HomeMy WebLinkAboutPermit Building 2009-5-20
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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City Job Number
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Name
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Phone '1tI4 - (,,'>-,7<0' Fax 7't <I, (" ":> 7 'I
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SPRINGFIELD
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Contact Person Number of Stories
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Mechanical
Electrical
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Has site review application been submitted? Heat Source: Primary , Secondary
DYes 0 No )a"N/A Water Heater Range Energy Path
If so, Name of Planner Do you require any of the following for this project?
Journal Number Over-width or Second Driveway 0 Yes 0 No
Temporary Power 0 Yes 0 No
Air Conditioning 0 Yes 0 No
Notice: All contractors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon
under provisions ofORS 701 and maybe required to be licensed in the jurisdiction where work is being perfonned.
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BUILDING
PERMIT
APPLICATI,ON
Shared Drive(T:)lBuilding Forms/Building PcnnitApplieatioIl 3-0S_doc
Status
Issued
225 Fifth Street, Springfield, .oR
541-726-3753 Phone
541-726-3676 Fax
541-7i6-37691nspection Line
(.. ( .
. ~. ~Y CITY OF SPRINGFIELD
~ / :J."-if'" Building/Combination Permit
~ J~.:1~.,.sf . PERMIT NO:COM2009-00711
.J-..V ~ ,..0\ ISSUED: OS/21/2009
VJ V 'APPLIED: OS/21/2009
'- r..,/J;)1J .NfJ' ~~/""~ EXPIRES: OS/21/2009
J SJ" -,) . VALUE: $ 9,000.00
SITE ADDRESS: 525 MILL ST
ASSESS.oR'S PARCEL N.o,: 1703352304500
Springfield TYPE .oF W.oRK: School
TYPE .oF USE:
Public
PR.oJECT DESCRIPTI.oN: Replace Siding
.owner: SPRINGFIELD SCH.o.oLDlSTRICT 19
Address: 525 MILL ST
SPRINGFIELD .oR 97477
I C.oNTRACT.oR INFCmMATION I
Contractor Type
Contractor
License
Expiration Date Phone
# of Units:
Primary .occupancy'Group:
Secondary .occupancy Group:
Primary Construction Type
Secondary Construction Type: .
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
. BU]LDINGI~F.oRMATl.oN I
E
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft .other:
.occupant Load:
VB
n/a
I DEVEL.oPMENT INF.oRMATI.oN I
REQUIRED PARKING
Total:
Handicapped:
Compact: '
.overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPR.oV~MENTS I
Sidewalk Type:
Downspouts/Drains:
I Valuation DescriDtion I
$ PerSq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Value
Date Calculated
Page I of2
Status
Issued
CITY OF SPRINGFIELD I
Building/Combination Permit
PERMIT NO: COM2009-007I 1
ISSUED: OS/21/2009
APPLIED: OS/2112009
EXPIRES: OS/21/2009
VALUE: $ 9,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769. Inspection Line
\
Total Value of Project
Fe~s Paid I
Fee Description
Amount Paid
Date Paid
Receipt Number
, Total Amount Paid
$0,00
I Plan Reviews ~.
To Request an inspection call the 24 hour recording at 726-3769. AU 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
work day.
I Reouired In~n~,~tio'1~ I
Final Building: After all required inspections have been requested and 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 he done in accordance with
the Ordinances of the City of Springlield 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 he 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
ti s d' struefioo. '
1 J '"' ^ ~_______
s/?- ( 1:n4
Date t ~
Owner or Contractors Signature
,
Page 2 of 2
225 Fifth. Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00711
COM2009-007,I I
COM2009-00711
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Building Penn it .
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
GARY NEWMAN
~R~GY~~_
Jar..
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000515.
Date: OS/21/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
025931 In Person
Payment Total:
Page 1 of 1
1:30:17PM
Amount Due
126.25
6,31
15,15
$147,71
Amount Paid
$147,71
$147,71
5/2112009