HomeMy WebLinkAboutPermit Building 1997-10-2 (2)
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RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 970840A
225 North Fifth Street
Springfield, OR 97477
Office: 726 -3759
Inspection Line: 726-3769
Location of Proposed Work: 5660 DAISY ST 4
Assessors Map #: 17023344
Lot: 23 Block: 1
Tax Lot #: 01422
Subdivision: MT VIEW
Owner: RANDOLPH ALLEN
Address: PO BOX 70491
Phone #: 688-5750
City/State/Zip: EUGENE, OREGON 97401
Describe Work:
NEW
QUAD AREA: 3RSC
OFFICE USE
LAND USE: 1150
ZONING CODE: PUD
Item
Main
Garage
FTG/PERIM FOUNDATION
Total Value
BUILDING PERMIT ---
Square Feet x $/Square Feet
=
Value
0.00
0.00
1,217.00
1,217.00
Building Permit Fee
Surcharge/Admin
22.00
1. 76
TOTAL FEE
(A)
23.76
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
SYSTEMS DEVL CHARGES
0.00
150.61
TOTAL MISCELLANEOUS PERMITS
(E)
150.61
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, D, and E combined)
174.37
--- BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT ---
This permit is granted on the express condition that the said construction
shall, in all respects, conform to the Ordinance adopted by the City of
Springfield, including the Development Code, regulating the construction and
use of buildings, and may be suspended or revoked at any time upon violation
of any provisions of said ordinances.
--- ADDITIONAL COMMENTS ---
ALL INSPECTIONS SHOWN ON ORIGINAL PERMIT APPLY TO THIS PROJECT. THIS PERMIT
IS FOR REVISED VALUES AND FEES ONLY. PLEASE REFER TO PERMIT ISSUED 7/21/97 FOR
ALL REQURIED INSPECTIONS.
Job Number: 970840A
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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 OR~ 701.055 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.
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Receipt Number:
Amount Received:
Received By: