HomeMy WebLinkAboutPermit Plumbing 2003-3-11
..
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-001S0
ISSUED: 03/11/2003
APPLIED: 03/10/2003
EXPIRES: 09/11/2003
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1278 HAMILTON ST
ASSESSOR'S PARCEL NO.: 1703342200222
Springfield TYPE OF
Single Family Residence
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Connect to sanitary sewer.
Owner: THOMAS ROGGE
Address: 1278 HAMILTON ST SPRINGFIELD OR 97477
Phone Number: 541-741-8134
ICONTRACfOR INFORMATION I
Contractor TVlle
Owner
Plumbing
Contractor
THOMAS ROGGE
THOMAS ROGGE
License
Expiration Date Phone
541-741-8134
541-741-8134
BUILDING INFORMATION I
# of Stories:
Height of
TY~~:::
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~'v !O ~~ :\.'\:.\) \l~ \~ 1..1>EV CLvnnCl" mr vRMA nON I
SETBACK;S-\,,\l~\ f:,'\:.\l o~~\\j. Rt;:QH~RED PARKING
"'\:)\ ~\'\:.~ ~, \,e':>~ '\1\'1
Front yard Setback: T' \)~\~' 'O~ 'VT' Overlay Dist: \a.-.rJ (e~\} J.~~~I:'U\: \O~'
Side I Setback: " ~" '\ # Street Trees' 0(e90\\ \ne 01 H:an9icapped:\
Side 2 Setback: ~ Paved Drive Rqd: G~\ \U~'''o,,\ed '0'1 e lu\6'C~:nP!!cf:~\)U '0
~'(\~ sa".'" ,nOS ~Ol"" u\es '
% of Lot Coverage:J'lIU\e cel\\el. Q\n1oug 0\ \ne I ol\e
\O",.~ \101' '\ .GQ'\ ~ieS \e~n. I'
~\(\\i\ICa ,..",?QG _..~l'\il\Co ._.~ne\e ".r.ca\IO
IPUBLlC tMPn.v>' cl.ti~isiou 1"l':~~l\\e\.I..I~~U\I\I\'1 ~AL\)'
UV- \'nn\n . ,..meg ^~~'2.'Z
cal I' ,,,, \~}.dew,!lkir.ype:
I"l''oel leI IS
l\U (Oo'WnspoutslDrains
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
P'rimary Construction Type
Secondary Construction
# of Bedrooms:
Lot Size:
Sq Ft tsl Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport:
Sq Ft Other:
Impervious Surface Area:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
Square Footal!e
Value
Date Calculated
1 of 2
Status: Issued
225 Fifth Street, SpringfieW, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 100/0 Administrative Fee
+ 7% Stale Surcharge
Sanitary Sewer - 1st 50 Feet
Sanitary Sewer - Improvement
Sanitary Sewer - Reimhursement
SDC Sanitary/Slorm Admin
Total Amount
.
. CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2003-001S0
ISSUED: 03/11/2003
APPLIED: 03/10/2003
EXPIRES: 09/1112003
VALUE:
Total Value of Project
I Fees Paid I
Amount Paid
Date
Receipt Number
$4.50
$3.15
$45.00
$319.01
$419.71
$36.94
3/11/03
3/11/03
3/11/03
3/11/03
3/11/03
3/1l/03
1200200000000000805
1200200000000000805
1200200000000000805
1200200000000000805
1200200000000000805
1200200000000000805
$828.31
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 Reouired Insoectinns I
1 Sanitary Sewer Line: Prior to filling trench and including required testing.
By signature, I state and agree, that 1 have carefuUy examined the completed application and do hereby certii)' that all
information hereon is true and correct, and I further certify that any and ail 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 certii)' that only contractors and employees who are in compliance with ORS 701.005 wiD 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
a~s d(J;.g construction. IAtW II) () 3
Owne~ or co~ Signature Date
2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
COM2003-00 150
COM2003-00 150
COM2003-00 150
COM2003-00150
COM2003-00 150
COM2003-00150
Payments:
T)Ile orPayment
Check
Paid By
Receipt #: 1200200000000000805
Date: 03/11/2003
Description
Sanitary Sewer - 1st 50 Feet
+ 7% State Surcharge
+ 10% Administrative Fee
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC SanitarylStonn Admin
Received By
Che<k Nnmber Confirm No
THOMAS ROGGE
djb
Page I orl
,
3/1112003
10:52:33AM t.
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Line Item Total:
.
Amount Paid
45.00
3.15
4.50
419.71
319.01
36.94
$828.31
.
Amount Paid
828.31
$828.31
How Received
In Person
Payment Total:
cReceipLrpl