HomeMy WebLinkAboutPermit Plumbing 2000-07-28SPRINGFIELD
Job# 99-01475-01
RESIDENTIAL PERMIT
City Of Springfield
Gommunity Services Division
Building Safety
Page 1 of 2
Job Number: 99-01475-01
Office:726-3759
lnspection Line: 726-3769
Tax Lot#: 01201
Subdivision:
TRFINSS: 01-000??04
DftTE:JUL 28 T-OOO
At'lT RECD: L $ I0 .00
IHANGE:$ 7.50
ftAOLlTtrEt ' flEClUnUl IJ.LI\. UJ.,
*
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 3095 Yolanda Ave Spr
AssessorsMap#: 17021933
Lot: Block: Addition:
ctTY oF sPRtmGFtEL4 OREGON
Owner: Patricia Lyon
Address: 3095 Yolanda
Scope Of Work: Plumbing
water line
Phone Number:
City/State/Zip:
New
541-747-8298
Springfield, OR97477
Value: $0
Contractor Type
Plumbing Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Contractor
Patrica Lyon
3095 Yolanda Ave,
97477
Registration # Expiration Date
Sq. Footage:
Phone
541-747-8298
p:
Bed
Range:
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.
Gonstruction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? [
(feet)
of ttle
(Sq. Feet)
Units:
1tt
n.l]-?re
Main:Accessory:Total:44\
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing Permit
Total Transfered Records
Transfered Records
1012511999 35974 25 $25.00
$25.00
Plumbin
State Surcharge For Plumbing Permit
Renew Permit - Plumbing
07t28t2000
0712812000
2704
2704
$.00
$12.5013
Job# 99-01475-01 Page 2 of 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing Administrative Fee
Total Plumbing
Plumbing
0712812000 2704 $.00
$12.50
Grand Total
By signature,
hereby certify
I state and agree that I have carefully examined the completed application and do
performed shall be done in accordance with th
and correct, and I further certify that any and all work
e 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
$37.50
that all information herein is true
7-2 tr-cc