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Home My WebLink AboutPermit Plumbing 2007-5-18 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00691 ISSUED: 05/18/2007 APPLIED: 05/15/2007 EXPIRES: 11/18/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4128 Camellia St Springfield ASSESSOR'S PARCEL NO.: JACOBS PART CAMELI TYPE OF WORK: Plumbing Only TYPE OF USE: New PROJECT DESCRIPTION: Install Sanitary and Storm Sewer lines for land partition approval Residential Owner: TIM AND MICHELLE JACOBS Address: PO BOX 734 PLEASANT HILL OR 97455 Phone Number: 541-741-1940 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: BlDJDD'l:NGINFORMATlON I THISfD.!;~:.';r L t S' # O.~:s.OTt~~:1 SHA' 0 lze: AUif~iglfti~~rwtuVe~ EXPIRE IF THE l~~ Ft 1st Floor: COW~J1fJll1f#t: NDER THIS PERM ~t{MK2nd Floor: AN'r~ater Type:OR IS ABAN IT JS~W1 Basement: RaUgeff,~pe?ERIOD DONED FORSq Ft GaragelCarport Energy Path:' Sq Ft Other: Sprinkled Building: nla Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: A~M"ItY\!l!~~: tOl/OlU, ~lliee,(lf't~r~ law reqUIres you to 'lotificl~ve9DflQPR~ by the Oregon Utility in OAR&'f?flLQ@(jWerlfleose rules are s t t ::152-001-0010 throu h e ort 0090. Yo" mal' .~ ~;- 'n I g OAR 952-00 I P'UJiMg IMPQ~~~J' rne rules I . ....r! lut:r lor rn~ O;egon Utility ~:r~~'f pe: ...."""'I,,,"-? ~ Otl - .34IibwnspoutslDrains: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00691 ISSUED: 05/18/2007 APPLIED: 05/15/2007 EXPIRES: 11/18/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtll00' Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll00' Amount Paid Date Paid Receipt Number $11.80 $5.90 $9.44 $45.00 $14.00 $45.00 $14.00 5/18/07 5/18/07 5/18/07 5/18107 5/18/07 5/18/07 5/18/07 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 2200700000000000776 Total Amount Paid $145.14 I Plan Reviews I 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 working day, inspections requested after 7:00 a.m. will be made the following work day. I Reauired Insoections I Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. 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 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 ofthe property, and the approved set of plans will remain on the site at all times durin onstruction. c ~ t--'-jf lj) f7{l Ow... 0' cont<acto"b" Cj-ltr07 Date Pal!e 2 of 2 225 Fifth Street Springfidd, Oregon 97477 541-726-3759 Phone C& of Springfield Official Receipt "'lopment Services Department Public Works Department Job/Journal Number eOM2007 -00691 cOM2007 -00691 cOM2007-00691 cOM2007-00691 eOM2007 -00691 eOM2007-00691 eOM2007-00691 Payments: Type of Payment Check cReceintl RECEIPT #: 2200700000000000776 Date: 05/18/2007 Description Sanitary Sewer - 1 st 50 Feet Sanitary Sewer Each Addtl 100' Storm Sewer - 1st 50 Feet Storm Sewer Each Addtl 100' + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By Ale Item Total: Check Number Authorization Received By Batch Number Number How Received djb 39756 In Person Payment Total: Page I of 1 11 :47:06AM Amount Due 45.00 14.00 45.00 14.00 5.90 9.44 11.80 $145.14 Amount Paid $145.14 $145.14 5118/2007