HomeMy WebLinkAboutPermit Plumbing 2000-12-08Job# 00-01766-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building SafetY
Page 1 of 2
SPRINGFIELD
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 242 00035th St Spr
AssessorsMap#: 17023131
Lot: Block: Addition:
Job Number: 00-01 766-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot #: 00400
Subdivision:
crTY oF SPRTNGFIELD, OREGOTV
Owner: Gary Branson
Address: 2427 DebraDr
Scope Of Work: Plumbing
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Phone Number:
City/State/Zip:
New
541-747-6684
Springfield, OR97477
Vatue: $O
sanitary sewer line and storm sewer line install as conditions of final partition for parcel#2
hehind 240 35th Street
Office Use
-
Land Use: # Of Buildings:
Zoning Code: Occupancy Group:
Bedrooms: Heat Source:
Range: Sq. Footage:
To request an inspection call the 24 hour recording at726-3769. 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
Plumbinq
Water Line
Sanitary Sewer Line
Storm Sewer Line
SW-Curbside
CC-Standard
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq. Feet)
Main:
-Prior to filling trench.
- Prior to filling trench.
- Prior to filling trench.
Public Works
-After forms are erected but prior to placement of concrete
-After forms are erected but prior to placement of concrete
I
syou to
rn L.ltlllty
# Of Stories: Height (feet):
Current Units: Proposed Units:
Census Gode: Does not apply
Accessory:Total:
EXP|I]E IFTHEWORK
Job# 00-01766-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
Water Service Footage
Sanitary Sewer Footage
Storm Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
12t08t2000
12t08t2000
12t08t2000
12t08t2000
1210812000
1210812000
4002
4002
4002
4002
4002
4002
165
40
200
$.00
$9.4s
$55.00
$25.00
$55.00
$4.05
$148.s0
Encroachment Permit - Residential
Totat Public Works
Public Works
12t08t2000 4002 1 $80.00
$80.00
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 will be used on this project. I further agree to ensure that all required inspections are
at the time and that the project address is readable from the street.
n ature Date
$228.50