HomeMy WebLinkAboutPermit Miscellaneous 2009-5-15
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00677
ISSUED:. 05/15/2009
APPLIED: 05/]5/2009
EXPIRES: 01/13/20]0
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3~76 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 750 66TH ST
ASSESSOR'S PARCEL NO.: 1702341300200
Springfield TYPE OF WORK: Curbcut
TYPE OF USE: New
PROJECT DESCRIPTION: Wastewater SDCs, Curbcut, and Plumbing.
Public.
Owner: LUNDBLAD ROY W
Address: 1444 VERA DR
SPRINGFIELD OR 97477
Owner: MIKE BLANKENSHIP CORP
Address: 8063 THURSTON RD
SPRINGFIELD OR 97478
Phone Numher: 541-746-0194
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
OWNER
License
Expiration Date Phone
BUILDING INFORM;\- TlON' .
VB
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy.Path:
Sprinkled. Building:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
n/a
..
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I. DEVELO:,l~~t\ IHrf?RMATlON I
'r-'f...\' \"~ \-fiX \".
~O~\C\\-fI\\ '2>\\r>-\.~?- \~ ?~w.r,o?-
\\\\'2> ?\\l'r-D \}~D \'2> r>-~eet Trees Rqd:
r>-\}\\\O C'r-D O?- Dlaved Drive Rqd:
CO\-fl\-fl'r-~ Dr>-'{ ?'r-?-\O % of Lot Coverage:
[l.~'{ \'O\)
REQUIRED PARKING
Total:
Handicapped:
Compact:
Notes:
Roof drains routed to weep holes at curb line..
I PUBLIC IMPROVEMENTS I
Sid~lValk.TYe'"
ATTEN IIUN:Ure~n law reqUIres you to.
. follow lillW'~'!Wlhe OrsijQfl Wlity
\lotification Center. Those rules are Mf fOI
n OAR as2~' -GO 1 0 tMNgh OAR _..00
)090. You mayObtlill ,.,: .., gf tM r.s I
oaI1illt tne ee"". (Nol9: .1Ple t"'phone
I1tImber for tn. 0feQ0Cl WIn, NotifiHnor]
is 1-800-332-234-).
Street Improvements:
Storm Sewer Available:
Special Instruction:
Page I 01"3
-':'SR",\~i;'~~:91 !!"";"
~
Status'
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541;726-3676 Fax
541-726-37691nspection Line
Description
Tvpe of Construction
Fee Description
+ 5% Technology Fee
Curhcut Permit
+ 12 % State Surcharge
+ 5% Technology Fee
Sanitary or Storm Sewer Cap
Sanitary Sewer - 1st 100 Feet
Sanitary Sewer - Improvement.
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimhursement
SDC Sanitary/Storm Admin
+ 12% State Surcharge
+ 5% Technology Fee
Storm Sewer - 1st 100'
Water Line - 1st 100'
Water Line - Each Addtll00'
,Total Amount Paid
CITY OF Snur"GFIELD
Building/Cqmbination Permit
PERMIT NO: COM2009-00677
ISSUED: 05/15/2009
APPLIED: 05/15/2009
EXPIRES: 01/13/2010
VALUE:
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Fpp<, Pqifl J
Amount Paid
Date Paid
Receipt Number
2200900000000000533
2200900000000000533
3200900000000000377
3200900000000000377.
3209900000000000377
3200900000000000377
3200900000000000377
3200900000000000377
3200900000000000377
3200900000000000377
3200900000000000377
3200900000000000377
2200900000000000789
2200900000000000789
2200900000000000789
.2200900000000000789
220~900000000000789
$4.40
$88.00
$16.08
$6.70
$58.00
$76,00
$504,88
$663.96
$10.00
$1,009.17
$97.90
$114.30
$20.52
$8.55
$76,00
$76.00
$19.00
5/15/09
5/15/09
5/19/09
5/19/09
5/19/09
5/19/09
5/19/09
5/19/09
5/19/09
5/19109
5/19/09
5/19/09
7/13/09
7/13/09 .
7/13/09
7/13/09
7/13/09
$2,849.46
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
work day.
~rp.1, Insnections.1
Curbcut- Standard: After forms are erected but prior to placement of concrete,
Septic Tank Pumped: After septic tank has been pumped and filled, Please provide the inspector with receipt and
verification from company performing pump and fill.
Paee 2 of 3
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~
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00677
ISSUED: 05/15/2009
APPLIED: 05/15/2009
EXPIRES: 01/13/2010
VALUE:
.
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filliug trench.
Water Line: Prior to filling trench and including required testing.
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 1 further certify that any aud all work performed shall he done in accordance with
the Ordinances of the City of Spriugfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will he made of any structure without permission of the Community Services Division, Building Safety.
I further certify that ollly contractors 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 perm' card is located at the front of the property, and the approved set of plans will remain on the site at all
times during constr tion.
cI I A l~
Owner or v.. (.ltracto Signature
1 f,);\ I '1
Date I' ~/ I
Page 3 of 3
225.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00677
COM2009-00677
COM2009'00677
COM2009-00677
COM2009-00677
Payments:
Type of Payment
Check
cReccintl
RECEIPT #:
Description
Water Line - 1st 100'
Water Line - Each Addtl 100'
Storm Sewer - 1 st 100'
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
MIKE BLANKENSHIP CORP
2200900000000000789
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 07/13/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
Page 1 of I
12547
In Person
Payment Total:
2:06:IOPM
Amount Due
76.00
19.00
76.00
8.55
20.52
$200.07
Amount Paid
$200.G7
$200.07
7/13/2009