HomeMy WebLinkAboutPermit Plumbing 2005-10-07Status Issued
225 Fifth Street, Springfield, OR
547-726-3753 Phone
S4l-126-1676F.ex
541-726-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-01386ISSUED: 1010712005APPLIED: 10/0512005
EXPIRES:. 04/07/2006
VALUE:
SITE ADDRESS: 5737 Mt Vernon Rd
ASSESSOR'S PARCEL NO.: JASPER MEADOWS 4T
PROJECT DESCRIPTION:
Springfield TYPE OF WORIft Plumbing Only
TYPE OF USE: New
Storm Sewer Line for Private Street Improvements
Residential
Owner:
Address:
HAYDEN HOMES
PO BOX 883
SPRINGFIELD OR 97477
PhoneNumber: 541-228-1081
License Expiration Date PhoneContractor Type Contractor
,R INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar SetbackthttEfrtttON: O
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
%o ofLot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
FOR
REQUIRED PARKING
Total:
Handicapped:
Compact:
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law
u e
Notification Center. Those ru
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Sidewalk Type:
Downspouts/Drains:
s{Att fiP,RT rTHE
oAY
$PerSqFt t
or multiplier
Square Footage
or Bid Amount
DEVELOPMENT INFORMA:
Description Type of Construction
Page I of2
0R ts
Value Date Calculated
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Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Eax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-01386ISSUED: 1010712005APPLIED: 10/05/2005EXPIRES: 0410712006
VALUE:
Fee Description
+ l0Yo Administrative Fee
+ 77o State Surcharge
Storm Sewer - lst 50 Feet
Total Amount Paid
Amount Paid
$4.s0
$3.rs
$4s.00
$s2.6s
Total Value of Project
Date Paid
t0t7tos
t0t7t05
t0t7t05
Receipt Number
2200500000000001400
2200500000000001400
2200500000000001400
Plan Reviews
Storm Sewer Line: Prior to filling trench.
Reouired fnsnections
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
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Owner or Contractors Signature
Pase2 of2
Date
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
225Fitth Street
Springfield, Oregon 97477
541-726-3759 Phone
-{ity of Springfield Oflicial Receipt
evelopment Services Department
Public Works Department
RECEIPT #: 2200500000000001400 Date: 1010712005 2:47:58PM
Jrb/Journal Number
ccM2005-0r386
coM200s-01386
coM2005-01386
Description
Storm Sewer - lst 50 Feet
+ 7% State Surcharge
+ lUYo Administrative Fee
Amount Due
45.00
3.ts
4.50
Item Total:$s2.6s
Payments:
Type ofPeyment Paid By Received By Batch Number Number How Received Amount Paid
CreditCard HAYDEN HOMES LLH 083033 Phone
Payment Total:
$52.6s
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t01712005 Page I of I
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uhecl(Number Authorization