HomeMy WebLinkAboutPermit Demolition 2003-06-27Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
54l-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
SITE ADDRESS: 1235 llTH ST
ASSESSOR'S PARCEL NO.: 1703264409300
PROJECT DESCRIPTION: Demolition of existing residential structure
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Demolition Residential
License Expiration Date Phone
Owner:
Address:
CALVARY TEMPLE OF SPFLD
1116 CENTENNIAL BLYD SPRINGFIELD OR 97477
Contractor Type
General
Owner
Contractor
OWNER
CALVARY TEMPLE OF SPFLD
CONTRACTOR INFORMATION
BUILDIN(
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
R-3
VN
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Notes:
Page I of2
ffifi1pg*;qtrdrtr'wBr
ffi.1
PERMIT NO: COM2003-00558ISSUED: 0612712003APPLIEDz 0612712003
EXPIRESz 1212712003
VALUE:
gbz-utr
(ou ma
ng the (
rerfort
er. (Nc
.traatnn
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-00558ISSUED: 0612712003APPLIEDz 0612712003
EXPIRESz 1212712003
VALUE:
Description Tvpe of Construction
Fee Description
+ l0oh Administrative Fee
+ 77o State Surcharge
Building Permit
Sanitary or Storm Sewer Cap
Total Amount Paid
Total Value of Project
Date Paid
6t27t03
6t27t03
6t27t03
6127t03
Value Date Calculated
Receipt Number
120020000000000166r
1200200000000001661
1200200000000001661
1200200000000001661
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Amount Paid
$9.00
$6.30
$4s.00
$45.00
$105.30
PIan Reviews
To Request an inspection call the 24 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.
1 Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is
requested and approved, and all debris is removed from the site.2 Sanitary Sewer Cap: Capped within five (5) feet of the property line and capped with an approved material as
required by the code.
Reouirec
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that ail
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.
or Contractors Signature
Paee 2 of 2
Date
)ct.t (2r -o3
Valuation Description I
225 Fifth Street
Springfield, Oregon 97 477
541-72G3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Receipt #: 1200200000000001661 Date: 0612712003 2:47zl4PM
coM2003-00558
coM2003-00558
coM2003-00558
coM2003-00558
Building Permit
Sanitary or Storm Sewer Cap
+ 7%o State Surcharge
+ lUYo Administrative Fee
45.00
45.00
6.30
9.00
Item Total:$105.30
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check CALVARY OPEN BIBLE dlm 10348 In Person
Payment Total:
$105.30
$10s.30(