HomeMy WebLinkAboutPermit Plumbing 2001-3-20
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I Job# 01-00267-01 I
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Page 1 of 2
TRANS#:01-0004721
DATE:MAR 20 2001
AMT RECD:2 $ 43.00
CHANGE:
CASHIER:003
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00267-01
225 North Fifth Street
Springfield. OR 97477
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 562 Kelly Blvd Spr
Assessors Map#: 17033414
lot: Block: Addition:
Tax lot #: 01000
Subdivision:
Owner:
Address:
Joyce Watts
564 Kelly Blvd
Phone Number: 541-744-0393
City/State/Zip: Springfield, OR 97477
New Value: $0
Scope Of Work: Plumbing
Installing an instanl start gas w/h to replace the existing w/h.
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour recording at 726-3769. All inspections 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
working day.
Final Plumbing
Required Inspections
I Plumbinq
-When all plumbing work'is complete.
Mechanical
Rough Mechanical
Final Mechanical
- Prior to cover.
- When all mechanical work is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
iArea (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Plumbing
03/20/2001 4721
03/20/2001 4721
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
Number of Fixtures
1
$5.00
$10.00
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Job# 01-00267-01
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Page 2 of2
Value/Quantity Fee Amount
Fee
Paid On Receipt#
I Plumbinll
03/20/2001 4721
03/20/2001 4721
$1.05
$.45
$16.50
State Surcharge - Plumbing
Administrative Fee - Plumbing
Total Plumbing
Minimum Mechanical Permit
Administrative Fee - Mechanical
ApplianceVent (Not Covered in SchedulE
Mechanical Issuance
State Surcharge - Mechanical
Total Mechanical
Grand Total
By sjgnature. 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 Ihis project. I further agree to ensure that all required inspections are
requested at the pr~rr:J time and ~ct address is readable from the street.
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Si\&aturel' Date
Mechanical
03/20/2001 4721
03/20/2001 4721
03/20/2001 4721
03/20/2001 4721
03/20/2001 4721
1
$10.50
$.45
$4.50
$10.00
$1.05
$26.50
$43.00