HomeMy WebLinkAboutPermit Plumbing 2004-07-15Building/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: COM2004-00882ISSUED: 0711512004APPLIED: 0711512004EXPIRES: 01/151200s
VALUE:
SITE ADDRESS: 380 21ST ST
ASSESSOR'SPARCELNO.: 1703361307000
PROJECT DESCRIPTION: Replace approx 20lf water line
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair Residential
Owner: HURST JACK R & RUTH MAXINE
Address: 380 N 21ST ST SPRINGFIELD OR 97477
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N OBK
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# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
License
.T 74466
Expiration Date
09/08/2005
Phone
541-688-7609
Contractor Tvpe
Plumbing
# 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:
R-3
VN
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Load:
$ Per Sq Ft
or multiplier
B
Square Footage
or Bid Amount
nla
Sidewalk Type:
Downspouts/Drains:
PARKING
.(orl
Valuation Descrintion
Description Tvpe of Construction
Total Value of Project
Value Date Calculated
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Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2004-00882ISSUED: 0711512004APPLIED: 0711512004EXPIRES: 01/1512005
VALUE:
Fees Paid
Fee Description
+ 10,,6 Administrative Fee
+ 7%o Stqle Surcharge
)m{ry Sewer - lst 50 Feet.,**Tx L trC' bg
Total Amount Paid
Amount Paid
$4.s0
$3.15
$45.00
$52.65
Date Paid
7lt5l04
7n5t04
7nst04
Receipt Number
1200400000000001085
1200400000000001085
1200400000000001085
Plan Reviews
To Request an inspection call the 24 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.
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 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 all required inspections are requested at the proper time, that each address is readable from the
located at the front of the property, and the approved set of plans will remain on the site at allstreet, that the
times during
(
Owner or Signature
-/5
Date
Pase2 of2
t t
Keoulreo InsDectrons I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
-!ty of Springlield Official Receipt
.-revelopment Services Department
Public Works Department
RECEIPT #: 1200400000000001085 Date: 0711512004 9:21:43AM
Job/Journal Number
coM2004-00882
coM2004-00882
coM2004-00882
Amount Due
3. l5
4.50
45.00
Item Total:$52.65
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check CARDWELL CONSTR djb 5823 In Person
Payment Total:
$s2.65
-ffi
711512004 Page I of I
5l
Description
+ 7o/o State Surcharge
+ l0% Administrative Fee
M*er- lst50Feet
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