HomeMy WebLinkAboutPermit Plumbing 2003-04-04Status Issued
215 Fifth Street, Springfield, OR
5'tl-726-3753 Phone
511-726-3676Fax
5.t I -7 26-37 69 lnspection Line
Building/Combination Permit
PERMIT NO: COM2003-00238ISSUED: 0410412003
APPLIEDz 0410412003
EXPIRES: 1010412003
VALUE:
( r ncr:
A rlrcss:
S . Ii ADDRESS: l4l7 OLYMPIC ST
rt ';ESSOR'S PARCEL NO.: 1703253210900
l',IOJECT DESCRIPTION: Sewer ine replacement
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair Residential
License Expiration Date Phone
76940 11/08/2003 5416897574
MCCOLLOCH ROBERT H
735 ASPEN ST SPRINGFIELD OR 97477
(' 'rlractor Type
( ncr
I ; rrrbing
Contractor
MCCOLLOCH ROBERT H
ROBERT STORRS
CONTRACTOR INFORMATION
)RMATION
# Iiuildings:
I rury Occupancy Group:
: ,n(lary Occupancy Group:
I 'rury Construction Type
t '',rury Construction Type:
f lcdrooms:
SETBACKS
] .,lr,rrdSetback:
: I Setback:
: I Setback:
' 'rrd Setback:
, .'tbacks:
! 'L't Improvements:
1 ",'r Sewer Available:
: 'l lnstruction:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
o/o of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARI(NG
Total:
Handicapped:
Compact:
''.irrtion Type of Construction $ Per Sq Ft Square Footage
PUBLIC IMPROVEMENTS
Pase 1 of2
Value Date Calculated
E1
-LrI,VtlLt rlulll\r rl\ryJ
Valuation Description I
Building/Combination Permit
PERNIIT NO:coM2,003-00238Status Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
ISSUED:
APPLIED:
EXPIRES:
VALUE:
04/04/2003
04i04/2003
10i04/2003
Fee Description
+ l0oh Administrative Fee
+ 7o/o State Surcharge
Sanitary Sewer - lst 50 Feet
Sanitary Sewer Each Addtl 100'
Total Amount Paid
Total Value of Project
Date PaiAmount Paid
$5.90
$4.13
$45.00
$14.00
$69.03
Receipt Number
1200200000000000950
1200200000000000950
12002000000000009s0
12002000000000009s0
414t03
4t4t03
4t4t03
414t03
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 Sanitary Sewer 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 Springlield 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 construction.
{/v I o3
Orvn er or Signature
Pase2 of2
rees rato I
Keourreo lnsDecttons
out"l /
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
4t412003
l:34:09PM
CitY of SPringfield
Development Services DePartment
Public Works DePartment
Official ReceiPt
Receipt #z 1200200000000000950
Date: 0410412003
Line Items:
Amount PaidJob/Journal Number
coM2003-00238
coM2003-00238
coM2003-00238
coM2003-00238
Sanitary Sewer - lst 50 Feet
Sanitary Sewer Each Addtl 100'
+ 7o/o State Surcharge
+ l0% Adminishative Fee
Line Item Total:
45.00
14.00
4.13
5.90
$69.03
Amount
Payments:
PaidType ofPayment Paid By Received By Check Number Confirm No How Received
69.03CreditCardROBERT H MCCU LLOCH DLM 000036 843932 In Person
Total:
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