HomeMy WebLinkAboutPermit Building 2003-4-16 (2)
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.
CITY OF SPRINGFIELD
Status
Issued
Building/Combination Permit
PERMIT NO: COM2003-00276
ISSUED: 04/16/2003
APPLIED: 04/16/2003
EXPIRES: 10/16/2003
VALUE: $ 2,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4006 FRANKLIN BLVD
ASSESSOR'S PARCEL NO.: 1703344201600
Eugene
TYPE OF WORK: Site Work Only
TYPE OF USE: New Commercial
PROJECT DESCRIPTION: Engineered standards for light poles at Camp Putt - see 02-00985-01 for electrical
Owner: ROTH & ROTH DBA
Address: % ROTH & ROTH PO BOX 70468 EUGENE OR 97401
SETBACKS
, CONTRACTOR INFORMATION I
~'-
Contractor ~~~~~\'\ ~'Expiration Date
BRAUN EXCAVATING INC \0o.~~J918li80\'O ~"'" 10/17/2003
ROTH & ROTH DBA ",\'a.~_00\ ,,~\~:<:>~...~
, BUILDlNfi'I~~kMA'fIO~I'~0 \~~~0 ^
,. Jr. '-II '" ~'\~ ~Ov
:'i.\V' (}QY ~ "'-~\Ov':0"'u' 0\6. \v0'
:0~~ ,1{..9~~to~.i,\\()\1 vO~~ ,'S'0'1.~O~'" Lot Size:
~ 'l-.O~ \~iiii!"'t\I\St~#r~~o\0' ~\'\ '"bf>.rI;\' Sq Ft 1st Floor:
'O~ '!i,v~p..t~'ij,~at: ~0\'~ O~ >S ~'/:'/:; Sq Ft 2nd Floor:
~o~ t-~tl:5qyt!'Sfi~ O\~ ';)().rs Sq Ft Basement:
\~ 0 ~.y;.~l\~ t,'YPl'i,(\0 , '" ....'?3 Sq Ft Garage/Carport
C)<::J ~e'i'g~f&ih\\0\~ Sq Ft Other:
~~~'<;J (j0\ Impervious Surface Area:
I DEVELOPMENT INFORMATION I
Phone
541-935-5940
Contractor Type
General
Owner
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: Total:
# Street Trees Rqd: i'andicapped:
Paved Drive Rqd: ~ ~\')~~ompact:
% of Lot Coverage: 1i''f.. \~ :~\\ \~ ~\)
'f..i-\l'\ ,?'f..\'o.\"" ~\)\'o.
," \., "l'c.. J'~\)
I PUBLIC 1l\m\.i)vt~,$;II\'f..\'o. ~~~~\) .
" J ..... \~ T'
\\'I\\~ ~ ;~1.'<-':.~ \')\'0. :-,~ewalk Type:
~"\~ ~\;" ,?'f..~ .
~ ~~~ '\)'# Downspouts/Drams:
,,\') " \ 'O<::i
~~
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriution I
Description
Tvpe of Construction
$ Per Sq Ft
Square Footal!c
Value
Date Calculated
Pal!e 1 of2
.
. CITY OF SPlUl'll\Jt<IELD'
Building/Combination Permit
PERMIT NO: COM2003-00276
ISSUED: 04/16/2003
APPLIED: 04/16/2003
EXPIRES: 10/1612003
VALUE: $ 2,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Bid Amount
Use Bid Amount
$1.00
2,000.00
$2,000,00
$2,000.00
04/16/2003
Total Value of Project
I Fp.p.s P3id I
$4.50
$3.15
$45,00
4/16/03
4/16/03
4/16/03
Receipt Number
1200200000000001015
1200200000000001015
1200200000000001015
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Amount Paid
Date Pai
Total Amount Paid
$52.65
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.
~uirp.d I'Isnpctions I
I Footing: After trenches are excavated.
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 tbe 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 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 property, and the approved set of plans will remain on the site at all
times during construction.
S\~L_
()Lv I
4- \ ~ - 0 J
Owner or Contractors Signature
Date
Pal!e 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
COM2003-00276
COM20OJ-00276
COM2003-00276
Payments:
Type of Payment
Check
Paid By
Description
Building Permit
+ 7% Slate Surcharge
+ 10% Administrative Fee
HA VIN FUN CO
Receipt #: 1200200000000001015
Date: 04/16/2003
Received By
Check Number Confirm No
djb
Page lofl
~/I6/2003 '
2:59:05PM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
.
Amount Paid
45.00
3.15
4.50
Line Item Total:
$52.65
How Received
Amount Paid
In Person
52.65
$52.65
--
Payment Total:
cReceipt.rpt
~/-'o !
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