HomeMy WebLinkAboutPermit Building 2008-11-12
Status
Issued
CITY OF SPRINlJ1<lELD'
Building/Combination Permit
PERMIT NO: COM2008-01649
ISSUED: 11/12/2008
APPLIED: 11/12/2008
EXPIRES: 05/12/2009
VALUE: $ 3,500.00
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726"3676 Fax
54I-726-3769 Inspection L,ine
SITE ADDRESS: 112 A ST
ASSESSOR'S PARCEL NO.: 1703353201101'
Springfield TYPE OF WORK: Carport
TYPE OF USE: Alteration
Commercial
PROJECT'DESCRIPTION: Enclose East side of covered breezeway
Owner: SLACK TODD P & JOY L
Address: 112 N A ST
SPRINGFIELD OR 97477
Contractor Type
I CONTRACTOR INFORMATION 1 '
?':-r-,,~-:-r.._,.. ,....-iti~;;;.t.Il~.I....-:;'; ......'.....,.:..-J.. "."..,
Contractor:,Jlfi r;; ;" ,"~ ,~, !i;], "', , '::" ' . , "License Expiration Date Phone
h!Dt!iicatill;IC;;:..ii,t-1~ -lH~I." ',. "....'!~ f~~." <".f. 1.., 1
# of Units:
Primary Occupancy Group:
Secondary Occupallcy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I"".,"..n.u'.vy.... ~~, "...~._....
OO\;\J).YOllllr;rBUlbDING INFORMATION .;),1
calling the cem'~r. (NOW: "'" ''''''1''''''''''
number for th€lhOff~t<iiies:mty Nollilcu.tloll
U Center aelgllilllf:stllt?ct&f'~,
Type, of Heat:
VB . Water Type:
"Range Type:
""Energy Path:
',~pri.~~h'.,d.,Buildiilg:" No
-,
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION 1
NoneEt .
,'"' "oJ', , ~I"RE 11' if HE ,WORK
l~~H~~~~Nt\8Fil~iM~fitR10lt is NOT
'COMMENCE~'UfPlgrJwmnONED FOR
ANY 180 DAY'~R1tJ6.overage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS 1
Street Improvements:
Storm Sewer Available:
, Speciallustruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Description I
Descr~ption
Type of Construction
$ Per Sq Ft.
. or multiplier
Square Footage
or Bid Amount
, Value
Date Calculated
Page I of2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2008-01649
ISSUED: 11/12/2008
APPLIED: 11/12/2008
EXPIRES: 05/12/2009
VALUE: $ 3,500.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Bid Amount
Use Bid Amount
$1.00
3,500.00
$3,500.00
. $3,500.00
11/12/2008
Total Value of Project
Fees P~id 1
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Building Permit
Amount Paid
Date Paid
Receipt Number
$6.97
$8.37
$3.49
$69.72
11/12/08
11/12/08
11/12/08
11/12/08
1200800000000001129
1200800000000001129
1200800090000001129
1200800000000001129
Total Amouut Paid
$88.55
I Plan Reviews ,I
TO,Request an inspection call the 24 hour recording at 726-3769. 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
w,ork day.
I ,~~iJ.\!, ir~,d J nS!lec.ti'!,~~.1
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Final Building: After all required inspections have been requested alld approved and the building is complete.
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 thisproject.
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.
./?
~
'/~2h~
Date I /
Owner or Contractors Signature
Page 2 of2 .
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0l649
COM2008-0l649
COM2008-0l649
COM2008-01649
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
, Description
Building Penn it
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
MAJOR F AMJL Y FUNERAL
HOME
City of Springfield Official Receipt
Development Services Department
Public Works Department
'1200800000000001129
Date: 11/12/2008
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cjc
4298.
In Person
Payment Total:
Page ]' of I
2:14:36PM
Amount Due
69.72
3.49
8.37
6.97
$88.55
Amount Paid
$88.55
$88.55
I I1l2/2008
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
City Job Number (]7.y ';?'-I 'i Date 11/; .?~ 8'
D I & 2 Family Dwelling or Accessory 0 New Construction 0 Demolition
o Multi-Family 0 Addition/AlterationlReplacement 0 Other
o CommerciaVIndustrial 0 TenanHmprovement
Job Address IIZ-N . .4 S+.
Lot Block
,r.
Subdivision .
Bldg No. Suite No.
Tax Maprrax Lot /lJrf? :7"-;>:;_ all DJ
Project Name
Description of Work/location on premises/special conditions :1x-ee7~
D
Name ~~ S \....c.k.
Mailing Address l \ t- N. fJ, S+ -
City So"J ~~,.('",-\II. State of.. Zip "'i7'-177
~
Phone 011- 7'-f' . "1'" 7 Fax Nt -')<[7-110 Z.
Owner Representative "T:d6. S\...~
Phone .\'-1/ - 7<.f(" ,'f'" 7 Fax rT/-7'fl-fr7 Z.
SQFt
X $/SQ Ft
Value
New Dwelling Area
Garage/Carport Area
Other Structure Area
Tota(Value "".,__' &3c;;:ap
r;m~~"'?"",0EOi>~?'li'i~m~ffi"'''lIi' _;nr1!ITrITL~iJ"''''''1M,",-*m,'-'':C'''N~'''''j~m~'!II''A\.>*JmsmP'''''''''i*'Ii!' "~IlIi" ~ . .-a
t'<>-','P<'''''iil***=''*' *' """ """"w,**'....C'w,.....,._...,.,._$"',,,,u'?""w __,_,,""010" _"'''Ii '7~ ~ "~",~-,"",,,,;",,r;.~.. Riil!. _
""'.-- -,.,-,.. '1"'1: ."".....:;ii:'"'I"M..'ltt''>.v .....- '1-' "'Wiil""-'1I!'~ . .
rff~()l!!~la F.i,,-~~~!!L.r: u . ~~am!___Y4?;~~~!m;~mTi@g0,Aj:t02t,,,,,x*,g~;,,,,,"
SQ Ft X $/SQ Ft Value
o
Name ~/ cdd 5/~ c...K
Mailing Address
Existing Building Area
New Building Area
City
Phone
. State
Fax
Zip
Total Value
D
Name
Address
City
Contact Person
Phone
Existing
New
State
Zip
Occupancy. Groujl( s)
Const. Type( s)
Number of Stories
Fax
D
General
Plumbing
Mechanical
Electrical
o Ireoil'ffiierciiilllfitii':1l'tmalfRiiQjec:t~lI
Has site review application been submitted?
DYes D No 0 N/A
If so, Name of Planner
Journal Number
o
Heat Source:' Primary
Water Heater Range
Do you require any of the following for this project?
Over-width or Second Driveway 0 Y~s D No
Temporary Power 0 Yes D No
Air Conditioning DYes 0 No
Notice: All contractors & subcontractors are requiTed to be licensed with the Construction Contractors Board oflbe State of Oregon
under provisions ofORS 701 and be to be licensed in the where work is being performed.
Energy Path
I PLAN CHECK FEE I ~.. s:;.. I RCPT# . I
BUILDING P.ERMIT
I DATE I 11//2.-/.1 F I BY
APPLICATION
Shared Drive(T:)IBuildingFormsIBuilding Permit Application 3-08.doc
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