HomeMy WebLinkAboutPermit Miscellaneous 2004-1-12
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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. . Lll l' OF ~rtul~uNELD
Building/Combination Permit
PERMIT NO: COM2004-0004I
ISSUED: 01112/2004
APPLIED: 01112/2004
EXPIRES: 07/12/2004
VALUE:
Status
Issued
SITE ADDRESS: 1145 MAIN ST
ASSESSOR'S PARCEL NO.: 1703354107200
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Alteration
Residential
'. PROJECT DESCRIPTION: Water line
Owner: KRAMER STEPHEN P
Address: 42113 DEERHORN RD SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
TUCKER PLUMBING CO
License
109801
Expiration Date
11107/2004
Phone
541-343-8008
BUILDING INFORMA nON I
'\,
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
l.;.pe of Heat: ~sqJ!! 2nd Floor:
~<:<:- :..",ater Type: ~O~~'F:~asement:
~~ ~nge Type: ~0<O ~qlft ~age/Carport
'\'<:- :.\. ~,,~ergy Path: ~ 0<f ~~OJ;!J'k
('\.<v~<<-~:<>' '<.\5 _~<.0 o>O~o><o~p~~~~ceArea:
<&'~'<r.,g)ithLOPMENTINFORMA'I~l0<'.,} ~- & ~,W0~V-
SETBACKS i>' o.."'~o.."?>' ~"'- 0~ -<;:oS" ~O'li .!!>"';.s-0 ~UIRED PARKING
~ ~- ~v .0 ~.<.; ;$' d~ '. .~g
. Frontyard Setback: '. ~ Cj ~ ~ ~. Overlay Dist~: ~. ~ ~. "'(;).s. U lJ-0 ~ :[fotal:
Side I Setback: A..~<(, ~~ ~ .::;:, ":J~ ~\5 # Street Trees it..;~ 0~ p(;) ~ ~ 0<:0 <fj>~ Handicapped:
Side 2 Setback~~" -X<<; # r-<$> _, -X<<; Paved Drivl)(t ~!::<~ ($i>'" _\ i!> ~~ 0CfJ <5' Compact:
~#~~~ ~~~'~F6d~
Rearyard Setbac~ .;:;. ~ ~ <;;;j % of Lot (IO~~;j 0)", ~ 0 U 0 .,c."
Solar Setbacks: ~ ":J~ ,'l> ....0 ~ S 4,0>:';$' ~;$' ~ .
C\ ...4.. ,0 ,," ...0. ,:-0 I
~' I PUBLIC IMPROVEMilifst~0' (~.
Street Improvements: <:' Sidewalk Type:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-I
VN
Storm Sewer Available:
Special Instruction:
DownspoutslDrains:
Notes:
I Valuation Descrintion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pal!elof2
.
. CITY OF SPRIrljuJ1H..LlJ
Building/Combination Permit
PERMIT NO: COM2004-00041
ISSUED: OIJ12/2004
APPLIED: OIJ12/2004
EXPIRES: 07J12/2004
VALUE:
'I
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
~ Fp.p.s Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - 1st 50 Feet
Water Line - Each AddtlIOO'
Amount Paid
Date Paid
Receipt Number
$7:30
$5.11
$45.00
$28.00
1112/04
1112/04
1112/04
1112/04
2200400000000000025
2200400000000000025
2200400000000000025
2200400000000000025
Total Amount Paid
$85.41
I Plan Reviews I
'.
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.OIJirp.d Insnp.r.tions I
1 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 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 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.
~L 1-("2~'Y
Owner or Contractors Signature Date
Paee 2 of2
~'
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00041
COM200.4-00041
COM2004-00041
COM2004-00041
Payments:
Type or Payment
Check
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Receipt #: 2200400000000000025
Description
Water Line - 1st 50 Feet
Water Line - Each Addtl 100'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
STEPHEN P. KRAMER
Received By
Check Number
Batch Number Authorization Number
Jrnp
0435
City of SpringfieldOfficilll Receipt
Development Services Department
Public Works Department
Date: 01/12/2004 2:33:07PM
Amount Paid
45.00
28.00
5.11
7.30
$85.41
Item Total:
How Received
In Person
Payment Total:
Amount Paid
$85.41
$85.41
.
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