HomeMy WebLinkAboutPermit Plumbing 2000-07-17SPR!NGF!ELD
Job# 00-01111-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Addition:
Page 1 of 2
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1410 Mill St Spr
AssessorsMap#: 17032744
Lot: Block:
Job Number: 00-01 1 1 1-01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot#: 07600
Subdivision:
ctTY oF SPRfiNGFfiEL4 OREGON
Owner: Jerry Bell
Address: 1410 MillSt
Scope Of Work: Plumbing
replace sewer line
Phone Number:
City/State/Zip:
New
541-746-7263
Springfield, OR97477
Value: $O
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Gode:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection callthe 24hour recording a1726-3769. 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.
Construction Types:
Occupancy Groups:N
THIS# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
Main:Accessory:
# Of Stories:
Current Units:
Census Code:Does not
Total:
IFTI-IEWORK
UNDER THIS PERIVIIT IS NoT
IVIENCED OR IS ABANDONED FOR
ANY 180 DAYPERIOD.
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Plumbing Permit Fee
State Surcharge For Plumbing Permit
Sanitary Sewer Footage
Plumbing Administrative Fee
Total Plumbing
Plumbing
0711712000
07117t2000
07t1712000
07t17t2000
2595
2595
2595
2595
100
$.00
$2.80
$40.00
$1.20
$,14.00
Grand Total $44.00
Job# 00-01111-01 Page 2 ot 2
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.
Date
-2d
s.Enitu6