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Home My WebLink AboutPermit Building 2004-04-21Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-00933ISSUED: 0412112004 APPLIEDz 0911912003EXPIRES: 1012112004VALUE: $ 114,702.00 SITE ADDRESS:426 S 42nd Pl ASSESSOR'S PARCEL NO.: PROJECT DESCRIPTION: PRASAD GYANENDRA 1243 NIXON AVE RENO NV 89509 Springfield TYPE OF WORK: Single Family Residence 1702323300601 TypE oF USE: New Residential SFR - Lot C - same as COM2003-00929 392 S 42nd Pl Place SDC Credit on this Iot for previous Residence. Owner: Address Contractor Type General Electrical Mechanical Plumbing Contractor DUANE A KNIGHTS BATEMAN ELECTRIC INC MARSHALLS INC SURRETTS PLUMBING INC License tztt2 151911 25790 158295 Expiration Date 07n0t2005 0612u2004 12t23t200s 0ur4t2006 Phone 541-726-2960 54t-99547s7 541-747-7445 541-741-3553 # of Units: 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: # ofStories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Trees Rqd: .Paved Drive Rqd: oh of Lot Coverage: I 16.50 Wall Heat Electric Electric Path 1 ca nufrrber Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: I R-3 u-1 VN 1,162 396 3 ) Yes 17.60 REQUIRED PARIilNG Total: 2 Handicapped: Compact: I Gravel onlaw Notes: Storm drainage to drain to Daisy Paee I of4 tor the L l,Utt-Lrll\t rl\ f UIIUYTA r rUNJ .Those .,. 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: COM2003-00933ISSUED: 0412112004APPLIED: 0911912003EXPIRES: 1012112004VALUE: $ 114,702.00 Description Dwellinss Garage Type of Construction V Wood Frame Garage $ Per Sq Ft or multiplier $90.60 $23.80 Square Footage or Bid Amount I,162.00 396.00 9nst03 10/r3103 10/13/03 10/13/03 10/13/03 4t2u04 4t2u04 4tzu04 4t2u04 4t2u04 4t2U04 4t2u04 4tzu04 4t2u04 4t?u04 4t2u04 4t21t04 4t2u04 4t2U04 4t2u04 4tzu04 4t2u04 4t2u04 4tzu04 Value $105,277.20 $9,424.80 $114,702.00 Date Calculated 09n9t2003 0911912003 Amount Paid Total Value of Project Date Paid Fee Description PIan Review Same As + l0oh Administrative Fee + 77o State Surcharge Sanitary Sewer - lst 50 Feet Sanitary Sewer Each Addtl 100' -Mechanical Issuance Fee- + l0o Administrative Fee + l0o/o Administrative Fee + 77o State Surcharge + 7o/o State Surcharge 2 Baths One or Two Family Addressing Assignment Building Permit Dryer Vent Exhaust Hoods Furnace - up to 100,000 btu Minimum/Adj ustment Mechanical Plan Review - Planning Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 SDC Sanitary/Storm Admin Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Total Amount Paid Receipt Number 1200200000000002119 1200200000000002301 1200200000000002301 1200200000000002301 1200200000000002301 1200400000000000518 1200400000000000518 1200400000000000518 1200400000000000518 1200400000000000518 1200400000000000s18 1200400000000000518 1200400000000000518 1200400000000000518 r200400000000000518 1200400000000000s18 1200400000000000518 1200400000000000sr8 1200400000000000518 1200400000000000518 1200400000000000518 1200400000000000sr8 1200400000000000s18 1200400000000000s18 $r00.00 $s.90 $4.r3 $4s.00 $14.00 $10.00 $5.00 $105.74 $3.50 $74.02 $254.00 $8.00 $614.40 $6.00 $9.00 $12.00 $6.00 $s9.00 $106.00 $38.00 $5.22 $104.40 $s0.00 $r2.00 $1,651.31 PIan Reviews Initial Reyiew Planning Review 09n6/2003 09n9t2003 09119t2003 r0n0t2003 APP APP LLH TAJ Paee2 of 4 Valuation Descrintion I l ees Paid I F PRIN 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: COM2003-00933ISSUED: 0412112004APPLIED: 0911912003 EXPIREST 1012112004VALUE: $ 114,702.00 Public Works Review Public Works Review Public Works Review 10t20t2003 04n5t2004 t0t06t2003 10t20t2003 04tr5t2004 10t06t2003 Public Works Review 09tr9t2003 0912412003 wI vRJ Site plan does not show storm drainage nor any utility connections or driveway locations. Contacted contractor 9 124 12003 regarding storm only, plans to take storm to 'ditch' in S 42nd Place. I have spoke with our Infrastructure Specialist and am waiting on information from Maintenance Surface Water Supervisor for information on storm drainage. Improvement agreements are being written by Survey. APP Revised SDC's Storm drainage to drain to Daisy Street via a private easement. Public Works review is complete, waiting for private easement from applicant. NO CONCRETE in public road right of way, please keep all concrete for driveway on private property. Encroachment permit is required if storm drainage requires new weephole. Structural Review 09trgt2003 10t20t2003 APP DJB 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. Sanitary Sewer Line: Prior to filling trench and including required testing. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underground Plumbing: Prior to Iilling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Water Line: Prior to filling trench and including required testing. Paee 3 of4 IO WE VRJ VRJ VRJ t4 20 9 l8 8 16 10 22 5 6 I 2t 13 t7 23 Reouired Insnecfions \ Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00933ISSUED: 0412112004APPLIEDz 0911912003EXPIRES: 1012112004VALUE: $ 114,702.00 15 Sanitary Sewer Line: Prior to filling trench and including required testing. 19 Storm Sewer Line: Prior to filling trench. 4 Final Plumbing: When all plumbing work is complete. 12 Rough Mechanical: Prior to Cover 3 Final Mechanical: When all mechanical work is complete. 11 Rough Electric: Prior to Cover 7 Electric Service: Approval required prior to utility company energizing service. 2 Final Electric: When all electrical work is complete. 24 Temporary Electric: Approval required prior to Utility Company energizing pole. 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. /xt- o/ Date Page 4 of 4 m ,rL.^ .-.- //ZrL,i -b- owner or Contrafo.-, Sglutr.u 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone ^!ty of Springfield Official Receipt -velopment Services Department Public Works Department RECEIPT #: 1200400000000000518 Date: 0412112004 2:34:18PM Job/Journal Number coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 Amount Due 8.00 38.00 106.00 59.00 10.00 105.74 2s4.00 6.00 614.40 6.00 9.00 74.02 12.00 12.00 104.40 5.22 3.s0 s.00 50.00 Item Total:$1,482.28 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check DUANE KNIGHTS djb In Person Payment Total: $1,482.28 -$i/8-'tE" 4912 412U2004 Page I of I ry! Description Addressing Assignment Residence Wiring Ea Addtl 500 Residence Wiring 1000 Sq Ft Plan Review - Planning -Mechanical Issuance Fee- + l0o/o Administrative Fee 2 Baths One or Two Family Dryer Vent Building Permit Minimum/Adjustrnent Mechanical Exhaust Hoods + 7o/o State Surcharge Vent Fan Fumace - up to 100,000 btu Storm Drainage Impervious Area SDC Sanitary/Storm Admin + 7o/o State Surcharge + l0% Administrative Fee Temp Power 200 amps or less 225 FIFTH STREET SPzuNGFIELD, OREGON 97477 I LEG ON 0\ DE N I COMMENCED OR IS ABANDO EL 1ICAL PERIMIT APPLICATION J. Ci t1-Jolt Numl)cr FEE SCHEDULE BELOW Nen' Residcntiitl' and not require SPBqIift thereof Zonlng -o B. Serviccs or leeders Multi-Famill' per drlelling unit. Serlicc Included: 1000 sq ft. or less Items Cost I $106.00 @ n 2-$ 19.00 38pPermits are and if rvork is not sttrrted u'ithin 180 da1's ofissuance or ifuork is suspendeflfgr l8o da1's' ;".rlhorized signature 2. CONTRACTOR INSTAILATION ONLY or N()T ICE: THIS PERMIT SHALL EXPIRE IF THE ffiffif(munr Elcctric Permit Inspection Fec is S{5'00 * Sttrchilrgcs AUTHOBIZED UNDEB THIS PE 0 T S 1)RMIT IS N NED TOR4 UBTOTAL OF ABOVE 77o Statc Surchargc I DrZ Administrative FceANY 180 DAY PERIOD. TOTAL Institllation, Alterations or Rclocation: 200 amps or less 201 anrps to 400 amPs :101 anrps to 600 amps 601 anrps to 1000 tIllPS : Over 1000 amps/r'olts Reconnect Onh' Electricar con,ro.,oMc, \fL. Snpen'isor License Nnrnber Tentporar-v Scn'ices or Feeders Installirtior,Alteration or Relocation 200 amps or less 201 amps to 400 amps Or.er .101 to 600 autps Over 600 alnps or 1000 r'olts see "B'' abot'e $ 63.00 s 125.00 s r 63.00 $375.00 $ 50.00 -l- $5o.oo $69.00 s100.00...".""-_ Expiration Constr Contr. Expiration , ,,j" Signlturc of Supcn'ising Electrician Orvncrs N Br':rnch Circtrits New Alteratiott or Extension Per Panel GU0r One Circuit : OWNER $43.00 tbtlow rules rvith Scn,icc $ 3.00 The installation is being ntade on iotilication not inclutled) prope$'I orvn rvhich is not intended oAR 9s2 -001 for sale, lease or rent.0090 You may obtain $50.00 $50.00 $25.00 $15.00 calling the center On'ncrs Signature:nurnber tor the Energl'/Comni CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: Com2003-00933 Revised NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEWDWELLING UNITS Prasad 426 S 42nd 17023233 tl 601 SINGLE FAMILY RESIDENCE BUTLDTNG SrZE (SF) 0 LOT SIZE (SF):8827 aH l-.1oO &HFa fr.l& 1070 1091 t092 1093 1094 1054 1055 1054 1056 1079 I 078 I. STORM DRAINAGE DIRECTRUNOFF TO CIry STORM SYSTEM lTFERvrous sr. | 360.00 x COST PER S.F s0.290 CHARGE $104.40 RLINOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F 0.00 x COST PER S.F s0.290 x DISCOTINT RATE 50% DISCOUNT $0.00 ITEM I TOTAL. STOR]VI DRAINAGE SDC $104.40 A. REIMBURSEMENTCOST: NLMBER OF DFU's 0 x COST PER DFU s22.64 B. IMPROVEMENT COST: NLIMBEROF DFU's 0 x COST PER DFU st7.2r : I $o.oo ITEM 2 TOTAL - CITY SANITARY SEWER SDC $0.00 3. TRANSPORTATION A. REIMBURSEMENT COST: ADTTRIP RATE 9.s7 x NUMBER OF LINITS 0 x COST PER TRIP $17.23 x NEW TRIP FACTOR 1.00 B. IMPROVEMENT COST: ADTTRIP RATE 9.57 x NUMBER OF UNITS 0 x COST PER TRIP $76.01 x NEW TRIP FACTOR l.00 ITEM 3 TOTAL - TRANSPORTATION SDC $0.00 4. SANITARY SEWER- MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's 0 x B. IMPROVEMENT COST: NUMBER OF FEU'S 0 x = I $0.00 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD( = = I $o.oo $0.00 COST PER FEU s332.86 COST PER FEU $34.83 SUBTOTAL (ADD ITEMS I,2,3, & 4)$104.40 5. ADMINISTRATIVE FEE: SUBTOTAL s 104.40 x ADM. FEE RATE 5% CHARGE $5.22 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Virginia Jurasevich 4n5t2004 PREPARED BY DATE TOTAL SDC CHARGES l-didi76- = I $0.00 : I $0.00 lT I-ddi-6- DRAINAGE FIXTURE UNIT CALCULATION TABLEDII U NUMBER OF NEW FXTURES x UNIT EQUTVALENT : DRAINAGE FXTTIRE UMTS DRAINAGE FIXTURE LTNITS NO. OF FIXTURES FIXTURE TYPE NEW (NOTE: FOR REMODELS,CAI.CULATE ONLY TTIE NET ADDITIONAT FXTURES) UNIT EQUIVALENT BATHTUB 0 0 3 0 DRINKING FOUNTAIN 0 0 1 0 FLOOR DRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 b 0 LAL]NDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTHESWASHER - 3 OR MORE (EA)0 0 b 0 MOBILE HOME PARK TRAP (1 PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0 SHOWER, SINGLE STALL 0 0 2 0 SHOWER, GANG (NUMBER OF HEADS)0 0 2 0 SNK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 0 SINK: COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0 URINAL, STALL / WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 b 0 TOILET, PRIVATE INSTALLATION 0 0 3 0 0 MISCELLANEOUS DFU ryPE NUMBER OF EDU'S 0 TOTAL DRAINAGE FIXTURE UNITS rEDU lsa toa unit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALUE BEFORE 1979 $4.92 1979 $4.92 1980 $4.83 1981 $4.77 1982 $4.64 1983 94.47 1984 $4.30 1985 $4.09 1986 s3.78 1981 $3.41 1988 $2.98 1989 $2.52 1990 $2.06 l99l $1.64 1992 s1.45 1993 s1.3r 1994 $ r.13 1995 $0.97 1996 s0.82 1997 s0.63 1998 $0.4r 1999 $0.22 2000 $0.04 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1979 TOTAL MWMC CREDIT 0 0 x I-$dloo- a^torrroR LAND 0F APPLICABLE) VALUE / IOOO $0.00 CREDITRATE s4.92 VALUE / IOOO CREDIT RATE $0.00 x $4.92 IE OLD 20 l-d-_ City of Springfield 225 Fifth Street, Springfield, OR97477 541-726-3759 Phone"541-726-3676 Fax March 22,2004 Job Number: Location: 89509 coM2003-00933 426 S 42ndPl Project SFR - Lot C - same as COM2003-00929 392 S 42ndPl Dear Permit Holder: The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid, the work which has been authorized by the permit must begin within 180 days of the date of issuance, and an inspection must be requested at least every 180 days. According to our records, you obtained a permit for a project at 426 S 42nd Pl which is set to expire on 412012004. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notify you that your permit(s) will be expiring shortly. If you are'ready to request an inspection for your project, please phone the inspection line at 541-726-3769. If you do not request an inspection prior to the expiration date, your permit(s) will expire and additional permit fees will be required in order to complete your project. If you have any questions, please feel free to phone me at 541-726-3790. Sincerely, Lisa Hopper Building S afety Supervisor PRASAD GYANENDRA 1243 NIXON AVE RENO, NV [En, Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00933ISSUED: 1011312003APPLIED: 09/1912003 EXPIRESz 0411312004VALUE: $ 114,702.00 SITEADDRESS: 426542ndPl Springfield TYPEOFWORI(: SingleFamilyResidence ASSESSOR'S PARCELNO.: 1702323300601 TYPE OF USE: New Residential PROJECT DESCRIPTION: SFR - Lot C - same as COM2003-00929 392 S 42nd Pl OWNCT: PRASAD GYANENDRA Address: 1243 NIXON AVE RENO NV 89509 Contractor Type General Electrical Mechanical Plumbing Contractor DUANE A KNIGHTS BATEMAN ELECTRIC INC MARSHALLS INC SURRETTS PLUMBING INC License tztt2 151911 25790 12t687 Expiration Date 07t10t2005 06t2U2004 12t23t2003 0u1412004 Phone 541-726-2960 541-9954757 541-747-7445 541-741-3553 CONTRACTOR INFORMATION # 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: PEHIOD. # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 1 R-3 u-1 YN 18.00 14.00 8.00 74.00 0.00 I 16.50 Wall Heat Electric Electric Path I 1,162 396 3 2 Yes r7.60 Sidewalk Type: REQUIRED PARIflNG Total: 2 Handicapped: Compact: Gravel HA L L SXniRF+F"IgFq,UpiX to Daisy AUTHORIZED U NDER THIS PERMIT IS NNO(PMMENCED OR IS ABANDONED FOR ,,...,,_,$ffiffi ssffi ffi6g;:,,,;1i,1,", *$,i;ffiilffi:;fi,nr,iil',,f -*iilffi :,i:t?IJI;f,,l,L.,fJr,i,**;' DEVELOPMENT INFORMATION PUBLIC IMPROYEMENTS ANY 180 DAY OT Pase I of3 rq'|fs DUILL'II\ U II'I ll ('TUYIA I IT-,I\ I Buildin g/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: COM2003-00933ISSUED: 1011312003 APPLIEDT 0911912003 EXPIRESz 0411312004VALUE: $ 114,702.00 Description Dwellinss Garage Tvpe of Construction V Wood Frame Garage $ Per Sq Ft or multiplier $90.60 $23.80 Square Footage or Bid Amount 1,162.00 396.00 9n5t03 10/13/03 10/13/03 10/13/03 10/13/03 Value 8105,277.20 $9,424.80 $114,702.00 Date Calculated 09n9t2003 09n9t2003 Total Value of Project Date PaidFee Description Plan Review Same As + l0o/o Administrative Fee + 7oh State Surcharge Sanitary Sewer - lst 50 Feet Sanitary Sewer Each Addtl 100' Total Amount Paid Amount Paid $100.00 $5.90 $4.13 $4s.00 $14.00 $169.03 Receipt Number 1200200000000002119 1200200000000002301 1200200000000002301 1200200000000002301 1200200000000002301 F'ees Paid Plan Reviews Initial Review Planning Review Public Works Review Public Works Review 09n6t2003 09n9t2003 09n9t2003 09119t2003 10/r0/2003 09t24t2003 APP APP WI LLH TAJ VRJ 1010612003 10t06t2003 wE vRJ Site plan does not show storm drainage nor any utility connections or driveway locations. Contacted contractor 9 124 I 2003 regardin g storm only, plans to take storm to 'ditch' in S 42nd Place. I have spoke with our Infrastructure Specialist and am waiting on information from Maintenance Surface Water Supervisor for information on storm drainage. Improvement agreements are being written by Survey. Storm drainage to drain to Daisy Street via a private easement. Public Works review is complete, waiting for private easement from applicant. NO CONCRETE in public road right of way, please keep all concrete for driveway on private property. Encroachment permit is required if storm drainage requires new weephole. Structural Review 09n9t2003 Page 2 of3 Valuation Description I Buitding/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: COM2003-00933ISSUED: 10/13/2003 APPLIEDz 0911912003 EXPIREST 0411312004VALUE: $ 114,702.00 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. 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 times during construction. of the property, and the approved set of plans will remain on the site at all /o.-t3-o3 Contractors Signature Date /lWA772p ,4?tfrtral /'4a# aD'*/rz /an Paee 3 of3 Keourreo lnsDecuons I 225'Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone j.City of Springfield Ofricial Receipt Development Services Department Public Works Department Receipt #:I Date: I 10:11:43AM coM2003-00933 coM2003-00933 coM2003-00933 coM2003-00933 Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtl 100' +'lo/o State Surcharge + lUYo Administrative Fee Item Total: 45.00 14.00 4.13 5.90 $69.03 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check GYANENDRAPRASAD dlm 2317 In Person Payment Total: s69.03 -5695r