HomeMy WebLinkAboutPermit Plumbing 2002-1-30
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I Job# 02-00110-01 I
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TRANS#:01-000790B
DATE:JAN 30 2002
AMT RECD:2 $ 51.75
CHANGE:
CASHIER:061
CITY OF SPRINGFIELD, OREGON
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 02-00110-01
225 Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 718 Island St Spr
Assessors Map#: 17033412
Lot: Block: Addition:
Tax Lot #: 03800
Subdivision:
Underfloor Plumbing
Rough Plumbing
Final Plumbing
Owner: Mathew Slager Phone Number: 541-744-3056
Address: 718 Island St City/State/Zip: Springfield, OR 97477
Scope Of Work: Plumbing New Value: $0,,",
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Install underfloor sump pump. Homeowner will have licensed el.e!<tii~~~~ ~~ri~'permit and
np.rfnrm p.1p.r.trir.,,1 wnrk. ,-:j';'(> \v;.0 0'i>7J.~ <?J':J7:'" s'(i{
Contractor Type Contractor Registratio~~t!O ~~I~~~~e ~0 Phone
.'.J'" 609 ",v;.o ~($ 0' '! 9v;.0. Q~'
ElectricalContr Mathew Slager ....6.'~.'0'i>0' ~0~' f;:/S"~O ~,0'i> \0\e.~,ci5"1-744-3056
718 Island St, Springfield. OR 97477 P ': .\V~ v0~ .~'\ .~vo .."S--0 ~o\'
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Mathew Slager \o\~'C~ <?J':J'/; ~7J.'i 0 ~\0~' \,O{;o. \5 ~~.?; 541-744-3056
718 Island St, Springfield, OR 97477 ". 0\>1 o,{O\) 0ce O~e r,t).'?i
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Office Use (',,," 't;)0 0(\'
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Quad Area: Land Use: . # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr. Type: Bedrooms: Heat Source:
Water Heater: Range: Sq. Footage:' .J
_0.....
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To request an inspection call the 24 hour recording at 726-3769. All inspections reqUested~~fe. I~"\
a.m. will be made the same working day, inspections requested after 7:00 a.m. will b~!T'a'8e.t~li\311~9
working day. Cf(;: ~ry..0--'i;; ,,\y..\S'? ~<f;.<;)(((
R . d I . tr.\'t~ :.~ '0 .<'\((-~ . ....,QO
equlre nspe.c.tlo~~<(;.~: ~<;)\l':' \Sry..'(:i,
I Plumbing ,,\~,..>. ,b'?-~ <;;.<;)O'?- 0<;)'
-Prior to insulation or decking. ry..\)" ~<f;.~G ~,?<f;.'?-~
-Prior to cover. (jO~ <of;:)<;)'f.
-When all plumbing work is complete. ry..~o,{ '\
Plumbing Contr
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
iArea(sq. Feet)
I Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
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Fee
Minimum Plumbing Permit Fee
Number of Fixtures
State Surcharge - Plumbing
8% Administrative Fee - Plumbing
Total Plumbing
Grand Total
Job# 02-00110-01
Paid On Receipt#
Plumbing
01/30/2002 7908
01/30/2002 7908
01/30/2002 7908
01/30/2002 7908
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Page 2 of 2
Fee Amount
Value/Quantity
1
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
requested at the proper time and that the project address is readable from the street.
tu;'n6f.L~ .-fiA--
Signature
.1..j.3tJ.,1 tJ?_
Date
$31.00
$14.00
$3.15
$3.60
$51.75
$51.75