HomeMy WebLinkAboutPermit Plumbing 2001-06-29SPR'AIGF'ELD
225 North Fifth Street
Springfield, OR97477
Job#01 -00666-0 1
RESIDENTIAL PERMIT
City Of SPringfield
Community Services Division
Building SafetY
Job Number: 01 -00666-01
Office: 726-3759
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Location Of Proposed Site: 333 S 00004th St Spr
AssessorsMaP#: 17033534
Lot: Block: Addition:
lnspection Line: 726-3769 PE
Tax Lot#: 06600
Subdivision:
clTY oF SPRINGFIELD, OREGON
Owner: Carla Smith
Address: 333 S 4th Street
Scope Of Work: Plumbing
Sewer repair
Phone Number:
City/State/ZiP:
New
541-521-3283
Springfield, OR97477
Value: $O
Gontractor TYPe
Plumbing Contr
Quad Area:
# Of Units:
Constr. TyPe:
Water Heater:
Contractor
Ray Sharp Construction lnc
2495 Devon Ave, Eugene, OR
97408-4678
Registration #
60926
Expiration Date
7t1212001
Phone
541-345-2279
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
OccupancY G roup:ATTENTIO
follow rul g5
onCNotificati Heat Source:
enter Sq. Footage:in OAB
PIumb
Sanitary Sewer Line -Prior to fllling trench'
Gonstruction TYPes:
Occupancy GrouPs:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(sq.F
Main:Accessory:
NOTICE;
THIS PEFiMIT SHALL EXPIBE IF THE WORK
AUTHOHIZED UNDER THIS PEBMIT IS NOT
# of Stories' COMMENCEDISEIEfim$DgNED FoR
Gurrent Units: ANY 160 DAyFEmeffid units:
Census Code:Does not aPPIY
Total:
Paid On ReceiPt#Value/QuantitY Fee Amount
Plumbin
Fee
Minimum Plumbing Permit Fee 0612912001 6015 $.oo
Required lnsPections
To request an inspection call the 24 hour recording a1726'3769..
,.r.*ittbemadethesameworkingday,inspectionsrequested
working day.
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Centeris 1
n Utitity Notification
Job# 01-00666-01 Page2 ot2
Fee Paid On Receipt# Value/Quantity Fee Amount
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
0612912001
06129t2001
06129t2001
601 5
601 5
601 5
41
$1.75
$25.00
$.75
$27.50
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 SpringfielO ahO tne Laws of
$27.s0
/Aq.0/
the State of Oregon. I further state that only contractors and employees who are in compliance with
ORS 701.055 will be on this project. I further agree to ensure that all required inspections are
requested at the ti and that the project address is readable from the street.
Signature Date