HomeMy WebLinkAboutPermit Miscellaneous 2009-7-21 (3)
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01050
ISSUED: 07/21/2009
APPLIED: 07/21/2009
EXPIRES: 02/03/2010
VALUE: $ 5,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1064 I' ST
ASSESSOR'S PARCEL NO.: 1703351106100
Springfield TYPE OF WORK: Foundation
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace foundation
Owner: DUSTRUD PETER
Address: 2100 MADISON ST
EUGENE OR 97405
I. CON~RACTOR INFORMATION'
Contractor Type
General
Mechanical
Plumbing
Contractor
OWNER
OWNER
OWNER
License
Expiration Date Phone
. BUILDING INFORMATION I
VB
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st 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
I DEVELOPMENT INFORMATION.
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
:..!!OrIC .
/!-lJr. f.
n, JL:I\ltIfJf\1' o. . ....., ....t..R
loi/mv 1'1'/'>0 ~d leg~nl'PUBm(JiIIV!l1.RQV,\lMEN;I:SI !V/fr Sf!
Ne,tit'--" - C' oP,8d L'. "'0 v'~"on Ut'II't 'U"h '/'/'[.0 'A/ / '"
Street Improvements: ,:',3,.on ;mt"L Those I '" I~' ".1MD' - S'itlew:l1k'l,fpe"
In OF,:, S~2-0(J1-00-1 r~ es are set lorth'Vy 'vCEO ;:'Ul:R r. 'rlf IF
Storm Sewer Availatile:', ' ..'I, ';iJ.'1 Dbl,f Ihrougn OAR 952-001_ 180 DAy D6:''\'Bs~ouW.IDr~~: riff Wo
Special Instruction: c: .": C"Ji1pr" ~~~Ples of the rules by PfRIOD BANDON Mlr IS N RI(
""'. " riot! rJr~G Ie" the telephone . ED FO Or
Notes: (' ~' . ,;- on UtiJlty NOlitiCation . R
Je,,,,, IS 1-000-332-2344). '
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
Pa!!e I of 3
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jl
Sta tus
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description Tvpe of Construction
Bid Amount Use Bid Amount
Fee Description
+ 12% State Surcbarge
+ 5% Technology Fee
Foundation Permit
Minimum/Adjustment Mechanical
,Minimum/Adjustment Plumbing
Plan Review Residential
+ 12% State Surcharge
+ 5% Technology Fee
+ 5% Technology Fee
Sidewalk Repair Permit
Water Line - 1st 100'
Total Amount Paid
Structural Review
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01050
ISSUED: 07/21/2009
APPLIED: '07/21/2009
EXPIRES: 0210312010
VALUE: $ 5,000.00
I Valuation Oescrintion I
$ Per Sq Ft
or multiplier
$1.00
Squ'are Footage
or Bid Amount
5,000.00
$5,000.00
$5,000.00
07/30/2009
Value
Date Calculated
Total Value of Project
fpp" Pr,if1J
Amount Paid
Rec~ipt Number
Date Paid
$26.91
$11.21
$87.25
$79.00
$58.00
$56.71
$9.12
$0.78
$3.80
$15.50
$76.00
1200900000000000818
1200900000000000818
1200900000000000818
1200900000000000818
1200900000000000818
1200900000000000818
1200900000000000865
1200900000000000866
1200900000000000865
1200900000000000866
1200900000000000865
7/21109
7/21109
7/21109
7121109
7/21109
7/21109
8/3/09
8/3/09
8/3/09
8/3/09
8/3/09
$424.28
I Plan Reviews I
07/2112009
0712112009
APP DJB
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.
~~/n'l;,~nsnections I
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
'Undertloor Plumbing: Prior to insulation or decking.
Undertloor Mechanical. Prior to insulation or decking and including required testing.
Final Building: After aU required inspections have beeD requested and approved and the building is complete.
Water Line: Prior to filling trench and including required testing.
Sidewalk - Setback: After forms are erected but prior to placement of concrete.
Pa!!e 2 of3
Status
Issued
CITY OF SPRINGFIELD
. Building/Combination Permit
PERMIT NO: COM2009-01050
ISSUED: 07/21/2009
APPLIED: 07/21/2009
EXPIRES: 02/0312010
VALUE: $ 5,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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 tbe 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 Divisiou, Building Safety.
I further certify that only 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, tbat~ termit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during co strucOOn) ~
12~< 'lhl~~ J 3' 0]
. I
Owner or Contractors Signature Date
Pa!!e 3 of 3
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 I 050
COM2009-0 I 050
Payments:
Type of Payment
Check
\
cReceintl
RECEIPT #:
Description
Sidewalk Repair Pennit
+ 5% Technology Fee
Paid By
PETER DUSTRUD
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000866
Date: 08/03/2009
Item Total:
l:heck Number Authorization
Received By Batch.Number Number How Received
lkw 330 In Person
Payment Total:
Page I of I
8:22:00AM
Amount Due
15.50
0,78
$16.28
Amount Paid
$16,28
$16.28
8/3/2009