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HomeMy WebLinkAboutPermit Miscellaneous 2005-9-6 . . 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 \l'lCl?-''' _ -<\At. _ ," \ !pUBLIC IMPROVEMENTS I t.'t?\?-.'t. ~\\\\\\\ \~~ "1- C.!;\r'\.\. -' 'IS? .,-\) ~ ,1":".",". '\\\" "c?-.Siilewall~,:rype: ~ \. l o'\;.?-.'\. \J~v" ,,\)I\\'<v \\\\S '\),\-tl;.:i) \)?-. \SDownspoutslDrains 1\\\\ -r" \\)-,\,,\-'0 ?\-?-.\\)'0 r GI'\" ,\),,'l v \'6" \-.,I',,'l .. 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~~. . O\"~'':J:~ ~'1 ~.. _1.,\eS ",.~ o.':}t~v-....... -<<:.~\IO~~60Q 'f GON'fRAaTOR J.NFe~TION I ..-< ,.... \~s v I '&\ r '" " '" r" 1\)\V ~\e' \~.' - 0'" 1(\u'" ~II'I ",va n\O "W.S \ala? '0" Lon \~cfij~~OO\..(l ,i'l' C?: C\', \'l\e N!:J~'\'c'3-\\ License _ X't&~SOJ\l.~€&~l\RU<;1J~~ 1.l'A<:. 312 \'~090.:u; \'l\0 cei;irolr!tiI1m~FoRMA nONI C?J;I\f\'" \O!'" 'c, ,.. :oe! ~e! \-.. # 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 nla I DEVELOPMENT INFORMATION I " 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 . . 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 ~~ /-;cO '" --IZ--. Owner or Contractors Signature 9M~S , Date 2 of 2 225 Fifth Street Springffeld, Oregon 97477 541-726-3759 Phone . .-"~<f!I~N_~_F1". ~.' p_ __ ' Wit .. I , , '.-~:'.', i, , . : J 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 'I (j' ~, :. ~r :1 " , " " :, :e " " , " " 9/6/2005 'f 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