HomeMy WebLinkAboutPermit Plumbing 2003-10-13Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541 -7 26-37 69 Inspection Line
PERMIT NO: COM2003-01035
ISSUED:
APPLIED:
EXPIRES:
VALUE:
r0113t2003
t0n3t2003
04n3t2004
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SITE ADDRESS: 707 S 4TH ST
ASSESSOR'S PARCEL NO.: 1703353404600
PROJECT DESCRIPTION: Curbcut and water line work only.
Owner: ROMIG ROB R & CAMI N
Address: 707 S 4TH ST SPRINGFIELD OR 97477
Springfield TYPE OF WORI(: Single Family Residence
TYPE OF USE: New Residential
License Expiration Date Phone
60298 tUt3t2003 541-689-825s
Contractor Tvpe
Plumbing
Right of Way
Contractor
PROSPERITY INVESTMENT
BOLES ENTERPRISES
CONTRACTOR INFORMATION
BUILDIN(
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
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:
Impervious Surface Area:
REQUIRED PARJflNG
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 1BO DAY PERIOD.
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Notes:ATTENTIOI\:Ur€$oir idw rBqurrtsi] yuu to
t;ffi;;i"; adoPt6d bY the oreson utititY
Notification Center' inot" rules are^sel forth
il ci#ffir-ool -oot o throush oAB e52-001
0090. You may obtaincopi6s of the rules bv
--l"ifing the center' (Note: the telephone
;rrni#t i;; the oreion Utilitv Notilication
Center is t -8OO-SS 2-2-M4L
Pase 1 of2
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-01035ISSUED: 1011312003APPLIED: 10/1312003
EXPIRESz 0411312004
VALUE:
Description Type of Construction
Fee Description
+ lOoh Administrative Fee
+ loh State Surcharge
Curbcut Permit
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
Total Value of Project
Date Paid
Value Date Calculated
Receipt Number
2200200000000001650
2200200000000001650
2200200000000001650
2200200000000001650
22002000000000016s0
Amount Paid
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
10/13/03
10/13/03
10/13/03
10/13/03
10/13/03
$5.90
$4.13
$75.00
$45.00
$14.00
Total Amount Paid $144.03
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.
I Curbcut - Standard: After forms are erected but prior to placement of concrete.
2 Water Line: Prior to lilling trench and including required testing.
tr'ees
nsnections
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 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 70f.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
street, 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 during
l0 t3'03
Owner or Contractors
'?
Paee2 of2
Date
Valuation Description I
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Receipt #:1650 Date:10n312003 11:01:37AM
Amount Paid
coM2003-01035
coM2003-01035
coM2003-01035
coM2003-01035
coM2003-01035
Curbcut Permit
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
+ 7Yo State Surcharge
+ llYo Administrative Fee
75.00
45.00
14.00
4.13
5.90
Item Total:$144.03
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check CAMI N ROMIG dlm 1222 In Person
Payment Total:
s 144.03
$144.03