HomeMy WebLinkAboutPermit Plumbing 2001-11-13
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Job# 01-01256-01
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TRANS#:01-0007243
DA TE : NOV 13 2001
AMT RECD:2 $ 103.50
CHANGE:
CASHIER: 032
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-01256-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 1625 Henderson Ave Eug
Assessors Map#: 17033443
Lot: Block: Addition:
Tax Lot #: 13302
Subdivision:
Owner:
Commercial Property Mgmt
718 BlackOak Drive, Suite A
Phone Number:
Address:
City/State/Zip: Medford" OR 97504
Addition Value: $0
Scope Of Work: Plumbing
Contractor Type
Plumbing Contr
Contractor
Roto Rooter Service
-44'; "T j _: ,We;-E~~.:..-.v. ::If: ~
Registration # Expiration Date Phone
-,11101- l- \ 1o-0~ ,64196111711
'\~- 30C>- 41 b/
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.
Water Line
Final Plumbing
Required Inspection~v 11l;/::
I Plumbing TJ.!ISPERMITSHALLEXPIRE/FTHEWORK
- Prior to filling trench. AUTH
-When all plumbing work is complete. ORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD. .
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
,Area (Sq. Feet)
I Main: Accessory:
# Of Stories: Height (feet):
Current Units: ProRosed Units: I '.. .. "W ,~
A"~-r-t:.ri n....'l\l:llregon aw reqU1!'~5 'JUt.! l....
Census Code: Does not apply folioV'. rules aoopted by the Oregon U:::ity
I Not'ication Center. Those rules are set forth
Total: il. -CAR 952-001-0010 through OAR 952-001-
. . .. r _ '-..
l.;U~U. YOU 1I1i:1}1 VUlalo. ...vfJ"..........., ....... '-.---J
calling the C,,'ltCi'. (NO:3: th_~ telephone
nJlll:Cer', ~ . .' ') Oregcm UWity N~ iification
Centdris 1-800-332-2344).
;.to 'i'
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Job# 01-01256-01
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Page 2 of2
Fee
Paid On Receipt#
I Plumbing
11/13/2001 7243
11/13/2001 7243
11/13/2001 7243
11/13/2001 7243
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Water Service Footage
Administrative Fee - Plumbing
Total Plumbing
Grand Total
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
equested at the proper time and that the project address is readable from the street.
~.Da:tl~ I !1/3-0(
50
$.00
$3.15
$45.00
$3.60
$51.75
$51.75
Date