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HomeMy WebLinkAboutPermit Building 2000-3-16 ~ '. I Job# 00-00413-01 I . Page 1 of2 TRANS#:01-0000962 DATE:MAR 16 2000 AMT RECD:2 $ 416.50 CHANGE: CASHIER: 004 ". CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-00413-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 2005 OLYMPIC St Spr Assessors Map#: 17032542 Lot: Block: Addition: Tax Lot #: 00506 Subdivision: Owner: Address: LARRY POLEN 2197 OLYMPIC STREET Phone Number: City/State/Zip: Remodel 541-746-6965 SPRINGFIELD, OR 97477 Value: $40,000 Scope Of Work: Commercial LEVEL CONCRETE SLAB FLOOR FOR FUTURE LEASE TENANTS. Contractor Type Contractor Registration # Expiration Date General Contr Ordell Construction Co 63030 1/2/2000 360 Shelley St, Springfield, OR 97477-1963 Phone 541-747-8734 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: 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 working day. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D [Ar~a (Sq. Feet) ~ Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# Plan Check 03/16/2000 0000962 Value/Quantity Fee Amount Commercial Plan Check Total Plan Check 40,000 $154.70 $154.70 Building Permit State Surcharge For Building Permit Buildin!l 03/16/2000 0000962 03/16/2000 0000962 40,000 $238.00 $16.66 ~ . Fee Building Administrative Fee Total Building Grand Total . Job# 00-00413-01 Paid On Receipt# r Buildin!l 03/1612000 0000962 . Page 2 of 2 Value/Quantity Fee Amount 1 $7.14 $261.80 $416.50 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 used on this project. I further agree to ensure that all required inspections are requested at the proper time, that the project 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 dur~ construction. /6 '3 _ /6 _ 2at? \1,(U_ _ r". /' --,A __ Sign~re 0 Date