HomeMy WebLinkAboutPermit Plumbing 2003-08-27Building/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: COM2003-00830ISSUED: 0812712003APPLIEDz 0812712003
EXPIRESz 0212712004
VALUE:
SITE ADDRESS: 626 28TH ST
ASSESSOR'S PARCEL NO.: 1703361111800
PROJECT DESCRIPTION: Replace 45ft sanitary sewer
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair Residential
owner: JEAN STEpHANIE sroNE REvocABLE TRUS
Address: 626 28TH ST SPRINGFIELD OR 97477
Contractor Type
Plumbing
Contractor
READY ROOTER DRAIN CLEANING
License
92524
Expiration Date
021t812005
Phone
541-744-799t
CONTRACTOR INFORMATION
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range \t
Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh 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:
R-3
Vlhr
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
REQUIRED PARIflNG
Total:
Handicapped:
u\es-g((
o
$2'
\s1
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Total Value of Project
Page I of2
Description Tvpe of Construction Value Date Calculated
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Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fa'x
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-00830ISSUED: 0812712003
APPLIEDz 0812712003
EXPIREST 0212712004
VALUE:
tr'ees Paid
Fee Description
+ l0oh Administrative Fee
+ 7o/o State Surcharge
Sanitary Sewer - lst 50 Feet
Total Amount Paid
Amount Paid
$4.s0
$3.15
$45.00
$s2.6s
Date Paid
8t27t03
8t27t03
8t27t03
Receipt Number
1200200000000002031
1200200000000002031
1200200000000002031
PIan Reviews
To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
1 Sanitary Sewer Line: Prior to lilling trench and including required testing.
Reouired Insnect
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springlield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during
*e7o3
or Contractors Signature Date
Pase2 of2
-I rFl
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Sprin!field Official Receipt
Development Services Department
Public Works Department
Date::51AM
coM2003-00830
coM2003-00830
coM2003-00830
+ 7o/o State Surcharge
+ l0o/o Administrative Fee
Sanitary Sewer - lst 50 Feet
3.15
4.50
45.00
Item Total:$s2.6s
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check READYROOTER djb In Person
Payment Total:
$52.65
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