HomeMy WebLinkAboutPermit Building 2010-4-21
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 778 CREST LN
ASSESSOR'S PARCEL NO.: 1703341408101
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00492
ISSUED: 04/21/2010
APPLIED: 04/21/2010
EXPIRES: 10/2112010
VALUE:
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
PROJECT DESCRIPTION: Replacing approximately 125 ft of sewer line
Owner: LUTES DONALD H & DONNIE
Address: 2177 FIRESIDE CRT
SPRINGFIELD OR 97477
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Residential
I CON:fRACTOR INFORMATION ~
Contractor Type
Plnmbing
Contractor License
JENCOURT ENVIRONMENTAL SERVICES 1182531
BUILDING INFORMATION ~
Phone
541-689-171 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:
Expiration Date
06/11/2010
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Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION ~
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Pl!red Drive Rqd:
% ,of Lot Coverage:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
REQUIRED PARKING
Total:
lIandicapped:
Compact:
Storm Sewer Available:
Specb,Unstruction:
~IUTlCE:
NoteI;~~i~~~M/T SHAll EXPIRE IF THE WaR
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$ Per Sq Ft
or multiplier
Sidewalk Type:
ATTENTION!-\'3~q!MQelllllteS ~:v
follow rules adopted by the or~~ set with
Notification Center.' Those ru~e~AR 952-001-
inOAR952-001-0010thro~g ofth rules-
btaln copies e ....
a I g the center. 0.. IfIc8IiCft
fC er for the Oregon Utility Not
Center is 1-800-332-2344).
Square Footage
or Bid Amount
Description
Type of Constrnction
Paee I 01'2
Value
Date Calculated
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541~726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00492
ISSUED: 04/21/2010
APPLIED: 04/21/2010
EXPIRES: 10/21/2010
VALUE:
Status
Issued
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.' Total Value of Project
LFees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technulogy Fee
Sanitary Sewer - 1st 100 Feet
Sanitary Sewer Each AddtlIOO'
Amount Paid Date Paid Receipt Number
$11.40 4/21110 1201000000000000370
$4.75 4/21110 1201000000000000370
$76.00 4/21/10 1201000000000000370
$19.00 4/21/10 1201000000000000370
Total Amount Paid
$111.15
Plan Reviews I
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To Request an inspection call the 24 hour r~cqrding'at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, ins'p~ctions requested after 7:00 a.m. will be made the following
work day.
I Reouired InsDect~
Sanitary Sewer Line: Prior to filling trench and including reqnired 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 tlllitany 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 lie rein, and
that NO OCCUPANCY will be made of any strnc'ture 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 ca~d is located at the front of the property, and the approved set of plans will remain on the site at all
time~uril1g constructi n.
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Date
Owner or Contractors Signat
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Paee 2 of 2
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225..fifth,,:Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000370
8:51 :05AM
Date: 04/21/2010
J~b/Journal Number
COM20 I 0-00492
COM20 1 0-00492
COM20 I 0-00492
COM20 1 0-00492
Payments:
Type of Paym.ent
Check
cReccintJ
Description
Sanitary Sewer - I st 100 Feet
Sanitary Sewer Each Addtl 100'
+ 12% State Surcharge
+ 5% Technology Fee
Amount Due
76,00
19,00
llAO
4,75
$111.15
Paid By
JENCOURT ENVIRO
SERVICES, LLC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
njm
In Person
$IILl5
1157
Payment Total:
$111.15
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