Loading...
HomeMy WebLinkAboutPermit Plumbing 2002-06-27SPRINOFIELD Job# 02-0077341 COMMERCIAL PERMIT Gity Of Springfield Community Services Division Building Safety Page 1 of 2 fr,-4llnE - F-4 nJ-.,1-r-ar i l\nll,Jtt. U.!- UUr-l.1 , J./ nATf ' Tl li\l Try rJnil'-jUnIL,tJUll al LUUi- .alf? rrr6n-- A {l-/{ nrnlll l\LUUrA + IlL l,..l I UI!t ii-L : Lrl ll-lltlJL ' t.rir_.urLLtrttLiUI-lrJi iiLl\ = UUI 225 Fifth Street Springfield, OR97477 Location Of Proposed Site: 129 00014th St Spr AssessorsMap#: 17033632 Lot: Block: Addition: Job Numbe r: 02-0077 3-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 03400 Subdivision: GITY OF SPRINGFIELD, OREGOI' Owner: Dr. Wallace Baldwin Address: 455 Alexander Lp #337 Scope Of Work: Plumbing Water Line Repair Phone Number: 541-746-9129 City/State/Zip: Eugene, OR 97401 New Value: $0 Contractor Type Plumbing Contr Gontractor Vos Plumbing lnc Po Box 2189, Eugene, OR 97402-0061 Registration # 41805 Expiration Date Phone 541485-0551 Quad Area: # Of Units: Gonstr. Type: Water Heater: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: 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. Required lnspections Plumbins Water Line -Prior to filling trench. Public Works Encroachment -After work has been completed Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? ! Area (Sq. Main: # Of Stories: Gurrent Units: Census Code: Does not apply ht (feet): Accessory:Total: Proposed Units: Job# 02-00773-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Plumbing Minimum Plumbing Permit Fee State Surcharge - Plumbing Water Service Footage 8% Administrative Fee - Plumbing Total Plumbing 0612712002 0612712002 0612712002 06t2712002 9759 9759 9759 9759 50 $.00 $3.1s $45.00 $3.60 $51.75 Encroachment Permit - Commercial Total Public Works Public Works 06t27t2002 9759 1 $120.00 $120.00 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 on this project. I further agree to ensure that all required inspections are at the and that the project address is readable from the street. Signature $171.75 Z Date