HomeMy WebLinkAboutPermit Plumbing 2004-06-25Building/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: COM2004-00779ISSUED: 0612512004APPLIEDz 0612512004
EXPIRESz 1212512004
VALUE:
SITE ADDRESS: 2434L4THPL
ASSESSOR'S PARCEL NO.: 1703243300113
PROJECT DESCRIPTION: Replacing 40lf water line
Owner: SHERMAN WARD C & DARLENE A
Address: 2434 N 14TH PL
Contractor Ulffi oilaia oopi68
READY
Springfield TYPE OF WORIC Plumbing Only
TYPE OF USE: Repair Residential
F
Contractor Tvpe
Plumbing
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
180
Expiration Date Phone
02n8t200s 541-744-7991
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
R-3
\rN
nla
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
\f
1 HIS r0R
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARI(NG
Total:
Handicapped:
Compact:It€$1,$
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
-
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TION
Valuation Descriotion
Description Type of Construction
Total Value of Project
Value Date Calculated
Buitding/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Frx
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00779ISSUED: 0612512004APPLIED:. 0612512004EXPIRES: 1212512004
VALUE:
Fee Description
+ l0Yo Administrative Fee
+ 1oh State Surcharge
Water Line - lst 50 Feet
Total Amount Paid
Amount Paid
$4.50
$3.1s
$4s.00
$s2.6s
Date Paid
6t25104
6t25t04
6t25t04
Receipt Number
1200400000000000980
1200400000000000980
1200400000000000980
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection 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.
Water Line: Prior to filling trench and including required testing.
Reouired Insnect
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true a4d 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.
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Owner or Contractors Signature Date
Pase2 of2
.T [}J
r ees ralo I
235 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Crty of Springfield Official Receipt
,,elopment Services Department
Public Works Department
RECEIPT #: 1200400000000000980 Date: 0612512004 l:07247PM
Job/Journal Number
coM2004-00779
coM2004-00779
coM2004-00779
Description
+ 7oA State Surcharge
+ l0% Administrative Fee
Water Line - lst 50 Feet
Amount Due
3. l5
4.50
45.00
Item Total:$52.6s
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
CreditCard DAVID NICHOLS djb 000422 004917 In Person $52.65
Payment Total:
-Sffi
612512004 Page I of I
lEr