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HomeMy WebLinkAboutPermit Plumbing 2003-12-09Building/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: COM2003-01228ISSUED: 1210912003APPLIEDz 1210912003 EXPIRESz 0610912004 VALUE: SITE ADDRESS: 568 S 5TH ST ASSESSOR'SPARCELNO.: 1703353405200 PROJECT DESCRIPTION: Replacing sanitary sewer, about 80' Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential Owner: Address: SAMPSON WENDY L 568 S sTH ST SPRINGFIELD OR 97477 Contractor Type Plumbing Contractor License NEW HORIZONS HEALTH CARE SYSTEMS66681 Expiration Date 05fiSt2004 Phone 541-746-4224 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-1 SETBACKS Frontyard Setback: Side I Setback: Side 2 Rearyard Solar Street Storm Sewer Available: Special Instruction: Notes: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o 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: $ Per Sq Ft or multiplier Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: REQUIRED PARJ(NG Total: Handicapped: Compact: Total Value of Project Pase I of 2 Description Type of Construction VaIue Date Calculated ffi D U ll-Irll\ (, rt\ r UX.IYrry..l .,.i,' i 5 o $+ Valuation Description I Building/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: COM2003-01228ISSUED: 1210912003APPLIEDz 1210912003 EXPIRESz 0610912004 VALUE: Fees Paid Fee Description + l0Yo Administrative Fee + 7o/o State Surcharge Sanitary Sewer - lst 50 Feet Sanitary Sewer Each Addtl 100r Total Amount Paid Amount Paid $5.90 $4.13 $45.00 $14.00 $69.03 Date Paid t2t9t03 t2t9t03 t2t9to3 t2t9t03 Receipt Number 220020000000000185r 22002000000000018sr 2200200000000001851 2200200000000001851 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. 1 Sanitary Sewer Line: Prior to filling trench and including required testing. Reouired Insnections 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 witl 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 street, that the permit card is located at the front the property, and the approved set of plans will remain on the site at all times during construction. tZ/n/" Owner re Date Pase 2 of 2 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 220O2O000000000 I 85 I Date:12t09t2003 1:58:38PM coM2003-01228 coM2003-01228 coM2003-01228 coM2003-01228 Sanitary Sewer - lst 50 Feet Sanitary Sewer Each Addtl 100' + 7o/o State Surcharge + l0%o Administrative Fee 45.00 14.00 4.13 5.90 Item Total:$69.03 Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check THOMPSON SEPTIC & ROOTER jmp SERVICE 18942 In Person Payment Total: $69.03 $69.03