HomeMy WebLinkAboutPermit Plumbing 2002-06-27SPRINOFIELD
Job# 02-0077341
COMMERCIAL PERMIT
Gity Of Springfield
Community Services Division
Building Safety
Page 1 of 2
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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