HomeMy WebLinkAboutPermit Plumbing 2001-09-19-L
Contractor TYPe
Plumbing Contr
Quad Area:
# Of Units:
Constr. TYPe:
Water Heater:
# Of Buildings:
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Handicap Access?
Area (Sq. Feet)
Main:
RESIDENTIAL PERMIT
City Of SPringfield
Gommunity Services Division
Building SafetY
Spr
Addition
Page 1 of2
Job Number: 01-01020-01
Office:726'3759
lnspection Line: 726-3769
Tax Lot#: 08400
Subdivision:
€h,
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 865 00022nd St
AssessorsMaP#: 17033612
Lot: Block:
Owner: Anolia bates
Address: 865 22nd Street
Scope Of Work: Plumbing
Repair sanitary sewer
Phone Number: 541-746-3370
City/State/Zip: Springfield, OR97477
New Vatue: $O
Contractor
Bohemia Plumbing & Construction lnc
33854 Row River Rd, Cottage Grove, OR
97424-8573
Registration #
41468
Expiration Date
3/3/03
Phone
541-942-8333
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy GrouP
Heat Source:
Sq. Footage:
To request an inspection callthe 24hour recording a1726-3769. All inspections requested before 7:00
a.m. will be made tne same working day, inspectio"ns requested after 7:00 a.m. will be made the following
working day.
Plumbing
Sanitary Sewer Line -Prior to filling trench
Construction TYPes:
Occupancy GrouPs:
Accessory:
# Of Stories: Height (feet):
Current Units: ProPosed Units:
Census Code: Does not aPPIY
Total:
Job#0 -0I,1r020-0 I
clnr oF sPRltlGFtEL4 OREcotv
Fee Paid On ReceiPt#Value/Quantity Fee Amount
Plumbin
Minimum Plumbing Permit Fee 0911912001 6735 $.00
. SPPINGFIELD
I\u
g\$rtu'
Fee Page 2 of 2
Paid On Receipt#Value/Quantity Fee Amount
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
0911912001
09/1 9/2001
0911912001
6735
6735
6735
75
$4.13
$59.00
$4.72
$67.85
$67.85Grand Total
By signature,
hereby certifY
I state and ag ree that I have carefullY examined the completed application and do
that all information herein is true and correct, and I further certify that any and allwork
performed sha llbe done in accordance with the Ordi nances of the City of Springfield and the Laws of
the State of Oreg on. I further state that only contractors and emploYees who are in comP liance with
ORS 055 will be used on this P roject. I further agree to ensure that all required insPections are
at the time and th at the project address is readable from the street.
Date
nature
0Job#1-0