HomeMy WebLinkAboutPermit Building 2004-10-5 (2)
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8: CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01225
ISSUED: 10/05/2004
APPLIED: 10/04/2004
EXPIRES: 04/05/2005
VALUE: $ 700.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2537 GAME FARM RD Springfield TYPE OF WORK: Church
ASSESSOR'S PARCEL NO.: 170322419?J9~ ')11',)
ATTENTION: Oregon 18W reI' c Y, . . TYPE OF USE: Alteration
'" ", t'-'(3 ! , ...' ,il \ }lId",
PROJECj:r, DES0RlP:r.,ONiXoWinilow'on'West end of sanctuary
N~tification Center. Those rL:18~ ~'~e :.~~ 1~~:'
Owner~n OI\,f1,~~t-U~ I-U€.lf:vBRIkQ6sm~0HN; tiy
Addresf,O~16Wt~roNGFIELD (QR..,\l74~~
calling th~ ~en~~r. \I~u,e." '''. :"~~ l\:l..""
number Tor Ine Ult::~UII VUlU1 ,\\..~I..__l.__.
Center is 1-600-332-2344h CONTRACTOR INFORMATION I
Commercial
Contractor Type
Contractor
License
Expiration Date Phone
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories:' E' Lot Size:
II.UJ'V .
Heigbt of 'structure SHALL EXPIRE IFS~ Ft 1st Floor:
T I ~f!H~ t-'t"t111'1I1 S'.F'rt"~fr.d"FIo"
ype 0 ea: q ..n 11. or:
watllL:.Wk\KIZED UNDER THIS PERSqFt:B~,ffiient:
RanfeC-Fy~~NCED OR IS ABANDONSq FOOarage/Carport
Ene"gYJPatllD DAY PERIOD. Sq Ft Other:
Sprinkled Building: nla Occupant Load:
A-3
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
I Valuation Descriotion I
Description Type of Construction
Bid Amount Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
700.00
Value
Date Calculated
Total Value of Project
Paee 1 of2
$700.00
$700.00
10/04/2004
,
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01225
ISSUED: 10/05/2004
APPLIED: 10/04/2004
EXPIRES: 04/05/2005
VALUE: $ 700.00
Status
Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I F f'''~ PlJi.IU
Fee Description
Plan Review Comm/IndlPublic
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Amount Paid
Date Paid
Receipt Number
$29.25
$4.50
$3.15
$45.00
10/4/04
10/5/04
10/5/04
1015/04
1200400000000001427
3200400000000000277
3200400000000000277
3200400000000000277
Total Amount Paid
$81.90
I Plan Reviews I
Structural Review
10/04/2004
10/04/2004
APP DLM
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 fo\lowing work
day.
I R..~uir..d Insn~
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Firewall: Located and constructed according to plans.
Final Building: After all required inspections have been requested and approved and the building is complete.
By signature, I state and agree, tbat I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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 tbat 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.
,!;~/~~~
Owner or contra~s Signature (
/Y~'-P-~'
Date
Paee 2 of2
223 Fifth Street
, Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-01225
COM2004-01225
COM2004-01225
Payments:
Type of Payment
Check
10/5/2004
.
RECEIPT #:
Descriptwn
Building Permit
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
EPISCOPAL CHURCH OF ST
JOHN
~~
Wit. ;
MJy of Springfield Official Receipt
.velopment Services Department
Public Works Department
3200400000000000277
Date: 10/05/2004
Item Total:
l.':beck Number Authorization
Received By Batch Number Number How Received
njm 4799 In Person
Payment Total:
Page 1 of I
9:38:39AM
Amount Due
45.00
3.15
4.50
$52.65
Amount Paid
$52.65
$52.65