HomeMy WebLinkAboutPermit Plumbing 2005-10-7
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~ CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01385
ISSUED: 10/0712005
APPLIED: 10/05/2005
EXPIRES: 04/07/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5733 Mt VerDon Rd
ASSESSOR'S PARCEL NO.: JASPER MEADOWS 4T
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
PROJECT DESCRIPTION: Storm Sewer Line for Private Street Improvements
Residential
Owner: HAYDEN HOMES
Address: PO BOX 883
SPRINGFIELD OR 97477
Phone Number: 541-228-1081
Contractor Type
Contractor
I CONTRACTOR INFORMATION'
License
Expiration Date Phone
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# 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:
nla
I DEVELOPMENT INFORMATION'
IiIIOTI~: l<! ~ ~WO~ ~
Frontyard Setlf~ PERMI'i' SHALl ~PIR!; ! ist:
Side I SetbackAUTHQRIZED UNDER THIS PERM ~~ rees Rqd:
Side 2 Setback!;.QtJlMENCED OR IS ABANOONEONOSfJ Drive Rqd:
Rearyard Setb~'i'N 1M 9/!:M ~!;ffi09. % of Lot Coverage:
Solar Setbacks.
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Description
Sidewalk Type:
I w requireS you to
ATTENTION: Oregon a 0 n Utility DownspoutslDrains:
follow rules adopted by th~le~e;r~ set forth
Notilication Center. Those hOAR 952-001-
. 52 001-0010 throug
1~~~~Rv:'.. ;",,,, obtain copies of the rules by
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II' g t~e G""'''' I' W'_' . t
ca In," I 0" DA;;;;'j'l.,,':f;c tion
mber I...'a ua on,( "."r ~lIon
nu CerllPr is 1-800-;J;j.,:-"'"....J.
. $ Per Sq Ft Square Footage
Tvpe of Construchon It' Ii B'd A t
. or mu Ip er or I moun
Value
Date Calculated
Storm Sewer Available:
Speclallnstruction:
Notes:
Paee I of2
.
. CITY OF SPRINGFIELD"
Building/Combination Permit
PERMIT NO: COM2005-01385
ISSUED: 10/07/2005
APPLIED: 10/05/2005
EXPIRES: 04/07/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Ff'f'S Pairl I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Storm Sewer - 1st 50 Feet
Storm Sewer Eacb Addtl 100'
Amount Paid
Date Paid
$5.90
$4.13
$45.00
$14.00
10/7/05
10/7/05
10/7/05
10/7/05
Receipt Number
2200500000000001398
2200500000000001398
2200500000000001398
2200500000000001398
Total Amount Paid
$69.03
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.
~nf'f'tio"i.l
Storm Sewer Line: Prior to fiUing trench.
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.
~ 7:.5~
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Owner or Contractors Signature
Date
Pa2e 2 of2
2;25 Fifth Street
Spring~eld, Oregon 97477
5"41-726-3759 Phone
Job/Journal Number
COM2005-0 1385
COM2005-0 1385
COM2005-0 1385
COM2005-0 1385
t Payments:
''"'I''ype of Payment
CreditCard
,;
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"
101712005
.
RECEIPT #:
.~r
~l
llllii.ity of Springfield Official Receipt
wevelopment Services Department
Public Works Department
2200500000000001398
Date: 10/0712005
Descrlptlon
Stonn Sewer - 1 st 50 Feet
Stonn Sewer Each Addtl 100'
+ 7% State Surcharge
+ 1O%'Administrative Fee
Paid By
HAYDEN HOMES
Received By
LLH
Page I of 1
Item Total:
Check Number Authorization
Batcb Number Number How Received
070093 Phone
Payment Total:
2:30:39PM
Amount Due
45.00
14,00
4.13
5.90
$69.03
Amount Paid
$69.03
$69.03