HomeMy WebLinkAboutPermit Plumbing 2002-10-31City of Springfield
Plumbing Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97 47 7
541-726-3759 Phone
541-726-3676Fax
541-726-3769 Inspection Line
PERMITNO.:
ISSUED:
APPLIED:
EXPIRES:
PLM2002-00112
10t3u2002
10t3u2002
4t30/2003
SITE ADDRESS:
ASSESSORS PARCEL NO.:
PROJECT DESCRIPTION:
6199 Thurston Rd
1702342403700
Connecting to sanitary sewer
(existing septic system to be
abandoned)
Springfield
TYPE OF WORK:
TYPE OF USE:
Alteration
Residential
OWNER/APPLICANT:
CHORLTON WILLIAM J & GLENDA
PO BOX 1602
PORTLAND OP.972O7
SMITH CHRIS A& MARCUS WILES
PO BOX 1602
PORTLAND OR972O7
PLUMBING CONTRACTOR:
Phone:
CCB#:44524 EXPIRES
541-683-6400
Description
+ 7%o Stale Surcharge
+ 8% Administrative Fee
Sanitary Sewer - lst 50 Feet
Amount Paid
3.15
3.60
45.00
Date Paid
1013y2002
1013U2002
10t3U2002
Receipt Number
2200200000000000 l 3 5
2200200000000000 l 3 5
2200200000000000 I 35
Cashier
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To Request an inryection 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 Insnections:
1 Sanitary Sewer Line: Prior to filling trench and including required testing.
2 Septic Tank Pumped: After septic tank has been pumped and filled. Please provide the inspector with receipt and
verification from company performing pump and fill.
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 certify that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfietd 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 project I
further agree to ensure that all required inspections are requested at the 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.
Owner
1
Signature Date
/o>
t0/3t/2002
4:12:26PM
City of Springfield
Development Services Department
Public Works Department
Oflicial Receipt
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
Receipt #: 2200200000000000 1 35
Date: 1013112002
.ne ltems:
Job/Journal Number Description Amount Paid
PLM2002-00112
PLM2002-001l2
PLM2002-00112
Sanitary Sewer - lst 50 Feet
+ 8% Administrative Fee
+ 7%o State Surcharge
Payments:
45.00
3.60
3. l5
Line Item Total:$51.75
Type ofPayment Paid By Received By Check Number Confirm No How Received Amount Paid
Check PEPSCO, LLC dlm r023 In Person 51.75
Total:
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