HomeMy WebLinkAboutPermit Plumbing 2004-9-22 (3) CITY OF SPRINGFIELD
` Building/Combination Permit
Status Issued PERMIT NO: COM2004-01151
225 Fifth Street,Springfield,OR ISSUED:• 09/22/2004
541-726-3753 Phone SCANNED APPLIED: 09/16/2004
541-726-3676 Fax EXPIRES: 03/22/2005
541-726-3769 Inspection Line VALUE:
SITE ADDRESS: 4548 ASTER ST 4550 SPRINGFIE TYPE OF WORK: Plumbing Only
ASSESSOR'S PARCEL NO.: 17023243 PARCEL 2
TYPE OF USE: New Residential
PROJECT DESCRIPTION: Utilities for lot partition
Owner: RAKOCZY WELKER ENTERPRISES INC Phone Number: 541-513-2228
Address: PO BOX 395 CRESWELL OR 97426
CONTRACTOR INFORMATION
Contractor Type Contractor License Expiration Date Phone
Plumbing RS PLUMBING CONTRACTING 103816 01/04/2006 541-461-4714
Sewer T C EARTHWORKS LLC 541-543-3786
BUILDING INFORMATION I
#of Units: #of Stories: Lot Size:
Primary Occupancy Group: Height of Structure Sq Ft 1st Floor:
Secondary Occupancy Group: Type of Heat: Sq Ft 2nd Floor:
Primary Construction Type Water Type: Sq Ft Basement:
Secondary Construction Type: Range Type: Sq Ft Garage/Carport
#of Bedrooms: Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
DEVELOPMENT INFORMATION y
REQUIRED PARKING
Frontyard Setback: Overlay Dist: Total:
Side I Setback: #Street Trees Rqd: Handicapped:
Side 2 Setback: Paved Drive Rqd: Compact:
Rearyard Setback: %of Lot Coverage:
Solar Setbacks:
[PUBLIC IMPROVEMENTS
Street Impr ntt. VON:Oregon law requires you
H� adopted by the Oregon Utility ittmE:Type:
Storm Sew461 ilditet a TignS YbFSk1411 EXPIRE IF THE WORK
Special In �q pinn Center. Those ruh OAR 952_001- AUTHORIZED UNDER THIS PERMIT IS NOT
Notes: InOAR'952-001 obtain tcopies of the rules by COMMENCED OR IS ABANDONED FOR
0090.You may ANY 180 DAY PERIOD.
oiling the center. (Note:the telep hone
one
number for the Oregon Uul tJ Plot
Center is 1-800-332-2 4A)
iluation Description I
Description Type of Construction $Per Sq Ft Square Footage Value Date Calculated
or multiplier or Bid Amount
Page 1 of 2
• CITY OF SPRINGFIELD
Building/Combination Permit
Status Issued PERMIT NO: COM2004-01151
225 Fifth Street,Springfield,OR ISSUED: 09/22/2004
541-726-3753 Phone APPLIED: 09/16/2004
541-726-3676 Fax EXPIRES: 03/22/2005
541-726-3769 Inspection Line VALUE:
Total Value of Project
I, Fees Paid I
Fee Description
Amount Paid Date Paid Receipt Number
Total Amount Paid $0.00
Plan Reviews
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.
Required Inspections
Water Line: Prior to filling trench and including required testing.
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 p rmit ca : • ocated at the fro t of the property,and the approved set of plans will remain on the site at all
times d r'ng c uct�, /
e fres, X7 02-A y
Own or Contractor Signature Date
Page 2 of 2
•
225 Fifth Street 6PNINGFISLD s of Springfield Official Receipt
Sprngfield, Oregon 97477 • Mitvelopment Services Department
541-726-3759 Phone Public Works Department
RECEIPT #: 1200400000000001380 Date: 09/22/2004 3:00:22PM
Job/Journal Number Description Amount Due
COM2004-01175 Wood Stove/Insert 30.00
COM2004-01175 Minimum/Adjustment Mechanical 15.00
.COM2004-01175 —Mechanical Issuance Fee— . 10.00
COM2004-0 1 1 75 +7%State Surcharge 3.15
COM2004-0 1 1 75 + 10%Administrative Fee 4.50
Item Total: $62.65
Payments: Check Number Authorization
Type of Payment Paid By Received By Batch Number Number How Received Amount Paid
CreditCard MICHAEL J EARLS dlm 861419 In Person $62.65
Payment Total: $62.65
•
9/22/2004 Page 1 of 1
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MECHANICAL PERMIT PLUMBING PERMIT
ITEM FEE ITEM FEE
Q,riggi Furnace Fixtures
5 Exhaust Hood Residential Balh(s) No.
Vent Fan No _ Sanitary Sewer FT.
_
„, -- Wood Stove/Inscrt/Fl Unit replaLe
' Unit 174 Water FT.
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: Mechanical Permit Subtotal CO
1,1 'Min $imum of$45.00 Plumbing Permit Subtotal
: ! State Surcharge 7% 'Minimum of$45.00
---; Administrative Fcc 10% State Surcharge 7%
4 1_ Issuance Fee
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Wert Administrative Fee 10%
4 TOTAL MECHANICAL
TOTAL PLUMBING
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