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Home My WebLink AboutPermit Plumbing 2004-05-26Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2004-00624ISSUED: 0512612004APPLIEDz 0512612004EXPIRES: 1112612004 YALUE: SITEADDRESS: 6399THST ASSESSORTS PARCEL NO.: 1703351300700 PROJECT DESCRIPTION: Install approx 25lf sanitary sewer Springfield TYPE OF WORK: Plumbing OnIy TYPE OF USE: New Residential Owner: VANDyNELAVONNEH Address: 639 N 9TH ST SPRINGFIELD OR 97477 Contractor Type Plumbing Contractor GARY ALAN MUSTIN Expiration Date 06t24t2004 Phone 541-463-7568 License 129990 ]iTRACTOR INFORMATION BUILDIN( # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Sprinkled o/o oILot Coverage: R-3 YN Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Compact: PARI(NG NOTI CE: THIS PERMIT S HALL EXPI AUlH ORIZED UND P ONED FOR ERMIT Sidewalk Type: Downspouts/Drains: ER THIS ,D DAY PER REIFT HE WORK IS NOT $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Total Value of Project t0D. Value '!qI I Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00624ISSUED: 0512612004APPLIED: 0512612004 EXPIRESz 1112612004 VALUE: tr'ees Paid Fee Description * l0o/o Administrative Fee + 7o/o State Surcharge Encroachment Permit Sanitary Sewer - lst 50 Feet Total Amount Paid Amount Paid $4.50 $3.1s $120.00 $45.00 $r72.65 Date Paid 5t26104 5t26t04 st26t04 5126t04 Receipt Number 1200400000000000811 1200400000000000811 1200400000000000811 1200400000000000811 Plan Reviews To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. wiII be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. 1 Sanitary Sewer Line: Prior to lilling 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. 26- Owner Date Pase? of2 rll Keourreo InsDecuons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone ^'ty of Springfield Official Receipt - rvelopment Services Department Public Works Department RECEIPT#: 120040000000000081I Date: 0512612004 1:14:08PM Job/Journal Number coM2004-00624 coill2004-00624 col[{[2004-00624 coM2004-00624 Description + 1oh State Surcharge + l0% Administrative Fee Sanitary Sewer - lst 50 Feet Encroachment Permit Amount Due 3.15 4.s0 45.00 120.00 Item Total:$172.65 Payments: Type of Payment Paid By checl(Number Authorization Received By Batch Number Number How Received Amount Paid CreditCard GARY MUSTIN djb 000394 026610 In Person $172.65 Payment Total: -ffi st26/2004 Page I of I raaittll,nxr|"D. I