Loading...
HomeMy WebLinkAboutPermit Plumbing 2000-1-19 '~ -. . .'- I Job# 00-00075-01 I Page 1 of2 TRANSU:01-0000307 DATE:JAN 19 2000 AMT RECD:1 $ 16.50 CHANGE: CASHIER: 018 SPRINQPIIILD ~. CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 00-00075-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 414 Main St Spr Assessors Map#: 17033531 Lot: Block: Addition: Tax LoU: 07400 Subdivision: Owner: Address: Gary Mathews 4034 Wakefield Court Phone Number: 541-744-2820 City/State/Zip: Eugene, OR 97404 New Value: $0 Scope Of Work: Plumbing Quad Area: 1CNW # 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, Backflow Device Required Inspections I Plumbing I -After device is installed but before backfilling trench, Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 ,Area (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# I' Plumbi~ 01/19/2000 01/19/2000 01/19/2000 ValuelQuantity Fee Amount Minimum Plumbing Permit Fee State Surcharge For Plumbing Permit Backflow Prevention Device 1 $5,00 $1,05 $10,00 , '0 . . Fee Job# 00-00075-01 Paid On Receipt# Plumbing 01/19/2000 Page 2 of2 Value/Quantity Fee Amount Plumbing Administrative Fee 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 701,0 5 will be used on this project. I further agree to ensure that all required inspections are request d thert7J~~~e, and't>>t the project address is readable from the street. / / (\ ,Lf4Aff/( /Ill mN /J-A- ~ 1// q 1?eoV ~Signature () Date ' $,45 $16.50 $16.50