HomeMy WebLinkAboutPermit Plumbing 2004-04-27Buildin g/C ombination Permit
Status Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2004-00339ISSUED: 0412712004APPLIED: 0312612004EXPIRES: 1012712004
VALUE:
SITE ADDRESS: 20011216TH ST I
ASSESSOR'S PARCELNO.: 1703363104603
PROJECT DESCRIPTION: Repair Sanitary Sewer
Owner: R&RpERKINSLLC
Address: 326 MAIN ST SPRINGFIELD OR 97477
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair Residential
Contractor Type
Electrical
Sewer
Contractor License
OREGON ELECTRIC SERVICE 38001
ROYAL FLUSH ENVIRONMENTAL SERVIC
Expiration Date
09114t2004
Phone
s41-343-1681
s4t-895-2072
)RMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Street Improvements:
Storm Sewer Available:
Special Instruction:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Trees Rqd:
Paved Drive Rqd:
%o oILot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Do\H?{p;rff &rtue s Y :,, *o
,
PUBLIC IMPROVEMENTS
Notes:
Pase I of3
I
r.-rl\ r rf-A(- r rrla. rr\ r' Yl]Ilj]lf:z1l_l
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
Building/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: COM2004-00339ISSUED: 0412712004APPLIEDz 0312612004
EXPIRESz 1012712004
VALUE:
Description Type of Construction
Fee Description
+ l0%o Administrative Fee
+ 77o State Surcharge
Add, Alter, Extend Circ
Fixture
Minimum/Adj ustment Electrical
Minimum/Adj ustment Plumbing
Total Amount Paid
Total Value of Project
Date Paid
VaIue Date Calculated
Receipt Number
120040000000000055r
1200400000000000551
1200400000000000551
1200400000000000551
1200400000000000551
1200400000000000551
Amount Paid
$9.00
$6.30
$43.00
$14.00
$2.00
$31.00
$105.30
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
4t27t04
4t27104
4127t04
4t27t04
4127104
4t27t04
Fees Paid
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
witl be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
I Rough Plumbing: Prior to cover and including required testing.
2 Final Plumbing: When all plumbing work is complete.
3 Rough Electric: Prior to Cover
4 Final Electric: When all electrical work is complete.
Reorrired Insnections
Paee 2 of3
\
Valuation Descrintion I
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3153 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00339ISSUED: 0412712004APPLIED: 0312612004EXPIRBS: 1012712004
VALUE:
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 Springlield 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.
4nr (5^t-
owner o, co(t o("{ors Signature Date
Page 3 of3
]25 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 7 26-3'7 69
OFFICE: '726-3'759
] LOCATION INST TION + -7-zoo
ELECTRICAL PER]WT APPLI CATION
3. COMPLETE FEE SCMDULE BELOW
A. New Residential-Single or
Multi-Famiiy per dweliing umt.
Included:
City Job N.omAer COtt t?Pc:t\'OO3S 7
of issuance or if work is
I 80 davs
Autnorized
Signature
2 CONTRACTOR INSTALLATION ONLY
Electrcat con0fi{ffiE
P0, Box 223i
or less
500
d Home or
Modular Dwelling
Service or Feeder
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 ampVvolts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
Items Cost Sum
$106.00
$1900
$5000
Address trllnrllr nnml-o.^truuilrr, lTryrluz
Citt Pt'o,rq3H3:&8/
Supen"isor License Number , Aa.f- -S
Expiration Date /o- or . 6-LI
Constr Contr. Number -\,*aO /
Erprration Date
$ 63.00
$ 75.00
$ 125.00
$ 163.00
$375.00
$ s0.00
_ $so.oo _
S of Supervrsing Electrician
201 amps to 400
O\,TN'E$EAIU on la!\ r'equres 9@-ce'
-tne O+egofrt00i00Y-
orvners Nu-.?ovt Perr Kr *, s
Crr.y sptJ.ph6ns 1ZC - Z4CO
OWNER INSTALLATION
The installation is being made on
propemy I own which is not intended
for sale, Iease or rent.
m,rrruru'*ffiffihg,:Hl37
D
One Circuit / s+:.oo
Lt3
Each Additional Circuit or with Service
or Feeder Permrt s 3.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _ $50.00
Sigr/Outline Lighting_ _ $50.00
Limited Energy/Res _ $25.00
Limited Energy/Comm _ $45.00
5. suBrorAr- or mo$fi^t
?% State Surcharge
| )Y,YK{drnrnistrative F ee
TOTAL
Ltf
97 6'
""i9'8'yil8t I ou
JOB
gi?tf-
tf so
sq.
Permits are
Lf u,ork is not stafled within 180
ANY 180 DAY PERIOD.
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
^ty of Springfield Oflicial Receipt
.- evelopment Services Department
Public Works Department
RECEIPT #: 120040000000000055r Date: 0412712004 1:52:12PM
Job/Journal Number
coM2004-00339
coM2004-00339
coM2004-00339
coM2004-00339
coM2004-00339
coM2004-00339
Description
+ 7Yo State Surcharge
+ l0% Administrative Fee
Fixture
Minimum/Adj ustment Plumbing
Add, Alter, Extend Circ
Minimum/Adj ustment Electrical
Amount Due
6.30
9.00
14.00
31.00
43.00
2.00
Item Total:$105.30
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check ROYAL FLUSH ENV djb 1366 In Person $105.30
Payment total:
-STdE5d-
412712004 Page I of I
ltloanc