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:
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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