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HomeMy WebLinkAboutPermit Building 2001-02-28CTTY OF SPRINGFTE LD, OREGON Job# 01-00180-01 RES!DENTIAL PERMIT City Of Springfietd Community Services Division Building Safety Addition: SPFINGFIELD Page 1 of 2 225 North Fifth Street Springfield, OR974T7 Location Of Proposed Site: T4S 00023rd St Assessors Map#: 17033611 Lot: Block: Owner: Loyce Peters Address: 745 23rd Scope Of Work: Single Family Residence spr Phone Number: City/State/Zip: Demolish Job Number: 01 -001 80-01 Office:726-9759 lnspection Line: 726-376g Tax Lot#: 14800 Subdivision: Springfield, OR9747t Value: $0 Contractor Type GeneralContr Contractor S Greg Payne 535 River Loop #1, Eugene, OR 97404 Registration # Expiration Date Phone 541-688-7038 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 callthe 24hour 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. 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 Demolition State Surbharge For Building Permit Building Administrative Fee Total Building 02t2812001 0212812001 02t2812001 4577 4577 4577 1 $18.00 $1.26 $.54 $19.80 Grand Total $19.80 Job# 01-00180-01 Page2 of 2 By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information herein is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein. I also agree to call for the required inspections as noted above (726-3769) at the appropriate times. I also state that I was provided with Lane Regional Air Pollutions phone number and asbestos removal information. I further agree that the project address will be readable from the street, and the permit card is located at the front of the prope uring the demolition "e .$,) k-, t, ' gnature Date