HomeMy WebLinkAboutPermit Building 2010-4-20
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Iss u ed
PERMIT NO: COM2010-00485
ISSUED: 04/20/2010
APPLIED: 04/20/2010
EXPIRES: 10/20/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1747 J ST
ASSESSOR'S PARCEL NO.: 1703362101300
Springlield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
Public
_ PROJECT DESCRIPTION: Water line and Encroachment Permit
Owner: PINO JARED S
Address: 1747 J ST
SPRINGFIELD OR 97477
Contractor Type
Plumbing
Contractor
OWNER
I CONTRACTOR INFORMATION .
License
Expiration Date Phone
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BUILDING INFORMATION ~
# 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:
n/a
I DEVELOPMENT INFORMATION ~
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dis!: '
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
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I PUBLIC IMPROVEMENnlr.~del~1 a~; ':aION) 'JalUaO 8416U!I(9:)
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Speciallnstructi?,'15 PERMIT SHALL EXPIRE IF nlltwoRK
JTHORIZED UNDER THIS PERMIT IS NOT
'tvlMENCED OR IS ABANDONED FOR
Notes:
I uu un
I Valuation Description ~
-. -. ._- .--.. ::-;~~"'"
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of 2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Encroachment Permit
Water Line - 1st 100'
Amount Paid
$9.12
$10.78
$139.50
$76.00
Total Amount Paid
$235.40
!.....~
Total Value of Project
Fees Paid ,
Date Paid
4/20/10
4/20/10
4/20/10
4/20/10
I Plan Reviews I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00485
ISSUED: 04/20/2010
APPLIED: 04/20/2010
EXPIRES: 10/20/2010
VALUE:
Receipt Number
2201000000000000378
2201000000000000378
2201000000000000378
2201000000000000378
To Request an inspection call the 24 hour re'cprdin.g' 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. .
Reouired InsDections ~
Water Line: Prior to filling trench and including required testing.
Encroachment: After item(s) have been removed to inspect condition of public right of way.
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 th ermit card is located at the front f the property, and the approved set of plans will remain on the site at all
times durin c nstruction
j
Owner or Contractors Signatur/
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Pa2e 2 of 2
Date
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.J7;~
WiL.
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000378
Date: 04/20/2010
1:22:18PM
Job/Journal Number
C0M2010-00485
COM201O-00485
C0M2010-00485
COM2010-00485
Payments:
Type of Payment
CreditCard
cReceintl
Description
Water Line - 1st 100'
+ 12% State Surcharge
Encroachment Permit
+ 5% Technology Fee
Paid By
NICOLE TULEY
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
76.00
9.12
139.50
10.78
$235.40
Amount Paid
Ikw
810839 In Person
Payment Total:
$235.40
$235.40
Page I of I
4/20/2010