HomeMy WebLinkAboutPermit Plumbing 2001-4-16
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I Job# 01-00381-01 I
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Page 1 of 2
TRANS#:01-0004954
DATE:APR 16 2001
AMT RECD:2 $ 1122.44
CHANGE:
CASHIER: 061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00381-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 3368 Gamefarm Rd Spr
Assessors Map#: 17032212
Lot: Block: Addition:
Tax Lot #: 01900
Subdivision:
Owner:
Address:
Thomas Elliott
3368 Gamefarm Rd
Phone Number: 541-746-4745
City/State/Zip: Springfield, OR 97477
New Value: $0
Scope Of Work: Plumbing
sewer connection
Contractor Type
Plumbing Contr
Contractor Registration # Expiration Date
Royal Flush Septic Service
33333 Howe Lane, Creswell, OR 97426
Phone
541-895-2072
Office Use
Quad Area: Land Use: NOTICE: # Of Buildings: -
# Of Units: Zoning Code: THIS PERMIT SHA9j:~tipiirlcfGrOup!ORK
Constr. Type: Bedrooms: AUTHORIZED UN~~'!t:~,99r~MIT IS NOT
Water Heater: Range: ",,,.mJ:Mr.FO OR~~A~~?J~I1\l~ED FOR
To request an inspection call the 24 hour recording at 726-3769. AllnnspgCti&'Xffe~\re'2ted before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
working day.
Sanitary Sewer Line
I
- Prior to filling trench.
Required Inspections
Plumbinll
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D .
,Area (Sq. Feet)
I Main: Accessory:
_-.-.'" ...., ..........._..._1_,., "'-""-:"':";-~~~:l
AI j L-1...J. - - ,
follo\i~' {' :j . #.PI:'~)!:'. ~., "",- ~jl~;<"I:n...I~'t~i~a~.,.'1
f\l..HiTicf....llul uc..f 11. I (If ~ P\ ":- .~i.:. "1<..', . ") :1.
in OI-lH ~::,~-UOH)LlIi' "l,-q';~11 0;\01 %2-00',-
0090. You n9~' )hl'l;r, ~!'l~i 'c '11 th9 rUl3S by
# Of Stories: callinA' "hi'l'" 't)JJJl~: :n~ t:Jlapho~3
. nu't1u....r~~~ ...c ~~ ;",. .::,:c" ."otilicatlon
Current Units: P.CroposedjUnlts:.",,). )"44)
\::;ill\,;.~ll':' -\,.o...V.vIJ_ -"'" .
Census Code: Does not apply
Total:
Fee
Paid On Receipt#
Plumbinll
04/16/2001 4954
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
$.00
Sanitary Sewer
Residential Sanitary MWMC
Residential Improvement MWMC
MWMC Administrative Fee
Sanitary Sewer SDC Reimbursement
SDC Administrative Fee
Property Annexed 1999
Total System Development
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
~ue;ted at the proper ~/~he project address is readable from the street.
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Signature Date
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Fee
Job# 01-00381-01 I
Page 2 of2
Paid On Receipt#
Plumbinn
04/16/2001 4954
04/16/2001 4954
04/16/2001 4954
Value/Quantity
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
130
System Development
04/16/2001 4954
04/16/2001 4954
04/16/2001 4954
04/16/2001 4954
04/16/2001 4954
04/16/2001 4954
04/16/2001 4954
19
1
1
1
19
25
Fee Amount
$2.80
$40.00
$1.20
$44.00
$306.85
$285.91
$24.33
$10.00
$403.75
$51.35
$-3.75
$1,078.44
$1,122.44