HomeMy WebLinkAboutPermit Plumbing 2001-01-18SPRINGFIELD
Job# 01-00045-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
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Job Number: 01 -00045-01
Office: 726-3759
!nspection Line: 726-3769
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1370 00005th St Spr
AssessorsMap#: 17032631
Lot: Block: Addition:
P"'\
Tax Lot#: 01900
Subdivision:
ctTY oF sPR rvGFtELD, OREGON
Owner: Dave Green
Address: 603 Gear St
Scope Of Work: Plumbing
replace sewer line
Phone Number:
City/State/Zip:
New
Reno, NV 89503
Value: $O
Contractor Type
General Contr
Gontractor Registration #
M & A Construction lnc BB92B
916 Prescott Lane, Springfield, OR97477
Expiration Date
2t11t2001
Phone
541-747-6504
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
To request an inspection call the 24 hour 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.
Required Inspections
Plumbi
Sanitary Sewer Line -Prior to filling trench.
Construction Types:
Occupancy Groups
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq.
Main: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 0111812001 4263 $.00
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Job# 01-00045-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
01t18t2001
0111812001
0111812001
4263
4263
4263
67
$2.80
$40.00
$1.20
$44.00
Grand Total
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
req at the proper time and that the project address is readable from the street.
Date
$44.00
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