HomeMy WebLinkAboutPermit Building 1999-8-24 (2)
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SPRINQFIELD
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 991150
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 5195 FORSYTHIA ST
Assessors Map #: 18020421
Lot: Block:
Tax Lot #: 05600
Subdivision:
Owner: DONALD SMITH
Address: 5195 FORSYTHIA STREET
Phone #: 746-6419
City/State/Zip: SPRINGFIELD, OREGON 97478
Describe Work: WHEELCHAIR RAMP ADDITION
Canst.
Contractor Contractor # Expires Phone
General: CONSULTING & PE 0056664 05/31/01 343-3262
2250 CHURCHILL EUGENE OR 974050000
QUAD AREA: 3RSC
OFFICE USE
LAND USE: 1150
To request an inspection, call the 24 hour recording at 726-3769.
All inspections requested before 7:00 a.m. will be made the same "orking day,
inspections requested after 7:00 a.m. will be made the following "ork day.
REQUIRED INSPECTIONS ---
FRAMING - Prior to cover.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Item
Main
Garage
WHEELCHAIR RAMP
Total Value
BUILDING PERMIT ---
Square Feet x $/Square Feet
Value
0..00
0.00
2,450.00
2,450.00
Building Permit Fee
Surcharge/Admin
TOTAL FEE
(A)
38.50
3.63
3.$'-
:1.5, 42.,~~
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--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
PLAN REVIEW FEE
0.00
25.03
TOTAL MISCELLANEOUS PERMITS
(E)
25.03
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, s, C, 0, and E combined)
~ CP7, }9
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SPRINQFIELD
Job Number: 991150
Page 2
--- 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.
Received By: DON MOORE
Plans Reviewed By: DON MOORE
Building Site Reviewed By: DON MOORE
Date: 08/24/99
- - - ADDITIONAL COMMENTS ---
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 Divisiont Building Safety. I further certify that only
contractors and employees who are in compliance with ORS 701.055 ~lill 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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Signature Date
- -- VALIDATION
Date Paid:
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Receipt Number:
Amount Received:
Received By: