HomeMy WebLinkAboutPermit Plumbing 2005-11-22Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2005-01632
ISSUED: 11/2212005APPLIED: lll22l200iEXPIRES:. 05/22/2006
VALUE:
SITE ADDRESS: 500 36TH ST
ASSESSOR'S PARCELNO.: r702311302300
PROJECT DESCRIPTION: Water line Repair
Springfield TYPE OF WORI(: Plumbing Only
TYPE OF USE: Repair
Expiration Date
08t23t2007
Residential
Phone
541-343-9339
Owner:
Address:
GARDNER ROBERT A SR
5OO 36TH ST
SPRINGFIELD OR 97478
Contractor Type
Plumbing
Contractor
BERNARD PETERSEN INC
License
93126
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
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:
oh of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:nla
Sidewalk Type:
NOTICE:
THIS PER
Square Footage
or Bid Amount
msFffirttrpiHt
Aurson IZED UNDER THIS PE
REQUIRED PARJflNG
Total:
Handicapped:
Compact:
IF THE WORK
RMIT IS NOTOOMMENCED OR IS ABANDO NED FORAruy re O DAY PE
er for the Or
Center is 1
$ Per Sq Ft
or multiplier
PUBLIC IMPROVEMENTS
Description Type of Construction
Pase 1 of2
Value Date Calculated
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Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Ftx
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-01632ISSUED: 11/2212005APPLIED: 77/22/200s
EXPIRESz 0512212006
VALUE:
Fee Description
+ l0Vo Administrative Fee
+ 77o State Surcharge
Water Line - lst 50 Feet
Total Amount Paid
Amount Paid
$4.s0
$3.15
$4s.00
$52.65
Total Value of Project
Date Paid
tU22t05
tu22t0s
ty22l0s
Receipt Number
3200500000000000652
3200500000000000652
3200s00000000000652
tr'ees Paid
Plan Reviews
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
Water Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Reou
By signaturer l state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with .
the Ordinances of the City of Springlield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety..
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required are requested at the proper time, that each address is readable from the
street, that the permit card is located at the
times during construction.
of the property, and the approved set of plans will remain on the site at all
\\,w6
Owner or Contractors Signature (-/
Pase2 of2
Date
225tr'ifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
-aity of Springfield Official Receipt
-levelopment Services Department
Public Works Department
RECEIPT #: 32005000000000006s2 Date: 1112212005 ttz27:224]Nl
Job/Journal Number
coM200s-01632
c3M2005-01632
coM2005-01632
Description
Water Line - lst 50 Feet
+ 1oh State Surcharge
+ l0% Administrative Fee
Amount Due
45.OO
3.15
4.50
Item Total:$s2.6s
Payments:
Type of Payment Paid By
Check Number
Received By Batch Number
Authorization
Number How Received Amount Paid
Check CARDWELL CONSTRUCTION lkw 6107 In Person $52.65
PaymentTotal: ffi
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