HomeMy WebLinkAboutPermit Land Drainage Alteration 2000-08-30ctTY oF SPRfiNGFIELq OREGON
Job# 00-00522-03
COMMERCIAL PERMIT
City Of Springfield
Gommunity Services Division
Building Safety
Page 1 of 3
SPRINGFIELD
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TftAN$*:01-0003068
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Al'lT RECD:I $ 1?0.CI0
CHANGE:$ 10.00
CASHIIR:06].
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 10 Harlow Rd Spr
AssessorsMap#: 17032233
Lot: Block: Addition:
Job Number: 00-00522-03
Office: 726-3759
lnspection Line: 726-3769
Tax Lot #: 00400
Subdivision:
Owner: McKenzie-Willamette Hospital Phone Number: 541-726-4432
Address: 1460 G Street City/State/Zip: Springfield, OR97477
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
COMMERGIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00522-03
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 10 Harlow Rd Spr
Assessors Map#: 17032233
Lot:Block:
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00500
Addition:Subdivision:law requiresYou to
Owner:McKenzie-Willamette Hospital
Address:1460 G Street
Scope Of Work: Land Drainage Alter Permit
Gateway Office Park
ln conjunction with Subdivision
NOTICE:
THIS PEBMIT SHALLEXPIBE IFTHEWORK
ATJTHORIZED UNDER THIS PERMIT 1S NOT
COMMENCED OB IS ABANDONED FOR
ANY 180 DAY PERIOD.
Phone
New
)90.
nI
application 1 998-04-0074,
ir I
set
rulcobY
routed
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 10 Harlow Rd Spr
AssessorsMap#: 17032233
Lot: Block: Addition:
Job# 00-00522-03
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 2 of 3
Job Number: 00-00522-03
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 00600
Subdivision:
Owner: McKenzie-Willamette Hospital Phone Number: 541-7264432
Address: 1460 G Street City/State/Zip: Springfield, OR97477
Scope Of Work: Land Drainage Alter Permit New Value: $0
Gateway Office Park
ln conjunction with Subdivision application 1998-04-0074, Jim Donovan Planner, will be routed
Contractor Type
Plumbing Contr
Contractor Registration # Expiration Date Phone
Centerline Excavation & Constructr* 98191 4127100 541-747-9215
800 S lBTh St, Springfield, OR97477
Quad Area:
# Of Units:
Gonstr. 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 a1726-3769. 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.
Required lnspections
Sanitary Sewer Line
Storm Sewer Line
-Prior to firing tr"n"tr @ l
-Prior to filling trench.
Zoning:
FloodPlain?Wetlands? f-l
Overlay District:
# of Street Trees:
Job# 00-00522-03 Page 3 of 3
Land Use:
Pave Driveway?
Journal numbers
1:
Comments:
Planner:
Urban Growth Boundary?
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA:
2:3:
Additiona! Requirements:
tr Gtenwood Area? ! Required Attachments:
Source Locn:
Material:
Flood Plain FEMA:
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main:Accessory:
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbin
Minimum Plumbing Permit Fee
State Surcharge For Plumbing Permit
Storm Sewer Footage
Plumbing Administrative Fee
Total Plumbing
0B/30/2000
0B/30/2000
0B/30/2000
0B/30/2000
3068
3068
3068
3068
535
$.00
$7.00
$100.00
$3.00
$110.00
Grand Tota!
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.
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 con
$110.00
g l>ol oc
Signatu Date