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Home My WebLink AboutPermit Plumbing 2004-03-16CITY OF SPRING Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-00289ISSUED: 0311612004APPLIED: 03/1612004EXPIRES: 0911612004 VALUE: SITE ADDRESS: 1565 MOHAWKBLVD ASSESSOR'SPARCELNO.: 1703253106800 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: New Commercial PROJECT DESCRIPTION: Replace 70lf water line Owner: MCDONALD'S-MOHAWK Address: % SASS INC 2073 OLYMPIC ST STE #211 SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Plumbing # of Units: Primary Occupancy Group: Secondary Primary Secondary # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Contractor GARY ALAN MUSTIN License 129990 Expiration Date 06t24t2004 Phone 541-463-7568 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 3{ $ Per Sq Ft or multiplier Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: REQUIRED PARIilNG Total: Handicapped: Compact: r\ rL r$(\\ Total Value of Project Pase 1 of2 Description Type of Construction Value Date Calculated ffiLI d Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: C Valuation Description Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Ftx 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-00289ISSUED: 0311612004APPLIEDz 0311612004 EXPIRESz 0911612004 VALUE: Fee Description + l0oh Administrative Fee + 7o/o State Surcharge Water Line - lst 50 Feet Water Line - Each Addtl 100' Total Amount Paid Amount Paid $5.90 $4.13 $4s.00 $14.00 $69.03 Date Paid 3n6t04 3fi6t04 3n6104 3n6t04 Receipt Number 1200400000000000333 1200400000000000333 1200400000000000333 1200400000000000333 Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection 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 work day. I Water Line: Prior to filling trench and including required testing. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon 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 pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Signature Date LL Pase2 of2 E r1T r ees raro I Keoulreo tnsDecuons I 225 Fifth Street ,i# Springfield, Oregon 97 477 541-726-3759 Phone Citg of Springfield Official Receipt Development Services Department Public Works Department #: 1200400000000000333 Date:03t16t2004 2:29:33PM coM2004-00289 coM2004-00289 coM2004-00289 coM2004-00289 Water Line - lst 50 Feet Water Line - Each Addtl 100' + 7o/o State Surcharge + l0o/o Administrative Fee 45.00 14.00 4.13 5.90 Item Total:$69.03 Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check GARYS ROOTER SERVICE djb 2196 In Person Payment Total: $69.03 $69.03