HomeMy WebLinkAboutPermit Plumbing 2008-1-8
Status
Issued
CITY OF SPRIN\..1' mLD .
Building/Combination Permit
PERMIT NO: COM2007-01928
ISSUED. 01108/2008
APPLIED' 12/28/2007
EXPIRES: 07/08/2008
VALUE:
225 FIfth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
SITE ADDRESS 1162 E ST
ASSESSOR'S PARCEL NO 1703351403600
Sprmgfield TYPE OF WORK Plumbmg Only
TYPE OF USE
RepaIr
Resldenllal
PROJECT DESCRIPTION 20' water hne
Owner BINDER DARLENE K
Address 1162 EST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Tvpe
Plumbmg
Contractor
OWNER
License
ExpiratIOn Date Phone
BUILDING INFORMATION I
# of UUltS
Pnmary Occupancy Group
Secondary Occupancy Group
Pnmary ConstructIOn Type
Secondary ConstructIOn Type
# of Bedrooms
# of Stones
HeIght of Structure
Type of Heat
Water Type
Range Type
Energy Path
Spnnkled BUlldmg
Lot SIZe
Sq Ft 1 Sl Floor
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft GaragefCdrport
Sq Ft Other
Occupant Load
nfa
I DEVELOPMENT INFORMATION I
Front yard Setback
S,de 1 Setback
SIde 2 Setback
Rearyard Setback
Solar Setbacks
Overlay Dlst
# Street Trees Rqd
Paved Drive Rqd
% of Lot Cnverage
REQUIRED PARKING
Totdl
HandIcapped
Compact
I PUBLIC IMPROVEMENTS I
Street Improvements
Storm Sewer AVdllable
Specldl InstructIOn
Notes
NOT'CE~. ~ " PLPIRE IF iHE W?RK
THI" utr.lvllT tl.1f.- S If~~.'''''' ,~ ,1:1T
" I DER TH\ 11'-'1..... I
f..UTHORIZED UN S r..Bf..NrJI\\('lflii:ifi8n Descrmtion
COMMENCED OR \
r..N"\f)\pl'or.Cd'n~fr~JP.~n $ Per Sq Ft Square Footage
or multlpher or BId Amount
SIdewalk Type
A~m1,g.tl~.Q\lfi~,11law reqUIres you to
follOw VMes aaopteo by the Oregon Utility
Notification Center Those rules are set forth
In OAR 952-001-0010through OAR 952-001-
0090. You may obtain copies of the rules by
"''''JlIIII~'2 tho. ,..'O'I"I+'at...~~ll"\iQ tho tofo~h"n,o
number for the Oregon Utility Notification
Center IS 1-800-332-2344)
DescnptlOn
Value
Date Calculated
Paee 1 of 2
-~~
CITY OF SPRINGFIELD'
Building/Combination Permit
Sta tus
Issued
PERMIT NO
ISSUED.
APPLIED
EXPIRES:
VALUE'
COM2007,OI928
0110812008
12/2812007
07/08/2008
225 F,fth Street, Spnngfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
Total Value of Project
Fees Palll I
Fee DeSCription
+ 10% AdmmlstratIve Fee
+ 12% State Surcharge
+ 5% Technology Fee
Water Lme - ht 50 Feet
Amount Pdld
Date PaId
ReCeIpt Number
$500
$600
$250
$50 00
118108
118/08
118/08
118/08
3200800000000000019
3200800000000000019
3200800000000000019
3200800000000000019
Total Amount PaId
$63 50
I Plan ReVieWS I
To Request an mspectlOn call the 24 hour recording at 726-3769. All mspectlOns requested before 7.00
a.m. will be made the same workmg day, Inspections requested alter 7:00 a m will be made the followmg
work day.
I Re/llllred Insnechons I
WateI Lme Pnor to filhng trench dnd mcludmg requIred testmg
By sIgnature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certIfy that all
mformatlOD hereon IS true and correct, and I further certify that dOY and all work performed shall be done In dccord.wce with
the Ordmances of the CIty of Spnngfield and the Laws of the State of Oregon pertammg to the work descnbed herem, and
that NO OCCUPANCY will be made of any structure wIthout permIssIOn of the CommuDlty ServIces DIVISIOn, BUlldmg Safety
I further certIfy thdt only contractors and employees who dre m comphance wIth ORS 701 005 WIll be used on thIS project
I further agree to ensure that all requIred mspectlOns are requested at the proper tIme, that each address IS reddahle from the
street, that the permIt cdrd IS located at the front of the property, and the approved set of plans ",II remdm on the SIte at dll
times dUrIng constructIOn
--- )
/'
Owner or Contractors SIgnature
/
C. (
--
1- Y- D ~
Date
Paee 2 of 2
225 FIfth Street
Springfield, Oregon 97477
54]-726-3759 Phone
Job/Journal Number
COM2007-0 1928
COM2007-0 1928
COM2007-0 1928
COM2007-0 1928
Payments
Type of Payment
Check
(,Re(,f.,mtl
RECEIPT #.
Description
Water Line - 1st 50 Feet
+ 5% Technology Fee
+ 10% AdminIstratIve Fee
+ 12% State Surcharge
PaId By
DARLENE BINDER
~,
CIty of Springfield OffiCIal ReceIpt
Development ServIces Departmcnt
PublIc Works Department
32008000000000000]9
Date: 01/08/2008
Item Total
Check Number Authorization
ReceIVed By Batch Number Number How Received
ddk
2543
In Person
Payment Total
Page I of I
90557AM
Amount Due
5000
250
500
600
$63 50
Amount Paid
$63 50
$63 50
118/2008