HomeMy WebLinkAboutPermit Plumbing 2004-02-11Building/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: COM2004-00166ISSUED: 0211112004
APPLIEDz 0211112004
EXPIRES: 08/1112004
VALUE:
SITE ADDRESS: 1008 25TH ST
ASSESSOR'S PARCEL NO.: 1703361103701
PROJECT DESCRIPTION: Replace water and sewer lines
Springfield TYPE OF WORI(: Single Family Residence
TYPE OF USE: Repair Residential
Owner: SCHMUNKNATHAN L
Address: 1008 25TH ST SPRINGFIELD OR 97477
Owner: MARVIN MARGOLIS
Address: 3045 WINTERCREEK DR EUGENE OR 97405
PhoneNumber: 541-686-2525
Contractor Type
Plumbing
Contractor
AL STONE
Expiration Date
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Phone
541-688-1479
License
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CONTRACTOR INFORMATION
m
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Y" ofLot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARI{NG
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Soecial Instruction:
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Sidewalk Type:
Downspouts/Drains:
DEVELOPMENT INFORMATION
IMPROVEMENTS
Page 1 of2
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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: COM2004-00166ISSUED: 0211112004APPLIED: 0211112004EXPIRES: 08/1112004
VALUE:
Description Type of Construction
Fee Description
+ l0Yo Administrative Fee
+ 7Vo State Surcharge
Sanitary Sewer - lst 50 Feet
Water Line - lst 50 Feet
Total Amount Paid
Total Value of Project
Date Paid
2nu04
2nu04
2nu04
2nu04
Value Date Calculated
Receipt Number
1200400000000000195
1200400000000000195
1200400000000000195
120040000000000019s
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Amount Paid
$9.00
$6.30
$45.00
$45.00
$10s.30
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.
I Sanitary Sewer Line: Prior to lilling trench and including required testing.
2 Water Line: Prior to fiIling 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 OCCUPAITCY 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 Signatur{
Paee2 of2
Date
Valuation Description I
rr ees raro I
t(eourreo Inspectrons I
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
I .f City of Springfield Oflicial t{eceipt
Development Services Department
Public Works Department
Receipt #: 1200400000000000195 Date: 0211112004 1:20:17PM
Amount Paid
coM2004-00166
coM2004-00166
coM2004-00166
coM2004-00166
Sanitary Sewer - lst 50 Feet
Water Line - lst 50 Feet
+ 7Yo State Surcharge
+ l0Yo Administrative Fee
45.00
45.00
6.30
9.00
Item Total:$105.30
Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check MARVIN MARGOLIS dlm 5707 In Person
Payment Total:$10s.30
$ 105.30
)
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LICENSE
NUMBLFT' 89613
NAME: AL STONE CONSTRUCTION INC
ADDRESS: 91774 HWY 99 S JUNCTION Clry OR 97448
woRKPHoNE s416881479 ENTtryrypE: corporationNUMBER:
LIcENSE STATUS: Active STATUS
CHANGED DATE:
EXPIRATION o,r.,,,.,.,, LICENSE Specialty
DATE: 3l15l2oo4 GATEGoRY: contractor/Att
Exempt (Cannot
DATE FIRST ot.t.tt.,^, EMPLOYER Have Employees -
LIGENSED: 3/15/1993 sTATUS: Has No workers'
Comp Coverage)
DEVELOPERS AMERICAN
INSURANCE CO. INSURANCE STATESBOND COMPANY:MERGED INTO COMPANY: INSURANCE#429 COMPANY
Find A Licensee - Results
BOND AMOUNT: $ 10000
BOND EFFECTIVE
TO:311512004
INSURANCE
AMOUNT:
INSURANCE
EFFEGTIVE TO:
$ 500000
21312005
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