HomeMy WebLinkAboutPermit Plumbing 2005-1-24
:.
. ~ITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00098
ISSUED: 01124/2005
APPLIED: 0112412005
EXPIRES: 07/24/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 1206 LA WNRIDGE AVE
ASSESSOR'S PARCEL NO,: 1703261103224
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
PROJECT DESCRIPTION: Replace water line approx 701ftotal, 2 lines serving duplex in same trench
Residential
Owner: JACK WAYMIRE
Address: PO BOX 70052
EUGENE OR 97401
I CONTRACTOR INFORMATION.
Contractor Type
Plumbing
Contractor
GARY ALAN MUSTIN
License
129990
Expiration Date
06/24/2006
Phone
541-463-7568
I BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
VN
# of Stories: Lot Size:
Height of Structure Sq Ft 1 st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: quires you tliR Ft Basement:
f," Raligel1YPf:lregon lawhre Oregon Util~ Ft Garage/Carport
,. '\I~.nergy/Path"pted by t a I 5 ra set ,Slllft Other:
Nuttl~P.rJI!~ejJEBUUili.1g~05e ruhe ..n~a.. 952-&FP'pant Load:
__ _^.. ^1'\4nthrnlln Uf\l1
I DEy.iLOP.M';.~;;';'I\\}AA"'''l\:1l1l; ll1e ruh,ali uV
ter \\'lUl" ..v.llep one REQUIRED PARKING
. calling the cen, Utility Notification
m_~.hiedllYJDlffil, Orego~ ""2-2344).
# Str~s'~~~Ouvv
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
R-3
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
CE' Downsl!o."tsLDFaJn~:
NOTI. EXPIRE IF 'tit 'Nun'
lHIS PERMIl SHA~~ lHIS PERMIl IS NOi
AUiHORIZEO UNO,S ABANOONED FOR
rnMMENCEO OH_
-., ....,.. --~,v3,
I ~N1 IUV ...,.1.
Valuation DescriDtion
Notes:
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of2
.
. CITY OF SrK11'1lJt<u'LIJ
Building/Combination Permit
PERMIT NO: COM2005-00098
ISSUED: 01124/2005
APPLIED: 01124/2005
EXPIRES: 07/24/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
Fpps PaW
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Water Line - 1st SO Feet
Water Line - Each Addtl 100'
Amount Paid
Date Paid
Receipt Number
$5,90
$4,13
$45,00
$14,00
1/24/05
1/24/05
1/24/05
1/24/05
2200500000000000091
2200500000000000091
2200500000000000091
2200500000000000091
Total Amount Paid
$69,03
I Plan Reviews ,
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.
~irplll~
Water Line: Prior to filling trench and including required testing,
By signature, I state and agree, that I 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.
JJ'~ /})J;/ ____.-
/ - V .
Owner or Contractors Signature
1-- .:zi/~~D
Date
Paee 2 of2
225 Fifth Street
, .
springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00098
COM2005-00098
COM2005-00098
COM2005-00098
Payments:
Type of Payment
Check
1/24/2005
.
RECEIPT #:
Deserlptlon
Waler Line - Isl50 Feet
Waler Line - Each AddU 100'
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
GARYS ROOTER SERVICE
ap~
~,
2200500000000000091
Reeelved By
djb
Check Number
Bateh Number
, Page I ofJ
lIlY of Springfield Official Receipt
.elopment Services Department
Public Works Department
Date: 01124/2005
Item Total:
AuthoriZation
Number How Received
1111
In Person
Payment Total:
2:35:04PM
Amount Due
45.00
14,00
4.13
5,90
$69,03
Amount Paid
$69.03
$69,03