HomeMy WebLinkAboutPermit Plumbing 2002-12-16
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City of Springfield
Plumbing Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
PLM2002-00121
12/16/2002
12/16/2002
6/16/2003
SITE ADDRESS:
ASSESSOR'S PARCEL NO.:
PROJECT DESCRIPTION:
140 FAIRVIEW DR
1703274100101
Sewer line Replacement
Springfield
TYPE OF WORK:
TYPE OF USE:
Alteration
Residential
OWNER/APPliCANT:
HOUSING AUTHORITY & URBAN
300 W FAIRVIEW DR
SPRINGFIELD OR 97477
RENEWAL AGENCY OF LANE CO
300 W FAIRVIEW DR
SPRINGFIELD OR 97477
HEAD START OF LANE COUNTY
221 B ST
SPRINGFIELD OR 97477
PLUMBING CONTRACTOR:
Phone:
CCB#:
EXPIRES:
Descriotion
Amount Paid
Date Paid
Receint Num her
Cashier
+ 7% State Surcharge
+ 8% Administrative Fee
Sanitary Sewer - 1 st 50 Feet
3.15
3.60
45.00
12/16/2002
12/16/2002
12/16/2002
1200200000000000406
1200200000000000406
1200200000000000406
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o n",\f"'fVt,l nspectlon c e our reoor m~aat . inspections requeste, elore; ~m: W,l e maue e same wor mg~ ay,
ins'l"r'l'1snf>mRfd$1l!t.'l.I!l<&~JGIiI Ii ;tli\fi, l/itGi ing working day.'Il' ,tiC,. "r'.,.' e nose rUles are sellOn'
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Rtq~I~~Yf.I~~~e~ti~~~;C.:B;NDONEO FOR .' -i,1(J '%' -,Id', Jbtain copies of the rules by
vv ,~"..-.. - -- C"lli-- '~f' ~enter. (Note: the telephone
ANY 180 DAY PERIOD. , 1,";lJ~ :rr ':OF' Oregon Utility Notification
B S. I d ha I h f IIy . d th I d.'., .' d' -d""h'l1::>b-::>344\'f ha II
Y .gnature, state an agree, t t ave care u examlDe e comp ete app .cation an 0 ere y certl y t t a
information hereon is true and correct, and I further certify that any and all w'ork 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. I
further certify 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, that each address is readable from the
street, and that the approved set of PITiftPlic~ble, will remain on the site at all times during construction.
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/Owner or ContractolS Signature Date
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