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HomeMy WebLinkAboutPermit Building 2000-04-28SPRINGFIELD Job# 00-00621-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety spr Addition Page 1 of2 TRflNES:01-00013?l I}ATE: AF,R TB TOOO AilT REID:I $ 20.00 CHRNEE:$ O.TO IAEHIER:059 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 132 S 0001sth St AssessorsMap#: 17033632 Lot: Block: Job Number: 00-00621 -01 Office:726-3759 Inspection Line: 726-3769 Tax Lot#: 05600 Subdivision: ctTY oF sPRtNcFtEL4 OREaON Owner: Joe Balaty Address: 33398 Howe Lane Scope Of Work: Foundation Only Phone Number: City/State/Zip: Repair 541 -895-5073 Creswell, OR 97426 Value: $1,000 Quad Area: # Of Units: Constr. Type: Water Heater: office use _ Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: 9q.Footage: To request an inspection call the 24 hour a.m. will be made the same workin g day, working day Footing Foundation Fina! Building -After trenches are excavated # Of Stories: Current Units: Census Accessory:Total: Paid On ng -After forms are erected but prior to concrete placement. -when all required inspections have been approved and the building is complete. Gonstruction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq Main: Fee HOJ slrltNUSd SIHI :SclIoN 04t28/2000 04t28t2000 Receipt# Vatue/euan 1393 1393 tity Fee Amount $1S.00 $1.26 Foundation Only State Surcharge For Building permit 1,000 auI isldol 00'e96 recording at 7:00 SOln] ttlt i' r0nci nL00-t o0ldope -l I 'oolHSdAvo 08t ANv Job# 00-00621-01 Page 2 of 2 Fee Paid On Receipt# Vatue/Quantity Fee Amount Build Building Administrative Fee Total Building 0412812000 1393 $.54 $19.80 Grand Total 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that the project 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 constru Date $19.80 ?- 26-oa