HomeMy WebLinkAboutPermit Plumbing 2005-7-27
, . .,~
Status: Issued
225 Fifth Street, Springfield, O'R
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRING}lELD .
Building/Combination Permit
PERMIT NO: COM2005-00983
ISSUED: 07/27/2005
, AI.r LIED: 07/2612005
. EXPIRES: 01127/2006
VALUE:
SITE ADDRESS: 6398 Forest Ridge Dr Springfield TYPE OF
ASSESSOR'S PARCEL NO.: MOUNTAINGATE 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 builts.
. Owner:
Address:
ALBERTS DEVELOPMENT
875 FAIRWA.-Y DR.
EUGENE OR 97401
Phone Number: 541-954-1978
I CONTRACTOK ll'iJ:'uKl\1A.TION .
Contractor Type
Sewer
Contractor
EGGE SAND & GRAVEL LLC
License
Expiration Date Phone
541-485-1515
I nuJ..i..DING ll'iJ:' UKll1A.l.lUl~.
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Yrimary 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 u~,,'ELOPMEN.l mJ:'UKl"lA.l.lUl'J .
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
fnllnw r1llpc; ::lrlnntprl hv thp Orpnnn I Jtilitv
Notification Center. ThosqP@BI.""CJ.wWOOVEMJ:'.,l~.l s.
in OAR 952-001-001 0 thrOl..l~11 Vf"\1\ ;:;J..U..-UU 1- .
0090. You may obtain copies of the rules by
Storm Sewer Avai~4r.lg the center. (Note: the telephone
Special Instructionllmber for the Oregon Utility Notification
Center is 1-800-332-2344).
Street
Sidewalk Type:
Notes:
DownspoutslDrains '
NOTiCE: .
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS P~RMIT IS NOT
"nn,.1ARr~lr'cn nn II:' ^O^l\lnnI\ICn cnn
I ValuationDescriPtion/l~Y 180 ?AY PERIOD.
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value.
Date Calculated
1 of 2
....:.-1tIr~f~,~;~~'~~ .~, '"
...;,q' t.
_.. _.0........ ,..~
"cC"" .,,=.'~,
CITY OF SPRINGFIELD C
Building/Combination Permit
PERMIT NO:' COM2005-00983
ISSUED: 07/27/2005
APPLIED: 07/26/2005
EXPIRES: 01127/2006
VALUE:
Status: ,Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
.~ 541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Sanitary Sewer - 1st 50 Feet
Storm Sewer - 1st 50 Feet
Amount Paid . Date Paid Receipt Number
$9.00 7/27/05 1200500000000001083
$6.30 . 7/27/05 1200500000000001083
$45.00 7/27/05 1200500000000001083
$45.00 7/27/05 1200500000000001083
Total Amount
$105.30
'I Plan Reviews I
To &equestan 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 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 wiD be made of any structure without permi'ssion 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
d~~~:P;~ k;:;~ 7/27/d!V'-- . .
c f ~, /' r
Owner or Contractors SignaMfre . r Date
2 of 2
225 Fifth Street
Springfield, Oregon 97477
54i~726-3'759 Phone
City of Springfield Official Receipt
velopment Services Department
Public Works Department
',~,
,"
RECEIPT #:
1200500000000001083
Date: 07/27/2005
12:13:18PM
Job/Journal Number
COM2005-00983
COM2005-00983
COM2005-00983
COM2005-00983
Description
Sanitary Sewer - 1st 50 Feet
Storm Sewer - 1st 50 Feet
+ 7% State Surcharge
+ 10% Administrative Fee
Amount Due
45.00
45.00
6.30
9.00
$105.30
Payments:
Type of Payment
Check
Item Total:
Check Number Au Utorization
Paid By Received By Batch Number Number How Received
LB OLSON AND ASSOCIATES IIh 9625 In Person
Payment Total:
Amount Paid
$105.30
$105.30
~ ~
;'
.,
~...!.
"
"
:r
7/27/2005
I of 1