HomeMy WebLinkAboutPermit Plumbing 2004-11-24Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-01448ISSUED: 1112412004
APPLIEDz 1112412004
EXPIREST 0512412005
VALUE:
SITE ADDRESS: 918 fST ST Springfield TYPE OF WORK: Plumbing Only
ASSESSOR'S PARCEL NO.: 1703352212700
TYPE OF USE: Repair Residential
PROJECT DESCRIPTION: Duplex 918 lst St and 162 H St - water line approx 40lf each in same trench
Owner: HALVERSON NANCy
Address: 17620 SW FULTON DR TUALATIN OR 97062
Contractor Type
Plumbing
Contractor License
READY ROOTER DRAIN CLEANING & R SN92524
Expiration Date
02n8t2005
Phone
s4t-744-7991
CONTRACTOR INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
btlornfes
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
Vo ofLot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:nla
CE:REQUIRED PARKING
I r,iS Prill,iiI StlALhoEXf IRE lF THE W0RK
A U I i i L i i i 2t r D t r ir r; EHalidtihpflditi1l i T I s N 0 I
cu l,l i,iri'.c tD 0R tsg{iBlnhp0NED F0R
AiTi 1UU IJAY PERiCD.
Sidewalk Type:
Downspouts/Drains:
$ Per Sq Ft
or multiplier
Square Footage
or Bid AmountDescription Type of Construction
Total Value of Project
Value Date Calculated
I
lrul.lJl.rrr\t rl\I t IUYI4! !!l1]l
Valuation Description I
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-01448ISSUED: 1112412004APPLIEDz 1112412004
EXPIRESz 0512412005
VALUE:
Amount Paid
$s.90
$4.13
$4s.00
$14.00
Date Paid Receipt Number
2200400000000001443
2200400000000001443
2200400000000001443
2200400000000001443
Fee Description
+ l0o/o Administrative Fee
+ 7Yo State Surcharge
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
tu24l04
tu24t04
tu24t04
tu24l04
Total Amount Paid $69.03
To Request an inspection call the24 hour recording at 726-3769. All inspection 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 work
day.
Water Line: Prior to lilling trench 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 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 pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS.701.005 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
stree! that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times
< /Z r,/ct ,7
Owner or Contractors Signature Date
Reouired Insnect
Page 2 of 2
2
Hees Prirl I
225Fifth Street
Springtield, Oregon 97 477
541-726-3759 Phone
City of Springlield Official Receipt
velopment Services Department
Public Works Department
RECEIPT #: 2200400000000001443 Date: 1112412004 2202:4tPIs.I
Job/Journal Number
coM2004-01448
coM2004-01448
coM2004-01448
coM2004-01448
Description
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
+ 7%o Stzte Surcharge
+ l0o/o Administrative Fee
Amount Due
45.00
14.00
4.13
s.90
Item Total:$69.03
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
CreditCard DAVID NICHOLS djb 007488 In Person
Payment Total:
$69.03
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1v2412004 Page I of I
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