HomeMy WebLinkAboutPermit Miscellaneous 2005-9-6
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01214
ISSUED: 09/06/2005
APPLIED: 09/06/2005
EXPIRES: 03/06/2006
VALUE:
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2709 Game Farm Rd
ASSESSOR'S PARCEL NO.: 1703224105700
Springfield TYPE OF
Site Work Only
PROJECT DESCRIPTION: Install water line to lot 5 Cline partition
TYPE OF USE: New
Residential
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.. Owner: CLINE RALPH G JR & BETTY A "o\) \0
. Address: 1150 wmsrLERS LN 1J\las , \)\\\\~
ROSEBURG OR 97470 A\ \~-s_I~~la<dO~ c.a\ \O~~.
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Lon \~cfij~~OO\..(l ,i'l' C?: C\', \'l\e N!:J~'\'c'3-\\ License
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# of Units: l\\)~ vel' # of Stories:
Primary Occupancy Group: Height of
Secondary Occupancy Type of Heat:
P'rimary Construction Type Water Type:
Secondary Construction Range Type:
# of Bedrooms: Energy Patb:
Sprinkled
Contractor Type
Plumbing
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I DEVELOPMENT INFORMATION I
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Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Street
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descrintion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Tvpe of Construction
1 of 2
Expiration Date
ll/24/2007
Phone
503-769-7751
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Otber:
Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
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CITY OF SPRINGFIELD
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
, 541-726-3769 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-01214
ISSUED: 09/06/2005
APPLIED: 09/06/2005
EXPIRES: 03/06/2006
VALUE:
Total Value of Project
Fees Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - 1st 50 Feet
Water Line - Each AddtllOO'
Amount Paid
Date Paid
Receipt Number
58.70
56.09
545.00
542.00
9/6/05
9/6/05
9/6/05
9/6/05
1200500000000001305
1200500000000001305
1200500000000001305
1200500000000001305
Total Amount
5101.79
I Plan Reviews I
- To Request an inspection can 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. win be made the following
work day.
Water Line: Prior to filling trench and including required testing.
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 win be made of any structure without permission of the Conununity 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 wiD remain on the site
at all times during constructiolL
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Owner or Contractors Signature
9M~S
,
Date
2 of 2
225 Fifth Street
Springffeld, Oregon 97477
541-726-3759 Phone
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aity of Springfield Official Receipt
_evelopment Services Department
Public' Works Department
JOb/Journal Number
C.OM2005-01214
COM2005-01214
C.ClM2005-01214
COM2005-01214
Payments:
Type of Payment
CreditCard
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9/6/2005
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RECEIPT #:
1200500000000001305
Date: 09/06/2005
Description
Water Line - 1st 50 Feet
Water Line - Each Addtl 100'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
RALPH CLINE
Received By
DJB
1 of I
Item Total:
L:heck Number AuthOl1zation
Batch Number Number How Received
086681 In Person
Payment Total:
2:35:23PM
Amou nt Due
45,00
42.00
6,09
8,70
S101.79
Amount Paid
$101.79
$101.79