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HomeMy WebLinkAboutPermit Building 2000-3-16 . . I Job# 00-00408-01 I . Page 1 of 2 TRANS#:01-0000950 DATE:MAR 16 2000 AMT RECD:2 $ 44.00 CHANGE: CASHIER: 059 .~~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-00408-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 1067 a St Spr Assessors Map#: 17033541 Lot: Block: Addition: Tax Lot #: 02900 Subdivision: Owner: Elmer Grace 1067 A Street Phone Number: 541-746-5500 City/State/Zip: Springfield, OR 97477 Alteration Value: $0 Address: Scope Of Work: Plumbing Office Use Land Use: # Of Buildings: Zoning Code: Occupancy Group: Bedrooms: " re"Heat,Ss"rce: \1 jt:..I"'l.ul'll.VI~YUjlld.W ~ilC::ij O'h. Range: toll ow rules adopted by the ~~i9e\;19': 'Iotitlcatlon (jenter, I nose rUles are sellOn, I To request an inspection call the 24 hour recording a~ C?R~!l!l~.OOijjOllR~oll!Jl\l@A81e.l5006re 7:00 a.m, will be made the same working day, inspectionsJOOlY.~rf!g9rooOOrtldtlpro~ t:lfJllti@~&1J3tf9110wing working day. calling the center. (Note: the telephone Re uirijH'1lllrP:Jeli~ nrAnnn Utility Notification q t _on,e.~:c 1 Sl("ln_~q?_?~44\. 1--- Plumbing I ' - Prior to filling trench. Quad Area: # Of Units: Constr. Type: Water Heater: Sanitary Sewer Line Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 I Area (Sq. Feet) I Main: Accessory: NOTICE: THIS PERMIT SHALL EXPIRE IFTHE WORK AUTHORIZED UNDER THIS PERMIT IS NOT # Of Stories COMMENCED OR~i~I~f8~lrED FOR Current UnitAN.Y 180 DAY PER!OB~osed Units: Census Code:'Does not apply Total: Fee Paid On Receipt# Plumbing 03/16/2000 950 03/16/2000 950 03/16/2000 950 Value/Quantity Fee Amount Minimum Plumbing Permit Fee State Surcharge For Plumbing Permit Sanitary Sewer Footage 75 $,00 $2,80 $40.00 . . Job# 00-00408-01 Paid On Receipt# Plumbing 03/16/2000 950 Value/Quantity . Page 2 of2 Fee Amount .r Fee Plumbing Administrative Fee Total Plumbing Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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, I further state that only contractors and employees who are in compliance with ORS 701,055 will be used on this project I further agree to ensure that all required inspections are requested at the proper time and that the project address is readable from the street ~~r,\'I\ <i. \\{\l,\1~ 3-1 h-OO Signature "~ Date $1.20 $44.00 $44.00