HomeMy WebLinkAboutPermit Plumbing 2001-12-28SPRINGF!ELD
Job# 01-01435-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of2
Job Number: 01-01435-01
Office:726-3759
!nspection Line: 726-3769
Tax Lot#: 00300
Subdivision:
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225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 268 00035th St Spr
AssessorsMap#: 17023131
Lot: Block: Addition:
ctTY oF SPRINGFIELD, OREGO^
Owner: Ron Holland
Address: 1220 Marsh Street
Scope Of Work: Plumbing
Water line - 85 ft.
Phone Number:
City/State/Zip:
New
805-543-4071
San Luis Obispo, CA 93401
Value: $O
Contractor Type
Plumbing Contr
Contractor Registration #
Don Lewis Plumbing 33076
500 Greenfield Street, Eugene, OR 97404
Expiration Date
6t10t2003
Phone
541 -688-1 931
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
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
Plum
Water Line - Prior to filling trench.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
(Sq. Feet)
Main:Accessory;
Fee
# Of Stories: Height (feet):
Current Units: proposed Units:
Census Code:Does not apply
Total:
Paid On Receipt#
Fee AmountMinimum plumbing permit Fee 12t28/2001 7634
Va
$.oo
Job# 01-01435-01 Page2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
State Surcharge - Plumbing
Water Service Footage
Administrative Fee - Plumbing
Total Plumbing
1212812001
12t28t2001
12t28t2001
7634
7634
7634
85
$4.13
$5e.00
$4.72
$67.85
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 be used on this project. I further agree to ensure that all required inspections are
at the proper time and that the project address is readable from the street.
Signature Date
$67.8s
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