HomeMy WebLinkAboutPermit Miscellaneous 2002-4-22
-''-e
i
I Job# 02-00473-01 I
.
Page 1 of 2
I RAhSil Ol-OC0869?
JP.TE' IjJf, ;CL ;:01;',
AI'~T ~::CD :;. ) l'JC I__~:
CH^N[ C . -(' '.'
,-.1 J'_, II j 1_..,.1
CASH.i:="\:Ot I
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00473-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 413 W Olympic St Spr
Assessors Map#: 17032741
Lot: Block: Addition:
Tax Lot #: 02800
Subdivision:
Owner:
Phone Number: 541 o-'>~~ ~
, , ~.,,~ ,,~~~ ~~
City/State/Zip: ,)-SPe.l)gfle!~ O~ 97477
\0~ 0<:$ .,,0 s:p .
Repair '1>~ 00~ 'i>~~@1U'e:0.,,'$3,500
.....cf:' ,\~ ,s.0 't-((." \~ 0
O\'?l" o'Q' 0~ ~O "S'0 ~o~, :(\
-<,O~:^O~\~ -<''(;\~~\O-.)~C>$ 0: ,0\0~~,#0
r.,- "'- ~~. \v' QY ,'1)'- _W'
~v ,s.0 r.0~ ~<:l .>(\v l..0' ".!'- ,,-.
Contractor ~ O~ \ '0'<- R~-!liSt!:S$iot\1!J J.xPjr!!lion Date
o~ ~ ,,5:J ,0 ~.~:(\ .f).1;
Steven Tofflemoyer "I ~,v r>.~';;66~:45",<-\0 0~0 ,,5/,1'5/2002
. ," 't-r II> ' c,~ 0\ ~"
PO Box 197, Springfield, OR 974?70 -{o "S'0 "S'0. ,,'8
,,<- "CI. ,~o. .., .,."
f\V- n..\" ~ ,- ~'CJ.
Office Use~'O' :(\;.C>i v'}~
(\~
Quad Area: land Use: # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr. Type: Bedrooms: Heat Source:
Water Heater: Range: Sq. ~tage:
-*.
To request an inspection call the 24 hour recording at 726-3769. All inspections!.eqb~sted before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.~'i.wUl be mad~he following
working day. ~i? .> ..) ,"<v
~'- -< \~.,
Required Insp8ctioilll c.-- ..."
"tJ .\:'..... r-.. ,1 ~
I Buil\}ing.... ( ,~."",
- ..... <) ,
-Steel location, bond beam~grouti~ or ve.rlicals ~cordance with use 2415.
-Prior to facing meterials anctframihg inspecJiC(ft;~V'"-
-When all required inspection~~ave be~proved and the building is complete.
()> >:\'~
~
Cindy Weber
Address:
413 W Olympic St
Scope Of Work: Single Family Residence
Repair wind damaged chimney
Contractor Type
General Contr
Phone
541-726-6752
Masonry
Fireplace
Final Building
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
rArea (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
.
.
"
Fee
Building Permit
State Surcharge For Building Permit
8% Building Administrative Fee
Total Building
Grand Total
Job# 02-00473-01
Paid On Receipt#
Building
04/22/2002 8692
04/22/2002 8692
04/22/2002 8692
.
Page 2 of 2
Value/Quantity
3,500
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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, I further state that only contractors and employees who are in compliance with
ORS 701.055 will be us n this project. I further agree to ensure that all required inspections are
requ t t e prop I l.lhe project address is readable from the street, that the permit card
is 10 te t e fr th property, and the approved set of plans will remain on the site at all times
during ucti
Fee Amount
$60.60
$4.24
$4.85
$69.69
$69.69
1;"2210'-
Date