HomeMy WebLinkAboutPermit Plumbing 2003-05-01Status Issued
225 Fifth Street, SPringlield' OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 InsPection Line
SITE ADDRESS: 183617TH ST
ASSESSOR'S PARCEL NO.: 1703252403400
PROJECT DESCRIPTION: Replace 35 feet water line
Owner: BRADLEY DENNIS L & VICKY L
Address: 1836 N 17TH ST SPRINGFIELD OR 97477
I
Contractor Type
Owner
Plumbing
Building/Combination Permit
PERMIT NO: COM2003-00321ISSUED: 05/01/2003
APPLIED: 05/0112003
EXPIRES: 11/0112003
VALUE:
Springlield TYPE OF WORK: Single Family Residence
TYPE OF USE: RePair Residential
NEW
# of Buildings:
Primary
Secondary
Primary
Secondary
# of Bedrooms:'\s
Stories:
Type of Heat:
Water Type:
Range Type:
Energy Path:
License
SYSTEMS66681
of Structure
Expiration Date Phone
0511512004 541-746-4224
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Overlay
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description Tvpe of Construction $ Per Sq Ft Square Footage
#
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARJ(NG
Total:
Handicapped:
Compact:
Pase I of2
Value Date Calculated
\
-
E
Valuation Description I
Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield' OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2003-00321ISSUED: 05/01/2003
APPLIED: 05/0112003
EXPIRES: 11/0112003
VALUE:
Fee Description
+ l0oh Administrative Fee
+ 77o State Surcharge
Water Line - lst 50 Feet
Total Amount Paid
Amount Paid
$4.s0
$3.1s
$45.00
$s2.6s
Total Value of Project
Date Pai
'fi1035/1i03
5lll03
Receipt Number
1200200000000001106
1200200000000001106
1200200000000001106
Plan
To Request an inspection call the24 hour recording at 726-3769. AII 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.
I Water 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 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
construction.5*/
Owner or Signature Date
red Insnections
Pase2 of2
UtfffiD
Eees Paid I
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield
Development Services Department
Public Works Department
Official Receipt
Receipt #: 120020000000000 1 1 06 Date:05/01/2003
coM2003-00321
coM2003-00321
coM2003-00321
Water Line - lst 50 Feet
+ 7%o State Surcharge
+ l|Yo Administrative Fee
45.00
3.15
4.50
Item Total:$52.6s
PryEeDt3:
Check djb 52.65THOMPSON SEPTIC AND
ROOTER
In Person
Payment Total:$s2.65
8:32:47ANI Page I ofl cReceipt.rpt
(
5/t/2003