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HomeMy WebLinkAboutPermit Plumbing 2001-03-20Job# 01-00265-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of2 Job Number: 01 -00265-01 Office: lnspection Tax Lot#: 01600 Subdivision: iftftNSS: C1-ililil4?1:j lftTt: liftF( I0 !ilti]_ fifiT RE[D:? S 4;t.L'1t] -l ,A i !aar - drt lni !UL- "nAOUTffr. r',nTUndl lj.Ll\'UUJ SPFINGFIELD 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2345 00005th St 1/2 Spr AssessorsMap#: 17032621 Lot: Block: Addition: ctTY oF SPRiNGFTELD, OREGON Owner: Martin Henner Address: 2675 Baker Boulevard Scope Of Work: Plumbing Phone Number: City/State/Zip: New 541-345-6466 Eugene,, OR 974 Value: Sewer line to replace old septic system on property in preparation of a building permit annlication. (frrtr r re) 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2345 00005th St 1/2 Spr AssessorsMap#: 17032621 Lot: Block: Addition: Job Number: 01 -00265-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 01600 Subdivision: RESIDENTIAL PERMIT City Of Springfield Communitv Services Division.diE' - Buiiding Safety Owner: Bob Durnell Address: 2675 baker blvd Scope Of Work: Plumbing Quad Area: # Of Units: Constr. Type: Water Heater: Phone Number: City/State/Zip: New eugene, OR 97403 Value: $0 Sewer line to replace old septic system on property in preparation of a building permit annlication. (frrtrtre'l office use - Land Use: # Of Buitdings: Zoning Code: Occupancy Group:Bedrooms: Heat Source:Range: Sq. Footage: Quad Area: # Of Units: Constr. Type: Water Heater: office use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: **" -00265-01 # Of Stories; Height (feet): Gurrent Units: ProPosed Units: Census Code: Does not aPPIY Page2 of2 To request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. wi1 be made tf," J"r"J*or-ki"g a;t, inspectio-ns requested after 7:00 a'm' will be made the following working daY. Gonstruction Types: Occupancy GrouPs: # Of Buildings: # Of Bedrooms: HandicaP Access? [ Area (Sq Main:Accessory:Total: Paid On ReceiPt#Value/QuantitY Fee Amount Plum Fee Minimum Plumbing Permit Fee State Surcharge - Plumbing Sanitary Sewer Footage Administrative Fee - Plumbing Total Plumbing 0312012001 0312012001 0312012001 0312012001 4719 4719 4719 4719 100 $.00 $2.80 $40.00 $1.20 $44.00 $44.00Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all inioiriation herein is true and correct, and I further certify that any and all work performed shall be oon. in iC.ordance withihe ordinances of the city of springfield and the Laws of the State of oregon. iirrtn"i it"te that only contractors and employees w.ho are in. compliance with oRS 701.055 will ue uslo on this pro;_ :t. ifurtn"r agree to ensure that all required inspections are requesteO at the properiime anO tirathg project address is readable from the street' Signature /W gi 't'%'bl sur'/ 0/" $/ Shtht Sani!a'1 gcdcr aL zW 't f'tl'' Date SPRIiIGFIELD Job# 01-00265-01 RESIDENTIAL PERMIT City Of Springfield Gommunity Services Division Building Safety Page 1 ol 2 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 2345 00005th St 1/2 Spr AssessorsMap#: 17032621 Lot: Block: Addition: Job Number: 01 -00265-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 01600 Subdivision: clTY oF SPRINGFIELD, OREGON Owner: Martin Henner Address: 2675 Baker Boulevard Scope Of Work: Plumbing Phone Number: City/State/Zip: New 541 -345-6466 Eugene,, OR 974 Value: Sewer line to replace old septic system on property in preparation of a building permit aonlication. /frrtrr re) RESIDENTIAL PERMIT City Of Springfield Community Services Division Job Number: 01-00265-01 Building Safety 225 North Fifth Street Office: 726-3759 Springfield, OR97477 Inspection Line: 726-3769 Location Of Proposed Site: 2345 00005th St 112 Spr AssessorsMap#: 17032621 Lot: Block: Addition: Tax Lot#: 01600 Subdivision: Owner: Bob Durnell Address: 2675 baker blvd Scope Of Work: Plumbing Quad Area: # Of Units: Constr. Type: Water Heater: Phone Number: Gity/State/Zip: New eugene, OR 97403 Value: $O Sewer line to replace old septic system on property in preparation of a building permit anolication. (frrfu rre'l Office Use - Land Use: # Of Buildings: Zoning Code: Occupancy Group: Bedrooms: Heat Source: Range: Sq. Footage: Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group Heat Source: Sq. Footage: Job# 01 -00265-01 Page 2 of 2 To request an inspection callthe 24hour 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. Construction Types: Occupancy Groups # Of Buildings: # Of Bedrooms: Handicap Access? (Sq. Feet) Main:Accessory:Total # Of Stories: Height (feet): Current Units: Proposed Units: Census Gode: Does not apply Fee Paid On Receipt# Value/Quantity Fee Amount Plumbinq Minimum Plumbing Permit Fee State Surcharge - Plumbing Sanitary Sewer Footage Administrative Fee - Plumbing Total Plumbing 0312012001 0312012001 03t20t2001 03t2012001 4719 4719 4719 4719 100 $.oo $2.80 $40.00 $1.20 $/14.00 Grand Total By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. 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 requested at the proper project address is readable from the street. Signature Date $44.00 3 -2-,2 - O /rz4