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HomeMy WebLinkAboutPermit Plumbing 2001-06-07SPRINGFIELD Job# 01-00578-01 RESIDENTIAL PERMIT Gity Of Springfield Community Services Division Building Safety Page 1 of2 h, 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 364 00020th St Spr Assessors Map#: 17033613 Lot: Block: Addition: Job Number: 01-00578-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 13000 Subdivision: crTY oF SPRTNGFTELD, OREGOI' Owner: Development Resource Corp Address: 975 Willagillespie Rd Scope Of Work: Plumbing Approx 150' sanitary line Phone Number: City/State/Zip: New 541-484-6693 Eugene, OR 97401 Value: $O Contractor Type Plumbing Contr Contractor Eugene Sand & Gravel lnc Po Box 1067, Eugene, OR 97440-1067 Registration # 44524 Expiration Date 2t23t2005 Phone 541-683-6400 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection call the 24 hour recording a1726-3769. 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 Inspections Plumbing Sanitary Sewer Line -Prior to filling trench Construction Types: l Occupancy Groups # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Feet) Main: # Of Stories: Gurrent Units: Census Code: Does not apply Height (feet): Proposed Units: 'tEl Accessory:Total: Fee Paid On Receipt# Value/Quantity Fee Amount Plumb Minimum Plumbing Permit Fee 0610712001 5716 $.oo fol :o ity orth v 180 OAY PERIOD' Job# 01-00578-01 Page2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Plumbi State Surcharge - Plumbing Sanitary Sewer Footage Administrative Fee - Plumbing Total Plumbing 0610712001 0610712001 06t07t2001 571 6 571 6 5716 150 $2.80 $40.00 $1.20 $44.00 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 used on this project. I further agree to ensure that all required inspections are at the that the project address is readable from the street. $44.00 ,l/1 a 6-?-o t Signature Date