HomeMy WebLinkAboutPermit Plumbing 2003-02-19Gity of Springfield
Plumbing Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97 471
541-726-37 59 Phone
541-126-3676Fax
541-7 26-3769 Inspection Line
PERMIT NO.:
ISSUED:
APPLIED:
EXPIRES:
PLM2003-00012
2n9t2003
2n9t2003
8t19t2003
SITE ADDRESS:
ASSESSOR'S PARCELNO.:
PROJECT DESCRIPTION:
873 S 47TH ST
1802051209301
Replacing Kitchen & Laundry
Springfield
TYPE OF WORK:
TYPE OF USE:
Repair
Residential
drain and associated ven
OWNERYAPPI,ICANT: PLTJMBING CONTRACTOR:
SCHAFFER GRANT B
797 PRESCOTT LN
SPRINGFIELD OR91477 : :-
Phone:
CCB#: E)GIRES:
Description
+ l0o/o Administrative Fee
+ 7% State Surcharge
Miscellaneous Plumbing
Amount Paid
4.50
3.l s
45.00
Date Paid Recein!,Number
02n9t2003 120020000000000072s02tr912003 120020000000000072502t19t2003 1200200000000000725
To Request an inryection call the 24 hour recording at726-37 69. All inspections requested before 7:00 am. will be made fte same working day,
inryections requested after 7:00 a.m. will be made ttre following working day.
Required Inspections:
1 Final Plumbing: When all plumbing work is complete.
2 Rough Plumbing: Prior to cover 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 certiff 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 pertaining to the work described herein I
further certi$ 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 requested at the proper time, that each address is readable from the
will remain on the site at all times during construction.
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street, and that the approved set ofplans, ifapp
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Expiration DateCCB#Phone #Contractor's Name
General
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1&2Pam.ilvDwelliil-,
SQ Ft X S/SQ Ft -- VALUE
New Dwelling Area
Garage/Carport Area
Other Structure Area
Total Value
C o m m er ci al/I r t da s*i a UIv[u lti- F am ilv
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Total Value
Exist. New
Existing Bldg. Area
New Bldg. Area
Occupancy Group(s)
Const. Type(s)
Number of Stories
Plumbing
Mechanical
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Has site review application been submitted?
fl Yes E No E N/A
If so, Name of Plamer_
Journal Number_
Notice: All contractors & subcontractors are required to be
licensed with the Consffuction Contractors Board of the
State of Oregon under provisions of ORS 701 and may be
required to be licensed in the jurisdiction where work is
Q Restdential Projects
Heat Source:Secondary
-
Water Heater Range-Energy Path
-
Do you require any of the following for this project?
Overwidth or Second Driveway f Ves E No
Do you need temporarypower? [Yes [No
Requires LDAP Yes f No E Applied for? Yes EXo E
Planner:Date
PLAN CHECKFEE RCPT#-----DATE BY
Shaed Drive(T:)/Building FormVBuilding Perrnit Applicationl{2.doc
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2t19t2003
3:01:l7PM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
225Fiftln Street
Springfield, Oregon 97 47 7
541-726-3759 Phone
Receipt #: 12002000000000 007 25
Date: 0211912003
Items:
Job/Journal Number Description Amount Paid
PLM2003-00012
PLM2003-00012
PLM2003-00012
Miscellaneous Plumbing
+ 7o/o State Surcharge
+ ljYo Administrative Fee
Payments:
45.00
3. l5
4.50
Line Item Total:$52.65
Type ofPayment Paid By Received By CheckNumber ConfirmNo How Received Amount Paid
Check THOMPSON SEPTIC lkw 18834 In Person 52.65
Total:$s2.6s
Page I of1 cReceipt.rpt