HomeMy WebLinkAboutPermit Plumbing 2001-08-31SPRINGFIELD
Job# 01-00936-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 512 00032nd St Spr
AssessorsMap#: 17023124
Lot: Block: Addition:
Job Number: 01-00936-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 07800
Subdivision:
Owner: John Montgomery Phone Number: 541-746-9434
Address: 51232nd Street City/State/Zip: Springfield, OR 97478
Scope Of Work: Plumbing New Value: $0
Water line repair
Emergency repair prior to issuing permit. Permit fee payment to be resolved within 30 days per
DIvl 083001 DB
Contractor Type Contractor Registration # Expiration Date Phone
Plumbing Contr right-way plumbing 541-484-3787
po box 70526, eugene, OR 97401
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
crTY oF SPRTNGFIELD, OREGOTV
To request an inspection call the 24 hour recording a1726-3769. All inspections 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
working day.
Required lnspections
PlumUing I
- Prior to filling trench.
Construction Types
Occupancy Groups:
Water Line
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq
Main:Accessory:
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Code: Does not apply
Total:
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbin
Minimum Plumbing Permit Fee 08t31t2001 6574 $.00
Job# 01 -00936-01 Page2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
State Surcharge - Plumbing
Water Service Footage
Administrative Fee - Plumbing
Total Plumbing
08t31t2001
0813112001
0813112001
6574
6574
6574
5
$3.15
$45.00
$3.60
$51.75
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with
ORS 701.055 will used this project. I further agree to ensure that all required inspections are
requested at that the project address is readable from the street.
Signature Date
$51.75
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