HomeMy WebLinkAboutPermit Plumbing 2006-6-2
.
. CITY OF ~rK11-oJ(d<1~L1J
Building/Combination Permit
PERMIT NO: COM2006-00662
ISSUED: 06/02/2006
APPLIED: 05/3112006
EXPIRES: 12/02/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 5295 HIGH BANKS RD
ASSESSOR'S PARCEL NO,: 1702283400703
Springfield TYPE OF WORK: Site Work Only
TYPE OF USE: New
PROJECT DESCRIPTION: Storm and sewer improvements for Highbanks subdivision
Residential
Owner: CUMMINS INVESTMENT LLC
Address: 31221 OSPREY RD
LEBANON OR 97355
Phone Number: 541-401-5272
Contractor Type
Plumbing
Contractor
KIPCO INC
I CONTRACTOR INFORMATION.
T~ )
AT eN IIUI\I: UIt:8uIIIGVW ,......'1.....-- 1- .'
follow rules adopted by the OrEi2en'~~;lt~hExPiration Date
Notification Center. Those rule::57!!.7.Q:.e~ ~~. 02103/2007
. OA~~c"'"" ..................."'...-----.
10 I' DlJILlJIl,';.INFORMATlON,I'ules by
0090. .-- "-,
call'ing t"e ~~!1tp.r. (Note: the telephone
"dS~n~ 'f' t'
ber f.-'" 'h" 1 ""oon Utility Noti Ica Ion
num ne/gllt of Structure )
CT9WdfHe~W;;;;<:-2344 .
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Phone
541-689-9265
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Overlay Dist:
# Street Trees Rqd: WOR\<.
"01\Cfp.a~~d e.'iiXt~'l.<1!?\P.t. It 1\-\t. IS !'l01
1\-\\S Pt.WoiTLot fbtRr~~,6 pt.RMI1
t>.U1\-\OR\I~~~ U~Q Ie. Mlfl,NDONt.D FOR
~'~Vdj]15"iMj>~Q~ENTS I
r"'" '
Sidewalk Type:
DownspoutslDrains:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
.
. CITY OF SPRINul'lJ<.LU
Building/Combination Permit
PERMIT NO: COM2006-00662
ISSUED: 06/02/2006
APPLIED: 05/31/2006
EXPIRES: 12/02/2006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
Fp.p.s P...idJ
Fee Description
+ 10% Administrative Fee
+ 8% State Surcharge
Fixture
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer Each Addtl100'
Storm Sewer - 1st 50 Feet
Amount Paid
Date Paid
$14.60
$11,68
$14,00
$45.00
$42.00
$45.00
6/2/06
6/2/06
6/2106
6/2106
6/2106
6/2106
Receipt Number
1200600000000000779
. 1200600000000000779
1200600000000000779
1200600000000000779
1200600000000000779
1200600000000000779
, Total Amount Paid
$172.28
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.
I Rp./lu,Lrp.d rnsnp.~tions I
Sanitary Sewer Line: Prior to filling trench and including required testing,
Storm Sewer Line: Prior to filling trench.
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 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 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.
I further certify that only contractors and employees who are in compliance with ORS 701.005 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, 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 jng J=on, b /Z /0 ~
O : C ' S' 0
wner or on tractors 'gnature ate
Paee 2 of2
225 Fifth Street
Springfield, Oregon 97477
54F726-3759 Phone
.
.~'.~......
WiLIiiiiinPI." I I
""".. ~ . -
~. ., ..
~ of Springfield Official Receipt
_elopment Services Department
Public Works Department
Job/Journal Number
COM2006-00662
COM2006-00662
COM2006-00662
COM2006-00662
COM2006-00662
COM2006-00662
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
1200600000000000779
Date: 06/02/2006
8:38:57AM
Description
Fixture'
Sanitary Sewer - I st50 Feet
Sanitary Sewer Each Addtl 100'
Storm Sewer - 1st 50 Feet
+ 8% State Surcharge
+ 10% Administrative Fee
Amount Due
14.00
45.00
42.00
45.00
11.68
14.60
Paid By
LB OLSON AND ASSOCIATES
Item Total:
<":heck Number Authorization
Received By Batch Number Number How Received
Amount Paid
::,.,.....6
djb
10680
In Person
Payment Total:
$172.28
$172.28
Page I ef I
6/2/2006