HomeMy WebLinkAboutPermit Plumbing 2001-11-07SPRII\IGFIELD
Job# 01-01234-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 ot 2
Job Number: 01 -01 234-01
Office:726-3759
!nspection Line: 726-3769
Tax Lot#: 00500
Subdivision:
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 4082 North St Spr
AssessorsMap#: 18020611
Lot: Block: Addition:
ctTY oF SPRTNGFTELD, OREGON
Owner: Leolyn McKinley
Address: 4082 North Street
Scope Of Work: Plumbing
Phone Number:
City/State/Zip:
New
541-520-
Springfield, OR 97478
Value: $O
Sanitary connection and septic abandon
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection callthe 24 hour recording at726-3769. 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.
Required lnspections
Please provide the
Plumbing I
- Prior to filling trench.
-After septic tank has been pumped and filled.inspector with receipt and ver
Sanitary Sewer Line
Septic Tank Pumped
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq. Feet)
Main:
,Q
Accessory
# Of Stories: Height (feet):
Current Units: Proposed Units
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Plumbing Permit Fee
Septic Tank Removal or Fill
State Surcharge - Plumbing
Sanitary Sewer Footage
11t0712001
1110712001
11t0712001
11t0712001
1
$.00
$14.00
$5.11
$s9.00
71 98
7198
7198
71 98 BO
Job# 01-01234-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Administrative Fee - Plumbing
Total Plumbing
Plumbing
11t07t2001 7198 $5.84
$83.s5
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
h6reby 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 roject address is readable from the street.
)/t1(Y l<;
sig Date
$83.e5
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