HomeMy WebLinkAboutPermit Building 2009-6-5
CITY, OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: cOM2009-00781
ISSUED: 06/0512009
APPLIE D: 06/04/2009
EXPIRES: 12/05/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
SITE ADDRESS: 380 S 58TH ST
. ASSESSOR'S PARCEL NO.: 170233440]601
Springfield TYPE OF WORK: Bathroom
TYPE OF USE:
PROJECT DESCRIPTION: Ownerto remodel bathroom to make it ADA
Residential
Owner:
Address:
EHL PROPERTY LLC . laW requires youto
399 E 10TH AVE STE ]01 ATTENTION: Ole~o; by the oregon U~\itih
EUGENE OR 97401 toll oW rules adop eThose rules are sezt 00~1_
'f allon Center. hOAR 95 -
EHL PROPERTY LLC ~o~~~ 95Z-001~001 0 thrOu~s of the rules by
399 E 10TH AVE STE 101 In You may obtain Copl. the telephone
EUGENE OR 97401 0090\.\. n the center. (Notle)t' 'l'tV Notification
r.A. m~ _ r-.~",....\t'\n \ \
number \UI ~""':: -I J~.()()_332-'L6~'"t'J'
I.Cl;)Nl'~CTOR INFORMATION I
Owner:
Address:
Contractor Type
Contractor
License
Expiration Date Phone
..BUlLDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Constrnction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
~~OTICE: Height of St(:~ffit IF iHE WORK
;THIS PERN!Npe\J"H~a\HIS PERMIi IS NOi
VN UiHORlz~retmtPe: ONED FOR
~OMMEN~t'/J~(I;~eI\BAND
fl,NY i 80 ~tY;n~~'W,;ilding No
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2~d Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENTINFORMATlON I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
.Compact:
I PUBLIC ]MPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special ]nstruction:
Sidewalk Type:
Downspouts/Drai~s:
Notes:
Page] of2
_~!'lINOfl~Q,;.
~ -; ..
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753.Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
Description
Type of Construction
Fee Description
+ 12% State Surcharge
+ 12% State Surcharge
+ 5% Technology Fee
Fixtnre
Not Covered Plumbing
Total Amount Paid
Plumbing Plan Review
06/04/2009
I Valuation Descriotion ,
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
CITY'OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00781
ISSUED: 06/05/2009
APPLIED: 06/04/2009
EXPIRES: 12/05/2009
VALUE:
RWC
Value
Date Calculated
Total Value of Project
Fees Paid I
Amount Paid
Date Paid
Receipt Number
]200900000000000627
]200900000000000627
1200900000000000627
]200900000000000627
]200900000000000627
field verify changes to ADA
To Request an inspection call the 24 hour recording at 726-3769. All inspections re!}uested 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.
$6.84
$13.80
$2.85
$57.00
$58.00
6/5/09
6/5/09
6/5/09
6/5/09
6/5/09
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 eontractors 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.
~-_.~.
c.... -2.\;:..
. - I
Owner or Contractors Signature
$138.49
I Plan Reviews I
06/03/2009
10
Reouired Insnec~!?,!!.~ ,
Page 2 of2
lc('5\o~
Date
225 Fifth Street
Springfield,Oregon97477
541~726-3759 Phone
Job/Journal Number
COM2009-0078I
I COM2009-00781
COM2009-0078I
COM2009-0078I
COM2009-0078!
COM2009-00782
COM2009-00782
COM2009-00782
COM2009-00782
. Payments:
Type of Payment
Check
cReceintl
City of Springfield Official Receipt
Development Services Department
P4blic Works Department
RECEIPT #:
1200900000000000627 .
Date: 06/0512009
]] :02:52AM
Description
Fixture
+ 5% TechnologyFee
+ 12% State Surcharge.
Not Covered Plumbing
+ 12% State Surcharge
.Fixture
Moved Structure Plumbing Conn
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
57.00
2.85
6.84
58.00
13.80
57;00
58.00
13.80
5.75
$273.04
Paid By
ELDERHEEALTH AND
. LIVING
Item Total:
Check Number Authorization
R~ceived By Batch Number Num,ber How' Received
cjc 4179 In Person
$273.04
Amount Paid
. Payment Total:
$273.04
/
Page I of I
6/5/2009