HomeMy WebLinkAboutPermit Plumbing 2007-02-20Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2007 -00257ISSUED: 0212012007APPLIEDz 0212012007EXPIRES: 08/2012007
VALUE:
SITE ADDRESS: 71710TH ST
ASSESSOR'S PARCEL NO.: 1703351106500
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair Residential
PROJECT DESCRIPTION: Replace approx 48lf sanitary sewer
Owner:
Address:
Contractor Type
Plumbing
VIRGIL STANLEY
7I7 IOTH ST
SPRINGFIELD OR 97477
Phone Number: 541-741-7654
,r i lclle I Uqurlti5 YOU IO
Contractor
OWNER
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,n OAR 952-oo1'0010
0090. You maY obtain
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Expiration Date Phone
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# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
enter
# ofStories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Enersv Path:
f{0}S#iir"d Bulding:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
VB
nla
COMMENCED OR IS ABANDONED F()B
Paved Drive Rqd:
o/o of Lot Coverage:
IT IS NOT
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARKING
Total:
Handicapped:
Compact:
ANYflStH:Hry;TTilfJ.}
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
PUBLIC IMPROVEMENTS
Description Type of Construction
Paee I of2
Value Date Calculated
1
Valuation Description I
S
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541 -7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2007 -00257ISSUED: 0212012007
APPLIEDz 0212012007
EXPIRESz 0812012007
VALUE:
Fee Description
+ l0o/o Administrative Fee
+ 57o Technology Fee
+ 87o State Surcharge
Sanitary Sewer - 1st 50 Feet
Total Amount Paid
Amount Paid
Total Value of Project
Date Paid
2t20107
2t20t07
2t20t07
2t20t07
Receipt Number
1200700000000000177
1200700000000000177
1200700000000000177
1200700000000000r77
$4.50
$2.25
$3.60
$4s.00
$ss.3s
Plan Reviews
To Request an inspection call the 24 hour recording at 726-3769. 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
work day.
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 Springfietd and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY wilt be made of any structure without permission of the Communify 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,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 du
d-;o - 07
Owner rs
Pase 2 of 2
Date
F ees rar(l I
l(eourreo lnsDecnons I
Construction Contractors Board
700 Summer St ltE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-3784621
Web Address: www.ccb.state.or.us
Perrrit *, c\ynu' 7- O oz
Address: 1l I l0 .f(
S
Issued by:\<
1
I
Date: Z-Ls o
Statement: Information Notice to Property Owners
About Gonstruction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential constructton permit applicants who are not
licensed with the Construction Contractors Board to sign thefollowing statement before a building
permit can be issued. This statement is requiredfor residential building, electrical, mechanical and
plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under
ORS 701.010(7), need not submit this statement. This statement will befiled with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38:
&,
1$z
I own, reside in, or will reside in the completed structure.
I understand that I must become licensed as a constnrction contactor if the structure is sold or
offered for sale before or on completion.
tr 3A. My general contractor is
(Name)(ccB #)
I urill instruct my general contractor that all subconhactors who work on the stnrcfirre must be
licensed with the Construction Contractors Board.
OR
38. I will be my own general contractor
If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
licensed with the CCB and will immediately notiff the office issuing this building permit of the
name of the contractor.
I hereby certify the above information is correct and that I have read and do understand the Information
Notice to Owners about Construction Responsibilities on the reverse side of this form.
Z ,7a o
o (Date)
(White copy to issuing agency perrnitfile, pink copy to applicant.)
Property_owner.doc 06-0 I -04