HomeMy WebLinkAboutPermit Plumbing 2004-11-29
-.
Status
Issued
~
.':"CITY OF M'Kll'lu1<IELD
Building/Combination Permit
PERMIT NO: COM2004-01453
ISSUED: 11/29/2004
APPLIED: 11/29/2004
EXPIRES: OS/29/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4757 JASPER RD
ASSESSOR'S PARCEL NO.: 1802051304200
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair Residential
PROJECT DESCRIPTION: Approx 200lf water line repla,cement ><> actual meter in front of 4709 Jasper Rd
Owner: LORETTA MACAULEY
Address: 4757 JASPER RD SPRINGFIELD OR 97478
Phone Number: 541-746-4026
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
Expiration Date
.'1""1_
READY ROOTER DRAIN CLEANING & R SW2524 ., .(\~.\I:ll/2005
\l\l\:i~ I 'X/.':!
BUILDING INFORMA TION'_'I'lleOi "01' U\I \ __ .
_.. Ole.., e\\O'\l'
.... ~', Ol\:\'>l '0'1 \\'Ie ale S:.o.nI'l'\.
#o~~t~!:i..:\O"a.dO?\ed osel\l\es ,..~~:,
Hei~~\WIStrfice~!\\61. 1\'1 ~IO\lg\'l ~ ~:lS t\i\i~~oor:
Typ,erg,UJ:!lltl1'\ 0' .cO' ~ ~ CO?ieS U'leFloor:
Water' ,,,,e~o2-0 o'o~l\ o\e: ~e ,~\ltent:
Ralige~e;O\l <<,a~l\\et. \N I' U\i\W:l t Garage/Carport
Ener'g9l'~"':,g \\'Ie e 0Ie9~;",t>32: t Other:
Sprinkl&jlB~ligt !'... \& '\~ Occupant Load:
n\1t1 ,..~.
License
Phone
541-744-7991
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
VN
I DEVJ'.Lvnnr.'H ul/FORMATION I '
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist: Total:
# Street Trees Rqd: Handicapp.fd:
Paved Drive Rqd: c{l.mAACt'l\'+-
% of Lot Coverage: '?-'t. W"' .; \S ~()\
Co' \. 't.'I-'i" 't.\\Wli'
r"1:\C\.' 1'1 c,\-\r>.'.: _ ...\.\6 'i' ,~<"I ~()\\
I PUBLIC IMPROv~s"l~\lIJ~\l\~ ~'Or>.~\l\J"~'
~D~~~~~~C't.~i~~'~\type:
Cr>.~'l i 'Q() \l DownspoutslDrains:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
, Valuation Deseriotion I
$ Per'Sq Ft Square Footage
or multiplier or Bid Amount
Value
Date Calculated
Total Value of Project
Page 1 of2
.
. CITY OF SPRIrliul'1ELD
Building/Combination Permit
PERMIT NO: COM2004-01453
ISSUED: 11/29/2004
APPLIED: 11/29/2004
EXPIRES: OS/29/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
I Fp.p.~ Pairl I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - 1st 50 Feet
Water Line - Each Addt1100'
Amount Paid
Date Paid
$7.30
$5.11
$45.00
$28.00
1l/29/04
1l/29/04
1l/29/04
1l/29/04
Receipt Number
1200400000000001657
1200400000000001657
1200400000000001657
1200400000000001657
Total Amount Paid
$85.41
I Plan Reviews I
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.
~ Rl'ouirl'rl w.~nl'ction~ I
Water Line: Prior to filling trench and including required testing.
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 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 of the property, and the approved set of plans will remain on the site at all
times during construction.
~a X 1//2..1/0'1
Owner or Contractors Signature
Date
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
,
5211-726-3759 Phone
Job/Journal Number
COM2004-0 1453
COM2004-0 1453
COM2004-0 1453
COM2004-01453
Payments:
Type of Payment
CreditCard
11/2912004
.
RECEIPT #:
Description
Water Line - 1st 50 Feet
Water Line - Each Addtl100'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
DAVID NICHOLS
ap'~A,II.!I-C!~~' .'........_'"
u..-i
~ti !
1200400000000001657
Received By
djb
Check Number
Batch Number
Page 1 of 1
Jily of Springfield Official Receipt
_elopment Services Department
Public Works Department
Date: 11/29/2004
Item Total:
Authorization
Number How Received
030790 In Pellion
Payment Total:
9:07:09AM
Amount Due
45.00
28.00
5.11
7,30
$85.41
Amouut Paid
$85.41
$85.41