HomeMy WebLinkAboutPermit Plumbing 2005-7-27
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2005-00985
ISSUED: 07/27/2005
APPLIED: 07/26/2005
EXPIRES: 01127/2006 '
VALUE:
SITE ADDRESS: 6420 Forest Ridge Dr ' Springfield TYPE OF
ASSESSOR'S PARCEL NO.: MOUNTAIN GATE PH 3 ~
Plumbing Only
TYPE OF USE: New Residential
PROJECT DESCRIPTION: Storm & Sanitary extension lines located in phase 3 for individual lots. Plan on file.
Will need as built~.
Owner: ALBERTS DEVELOPMENT
Address: 875 FAIRWAY DR.
EUGENE OR 97401
Phone Number: 541-954-1978
I CONTRAL.I UJ( INFORMATION.
Contractor Type'
Sewer
Contractor
EGGE SAND & GRAVEL LLC
,I BUILumlJ mFORMATION.
License
Expiration Date Phone
541-485-1515
# of Units:
Primary Occupancy Group:
Secondary Occupancy
P'rimary Construction Type
Secondary Construction
# of Bedrooms:
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled
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 DEVELOP MEN I HwORMA TION .
REQUIRED PARKING
Total:
Handicapped:
Compact:
Front yard Setback: Overlay Dist:
Side 1 Setback: # Street Trees
Side 2 Setback: Paved Drive Rqd:
Rearyard Setback: , % of Lot Coverage:
Solar Setbacks: ATTENTION: Oregon law requires you to
fnllf"\ul "lllt"I~ 1""lI,.J.....r...--' ,-. II ,-, .
.. - -.-..-t-'......e. l...J Il. 'v ~ICVV.!.l' 'JH'U,.'
~otlflcation Center, rhostt~~s;,.wg~P.Y~MJ!.l, ISI
Street In OAR 952-001-0010 through OAR 952-001-
~090. You may obtain copies of the rules by
Stor~ Sewer A~ad~%1g the center. (Note: the telephone
SpeCial InstruchoYiumber for the Oregon Utility Notification
Center is 1-800-332-2344).
Sidewalk Type:
DownspoutslDrains
Notes:
NOTiCE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PFRMIT I~ flinT
, . I~UIVIMtNCED OR IS ABANDONED FOR
I Valuation Description \NY 180 DAY PERIOD.
Description
,Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
, 1 of 2
~1..=-..--,J"" .',..., "~',,', Iff.,
111I=. ..-....~~~ ,'~
~ Wi", I
<'_'00',,"' ,'~ . .,-~~.. ".,._.J' '"Y
Sta,tus: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00985
ISSUED: 07/27/2005
APPLIED: 07/26/2005
EXPIRES: 01127/2006
VALUE:
Total Value of Project
L Fees Paid I
Fee Description
+ 10% Administrative Fe~
+ 7% State Surcharge
Sanitary Sewer - ht 50 Feet
Sanitary Sewer Each AddtI 100'
Storm Sewer - ht 50 Feet
Storm Sewer Each Addtll00'
Amount Paid Date Paid Receipt Number
$14.60 7/27/05 1200500000000001085
$10.22 7/27/05 1200500000000001085
$45.00 7/27/05 1200500000000001085
$28.00 7/27/05 1200500000000001085
$45.00 7/27/05 1200500000000001085
$28.00 7/27/05 1200500000000001085
. Total Amount
$170.82
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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.'
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon i~ 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 wiD 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 the permit card is located at the front of the pro~,~' and the approved set of plans WiD remain on the site
at all times~5..on ructi n. o. J ~ '
~O~ j/J ,~~~ //-</~-3-
~, # / '/ / '
Owner or Contractors Sigmffure Date
2 of 2
225 Fifth Street
Sp'ingficld, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
velopment Services Department
Public Works Department
Job/Jo~rnal Number
COM2005-00985
COM2005-00985
COM2005-00985
C:OM2005-00985
COM2005~00985
COM2005-00985
Payments:
TyPe of Payment
Check
,-
.,;
'"
,
7/27/2005
RECEIPT #:
1200500000000001085
Date: 07/27/2005
Description ,
Sanitary Sewer - ]st 50 Feet
Sanitary Sewer Each Addtl 100'
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtl100'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By Received By
LB OLSON AND ASSOCIATES llh
Item Total:
Check Number AuthOrIzatIon
Batch Number Number How Received
9625 In Person
Payment Total:
1 of ]
12:14:10PM
Amount Due
45:00
28.00
45.00
28.00
10.22
14.60
$170.82
Amount Paid
$170.82
$170.82