required inspections have been approved and the buildin9 is complete,
numbe-rforthe Oregon Utility Notiiication
Cenleris 1-800-332-2344),
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
rArea (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
~MG~D OR IS ABANDONED FOR
NO~ddlllIlM1YtifRIOD.
Total:
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Fee
Building Permit
State Surcharge For Building Permit
8% Building Administrative Fee
Total Building
Grand Total
..t1e-V
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Signature
Job# 02-00973-01 I
Paid On Receipt#
[' Building
08/12/2002 10269
08/12/2002 10269
08/12/2002 10269
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Value/Quantity Fee Amount
I
1,900 $45,00
$3,15
$3,60
$51.75
$51.75
~ /-z-2.Go2.-
Date '
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o 22511IT1'I ~'TREET . SFRlNGFIELD,OR 97477 . FH:(541)726-375:{ . FAX: (541)726-3689
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~ [-O-properryO"'/~e~--".. - - ~~---- -------.1'
~) Name (.:",t{ A-(~ 13 ft'<.I"'-i-
~i Mailing Address j..o J--;j -:LrvuL A "t;}. W L':> Y
'01 City S:-~o' .,- ,t...,"lcI State <YZ... Ziny7Y77
~i Phone 7 ''17 - ~ 1i. '9 Fe"
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o Applicant
~ Name 54",.a.-
'1" Mailing Address
a City
Phon'"
o Architect/DesignerlEngineer
.~ Name
~,\ Ad~~<<
WI) Ci~'
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CITY OF SPRINGFIELD, OREGON \.j
CityJobNumber 1)2 -~~" ~
8 I & 2 Family DwelIing or Accessory ~ New Construction
M ulti- Family Addition! AlterationlReplacement
o CommerciaIlIndustrial Tenant Improvement
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o Demolition
o Other
Job Address
Lot
Block
Subdivisior
Bldg No
Tax Maprrax Lot /fltt'> ]I! 2- 2..
Suite Nn
/:>//1') ()
Project Name
Description ofWork/location on premises/special conditions
ll&2FamilvD;.:eI/i;'~'~_====--- I
SQFtX $/SQFt = VALUE
New DwelIing Area
Garage/Carport Area
Other Structure Area
Owner Representative
Phone
Fax
Total Value
CommerciaVlndustriaVMulti-Familv
SQ Ft, X $/SQ, Ft =
VALUE
State
Zip
Existing Bldg, Area
New Bldg, Area
Total Value
Exist.
New
<;tate_ Zip
Occupancy Group( s)
Const. Type(s)
Number of Stories
Contact Persop
Phone
I 0 Contractor(s)
Contractor's Name
FOY
CCB#
Expiration Date
Phone #
General
Plumbing
Mechanical
Electrical
LQ Commerciall/lldustrial Pro;ects
Has site review application been submitted?
o Yes ONo 0 NIA
Ifso, Name of PI ann'"
o Residential Projects
Journal Number
Heat Source: Primary Secondary
Water Heater "mge Energy Path
Do you require any of the following for this project?
Overwidth or Second Driveway 0 Yes 0 No
Do you need temporary power? OYes ONo
Notice: All contractors & subcontractors are required to be
licensed with the Construction Contractors Board of the
State of Oregon under provisions of ORS 70 I and may be
required to be licensed in the jurisdiction where work is
beinl! nerformed.
If PLAN CHECK FEF
Requires LDAP
Planner'
Yes 0 No 0 Applied for? Yes ONo 0
Date:
RCPT#
1)AT"
BY
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Shared Drive(T:)lBuilding FonnsIBuilding Permit Applicationl~2.doc