HomeMy WebLinkAboutPermit Plumbing 2001-2-26
'\
ii? ,\
.
I Job# 01-00162-01 I
.
Page 1 of 2
TRANS#:01-0004549
DATE:FEB 26 2001
AMT RECD:l $ 50.50
CHANGE:$ 23.00
CASHIER:003
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT.
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00162-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 578 kelly Blvd Spr
Assessors Map#: 17033414
Lot: Block: Addition:
Tax Lot #: 00901
Subdivision:
Owner:
Sandra Vermoya
578 Kelly Blvd
Phone Number: 541-746-9782
City/State/Zip: Springfield, OR 97477
Alteration Value: $0
Address:
Scope Of Work: Plumbing
Replace existing water service
Contractor Type
Plumbing Contr
Contractor Registration # Expiration Date
Ready Rooter / chapman plumb
88608 ermi bee rd. springfield. OR 97478
Phone
541-744-7991
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.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
Fee
Paid On Receipt#
Plumbin!l
02/26/2001 4549
02/26/2001 4549
02/26/2001 4549
02/26/2001 4549
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Water Service Footage
Administrative Fee - Plumbing
Total Plumbing
Grand Total
35
$.00
$1.75
$25.00
$.75
$27.50
$27.50
""
"
\,
.
I Job# 01-00162-01 I . Page 2 of 2
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.
~~~/~b~
Signature
O{-~b-O/
Date
~.
...... I"'"
..
DUPLICATE RECEIPT DUPLICATE RECEIPT
____ ________ _____ _____.______ ----______0--
----------------------------------------
CITY OF SPRINGFIELD
225 FIFTH STREET
SPRINGFIELD. OR 97477
(541 )'126-3753
-----~----------------------------------
----------------------------------------
WELCOME TO DEVELOPMENT
SERVICES AND PUBLIC WORKS
---- ---------- - -.. - ----- -- - - - -_._-- -- - -- --
- ---- - -- --- - -- --- --- -_._--- ---- -- -- ----_.~
REG-RECEIPT:OI-0004549 C:FEB 26 2001
CASHIER 10:003 10:49 am A:FEB 26 2001
------ -- ----- -- --- - ---.- - - -- - --- - --------
---------------------....-----------------
1005 PLUMBING PERfIlT $0.00
JOB~:01-00162-01
1099 STATE SURCHARGE(7X) $0.00
JOB#:01-00162-01
1098 ADMIN FEE(3X) $0.00
JOB#:01-00162-01
1005 PLUMBING PERMIT $25.00
JOB~:01-00162-01
1099 STATE SURCHARGECiX) $1.75
JOB#:01-00162-01
1098 ADMIN FEE(3%) $0.75
JOB#:01-00162-01
TOTAL DUE $27.50
RECEIVED FROM:
READY ROOTER
CASH: $50.50
TOTAL TENOERED $50.50
CHANGE DUE $23.00
----------------------------------------
__ - ___ __ ___ - - - __.____.. __ - - ________ - ____ u_
*Pay Name :READY ROOTER
*Mail Addr :88608 ERMIBEE RD
*Cty/St/Z :CAMP CREEK OR 97478
*Site Addr :578 KELLY Bl.VD
-- ------- - -.. ....----- -- -- -- ----,--- - -- - - ---
----------------------------------------
-----..-------------- ------- ------- ------
- ------ - ---- --- ----- --- -- --- - ----- - -..---
THAUK VOU!!!!!!
----------------------------------------
-- ---- - -- ------ -- - --- -- --..- -- ------ - ----
DUPLICATE RECEIPT DUPLICATE RECEIPT
'"