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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 €fr 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