HomeMy WebLinkAboutPermit Plumbing 2001-02-21SPR!NGFIELD
Job# 01-00146-01
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Page 1 of 2
225 North Fifth Street
Springfield, OR97477
Location Of Proposed Site: 1219 00012th St Spr
Assessors Map#: 17032644
Lot: Block: Addition:
Job Number: 01 -00146-01
Office: 726-3759
lnspection Line: 726-3769
Tax Lot#: 11100
Subdivision:
ctrY oF SPRiNGFiELD, OREGOTV
Owner: Cliff Ellis
Address: 1219 12th St
Scope Of Work: Plumbing
40'sewer line
Phone Number:
City/State/Zip:
New
Springfield, OR97477
Value: $O
Contractor Type
Plumbing Contr
Contractor
Hoffman Northwest lnc
23311Madero St, Mission Viejo, CA
92691
Registration #
71162
Expiration Date
1t16t2001
Phone
541-689-1711
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
-
Land Use:
Zoning Gode:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
Torequestaninspectioncallthe24hourrecordingat726.3769.Atlinspectionsrequestedbefore7:00,
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following i,'
working daY' ll' ' -"''"
Required lnspections
PlumUlng I
Sanitary Sewer Line -Prior to filling trench.
Construction Types:
Occupancy Groups:
14l
NOTICE:
# Of Buildings:
# Of Bedrooms:
Handicap Access?
Area (Sq
Main:Accessory:
# Of Stories:
Current Units:
Census Code: Does not
Total
Height (feet):
Proposed Units:
apply
Fee Paid On Receipt# Value/Quantity Fee Amount
Plum
Minimum Plumbing Permit Fee 02121t2001 4499 $.00
Job# 01-00146-01 Page 2 oI 2
Fee Paid On Receipt# Value/Quantity Fee Amount
Plumbing
State Surcharge - Plumbing
Sanitary Sewer Footage
Administrative Fee - Plumbing
Total Plumbing
0212112001
0212112001
02t2112001
4499
4499
4499
40
$1.75
$2s.00
$.75
$27.50
Grand Tota!
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
the proper time the project address is readable from the street.
re Date
$27.50
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