HomeMy WebLinkAboutPermit Plumbing 2003-01-16IIOTICE;
THIE F
',llT
SHALT EXPIRE lF THE WORK
H-nEo UNoER THts PERMTT ls NoT
MMENOED ON Ig ABANDONED FOR
1EO DAY PERIOD,
City of SPringfield
Plumbing Permit
0
Statu s: Issued
225 Fifth Street
Springfield,Oregon 97477
541-726-3',759 Phone
541-72G367 6Fax
541-7 26-3769 InsPection
SITE ADDRESS:
ASSESSORS PARCEL NO':
PROJECT DESCRIPTION:
OWIT{ER/APPLICANT:
KENNETH CORNELruS
38549 WENDLING RD
MARCOLA OR 97454
Descrintion
+ l}Yo Administrative Fee
+ 7% State Surcharge
Backflow Device
Minimun/Adj ustment Plumbing
To Reque$ an inspection call ttre 24
inspections requested after 7:00 a'm'
165 S 43RD ST APT A
1702323103501
Backflow device
541-933-2402
Springfield
TYPE OF WORK:
TYPEOF USE:
PLM2003-00004
u1612003
u1612003
711612003
New
Residential
PLUMBING CONTRACTOR:
MEDALLION LANDSCAPE SERVI(
PO BOX 1089
MARCOLA OR 97454
Phone: 541-933-2745
CCB#:7118 EXPIRES: 021281200?
Amount Paid
4.50
3.15
14.00
31.00
Date Paid
0yr612003
0t1t612003
0r11612003
011612003
Receint Number
1200200000000000564
1200200000000000564
1200200000000000564
1200200000000000564
Required Insnections:
lBackflowDevice:Priortocoveringandprovideacopyofthetestreportonsiteatthetimeofinspection.
BySignature,Istateandagree,thatlhave-carefullyexaminedthecompletedapplicationanddoherebycertifythatall
information hereon is true-and correct, and I further certify that any "na
at work performed shall be done in accordance
with the ordinances of the city of Springfield and the laws of the State of oregon pertaining to the work described herein' I
further certify that only contractors and employees who are in compliance with oRS 701'055 will be used on this projecL I
further agree to "n.r." th"t arl required inrp"ciion, are requesteo at ttre proper time, that each address is readable from the
street, and that the approved set of plans, if applicable, will remain on the site at all times during construction'
hourrecording il.726-3T69.AllinspectionsrequestedbeforeT:00am'willbemadethesameworkingday'
will be made the following working day'
Owner or Contmcton Sipfrafure Date
/6 O3
t/16/2003
l0:45:48AM
City of Springfield
Development Senices Department
Public Works Department
Official Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #: 1200200000000000564
Date: 0111612003
,ine Items
Amount PaidJob/Journal Number Description
PLM2003-00004
PLM2003-00004
PLM2003-00004
PLM2003-00004
Backflow Device
Minimum/Adj ustrnent P lumbing
+ lUYo Administrative Fee
+ 7o/o State Surcharge
Payments:
14.00
31.00
4.50
3.15
Line Item Total:$52.65
Type of Payment Paid BY Received By Check Number Confirm No How Received Amount Paid
Cash
Change
MEDALLION LANDSCAPE SRVC djb
MEDAILION LANDSCAPE SRVC djb
In Person
In Person
60.00
(7.3s)
Total:$52.65
Page I of2 cReceipt.rpt
)
t/t6/2003
10:45:48AM
City of Springfreld
Development Services D epartm ent
Public Works Department
Official Receipt
225 Fifth Street
Springfietd, Oregon 97 477
541-726-3759 Phone
Receipt #: 1200200000000000564
Date: 0111612003
Amount PaidJob/Journal Number Description
PLM2003-00004
PLM2003-00004
PLM2003-00004
PLM2003-00004
Backflow Device
Minimurr/Adjusknent Plumbing
+ l0o/o Administrative Fee
+ 7o/o State Surcharge
Payments:
14.00
31.00
4.50
3.15
Line Item Total:$52.6s
Tlpe of Payment Paid By Received By Check Number Confirm No How Received Amount Paid
Cash
Change
MEDALLION LANDSCAPE SRVC djb
MEDALLION LANDSCAPE SRVC djb
In Person
In Person
60.00
(7.3s)
Total:$52.6s
Page2 of 2 cReceipt.rpt
*GffiTNM*
a.
City of Springfield
225 Fifth Street, Springfield, OR97477
541:726-3759 Phone
541-726-3676 Fzx
June23,2003
CORNELruS KENNETH
38549 WENDLING RD
MARCOLA OR
Job Number:
Location:
97454
PLM200340004
165 S 43RD ST APTA
Project:Backflow device
Dear PermitHolda:
The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid,
the work which has been authorized by the permit must begin wthin I 80 days of the date of isuance, and an
inspection must be requested at least every 180 days.
According to our records, you obtained a permit for a project at 165 S 43RD ST APT A which is set to expire on
711612003. Our records indicate that you have not requested an inspection within the past five (5) months. This
letter is writtsn to notifu you that your permit$) will be expiring shortly. If you are ready to request an
inspection for your project, please phone the inspection line at 541-726-37 69. If you do not request an inspection
prior to the expintion date, your permit(s) will expire and additional permit fees will be required in order to
complete your project.
Ifyou have any questions, please feel free to phone me at 541-7263790.
Sincerely,
Lisa Hopper
Building Safety Supervisor